IN THE SUPREME COURT OF INDIA CIVIL APPELLATE JURISDICTION CIVIL APPEAL NO. 1386 OF 2001 Ms. Ins.

Malhotra Versus Dr. A. Kriplani & Ors. ..... Respondents ..... Appellant

JUDGMENT Lokeshwa !"#$h Pa#%a& J.

1]

This appeal arises ou o! or"er "a e" 1#$%&$'%%% o! he Co(su)er Dispu es Re"ressal Co))issio(

Na io(al

*herei(a! er re!erre" as he +Co))issio(,- i( Ori.i(al Pe i io( No$ '/# o! 1&&'0 1here23 a 4o)plai( !ile" 23

Ms$ I(s$ Malho ra54o)plai(a( has 2ee( "is)isse"$ '] 6rie! !a4 s lea"i(. o he !ili(. o! his appeal are as

!ollo1s7 '$1] The 4o)plai(a( 5appella( herei( is he sis er o! Pri3a Malho ra 1ho "ie" o( '8$%9$1&9& i( 6o)2a3 Hospi al5 respo("e( (o$ : herei($ I( Ma30 1&9& Pri3a Malho ra

2 4o)plai(e" o! 2ur(i(. se(sa io( i( s o)a4h0 ;o)i i(. a(" "iarrhea$ O( 1<$%:$1&9&0 her !a)il3 "o4 or Dr$ P$ H$ Joshi he pa ie( a")i e" o 6o)2a3 Hospi al !or a(" rea )e( u("er he 4are o!

a";ise" o .e i(;es i.a io(

Dr$ Ra)a)oor h3$ a")i e" o he

O( 18$%:$1&9&0 Pri3a Malho ra 1as 6o)2a3 Hospi al0 2u o( ha "a3

Dr$ Ra)a)oor h3 1as ou o! s a io( a(" i( his a2se(4e Dr$ Chau2al e=a)i(e" Pri3a Malho ra a(" pres4ri2e" o u("er.o se;eral es s$ Pri3a Malho ra 1as "ia.(ose" as ha;i(. >o4h?s o! a2"o)e($ '$'] O( 1/@1:$%:$1&9&0 Dr$ Jai( suspe4 i(. Ai"(e3 pro2le) re!erre" Pri3a Malho ra o Dr$ A$>ripla(i0 a Nephrolo.is $ O( 19$%:$1&9&0 Dr$ A$ >ripla(i i(!or)e" appella( ha Pri3a The

Malho ra ha" Ai"(e3 !ailure a(" 4hro(i4 re(al !ailure$ appella(

4o(se( e" !or i))e"ia e Hae)o"ial3sis as 1as

re4o))e("e" 23 he "o4 or o sa;e Pri3a Malho ra?s li!e$ I( spi e o! Hea)o"ial3sis0 Pri3a Malho ra 4o( i(ue" ;o)i i(. a(" "iarrhea a(" he sa)e 1e( ou o ha;e

o! 4o( rol$

Dr$ A$ >ripla(i "ire4 e" per!or)a(4e o! 6a5)eal a(" 6a5 e(e)a es s suspe4 i(. >o4h?s o! a2"o)e( a(" he 1o es s

3 4o(!or)e" "ila e" loops o! s)all i( es i(e$ She h 4arrie" ou as4e i4 appi(.$ O( Dr$ Vasa( S$

''$%:$1&9&0

Dr$ A$ >ripla(i a";ise" Peri o(eos4op3 !or 4o(!ir)i(. >o4h?s o! a2"o)e($ O( he sa)e "a30 o( he re4o))e("a io( o! Dr$ Vasa( S$ She h a(" Dr$ A$ >ripla(i0 ul raso(o.raph3 o! upper a2"o)e( 1as per!or)e" o( Pri3a Malho ra !or 4o(!ir)a io( o! >o4h?s o! a2"o)e($ O( <1$%:$1&9&0 Dr$ Vasa( S$ She h

per!or)e" as4e i4 appi(. o( Pri3a Malho ra a(" he "ia.(osis )a"e !ro) His opa holo.is a2"o)e( *a( i )ali.(a( -$ 1as 4o(!ir)a io( o! >o4h?s Dr$ A$ >ripla(i pres4ri2e"

S rep o)34i( i(Be4 io( 1i h o her )e"i4i(es$ The 1o repor s o! M$D$ *Pa holo.is - a(" Dr$ Aru( Chi ale "a e" %1$%9$1&9& 1oul" sho1 (o T$6$ or.a(is) i( Peri o(eal Flui"$ O(

%<$%9$1&9&0 Dr$ A$ >ripla(i a";ise" CT s4a( !or 4o(!ir)a io( o! T$6$ lo1er a2"o)e($ Pri3a Malho ra ;o)i e" a(" 4oul" (o 2e 4o( rolle" e;e( 23 .i;i(. I$V$C$C Peri(or) i(Be4 io($ O(

%/$%9$1&9&0 4hes C5ra3 aAe( 23 C5ra3 Depar )e( o! he 6o)2a3 Hospi al sho1e" lu(. a(" pleura (or)al$ '$<] O( %9$%9$1&9&0 Dr$ Vasa( S$ She h a(" Dr$ DMrs$] S$ R$ Jaha.ir"ar e=a)i(e" Pri3a Malho ra a(" a";ise" laparos4op3$

' The opera io( 1as o 2e per!or)e" 23 Dr$ DMrs$] S$ R$

Jaha.ir"ar o( %&$%9$1&9&$ Four 2o les o! 2loo" 1ere .i;e( o Pri3a Malho ra "uri(. "ia.(osis$ pro!ile es s 1ere per!or)e"$ Li;er pro!ile a(" re(al

Li;er pro!ile sho1e" EAus ralia

A( i.e(? posi i;e a(" re(al pro!ile sho1e" lo1 seru) so"iu) a(" seru) po assiu)$ O( %&$%9$1&9&0 Dr$ Pra)o" 4a)e a a2ou <7%% a$)$ a(" re)o;e" Fe)oral Ca h$ O(

ha "a30 Pri3a Malho ra 1as ha;i(. hi.h !e;er$ O( he sa)e "a30 Dr$ DMrs$] S$ R$ Jaha.ir"ar0 4oul" (o a e(" he hospi al a(" i( her a2se(4e Dr$ Pra i)a Prasa" per!or)e"

Laparos4op3 1he(

Dr$ A$ >ripla(i0 Dr$ Vasa( S$

She h a(" Dr$ S$ Fup a 1ere also prese( i( he O$T$ '$8- A! er he opera io(0 Pri3a Malho ra 1as re)o;e" o he re4o;er3 roo) 1here she alle.e"l3 ol" he appella( 23

.es ures ha she 1as ha;i(. se;ere pai( i( he 4hes a(" she 1as spee4hless a(" ha;i(. 2rea hi(. "i!!i4ul 3$

Dr$ A$ >ripla(i o2ser;e" ha

here 1as (o (ee" o 1orr3 a("

Pri3a Malho ra 1oul" 2e Aep i( I$C$U !or 1o "a3s u("er o2ser;a io($ O( 1'$%9$1&9&0 Pri3a Malho ra 1as shi! e" o <r" !loor o! he hospi al$ A44or"i(. o he appella( 0 Pri3a

( Malho ra s ar e" 2e4o)i(. se)i54o(s4ious a(" erra i4 i( 2eha;iour$ O( '%$%9$1&9&0 Pri3a Malho ra "e;elope"

i( es i(al !is ula lea"i(. o her hro1i(. ou liGui" !ro) her 2o"3 a(" she "e;elope" serious i(!e4 io(s sep i4e)ia$

O( ''$%9$1&9&0 Pri3a Malho ra 2e4a)e "eep u(4o(s4ious a(" she passe" (o uri(e a(" her !a4e 1as s1olle($

O( '<$%9$1&9&0 Dr$ A$ >ripla(i a";ise" Hae)o"ial3sis a(" P(eu)o hora=$ U(!or u(a el30 o( '8$%9$1&9& a a2ou

&71# a$)$0 Pri3a Malho ra e=pire"$

O( he sa)e "a30 post-

mortem upo( he "ea" 2o"3 o! Pri3a Malho ra 1as 4o("u4 e" a J$J$ Hospi al0 6o)2a3$ The post-mortem repor re;eale" he 4ause o! "ea h 1as "ue o Peri o(i is 1i h re(al !ailure$ '$#The appella( !ile" poli4e 4o)plai( a.ai(s he "o4 ors

o! 6o)2a3 Hospi al i( AHa" Mai"a( Poli4e S a io(0 6o)2a3$ I( he 3ear 1&&%0 4o)plai( 1as also !ile" 2e!ore he

Maharash ra Me"i4al Cou(4il$ '$/O( %'$%:$1&&'0 1ri e( 4o)plai( 1as se( 23 pos o

he Na io(al Co(su)er Dispu es Re"ressal Co))issio(0 1hi4h 1as re.is ere" as Co)plai( No$ '/# o! 1&&' a.ai(s Dr$ A$ >ripla(i0 Dr$ DMrs$] Pra i)a Prasa"0 Dr$ S$ Fup e0

6 Dr$ Si(.ha(ia0 Dr$ DMrs$] S$ R$ Jaha.ir"ar a(" Dr$ Sa4h"e;a$ O( (o i4e0 he respo("e( s e( ere" appeara(4e a(" !ile" heir separa e 1ri e( s a e)e( s$ 1as (o a par 3 i( The 6o)2a3 Hospi al i(i iall3 A( appli4a io( !or

he 4o)plai( $

i)plea")e( o! 6o)2a3 Hospi al as par 3 respo("e( (o$ : 1as allo1e" 23 he Co))issio( i( he 3ear 1&&/$ <Duri(. he he 4ourse o! he pro4ee"i(.s 2e!ore he o

Co))issio(0

appella(

1as .ra( e"

oppor u(i 3

pro"u4e 1ri e( opi(io( o! e=per "o4 ors i( suppor o! her alle.a io(s )a"e i( he 4o)plai( a.ai(s he (a)e" "o4 ors

a(" 6o)2a3 Hospi al !or heir )e"i4al (e.li.e(4e or la4A o! proper )e"i4al rea )e( o "e4ease" Pri3a Malho ra$ The

appella( 4oul" (o lea" he e;i"e(4e o! a(3 e=per "o4 or i( suppor o! her 4o)plai( ha (o e=per a(" she plea"e" 2e!ore "o4 or 1as 1illi(. he

Co))issio(

o .i;e a( hou.h0

opi(io( a.ai(s

he "o4 ors o! 6o)2a3 Hospi al

a44or"i(. o her0 u(o!!i4iall3 so)e "o4 ors ha" e=presse" a( opi(io( Malho ra$ ha i(Bus i4e ha" 2ee( "o(e o "e4ease" Pri3a o appear o( The

The appella(

1as issue" (o i4e

%&$%:$'%%% !or re4or"i(. o! her 4ross5e=a)i(a io($

) 4ou(sel !or ha he respo("e( s s a e" 2e!ore he Co))issio(

he3 "i" (o i( e(" o 4ross5e=a)i(e he appella( $ No(e

o! he respo("e( ha" appeare" as 1i (ess i( suppor o! his or her "e!e(4e0 as plea"e" i( he 1ri e( s a e)e( $ <$1- O( 4o(si"era io( o! he e( ire )a erial o( re4or"0 he Co))issio( vide i s or"er "a e" 1#$%&$'%%% "is)isse" he 4o)plai( o! he appella( hol"i(. ha he 4o)plai(a( has

(o 2ee( a2le o es a2lish a 4ase o! )e"i4al (e.li.e(4e a.ai(s he respo("e( s$ 86ei(. a..rie;e" here230 he appella( has !ile" his

appeal u("er Se4 io( '< o! he Co(su)er Dispu es Re"ressal Co))issio( A4 0 1&9/ *herei(a! er re!erre" o as he +A4 ,-$ #Ie ha;e hear" lear(e" 4ou(sel !or he par ies0 1ho ha;e hrou.h he or"er o! he Co))issio( a(" o her

aAe( us

rele;a( )a erials 2rou.h o( re4or"$ /The lear(e" 4ou(sel appeari(. !or he appella(

4o( e("e" ha

he or"er o! he Co))issio( is 2a" o( !a4 s

a(" i( la1 as he sa)e is passe" 1i hou proper appre4ia io( o! he e;i"e(4e o! he appella( )a"e i( e=a)i(a io(5i(54hie! 2e!ore he Co))issio( 1hi4h has .o(e u(re2u e" a("

8 u(4o( ro;er e" as she has (o 2ee( 4ross5e=a)i(e" 23 he respo("e( s$ He (e= 4o( e("e" ha (o(e o! he respo("e( s ha;e appeare" !or 4ross5e=a)i(a io( 2e!ore he Co))issio( (or a(3 o(e o! he) has !ile" e;i"e(4e o( a!!i"a;i as

pres4ri2e" u("er Se4 io( 1< *8- *iii- o! Pro e4 io( A4 0 1&9/ 1hi4h 2e!ore pres4ri2e" he Dis ri4

he Co(su)er pro4e"ure Foru)$ o( The

a")issio( o! 4o)plai(

lear(e" 4ou(sel also 4o( e("e" ha si(4ere e!!or s0 4oul" (o .e

he appella( 0 "espi e her

he assis a(4e o! e=per "o4 ors

i( suppor o! her 4o)plai( a(" o "islo".e he 4lai) o! he respo("e( s0 he Co))issio( i( he i( eres o! he appella( 4oul" ha;e o( i s o1( su))o(e" e=per "o4 ors !ro) so)e Fo;er()e( i(s i u io(s a Delhi o as4er ai( 1he her proper a(" (e4essar3 )e"i4al rea )e( 1as .i;e( 23 he "o4 ors o Pri3a Malho ra or he "o4 ors o! 6o)2a3 Hospi al i( "is4har.e a(" per!or)a(4e o! (e.li.e( a(" 4areless$ /$1- I( suppor o! his su2)issio( relia(4e is pla4e" upo( a "e4isio( o! his Cour i( Ci;il Appeal No$ <#81 o! '%%' i le" Martin F. DSouza v. Mohd. Ishfaq "e4i"e" o( 1:$%'$'%%&$ heir "u ies 1ere0 i( a(3 )a((er0

* I( he sai" 4ase0 he Di;isio( 6e(4h o! his Cour has passe" so)e "ire4 io(s0 1hi4h rea" as u("er75 +Ie0 here!ore0 "ire4 ha 1he(e;er a 4o)plai( is re4ei;e" a.ai(s a "o4 or or hospi al 23 he Co(su)er Foru) *1he her Dis ri4 0 S a e or Na io(al- or 23 he Cri)i(al Cour he( 2e!ore issui(. (o i4e o he "o4 or or hospi al a.ai(s 1ho) he 4o)plai( 1as )a"e he Co(su)er Foru) or Cri)i(al Cour shoul" !irs re!er he )a er o a 4o)pe e( "o4 or or 4o))i ee o! "o4 ors0 spe4ialiHe" i( he !iel" rela i(. o 1hi4h he )e"i4al (e.li.e(4e is a ri2u e"0 a(" o(l3 a! er ha "o4 or or 4o))i ee repor s ha here is a pri)a !a4ie 4ase o! )e"i4al (e.li.e(4e shoul" (o i4e 2e he( issue" o he 4o(4er(e" "o4 or@hospi al$ This is (e4essar3 o a;oi" harass)e( o "o4 ors 1ho )a3 (o 2e ul i)a el3 !ou(" o 2e (e.li.e( $ Ie !ur her 1ar( he poli4e o!!i4ials (o o arres or harass "o4 ors u(less he !a4 s 4learl3 4o)e 1i hi( he para)e ers lai" "o1( i( Ja4o2 Ma he1?s 4ase *supra-0 o her1ise he poli4e)e( 1ill he)sel;es ha;e o !a4e le.al a4 io($, :Mr$ Sh3a) Di1a(0 Se(ior A";o4a e appeari(. o( 2ehal!

o! Dr$ >ripla(i0 has 4a(;asse" 4orre4 (ess o! he ;ie1s aAe( 23 he Co))issio( i( he i)pu.(e" or"er$ He su2)i e" ha he approa4h o! he Co))issio( i( appre4ia i(. he

4o(seGue(4es o! he 4o)plai( a(" he "e!e(4e o! he "o4 ors aAe( i( heir 1ri e( s a e)e( s 4a( (e;er 2e !ou(" !aul 3$ He he( 4o( e("e" ha he e;i"e(4e o! he appella( i(

10 e=a)i(a io(5i(54hie! "oes (o es a2lish ha Dr$ A$ >ripla(i 1as e;er (e.li.e( i( per!or)i(. his "u ies i( his "is4ipli(e$ He 4o( e("e" ha he rea )e( 1hi4h 1as a"op e" 23 he he a";i4e a(" opi(io( o!

"o4 ors 1as i(4o(!or)i 3 1i h

Dr$ P$H Joshi a(" Dr$ Ra)a)oor h3 a(" he appella( has (o pro;e" o( re4or" ha here 1as a(3 Ai(" o! "isa.ree)e(

or "i;er.e(4e o! opi(io( 2e 1ee( Dr$ A$ >ripla(i o( he o(e ha(" a(" Dr$ P$H$ Joshi o( he o her ha("$ 4ou(sel !or o her respo("e( s has a"op e" The lear(e" he ar.u)e( s

a";a(4e" 23 Mr$ Sh3a) Di1a(0 Se(ior A";o4a e appeari(. !or Dr$ A$ >ripla(i$ 9I( or"er o appre4ia e he ri;al 4o( e( io(s o! he lear(e"

4ou(sel !or he par ies0 1e ha;e e=a)i(e" he i)pu.(e" or"er o! he Co))issio( a(" he e;i"e(4e le" 23 he par ies$ The Co))issio( i( is or"er has (o i4e" he "e4isio( o!

Maharash ra Me"i4al Cou(4il "a e" 1<$%#$1&&&0 1here23 he Re.is rar o! he Cou(4il 4o(;e3e" ha he Maharash ra

Me"i4al Cou(4il a! er "is4ussio( o( he )eri s a(" "e)eri s o! he 4ase u(a(i)ousl3 resol;e" ha E here is (o (e.li.e(4e o( he par o! )e"i4al pra4 i io(ers a(" he3 ha;e )a(a.e" he

11 4ase o he 2es o! heir a2ili 30 here!ore0 i 1as u(a(i)ousl3 resol;e" o "rop he sai" i(Guir3 a(" he )e"i4al pra4 i io(ers 2e e=o(era e"$? &The or"er o! he Co))issio( 1oul" re;eal ha

Dr$ P$H Joshi ha" )a"e (o i(. o( '/$%:$1&9& 1hi4h rea"s +Laparos4op3 SOS shall re;ie1 la er, 1hile re!erri(. he 4ase o! Pri3a Malho ra o Dr$ S$R$ Jaha.ir"ar 1ho a i)e 1as i(54har.e o! Depar )e( o! he rele;a( a("

O2s e ries

F3(ae4olo.3 o! he 6o)2a3 Hospi al$ The appella( ha" (o 4o)plai( o )aAe a.ai(s Dr$ P$H$ Joshi0 ra her she ha" .o

!ull !ai h i( hi)$ As (o i4e" a2o;e0 Dr$ S$R$ Jaha.ir"ar 1as ou o! o1( o( he "a3 1he( he pa ie( 1as o 2e opera e" upo( a(" i( her a2se(4e Pri3a Malho ra 1as e=a)i(e" 23 Dr$ Pra i)a Prasa" a(" she has !ile" 1ri e( s a e)e( 2e!ore he Co))issio( i( 1hi4h i has 4a e.ori4all3 2ee( s a e" ha o( perusal o! he 4ase papers0 she (o i4e" ha he pa ie( 1as

re!erre" o her 2e4ause o! suspe4 e" +Tu2er4ular Peri o(i is, o! he lo1er a2"o)e( a(" +re(al !ailure,$ O( e=a)i(a io( o! Pri3a Malho ra0 Dr$ Pra i)a Prasa" (o i4e" ha 1as (o .e i(. )e(s rua io( !or he las he pa ie(

hree )o( hs

12 al hou.h 2e!ore ha perio"0 her )e(s rua io( perio"s 1ere s a e" o 2e (or)al$ A! er 4li(i4al e=a)i(a io(0 Dr$ Pra i)a Prasa" a";ise" Ul raso(o.raph o! he pel;is a(" laparos4op3 o 4o(!ir) he e=is e(4e o! u2er4ulosis o! he .3(ae4olo.i4al par s$ Dr$ Pra i)a Prasa" s a e" ha laparos4op3 1as he "ia.(osis o!

4o(si"ere" (e4essar3 !or 4o(!ir)a io( o! u2er4ulosis o! he a2"o)e( a(" o .e

he his opa holo.i4al

repor $ She s a e" ha i( he prese(4e o! Dr$ Vasa( V$ She h laparos4op3 1as "o(e$ The laparos4op3 1as (o 4o( ra5

i("i4a e" !ro) he ;arious i(;es i.a io( repor s a(" 4he4A5 ups 4arrie" ou Co))issio( has o( i( he pa ie( is or"er prior o %&$%9$1&9&$ he The

e= ra4 e"

(e4essar3

a;er)e( s )a"e 23 Dr$ Pra i)a Prasa" i( her 1ri e( s a e)e( i( re.ar" o he pro4e"ure a(" )e ho" o!

4o("u4 i(. laparos4op3 1hi4h0 i( our ;ie10 are (o (e4essar3 o 2e repea e" i( his Bu".)e( !or u((e4essaril3 2ur"e(i(. he re4or"$ The re4or" pro"u4e" 2e!ore he Co))issio(

1oul" sho1 ha i( he opera io( hea re0 he pa ie( 1as Boi( l3 e=a)i(e" 23 Dr$ A$ >ripla(i a(" Dr$ S$R$ Fup e0 Ho($ A(aes hesiolo.is a(" he3 ha" aAe( 4o(s4ious "e4isio( ha

13 he laparos4op3 Dr$ Pra i)a 1as (o !el 4o( ra5i("i4a e" ha a( a e)p i( a(3 1a3$ o 4o("u4

Prasa"

laparos4op3 ha" o 2e a2a("o(e" a(" i 2e4a)e (e4essar3 o per!or) he laparo o)3 o .e issue !or 2iops3 1hi4h 1as he

)ai( a(" o(l3 o2Be4 i;e o! he i(;es i.a io($ I( he pro4ess0 he per!ora io(s 4ause" "uri(. laparos4op3 1ere "ul3 he

su ure"$

O( ope(i(. he a2"o)e(0 i 1as (o i4e" ha

pa ie( ha" a4 i;e )ili ar3 u2er4ulosis$ Peri o(eu) a(" all he a2"o)i(al s ru4 ures 1ere a"here" o.e her$ I 1as also (o i4e" ha he i( es i(es 1ere per!ora e" "ue o i( ro"u4 io( ro4ar a(" 4a((ula$ I 1as s a e" 23

o! laparos4op3

Dr$ Pra i)a Prasa" ha Dr$ Vasa( V$ She h per!or)e" he peri o(eal 2iops3 a(" su ure" si= i( es i(al per!ora io(s$ The laparo o)3 1as per!or)e" 1i h 4o)ple e su44ess a(" "i" (o 4rea e a(3 4o)pli4a io( o he pa ie( $ also su2)i e" i( her s a e)e( pro;e" 23 ha Dr$ Pra i)a Prasa" i 1as 4o(4lusi;el3 ha he su ure"

he post-mortem e=a)i(a io(

i( es i(es ha" heale" a(" ha" (o "e;elope" a(3 leaA$ 1%Dr$ Pra i)a Prasa" has s ro(.l3 re!u e" he alle.a io( he appella( ha Tu2er4ular Peri o(i is ha"

)a"e 23

1' "e;elope" "ue o laparos4op3$ She s a e" ha Tu2er4ular su""e(l3

Peri o(i is is a 4hro(i4 "isease 1hi4h 4oul" (o "e;elop$ 4o("u4 e"$ s a e)e( I 1as alrea"3 prese(

1he( laparos4op3 1as he 1ri e( here 1as

Dr$ Pra i)a Prasa" also s a e" i( ha he alle.a io(s o! he appella( ha

a "epar ure !ro) he li(e o! a4 io( aAe( 23 Dr$ P$H$ Joshi a(" Dr$ Ra)a)oor h30 1ere 1holl3 u( rue$ She s a e" ha i(

!a4 0 a perusal o! he 4ase papers 1oul" sho1 ha Dr$ P$H$ Joshi ha" hi)sel! su..es e" laparos4op3 o( he pa ie( $ 1as her s a e)e( ha )e"i4al opi(io( 1as 4lear I ha

u2er4ulosis o! i( es i(es 4oul" 2e "e e4 e" 2es a(" easil3 23 per!or)i(. laparos4op3$ The alle.a io(s o! he appella( he ri.h lu(. o! Pri3a Malho ra 1as 4ollapse" "ue laparos4op3 has e)pa he i4all3 ha 2ee( "e(ie" 23 ha o he her$ he

Dr$ Pra i)a Prasa" plea"e" "ire4 io( o! he

"uri(. laparos4op3

ro4ar a(" 4a((ula 1ere

o1ar"s pel;is

*"o1(1ar" "ire4 io(- eli)i(a i(. a(3 4ha(4e o! 4ausi(. p(eu)o hora= or 4ollapse o! he lu(.$ The appella( 4oul" he

(o lea" e;i"e(4e o! a(3 e=per "o4 or o 4ou( er or re2u

1( s a e)e( s a e)e( $ 11I( he li.h o! he u(re2u e" a(" u(4o( ro;er e" )a"e 23 Dr$ Pra i)a Prasa" i( her 1ri e(

s a e)e( o! Dr$ Pra i)a Prasa"0 he Co))issio(0 i( our ;ie10 has ri.h l3 4o)e o he 4o(4lusio( ha he appella( has

!aile" o es a2lish ha Dr$ Pra i)a Prasa"0 i( a(3 )a((er0 1as (e.li.e( or 4areless i( per!or)i(. laparos4op3 upo( he "e4ease"$ 1'The appella( also alle.e" ha Dr$ A$ >ripla(i a(" his he li(e o! rea )e( 2ei(.

ea) o! "o4 ors ha" "is4ar"e"

pursue" 23 Dr$ Ra)a)oor h3 a(" Dr$ P$H$ Joshi0 1hi4h ha" resul e" i( he "ea h o! Pri3a Malho ra$ The appella( 4oul" (o e;e( re)o el3 su2s a( ia e his alle.a io( )a"e a.ai(s Dr$ A$ >ripla(i$ There is (o a( io a o! e;i"e(4e o( re4or" o pro;e ha Dr$ A$ >ripla(i ha" e;er "epar e" !ro) he li(e o! rea )e( 2ei(. aAe( a(" a"op e" 23 Dr$ Ra)a)oor h3 a(" Dr$ P$H$ Joshi$ The appella( has 4learl3 a(" u(eGui;o4all3 s a e" ha she ha" (o 4o)plai( a.ai(s he li(e o! rea )e(

2ei(. a";ise" 23 Dr$ P$H$ Joshi$ I 1as 4a e.ori4all3 s a e" 23 Dr$ Pra i)a Prasa" a(" Dr$ A$ >ripla(i i( heir respe4 i;e

16 1ri e( s a e)e( s 1ri i(. ha i 1as Dr$ P$H$ Joshi 1ho ha" i( laparos4op3 a(" he sai"

re4o))e("e"

re4o))e("a io( 1as pla4e" o( re4or" o! he Co))issio( 23 Dr$ Pra i)a Prasa" i( suppor o! her 1ri e( s a e)e( $ The "o4 ors5respo("e( s 1ho 1ere i(;ol;e" i( he rea )e( o! "e4ease" Pri3a Malho ra ha;e es a2lishe" o( re4or" ha he

4ourse o! rea )e( pursue" 23 he) i( he 6o)2a3 Hospi al 1as i( (o 1a3 4o( ra"i4 or3 or a.ai(s he rea )e( .i;e( 23

Dr$ Ra)a)oor h3$ I( !a4 0 Dr$ Ra)a)oor h3 ha" e=a)i(e" he pa ie( a(" 4arrie" he i(;es i.a io( as a resul 1as !ou(" ha !ailure$ Dr$ hereo! i

he pa ie( 1as su!!eri(. !ro) 4hro(i4 re(al Ra)a)oor h3 reGues e" Dr$ A$ >ripla(i5

respo("e( (o$1 !or a( opi(io( re4or"e" as +U(i No e, "a e" 1/$%:$1&9&0 a 4op3 hereo! has 2ee( pro"u4e" 2e!ore he

Co))issio( "ul3 si.(e" 23 Dr$ Ra)a)oor h3$ The 4o( e( s o! he +U(i No e, are e= ra4 e" 23 he Co))issio( i( i s

or"er$ 1<Dr$ Vasa( S$ She h o! 6o)2a3 Hospi al !or he !irs i)e

e=a)i(e" Pri3a Malho ra o( '8$%:$1&9& a(" !ou(" he pa ie( su!!eri(. !ro) Ai"(e3 !ailure$ Dr$ Vasa( S$ She h 1as

1) i(!or)e" ha si(4e a2ou he pa ie( ha" 2ee( u("er.oi(. hae)o"ial3sis 19$%:$1&9&$ O( '1$%:$1&9&0 o( 4li(i4al

e=a)i(a io( a(" .oi(. hrou.h he repor s o! he i(;es i.a io( 4o("u4 e" ill ha "a30 i 1as !ou(" ha he pa ie( 1as

su!!eri(. !ro) e("5s a.e re(al !ailure a(" 1oul" reGuire Ai"(e3 ra(spla( !or her sur;i;al$ Ihe( ;arious es s 1ere 4arrie" ou 0 Dr$ A$ >ripla(i suspe4 e" su!!eri(. !ro) a2"o)i(al su!!eri(. !ro) a2"o)i(al u2er4ulosis$ he pa ie( o 2e he he

I( ;ie1 o!

u2er4ulosis a(" also o!

.as roi( es i(al pro2le)s 1hi4h ha" .o(e ou o! propor io( o he Ure)ia0 he e=per "o4 ors5respo("e( s ha" "e4i"e" (o o 4arr3 ou a(3 opera io( !or Ai"(e3 ra(spla( $ Dr$ A$ ha i

>ripla(i a(" Dr$ Vasa(

S$ She h 2o h ha" a.ree"

1oul" (o 2e a";isa2le o 4arr3 ou Ai"(e3 ra(spla( 0 ha;i(. re.ar" o he s a e o! heal h o! he pa ie( $ The posi io( o! he pa ie( 1as !ull3 e=plai(e" 23 Dr$ Vasa( S$ She h o he

pa ie( a(" he appella( a(" 2o h o! he) 1ere i(!or)e" ha re(al !ailure 4ases s oo" sur.er3 2o"il3 a(" 1ere liAel3 o

"e;elop 4o)pli4a io(s !ollo1i(. )i(or sur.er3 a(" )i.h e;e( resul i( "ea h$ O( <1$%:$1&9&0 Dr$ Vasa( S$ She h

18 per!or)e" "ia.(os i4 peri o(eal ap !or as4e i4 !lui"

e=a)i(a io( a(" also o Bu".e 1he her laparos4op3 1oul" 2e sa!e or (o $ pa ie( Ha;i(. re.ar" o he ;arious pro2le)s o! he he pa holo.i4al a(" o her repor s o! o he he

a(" also

pa ie( 0 Dr$ A$ >ripla(i a(" his 4ollea.ues 4a)e 4o(4lusio( ha pa ie(

here 1as (o 2e er )e ho" a;aila2le !or he

ha( o per!or) laparos4op3$ Dr$ Ra)a)oor h3 also

e=a)i(e" pa ie( o( %8$%9$1&9& a(" appro;e" he "e4isio( o! Dr$ A$ >ripla(i o s ar a( i5 u2er4ulosis "ru.s a(" a";ise" a")i(is ra io( o! ri!a)pi4i(@p3raHi(a)i"e$ Dr$ Ra)a)oor h3 ha" also i(sis e" upo( "e4isio( o "o his opa holo.i4al issue "ia.(osis o 4o(!ir) e=is e(4e o! u2er4ulosis$ 18Dr$ DMrs$] S$R$ Jaha.ir"ar5respo("e( s a e" ha Pri3a o 6o)2a3 Hospi al u("er he

Malho ra 1as a")i e"

o2ser;a io( o! Dr$ Ra)a)oor h3 a(" 1as la er 2ei(. rea e" 23 Dr$ A$ >ripla(i 1ho re!erre" laparos4op3$ he pa ie( o her !or

I 1as Dr$ Vasa( S$ She h 1ho o( or a2ou elepho(e a(" .a;e her he

%9$%&$1&9& 4o( a4 e" her o( "e ails o!

he 4o)pli4a io(s o! Pri3a Malho ra$ ha

Dr$ S$ R$

Jaha.ir"ar s a e"

Dr$ DMrs$] Pra i)a Prasa" 1ho ha"

1* spe4ial rai(i(. o per!or) issue 2iops3 23 laparos4op3 1as assi.(e" he Bo2$ Dr$ A$ >ripla(i is a Nephrolo.is 0 1ho a rele;a( he

i)e 1as he I(54har.e o! he Nephrolo.3 U(i o! he Dr$ Vasa( S$ She h is he Fe(eral sur.er3$

6o)2a3 Hospi al$

Sur.eo(0 1ho is spe4ialiHe" i( Ai"(e3

ra(spla(

Dr$ Vasa( S$ She h ha" o "o laparo o)3 o( Pri3a Malho ra a! er ha;i(. super;ise" laparos4op3 4o("u4 e" 23 Dr$ DMrs$] Pra i)a Prasa"$ O( '1$%:$1&9&0 he pa ie( 1as re!erre" 23 Dr$ Ra)a)oor h3 o Dr$ A$ >ripla(i a(" Dr$ Vasa( S$ She h$ O( "e aile" 4li(i4al e=a)i(a io( a(" .oi(. hrou.h he

re4or"s o! he i(;es i.a io( "o(e up o '1$%:$1&9&0 Dr$ Vasa( S$ She h 4a)e o he 4o(4lusio( ha pa ie( 1as a he e("5

s a.e o! re(al !ailure a(" as su4h she (ee"e" Ai"(e3 ra(spla( !or her sur;i;al as a! er )ul iple sessio(s o! he a2"o)e( "i" (o se le "o1( a(" also !ea ures o! i( es i(al

hae)o"ial3sis

2e4ause o! o44urre(4e o! re4urre( o2s ru4 io(0 i 1as "e4i"e" (o he 4ase o! he pa ie( $ opi(io( .i;e( 23

o ha;e sur.i4al i( er;e( io( i(

Dr$ Vasa( S$ She h a.ree" o he

1o "o4 ors (a)el30 Dr$ A$ >ripla(i a(" he issue o! Ai"(e3 ra(spla( a io( "i"

Dr$ Ra)a)oor h3 ha

20 (o arise ill a2"o)i(al u2er4ulosis 1oul" .e heale"

4o)ple el3$ 1#O( re5e=a)i(a io( a(" re5appraisal o! he e( ire )a erial here 1as a2solu el3 (o "i!!ere(4e or ea) o! spe4ialis s a("

o( re4or"0 1e !i(" ha

"i;er.e(4e o! opi(io( 2e 1ee( a

e=per s 4o(sis i(. o! Dr$ Ra)a)oo h30 Dr$ P$H$ Joshi a(" Dr$ A$ >ripla(i a a(3 s a.e a2ou rea )e( he )e ho" a(" )o"e o! his 4ase$

a"op e" 23 "o4 ors5respo("e( s i(

Do4 ors ha" i(!or)e" he pa ie( a(" her rela i;es 1ell i( i)e ha 4o("i io( o! Pri3a Malho ra 1as 4ri i4al a(" Ai"(e3 ra(spla( a io( 4oul" (o 2e "o(e (earl3 !or o(e 3ear a(" also he 4o(seGue(4e o! he re(al !ailure su!!ere" 23 he pa ie( $ Dr$ Vasa( S$ She h ha" opi(e" ha a e)p o "o

laparos4op3 ha" !aile" i( spi e o! 1o a e)p s a(" i 2e4a)e all he )ore i)por a( 2iops3 a(" o44urre" "ue o per!or) laparo o)3 o .e ha issue !or ha;e

o a;oi" a(3 !ur her i(Bur3 o he a e)p a

)i.h

laparos4op3$

O( ope(i(.

a2"o)e( o! he pa ie( i 2e4a)e 4lear ha e= e(si;e 4hro(i4 peri o(i is plas eri(.

he pa ie( ha"

he 1hole i( es i(al o i( ro"u4 io( o!

ra4 a(" i( es i(es 1ere per!ora e" "ue

21 laparos4opi4 pressure a(" 4a((ula$ per!or)e" peri o(eal 2iops3 a(" Dr$ Vasa( su ure" si= S$ She h i( es i(al

per!ora io(s o s ar 1i h$ The pa ie( 1as pu i( I$C$U a(" a he i(i ial s a.es she 1as "oi(. 1ell 2u u(!or u(a el3 o(

1:$%9$1&9& i$e$ ei.h "a3s a! er he opera io( she "e;elope" Bau("i4e pro2a2l3 "ue o a( i5 u2er4ulosis "ru.s 1hi4h ha" o 2e s oppe"$ '%$%9$1&9&0 The )a erial o( re4or" 1oul" sho1 he pa ie( ha o( he

"e;elope" a !lui" leaA !ro)

a2"o)e( "ue o he leaAa.e o! as4i es or 2e.i((i(. o! !e4al !is ula$ The 4o("i io( o! Pri3a Malho ra s ar e" "e eriora i(. "a3 23 "a3 "espi e 2es 4are a(" a e( io( o! spe4ialis s i( I$C$U$ The appella( 1as Aep !ull3 i(!or)e" a2ou he

"e eriora i(. 4o("i io( o! a2rup l3 rea )e( i(s ru4 e" he

he pa ie( 0 2u "o4 ors o s op

he appella( hae)o"ial3sis

o he pa ie( $ 6e4ause o! he persis i(. "e)a(" o!

he appella( 0 hae)o"ial3sis 1as s oppe" 1hi4h a44or"i(. o he respo("e( s resul e" i( he u( i)el3 "ea h o! Pri3a

Malho ra$ E=hi2i 5C 1hi4h 1as par o! he 4o( i(ua io( shee o! rea )e( o! Me"i4al Resear4h Ce( re o! 6o)2a3 Hospi al pla4e" o( re4or" o! he Co))issio( 1oul" re;eal ha o(

22 '<$%9$1&9& a &$%% p$)$0 he pa ie( 1as e=a)i(e" a(" i 1as also re4or"e" hereo( +"is4usse" 1i h rela i;es a(" e=plai(e" he 4o(seGue(4es o! (o "rai(i(. o! p(eu)o hora= a(" (o "oi(. hae)o"ial3sis,$ The appella( "i" (o per)i su4h

rea )e( a(" .a;e i( 1ri i(. +I re!use" Hae)o"ial3sis a(" P(eu)o hora= o( )3 risA,$ 1/!a4 I( he !a4 s a(" 4ir4u)s a(4es (o i4e" herei(a2o;e0 he re)ai(s ha 1he( Pri3a Malho ra 1as 2rou.h o

6o)2a3 Hospi al !or rea )e( her heal h 1as i( ;er3 2a" 4o("i io($ Re(al !ailure ha" alrea"3 aAe( pla4e$ I( he post mortem repor 4o("u4 e" a J$J$ Hospi al0 6o)2a30 i !i("s re4or"e" ha +pa ie( 1as si4A si(4e !our )o( hs 23 loose )o io(0 ;o)i i(. a(" she 1as a")i e" i( 6o)2a3 Hospi al si(4e 18$%:$1&9&$ She 1as opera e" o( %&$%9$1&9& a(" "ie" o( '8$%9$1&9&$ The 4ause o! "ea h 1as "ue o peri o(i is 1i h re(al !ailure,$ 1:I( he 2a4A"rop o! he !a4 ual si ua io( o! he prese(

4ase0 1e ha;e e=a)i(e" he pri(4iples o! la1 lai" "o1( 23 his Cour i( he "e4isio(s 4i e" 23 he lear(e" 4ou(sel$

23 19A hree Ju".e 6e(4h o! his Cour i( he 4ase o! Jacob

Mathew v. State of Punjab and Another D(2005 ! ""# $] ha" he o44asio( o "eal 1i h a(" "e4i"e he lia2ili 3 o!

"o4 ors i( a "ea h 4ase arisi(. "ue

o 4ri)i(al )e"i4al

(e.li.e(4e !or a( o!!e(4e u("er Se4 io( <%85A o! he I("ia( Pe(al Co"e0 19/%$ I( he 4ase o! pro!essio(al (e.li.e(4e0 i

1as o2ser;e" ha i( he la1 o! (e.li.e(4e0 pro!essio(als su4h as la13ers0 "o4 ors0 ar4hi e4 s a(" o hers are i(4lu"e" i( he 4a e.or3 o! perso(s pro!essi(. so)e spe4ial sAill or as sAille" perso(s .e(erall3$ A(3 asA 1hi4h is reGuire" o 2e per!or)e" 1i h a spe4ial sAill 1oul" .e(erall3 2e a")i e" or u("er aAe( o 2e per!or)e" o(l3 i! he perso( possesses he reGuisi e sAill !or per!or)i(. ha asA$ A(3 reaso(a2le )a( e( eri(. i( o a

pro!essio( 1hi4h reGuires a par i4ular le;el o! lear(i(. o 2e 4alle" a pro!essio(al o! ha 2ra(4h0 i)plie"l3 assures he

perso( "eali(. 1i h hi) ha

he sAill 1hi4h he pro!esses o

possess shall 2e e=er4ise" 1i h reaso(a2le "e.ree o! 4are a(" 4au io($ He "oes (o assure his 4lie( o! he resul $ A

ph3si4ia( 1oul" (o assure he pa ie( o! !ull re4o;er3 i( e;er3 4ase$ A sur.eo( 4a((o a(" "oes (o .uara( ee ha he resul

2' o! sur.er3 1oul" i(;aria2l3 2e 2e(e!i4ial0 )u4h less o he e= e( o! 1%%J !or he perso( opera e" o($ The o(l3

assura(4e 1hi4h su4h a pro!essio(al 4a( .i;e or 4a( 2e u("ers oo" o ha;e .i;e( 23 i)pli4a io( is ha he is

possesse" o! he reGuisi e sAill i( ha 2ra(4h o! pro!essio( 1hi4h he is pra4 isi(. a(" 1hile u("er aAi(. he per!or)a(4e o! he asA e( rus e" o hi) he 1oul" 2e e=er4isi(. his sAill 1i h reaso(a2le 4o)pe e(4e$ This is all 1ha approa4hi(. he perso( his

he pro!essio(al 4a( e=pe4 $ Ju".e" 23

s a("ar"0 he pro!essio(al )a3 2e hel" lia2le !or (e.li.e(4e o( o(e o! 1o !i("i(.s7 ei her he 1as (o possesse" o! he

reGuisi e sAill 1hi4h he pro!esse" o ha;e possesse"0 or0 he "i" (o 4ase0 e=er4ise0 1i h reaso(a2le 4o)pe e(4e i( he .i;e( o 2e

he sAill 1hi4h he "i" possess$ The s a("ar"

applie" !or Bu".i(.0 1he her (e.li.e( or (o 0 1oul" 2e

he perso( 4har.e" has 2ee( ha o! a( or"i(ar3 4o)pe e(

perso( e=er4isi(. or"i(ar3 sAill i( ha pro!essio($ I is (o possi2le !or e;er3 pro!essio(al o possess he hi.hes le;el o! e=per ise or sAills i( ha 2ra(4h 1hi4h he pra4 i4es$ A hi.hl3 sAille" pro!essio(al )a3 2e possesse" o! 2e er Guali ies0 2u

2( ha 4a((o 2e )a"e he 2asis or he 3ar"s i4A !or Bu".i(. he per!or)a(4e o! he pro!essio(al pro4ee"e" a.ai(s o(

i("i4 )e( o! (e.li.e(4e$ DParas 19 a(" 89*<-] 19$1- I( he 4ase o! )e"i4al (e.li.e(4e0 i has 2ee( hel" ha he su2Be4 o! (e.li.e(4e i( he 4o( e= o! )e"i4al pro!essio( (e4essaril3 4alls !or rea )e( 1i h a "i!!ere(4e$ There is a )arAe" e("e(43 o looA !or a hu)a( a4 or o 2la)e !or a( u( o1ar" e;e( 0 a e("e(43 1hi4h is 4losel3 li(Ae" 1i h he "esire o pu(ish$ Thi(.s ha;e .o(e 1ro(. a("0 here!ore0

so)e2o"3 )us 2e !ou(" o a(s1er !or i $ A( e)piri4al s u"3 1oul" re;eal ha )ore 4o)ple= he 2a4A.rou(" o a )ishap is !reGue( l3 !ar ha( )a3 .e(erall3 2e assu)e"$ I 4a( 2e

"e)o(s ra e" ha a4 ual 2la)e !or he ou 4o)e has o 2e a ri2u e" 1i h .rea !ailure0 he 4au io($ For a )e"i4al a44i"e( )a3 lie 1i h he or

respo(si2ili 3

)e"i4al

pra4 i io(er0 a(" eGuall3 i )a3 (o $ The i(a"eGua4ies o! he s3s e)0 he spe4i!i4 4ir4u)s a(4es o! he 4ase0 he (a ure o! hu)a( ps34holo.3 o i sel! a a(" resul sheer i( 4ha(4e 1hi4h )a3 he ha;e

4o)2i(e"

pro"u4e

"o4 orKs

4o( ri2u io( is ei her rela i;el3 or 4o)ple el3 2la)eless$ The

26 hu)a( 2o"3 a(" i s 1orAi(. is (o hi(. less ha( a hi.hl3 4o)ple= )a4hi(e$ Couple" 1i h he 4o)ple=i ies o! )e"i4al s4ie(4e0 he s4ope !or )isi)pressio(s0 )is.i;i(.s a("

)ispla4e" alle.a io(s a.ai(s

he opera or0 i$e$

he "o4 or0

4a((o 2e rule" ou $ O(e )a3 ha;e (o io(s o! 2es or i"eal pra4 i4e 1hi4h are "i!!ere( !ro) he reali 3 o! ho1 )e"i4al pra4 i4e is 4arrie" o( or ho1 he "o4 or !u(4 io(s i( real li!e$ The !a4 ors o! pressi(. (ee" a(" li)i e" resour4es 4a((o 2e rule" ou !ro) 4o(si"era io($ Deali(. 1i h a 4ase o! )e"i4al (e.li.e(4e (ee"s a "eeper u("ers a("i(. o! he pra4 i4al si"e o! )e"i4i(e$ The purpose o! hol"i(. a pro!essio(al lia2le !or his a4 or o)issio(0 i! (e.li.e( 0 is o )aAe li!e sa!er a(" o eli)i(a e he possi2ili 3 o! re4urre(4e o! (e.li.e(4e i( !u ure$ The hu)a( 2o"3 a(" )e"i4al s4ie(4e0 2o h are oo 4o)ple= o 2e easil3 u("ers oo"$ To hol" i( !a;our o! e=is e(4e o! (e.li.e(4e0 asso4ia e" 1i h he a4 io( or i(a4 io( o! a )e"i4al pro!essio(al0 reGuires a( i(5"ep h u("ers a("i(. o! he

1orAi(. o! a pro!essio(al as also he (a ure o! he Bo2 a(" o! errors 4o))i e" 23 4ha(4e0 1hi4h "o (o (e4essaril3 i(;ol;e he ele)e( o! 4ulpa2ili 3$

2) 19$'- Ne.li.e(4e i( he 4o( e= o! he )e"i4al pro!essio( To i(!er

(e4essaril3 4alls !or a rea )e( 1i h a "i!!ere(4e$ rash(ess or (e.li.e(4e o( he par

o! a pro!essio(al0 i(

par i4ular a "o4 or0 a""i io(al 4o(si"era io(s appl3$ A 4ase o! o44upa io(al (e.li.e(4e is "i!!ere( !ro) o(e o! pro!essio(al (e.li.e(4e$ A si)ple la4A o! 4are0 a( error o! Bu".)e( or a( a44i"e( 0 is (o proo! o! (e.li.e(4e o( he par o! a )e"i4al pro!essio(al$ So lo(. as a "o4 or !ollo1s a pra4 i4e a44ep a2le o he )e"i4al pro!essio( o! ha "a30 he 4a((o 2e hel" lia2le !or (e.li.e(4e )erel3 2e4ause a 2e er al er(a i;e 4ourse or )e ho" o! rea )e( 1as also a;aila2le or si)pl3 2e4ause a )ore sAille" "o4 or 1oul" (o ha;e 4hose( o !ollo1 or resor o ha pra4 i4e or pro4e"ure 1hi4h he a44use" !ollo1e"$ The 4lassi4al s a e)e( o! la1 i( Bo a!s case0 *1&#:- ' AII ER 1190 a p$ 1'1 D5F Dse ou i( para 1& herei(] has 2ee( 1i"el3 a44ep e" as "e4isi;e o! he s a("ar" o! 4are reGuire" 2o h o! pro!essio(al )e( .e(erall3 a(" )e"i4al pra4 i io(ers i( par i4ular0 a(" hol"s .oo" i( i s appli4a2ili 3 i( I("ia$ I( or 0 i is e(ou.h !or he "e!e("a( o sho1 ha he s a("ar" o!

4are a(" he sAill a ai(e" 1as ha o! he or"i(ar3 4o)pe e(

28 )e"i4al pra4 i io(er e=er4isi(. a( or"i(ar3 "e.ree o!

pro!essio(al sAill$

The !a4

ha a "e!e("a( 4har.e" 1i h he .e(eral a(" appro;e" he 4har.e$ I is (o

(e.li.e(4e a4 e" i( a44or" 1i h pra4 i4e is e(ou.h

o 4lear hi) o!

(e4essar3 !or e;er3 pro!essio(al o possess he hi.hes le;el o! e=per ise i( ha 2ra(4h 1hi4h he pra4 i4es$ Three hi(.s are per i(e( o 2e (o e"$ Firs l30 he s a("ar" o! 4are0 1he(

assessi(. he pra4 i4e as a"op e"0 is Bu".e" i( he li.h o! A(o1le".e a;aila2le a he "a e o! he i)e *o! he i(4i"e( -0 a(" (o a he 4har.e o! (e.li.e(4e

rial$ Se4o("l30 1he(

arises ou o! !ailure o use so)e par i4ular eGuip)e( 0 he 4har.e 1oul" !ail i! he eGuip)e( 1as (o .e(erall3 a;aila2le a ha poi( o! i)e * ha is0 he i)e o! he i(4i"e( - o( 1hi4h

i is su..es e" as shoul" ha;e 2ee( use"$ Thir"l30 1he( i 4o)es o he !ailure o! aAi(. pre4au io(s0 1ha has o 2e see( is 1he her hose pre4au io(s 1ere aAe( 1hi4h he or"i(ar3 e=perie(4e o! )e( has !ou(" o 2e su!!i4ie( L a !ailure o use spe4ial or e= raor"i(ar3 pre4au io(s 1hi4h )i.h ha;e

pre;e( e" he par i4ular happe(i(. 4a((o 2e he s a("ar" !or

2* Bu".i(. he alle.e" (e.li.e(4e$ DParas 89 *'-0 89 *8-0 1& a(" '8] 19$<A.ai(0 i has 2ee( hel" ha i("is4ri)i(a e prose4u io(

o! )e"i4al pro!essio(als !or 4ri)i(al )e"i4al (e.li.e(4e is 4ou( er5pro"u4 i;e a(" "oes (o ser;i4e or .oo" o he so4ie 3$ A )e"i4al pra4 i io(er !a4e" 1i h a( e)er.e(43 or"i(aril3 ries his 2es o re"ee) he pa ie( ou o! his su!!eri(.$ He "oes (o

.ai( a(3 hi(. 23 a4 i(. 1i h (e.li.e(4e or 23 o)i i(. o "o a( a4 $ O2;iousl30 here!ore0 i 1ill 2e !or he 4o)plai(a( 4learl3 )aAe ou o

a 4ase o! (e.li.e(4e 2e!ore a )e"i4al

pra4 i io(er is 4har.e" 1i h or pro4ee"e" a.ai(s 4ri)i(all3$ A sur.eo( 1i h shaA3 ha("s u("er !ear o! le.al a4 io( 4a((o per!or) a su44ess!ul opera io( a(" a Gui;eri(. ph3si4ia( 4a((o a")i(is er he e("5"ose o! )e"i4i(e o his pa ie( $ I! he ha("s 2e re)2li(. 1i h he "a(.li(. !ear o! !a4i(. a he e;e( o! !ailure !or 1ha e;er

4ri)i(al prose4u io( i(

reaso(551he her a ri2u a2le o hi)sel! or (o 0 (ei her 4a( a sur.eo( su44ess!ull3 1iel" his li!e5sa;i(. s4alpel o per!or) a( esse( ial sur.er30 (or 4a( a ph3si4ia( su44ess!ull3 a")i(is er he li!e5sa;i(. "ose o! )e"i4i(e$ Dis4re io( 2ei(.

30 he 2e er par o! ;alour0 a )e"i4al pro!essio(al 1oul" !eel 2e er a";ise" o lea;e a er)i(al pa ie( o his o1( !a e i( he

4ase o! e)er.e(43 1here he 4ha(4e o! su44ess )a3 2e 1%J *or so-0 ra her ha( aAi(. he risA o! )aAi(. a las "i 4h e!!or o1ar"s sa;i(. he su2Be4 a(" !a4i(. a 4ri)i(al prose4u io( i! his e!!or !ails$ Su4h i)i"i 3 !or4e" upo( a "o4 or 1oul" 2e a "isser;i4e o he so4ie 3$ DSee paras '90 '& a(" 8:] 19$8I( he 4ase o! State of Punjab v. Shiv "a! and

#thers D'%%#] : SCC 10 a hree Ju".e 6e(4h o! his Cour 1hile "eali(. 1i h he 4ase o! )e"i4al (e.li.e(4e 23 he "o4 or i( 4o("u4 i(. s erilisa io( opera io(s0 rei era e" a("

rea!!ir)e" ha u(less (e.li.e(4e o! "o4 or is es a2lishe"0 he pri)ar3 lia2ili 3 4a((o 2e !as e(e" o( he )e"i4al

pra4 i io(er$ I( para.raph / o! he Bu".)e( i is sai"7 *pa.e (o$ :+Ver3 re4e( l30 his Cour has "eal 1i h he issues o! )e"i4al (e.li.e(4e a(" lai" "o1( pri(4iples o( 1hi4h he lia2ili 3 o! a )e"i4al pro!essio(al is "e er)i(e" .e(erall3 a(" i( he !iel" o! 4ri)i(al la1 i( par i4ular$ Re!ere(4e )a3 2e ha" o Jacob Mathew v. State of Punjab *'%%#- / SCC 1$ The Cour has appro;e" he es as lai" "o1( i( Bo a! v. Friern $os%ita Mana&e!ent 'o!!ittee (1&#:- 1 ILR #9'7 *1&#:- ' AII ER 119 *M6D-

31 popularl3 A(o1( as 6ola)?s es 0 i( i s appli4a2ili 3 o I("ia,$ 1&$ I( he li.h o! he proposi io(s o! la1 se le" i( he a2o;e

4i e" Bu".)e( s o! his Cour 0 1e are o! he ;ie1 ha 2o h o( !a4 s a(" i( la1 (o 4ase is )a"e ou 23 he appella( a.ai(s he respo("e( s$ The alle.a io(s )a"e i( he 4o)plai( "o

(o )aAe ou a 4ase o! (e.li.e(4e or "e!i4ie(43 i( ser;i4e o( he par o! he respo("e( s$ I is (o ha he 4ase o! he appella(

he "o4 ors (a)e" i( he 4o)plai( are (o Guali!ie" he

"o4 ors a(" spe4ialiHe" i( heir respe4 i;e !iel"s o rea

pa ie( 1ho) he3 a.ree" o rea $ All he "o4 ors 1ho rea e" he pa ie( are sAille" a(" "ul3 Guali!ie" spe4ialis s i( heir respe4 i;e !iel"s a(" he3 ha;e rie" heir 2es o sa;e he li!e

o! Pri3a Malho ra 23 Boi(i(. heir ha("s a(" hea"s o.e her a(" per!or)e" heir pro!essio(al "u ies as a ea) 1orA$ The appella( has (o 4halle(.e" he post mortem repor "a e"

'#$%9$1&9& su2)i e" 23 J$J$ Hospi al 1herei( i has 2ee( s a e" ha 2e!ore Pri3a Malho ra 1as a")i e" o 6o)2a3 Hospi al0 she 1as si4A si(4e !our )o( hs 23 loose )o io( a(" ;o)i i(.$ A 4op3 o! post mortem repor o! "e4ease" Pri3a

32 Malho ra pla4e" o( re4or" o! he Co))issio( 23

Dr$ A$ >ripla(i 1i h his e;i"e(4e o( a!!i"a;i 1oul" rea" as u("er7 III] Mi4ros4op3 N 1- >i"(e3s *sa)e his olo.3 i( se4 io(s !ro) he 1o 2i s- re;eal a";a(4e" Ai"(e3 "isease i( he e(" s a.e$ Mos o! he .lo)eruli are s4lerose"@h3ali(ise" a(" s ru4 urall3 o2sole e$ So)e o! he !e1 .lo)eruli (o e!!e4 e" 23 a";a(4e" s4lerosis re;eal h3per4ellulari 3 i("i4a i(. ha he e(" s a.e is he resul o! 4hro(i4 pro.ressi;e "i!!use proli!era i;e .lo)eruli(ephri is. The e(" s a.e lesio( is e= e(si;e0 irre;ersi2le a(" 4a( 4ause i( ra4 a2le 4hro(i4 re(al !ailure$ I( ers i ial !i2rosis a(" i(!la))a io( are 1i"esprea"$ Fi(all30 i 1as opi(e" 23 "o4 ors ha he "ea h o! Pri3a

Malho ra 1as "ue o peri o(i is 1i h re(al !ailure$ '%O( our i("epe("e( e=a)i(a io( o! he or"er o! he

Co))issio( a(" o her e( ire )a erial o( re4or" "is4usse" herei(a2o;e0 1e !i(" ha he Co))issio( has properl3 a("

ri.h l3 appre4ia e" he e( ire !a4 ual a(" le.al aspe4 s o! he )a er a(" here is (o i(!ir)i 3 or per;ersi 3 i( he !i("i(.s re4or"e" 23 he Co))issio( 1hi4h 1arra( s a(3 i( er!ere(4e i( his appeal$

33 '1No o her poi( has 2ee( raise" 23 he appella( $ Ie0

hus0 !i(" (o )eri a(" su2s a(4e i( a(3 o! he su2)issio(s )a"e o( 2ehal! o! he appella( $ ''I( he resul !or he a2o;e5s a e" reaso(s here is (o

)eri i( his appeal a(" i is0 a44or"i(.l30 "is)isse"$ '<The par ies are le! o 2ear heir o1( 4os s$

........................................J. +Lokeshwa !"#$h Pa#%a,

........................................J. +-. !./e sha# 0e//1, Ne1 Delhi0 Mar4h '80 '%%&$

3'