KERALA| 5TH JUNE 2025
LEGAL FOCUS: DISTINCTION BETWEEN MEDICAL NEGLIGENCE AND CULPABLE HOMICIDE
The Kerala High Court has clarified that medical negligence resulting in death does not automatically attract Section 304 of the Indian Penal Code (IPC), which deals with culpable homicide not amounting to murder, unless there is intent to cause death or knowledge that death was a likely consequence.
“An act of medical negligence, even if resulting in death, would not automatically constitute culpable homicide unless there is intent or knowledge that the death would be a likely consequence. Medical negligence cannot be equated with culpable homicide. In medical negligence cases, if the death is due to failure to exercise reasonable care or a breach of duty by a medical professional, Section 304 A may be invoked.” as per the court discretions
— Justice Kauser Edappagath, Kerala High Court
CASE BACKGROUND:
The ruling was made in a criminal revision petition filed by Dr. K Rajagopalan, a surgeon who performed an appendectomy on a 10-year-old girl in 2012 at a private nursing home in Palakkad.
Dr. Rajagopalan administered spinal anaesthesia himself without involving a qualified anaesthetist.
The child suffered a cardiac arrest during the procedure and died within minutes.
The mother of the deceased filed a complaint, and the police registered a case under Section 304 IPC.
It was alleged that the doctor acted with the knowledge that proceeding without an anaesthetist could result in the patient’s death.
SESSIONS COURT DENIAL AND HIGH COURT APPEAL
The doctor first sought discharge from the case before the Sessions Court, which was dismissed. He then moved the High Court, represented by Advocate KP Balagopal.
His legal team argued that:
Even assuming the allegations are true, the facts do not meet the threshold for Section 304 IPC.
At most, the case might involve Section 304A IPC (causing death by negligence).
The doctor did not have the required knowledge or intent to make the act culpable homicide.
The Public Prosecutor EC Bineesh, relying on a medical board report, countered that the spinal anaesthesia complications were mismanaged, leading to the child’s death.
HIGH COURT ANALYSIS: NO PRIMA FACIE EVIDENCE OF KNOWLEDGE OR INTENT
After reviewing the medical records, submissions, and expert opinions, the Court found:
“The materials on record do not even prima facie suggest that the petitioner had the degree of knowledge to the extent that his act was likely to cause the death of the child. Doctors with MBBS registration are qualified to give anaesthesia.”
— Justice Kauser Edappagath
The Court emphasized that Dr. Rajagopalan was a qualified and experienced professional, and there was no evidence indicating he knew or intended for his action to result in death.
VERDICT: DISCHARGE FROM SECTION 304 IPC CASE
In light of the findings, the Court:
Set aside the Sessions Court’s dismissal of the discharge application.
Discharged Dr. K Rajagopalan from the charges under Section 304 IPC.
LEGAL REPRESENTATION
For the Petitioner: Advocate KP Balagopal
For the Complainant: Advocate Unni Sebastian Kappen
For the State: Public Prosecutor EC Bineesh
LEGAL SIGNIFICANCE
This case reinforces the legal distinction between criminal medical negligence and culpable homicide:
Section 304 IPC vs Section 304A IPC
Medical negligence law in India
Culpable homicide not amounting to murder
Doctor liability in surgical death
Spinal anaesthesia complications legal precedent
High Court discharge in medical negligence case
CONCLUSION
This judgment by the Kerala High Court provides a vital precedent affirming that not all acts of medical negligence leading to death qualify as culpable homicide, unless specific intent or knowledge is established. It highlights the need for a measured legal approach in cases involving professional medical errors.
