Justice PV Kunhikrishnan, sitting as a single judge, emphasized the need for societal and governmental support to ensure nurses can perform their duties without fear of baseless prosecution.
Kerala: The Kerala High Court recently held that nurses accused of medical negligence should not be arrested routinely unless their detention is essential for the investigation.
Justice PV Kunhikrishnan, sitting as a single judge, emphasized the need for societal and governmental support to ensure nurses can perform their duties without fear of baseless prosecution.
“I firmly believe that nurses deserve protection from malicious prosecution. They must receive moral support from society and the government to work without the fear of unwarranted legal action and to be recognized as the Indian counterparts of Nightingale,”
the Court observed.
The Court ruled that nurses should receive the same legal safeguards as doctors, following the precedent set by the Supreme Court in Jacob Mathew v. State of Punjab.
“In line with the directives in Jacob Mathew’s case, this Court declares that a nurse, whether in government service or a private hospital, accused of negligence or rash conduct, should not be arrested merely on the filing of a complaint. Arrest should only be made if it is essential for the investigation or evidence collection, or if the investigating officer has reason to believe the nurse will evade prosecution without detention,”
the judgment stated.
Background Facts
The second respondent’s 10-year-old daughter was admitted to the hospital with symptoms of diarrhea and vomiting. She was given medication and placed in the observation ward. Later, the child developed a high fever, which the second respondent reported to the petitioner, a nurse. According to the second respondent, the nurse advised him to sponge the child’s body with a wet towel. He claimed that both the doctor and the nurse did not respond promptly when he reached out again. Eventually, the nurse took the child to the doctor, who declared her dead.
Based on the complaint, a crime was registered, and the final report was filed solely against the nurse, alleging medical negligence.
Court Observations
The Court noted that the petitioner nurse was responsible for managing 30 to 40 patients simultaneously. It observed that she did not attend to the child immediately, as the doctor had assessed the child’s condition as stable after reviewing her blood reports. When the child’s fever spiked, the nurse advised the father to take the child to the doctor.
The Court further acknowledged that the child’s father submitted an affidavit expressing no grievance against the nurse, who was working as temporary staff at the hospital. He also alleged that the investigation was flawed and conducted to shield those truly responsible for the medical negligence.
Referring to the precedents Kurban Hussain Mohamedali Rangawalla v. State of Maharashtra (1964) and Ambalal D. Bhatt v. State of Gujarat (1972), the Court reiterated that for an offence under Section 304A of the IPC to be established, death must be caused directly by a rash or negligent act, without the involvement of another person’s negligence.
The Court emphasized that nurses spend more time with patients than doctors and that an experienced nurse can make a significant difference in a patient’s outcome. Acknowledging the dedication of nurses, the Court remarked:
“The devotion, hard work, and readiness of the nursing community to handle medical emergencies at any hour deserve societal appreciation. Nursing is not just a profession—it is a calling. Nurses are regarded as the backbone of the healthcare system, providing not only care but also compassion for their patients.”
Citing the decision in Jacob Mathew and referring to a State Government notification (Circular No. 73304/ssb3/2007/Home dated 16.06.2008), the Court observed that nurses in both government and private hospitals should receive legal protection similar to that of doctors when prosecuted under Section 304A IPC for alleged medical negligence.
The Court issued additional directions:
- Private Complaints: Courts shall not entertain private complaints of medical negligence against nurses unless the complainant submits credible prima facie evidence, including a professional opinion from a competent authority supporting the allegation of negligence.
- Independent Medical Opinion: Investigating officers must secure an independent medical opinion, ideally from medical experts qualified in the relevant nursing field and accompanied by a doctor capable of providing an unbiased assessment.
The Court further directed the State government to issue a circular adopting the principles established in Jacob Mathew, ensuring nurses receive the same protections as doctors. The government was instructed to implement this circular within three months.
“The nurses, whether employed by the government or private hospitals, must be afforded the same protection as doctors under Section 304A of the IPC in cases of alleged medical negligence. The government should issue appropriate orders or circulars in alignment with the Jacob Mathew judgment to safeguard nurses from frivolous or malicious prosecutions,” the Court concluded.
Justice Kunhikrishnan highlighted the invaluable contribution of nurses, stating that anyone who has been admitted to a hospital or accompanied a patient would appreciate their dedication.
“They work tirelessly, day and night, spending significantly more time with patients than doctors. In certain medical emergencies, an experienced nurse can make a greater impact on a patient’s recovery than even a seasoned doctor,” the judge remarked.
The Court further stressed that nurses go beyond treating illnesses; they provide genuine care for patients.
“Florence Nightingale, a pioneer of modern nursing and healthcare reform, exemplified the essence of compassionate care. Her legacy underscores that nursing is not just about treating diseases but about caring for patients. Nurses have a unique ability to provide care in ways that others cannot,”
the order observed.
This order was issued while hearing a petition filed by a nurse charged with medical negligence under Section 304 of the Indian Penal Code (culpable homicide not amounting to murder).
The Court noted that despite the doctor providing treatment, only the nurse was named as an accused by the police. However, the father of the child submitted an affidavit stating he had no grievance against the nurse and alleged that the investigation was poorly conducted to shield the actual culprits.
Considering these facts, the Court quashed the case against the nurse but clarified that the police could proceed against others if new evidence implicating them emerges.
Case Title: Celinamol Mathew v. State of Kerala
VIEW ORDER
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