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Criminal liability for medical negligence cases
in India
Under the Indian Penal Code [IPC], the following provisions deal with
medical malpractice.
Sections 52 – Good faith
Section 80 – Accident in doing a lawful act
Section 81 – Act likely to cause harm, but done without criminal
intent, and to prevent other harm
Section 83 – Act of a child above seven and under twelve of immature
understanding
Section 88 – Act not intended to cause death, done by consent in good
faith for person’s benefit
Section 90 – Consent known to be given under fear or misconception
Section 91 – Exclusion of acts which are offences independently of harm
caused
Section 92 – Act done in good faith for benefit of a person without
consent
Section 304A – Causing death by negligence
Section 337 – Causing hurt by act endangering life or personal safety
of others
Section 338 – Causing grievous hurt by act endangering life or personal
safety of others
Proving negligence
In burden for proving medical negligence lies with the complainant (the
patient). The patient must bring forth clear evidence of medical
negligence.
The National Consumer Disputes Redressal Commission as well as
the Supreme Court have held, in various cases, that the standard for
proving medical negligence against a doctor is extremely high.
A doctor patient relationship is one of trust, and normally, before
particularly risky operations, the patient is made to sign a waiver,
that excludes any liability the doctor may have if anything goes wrong.
Thus, it must be noted that it is extremely difficult to approach a
court with a case of medical negligence.
Filing a case of medical negligence
A patient can approach medical negligence from the perspective of a
consumer and go under the Consumer Protection Act, 1986, which is more
likely to yield results as opposed to going the IPC and criminal case
way.
1. A complaint can be filed in the District Consumer Disputes
Redressal Forum if the value of services and compensation claimed
is less than 20 lakh rupees, or before the State Commission, if
the value does not exceed more than 1 crore rupees. If, however,
the value of the goods or services and the compensation exceeds
more than 1 crore rupees, the National Commission is to be
approached.
2. The Forums have the power to summon the parties before it and make
their case.
3. Only monetary damages may be claimed under the Consumer Protection
Act, and no criminal liability will fall on the doctor.
What is medical negligence?
“Negligence” is the failure to exercise a duty of care towards another
person. In general, negligence has three ingredients:
1. X owes a duty of care to Y.
2. X has breached this duty.
3. X has suffered some form of injury due to this breach of duty by
Y.
In the case of medical negligence mostly the doctor is ‘X’. Negligence
is predominantly a theory of liability concerning allegations of
malpractice by medical professionals.
The following Sections of IPC are related to medical professionals:
Sec. 29: Deals with documents
29. "Document".--The word "document" denotes any matter expressed or described upon any
substance by means of letters, figures or marks, or by more than one of those means,
intended to be used, or which may be used, as evidence of that matter.
Explanation 1: It is immaterial by what means or upon what substance the letters, figures
or marks are formed, or whether the evidence is intended for, or may be used in, a Court
of Justice, or not.
Illustrations
A writing expressing the terms of a contract, which may be used as evidence of the
contract, is a document.
A cheque upon a banker is a document.
A power-of-attorney is a document.
A map or plan which is intended to be used or which may be used as evidence, is a
document.
A writing containing directions or instructions is a document.
Explanation 2.: Whatever is expressed by means of letters, figures or marks as explained
by mercantile or other usage, shall be deemed to be expressed by such letters, figures or
marks within the meaning of this section, although the same may not be actually
expressed.
Illustration
A writes his name on the back of a bill of exchange payable to his order. The meaning of
the endorsement as explained by mercantile usage, is that the bill is to be paid to the
holder. The endorsement is a document, and must be construed in the same manner as if the
words "pay to the holder" or words to that effect had been written over the signature.
Sec. 52: Describes "good faith"
"Good faith": Nothing is said to be done or believed in "good faith" which is done or
believed without due care and attention.
Sec. 90: Related to consent: Consent known to be given under fear or misconception:
A consent is not such a consent as is intended by any section of this Code, if the
consent is given by a person under fear of injury, or under a misconception of fact, and
if the person doing the act knows, or has reason to believe, that the consent was given
in consequence of such fear or misconception; or Consent of insane person.
Consent of insane person- if the consent is given by a person who, from unsoundness of
mind, or intoxication, is unable to understand the nature and consequence of that to
which he gives his consent; or Consent of child.
Consent of child.- unless the contrary appears from the context, if the consent is given
by a person who is under twelve years of age.
Sec. 176: Failure to inform police whenever essential
176. Omission to give notice or information to public servant by person legally bound to
give it: Whoever, being legally bound to give any notice or to furnish information on any
subject to any public servant, as such, intentionally omits to give such notice or to
furnish such information in the manner and at the time required by law, shall be punished
with simple imprisonment for a term which may extend to one month, or with fine which may
extend to five hundred rupees, or with both; or, if the notice or information required to
be given respects the commission of an offence, or is required for the purpose of
preventing the commission of an offence, or in order to the apprehension of an offender,
with simple imprisonment for a term which may extend to six months, or with fine which
may extend to one thousand rupees, or with both; [or, if the notice or information
required to be given is required by an order passed under sub-section (1) of section 565
of the Code of Criminal Procedure, 1898 (5 of 1898), with imprisonment of either
description for a term which may extend to six months, or with fine which may extend to
one thousand rupees, or with both.]
Sec. 269-271: Related to spread of infectious disease and disobedience of a quarantine
rule.
269. Negligent act likely to spread infection of disease dangerous to life: Whoever
unlawfully or negligently does any act which is, and which he knows or has reason to
believe to be, likely to spread the infection of any disease dangerous to life, shall be
punished with imprisonment of either description for a term which may extend to six
months, or with fine, or with both.
270. Malignant act likely to spread infection of disease dangerous to life:
Whoever malignantly does any act which is, and which he knows or has reason to believe to
be, likely to spread the infection of any disease dangerous to life, shall be punished
with imprisonment of either description for a term which may extend to two years, or with
fine, or with both.
271. Disobedience to quarantine rule: Whoever knowingly disobeys any rule made and
promulgated for putting any vessel into a state of quarantine, or for regulating the
intercourse of vessels in a state of quarantine with the shore or with other vessels, for
regulating the intercourse between places where an infectious disease prevails and other
places, shall be punished with imprisonment of either description for a term which may
extend to six months, or with fine, or with both.
Sec. 272-273: Related to adulteration of food and drinks.
272. Adulteration of food or drink intended for sale: Whoever adulterates any article of
food or drink, so as to make such article noxious as food or drink, intending to sell
such article as food or drink, or knowing it to be likely that the same will be sold as
food or drink, shall be punished with imprisonment of either description for a term which
may extend to six months, or with fine which may extend to one thousand rupees, or with
both.
273. Sale of noxious food or drink: Whoever sells, or offers or exposes for sale, as food
or drink, any article which has been rendered or has become noxious, or is in a state
unfit for food or drink, knowing or having reason to believe that the same is noxious as
food or drink, shall be punished with imprisonment of either description for a term which
may extend to six months, or with fine which may extend to one thousand rupees, or with
both.
Sec. 274-276: Related to adulteration of drugs.
274. Adulteration of drugs: Whoever adulterates any drug or medical preparation in such
a manner as to lessen the efficacy or change the operation of such drug or medical
preparation, or to make it noxious, intending that it shall be sold or used for, or
knowing it to be likely that it will be sold or used for, any medicinal purpose, as it
had not undergone such adulteration, shall be punished with imprisonment of either
description for a term which may extend to six months, or with fine which may extend to
one thousand rupees, or with both.
275. Sale of adulterated drugs.--Whoever, knowing any drug or medical preparation to
have been adulterated in such a manner as to lessen its efficacy, to change its
operation, or to render it noxious, sells the same, or offers or exposes it for sale, or
issues it from any dispensary for medicinal purposes as unadulterated, or causes it to be
used for medicinal purposes by any person not knowing of the adulteration, shall be
punished with imprisonment of either description for a term which may extend to six
months, or with fine which may extend to one thousand rupees, or with both.
276. Sale of drug as a different drug or preparation: Whoever knowingly sells, or offers
or exposes for sale, or issues from a dispensary for medicinal purposes, any drug or
medical preparation, as a different drug or medical preparation, shall be punished with
imprisonment of either description for a term which may extend to six months, or with
fine which may extend to one thousand rupees, or with both.
Sec. 304-A: Deals with death caused by a negligent act.
Causing death by negligence: Whoever causes the death of any person by doing any rash or
negligent act not amounting to culpable homicide shall be punished with imprisonment of
either description for a term which may extend to two years, or with fine, or with both.]
Sec. 306-309: Related with abatement of suicide.
306. Abetment of suicide: If any person commits suicide, whoever abets the commission of
such suicide, shall be punished with imprisonment of either description for a term which
may extend to ten years, and shall also be liable to fine.
307. Attempt to murder: Whoever does any act with such intention or knowledge, and under
such circumstances that, if he by that act caused death, he would be guilty of murder,
shall be punished with imprisonment of either description for a term which may extend to
ten years, and shall also be liable to fine; and, if hurt is caused to any person by such
act, the offender shall be liable either to [imprisonment for life], or to such
punishment as is herein before mentioned.
Attempts by life-convicts.
Attempts by life-convicts: [When any person offending under this section is under
sentence of [imprisonment for life], he may, if hurt is caused, be punished with death.]
Illustrations
(a) A shoots at Z with intention to kill him, under such circumstances that, if death
ensued A would be guilty of murder. A is liable to punishment under this section
(b) A, with the intention of causing the death of a child of tender years, exposes it in
a desert place A has committed the offence defined by this section, though the death of
the child does not ensue.
(c) A, intending to murder Z, buys a gun and loads it. A has not yet committed the
offence. A fires the gun at Z. He has committed the offence defined in this section, and,
if by such firing he wounds Z, he is liable to the punishment provided by the latter part
of 3*[the first paragraph of] this section.
(d) A, intending to murder Z by poison, purchases poison and mixes the same with food
which remains in A's keeping; A has not yet committed the offence in this section. A
places the food on Z's table or delivers it to Z's servants to place it on Z's table. A
has committed the offence defined in this section.
308. Attempt to commit culpable homicide: Whoever does any act with such intention or
knowledge and under such circumstances that, if he by that act caused death, he would be
guilty of culpable homicide not amounting to murder, shall be punished with imprisonment
of either description for a term which may extend to three years, or with fine, or with
both; and, if hurt is caused to any person by such act, shall be punished with
imprisonment of either description for a term which may extend to seven years, or with
fine, or with both.
Illustration
A, on grave and sudden provocation, fires a pistol at Z, under such circumstances that if
he there by caused death he would be guilty of culpable homicide not amounting to murder.
A has committed the offence defined in this section.
309. Attempt to commit suicide.--Whoever attempts to commit suicide and does any act
towards the commission of such offence, shall be punished with simple imprisonment for a
term which may extend to one year 1*[or with fine, or with both.]
Sec. 312-314: Related to causing mis-carriage, abortion and hiding such facts.
312. Causing miscarraige.--Whoever voluntarily causes a woman with child to miscarry,
shall if such miscarriage be not caused in good faith for the purpose of saving the life
of the woman, be punished with imprisonment of either description for a term which may
extend to three years, or with fine, or with both; and, if the woman be quick with child,
shall be punished with imprisonment of either description for a term which may extend to
seven years, and shall also be liable to fine.
Explanation.-A woman who causes herself to miscarry, is within
the meaning of this section.
313. Causing miscarriage without woman's consent.—Whoever commits the offence defined in
the last preceding section without the consent of the woman, whether the woman is quick
with child or not, shall be punished with [imprisonment for life], or with imprisonment
of either description for a term which may extend to ten years, and shall also be liable
to fine.
314. Death caused by act done with intent to cause miscarriage:
Whoever, with intent to cause the miscarriage of a woman with child, does any act which
causes the death of such woman, shall be punished with imprisonment of either description
for a term which may extend to ten years, and shall also be liable to fine; if act done
without woman's consent, if act done without woman's consent and if the act is done
without the consent of the woman, shall be punished either with [imprisonment for life],
or with the punishment above mentioned.
Explanation.-It is not essential to this offence that the offender should know that the
act is likely to cause death.
Sec. 315-316: Deals with act to prevent child being born alive or to cause it to die
after birth.
Section 315: Act done with intent to prevent child being born alive or to cause it to die
after birth: Whoever before the birth of any child does any act with the intention of
thereby preventing that child from being born alive or causing it to die after its birth,
and does by such act prevent that child from being born alive, or causes it to die after
its birth, shall, if such act be not caused in good faith for the purpose of saving the
life of the mother, be punished with imprisonment of either description for a term which
may extend to ten years, or with fine, or with both.
Section 316: Causing death of quick unborn child by act amounting to culpable homicide:
Whoever does any act under such circumstances, that if he thereby caused death he would
be guilty of culpable homicide, and does by such act cause the death of a quick unborn
child, shall be punished with imprisonment of either description for a term which may
extend to ten years, and shall also be liable to fine.
Illustration
A, knowing that he is likely to cause the death of a pregnant woman, does an act which,
if it caused the death of the woman, would amount to culpable homicide. The woman is
injured, but does not die; but the death of an unborn quick child with which she is
pregnant is thereby caused. A is guilty of the offence defined in this section.
Sec. 319-322: Related to causing hurt, grievous hurt, loss of vision, loss of hearing or
disfigurement.
319. Hurt: Whoever causes bodily pain, disease or infirmity to any person is said to
cause hurt.
320. Grievous hurt: The following kinds of hurt only are designated as "grievous":-
First, Emasculation.
Secondly, Permanent privation of the sight of either eye.
Thirdly, Permanent privation of the hearing of either ear.
Fourthly, Privation of any member or joint.
Fifthly, Destruction or permanent impairing of the powers of any member or joint.
Sixthly, Permanent disfiguration of the head or face.
Seventhly, Fracture or dislocation of a bone or tooth.
Eighthly, Any hurt which endangers life or which causes the sufferer to be during the
space of twenty days in severe bodily pain, or unable to follow his ordinary pursuits.
321. Voluntarily causing hurt: Whoever does any act with the intention of thereby causing
hurt to any person, or with the knowledge that he is likely thereby to cause hurt to any
person, and does thereby cause hurt to any person, is said "voluntarily to cause hurt".
322. Voluntarily causing grievous hurt: Whoever voluntarily causes hurt, if the hurt
which he intends to cause or knows himself to be likely to cause is grievous hurt, and if
the hurt which he causes is grievous hurt, is said "voluntarily to cause grievous hurt".
Explanation - A person is not said voluntarily to cause grievous hurt except when he both
causes grievous hurt and intends or knows himself to be likely to cause grievous hurt.
But he is said voluntarily to cause grievous hurt, if intending or knowing himself to be
likely to cause grievous hurt of one kind, he actually causes grievous hurt of another
kind.
Illustration
A, intending of knowing himself to be likely permanently to disfigure Z's face, gives Z a
blow which does not permanently disfigure Z's face, but which causes Z to suffer severe
bodily pain for the space of twenty days. A has voluntarily caused grievous hurt.
Sec. 336-338: Deals with causing hurt by rash or negligent act.
336. Act endangering life or personal safety of others: Whoever does any act so rashly or
negligently as to endanger human life or the personal safety others, shall be punished
with imprisonment of either description for a term which may extend to three months or
with fine which may extend to two hundred and fifty rupees, or with both.
337. Causing hurt by act endangering life or personal safety of Others: Whoever causes
hurt to any person by doing any act so rashly or negligently as to endanger human life,
or the personal safety of others, shall be punished with imprisonment of either
description for a term which may extend to six months, or with fine which may extend to
five hundred rupees, or with both.
338. Causing grievous hurt by act endangering life or personal safety of others.--Whoever
causes grievous hurt to any person by doing any act so rashly or negligently as to
endanger human life, or the personal safety of others, shall be punished with
imprisonment of either description for a term which may extend to two years, or with fine
which may extend to one thousand rupees, or with both.
Of wrongful restraint and wrongful confinement.
Sec. 340-342: Related to wrongful confinement.
Section 340: Wrongful confinement: Whoever wrongfully restrains any person in such a
manner as to prevent that person from proceeding beyond certain circumscribing limits, is
said "wrongfully to confine" that person.
Illustrations
(a) A causes Z to go within a walled space, and locks Z. Z is thus prevented from
proceeding in any direction beyond the circumscribing line of wall. A wrongfully confines
z.
(b) A places men with firearms at the outlets of a building, and tells Z that they will
fire at Z if Z attempts leave the building. A wrongfully confines Z.
341. Punishment for wrongful restraint: Whoever wrongfully restrains any person shall be
punished with simple imprisonment for a term which may extend to one month, or with fine
which may extend to five hundred rupees, or with both.
342. Punishment for wrongful confinement: Whoever wrongfully confines any person shall be
punished with simple imprisonment of either description for a term which may extend to
one year, or with fine which may extend to one thousand rupees, or with both.
Sec. 491: Related to breech of contract.
Breach of contract to attend on and supply wants of helpless Person: Whoever, being bound
by a lawful contract to attend on or to supply the wants of any person who, by reason of
youth, or of unsoundness of mind, or of a disease or bodily weakness, is helpless or
incapable of providing for his own safety or of supplying his own wants, voluntarily
omits so to do, shall be punished with imprisonment of either description for a term
which may extend to three months, or with fine which may extend to two hundred rupees, or
with both.
Sec. 499: Related to defamation.
Defamation: Whoever by words either spoken or intended to be read, or by signs or by
visible representations, makes or publishes any imputation concerning any person
intending to harm, or knowing or having reason to believe that such imputation will harm,
the reputation of such person, is said, except in the cases hereinafter excepted, to
defame that person.
Explanation 1- It may amount to defamation to impute anything to a deceased person, if
the imputation would harm the reputation of that person if living, and is intended to be
hurtful to the fellings of his family or other near relatives.
Explanation 2 - It may amount to defamation to make an imputation concerning a company or
an association or collection of persons as such.
Explanation 3- An imputation in the form of an alternative or expressed ironically, may
amount to defamation.
Explanation 4- No imputation is said to harm a person's reputation, unless that
imputation directly or indirectly, in the estimation of others, lowers the moral or
intellectual character of that person, or lowers the character of that person in respect
of his caste or of his calling, or lowers the credit of that person, or causes it to be
believed that the body of that person is in a loathsome state, or in a state generally
considered as disgraceful.
Illustrations
(a) A says-"Z is an honest man; he never stole B's watch",intending to cause it to be
believed that Z did steal B's watch. This is defamation, unless it fall within one of the
exceptions.
(b) A is asked who stole B's watch. A points to Z, intending to cause it to be believed
that Z stole B's watch. This is defamation, unless it fall within one of the exceptions.
(c) A draws a picture of Z running away with B's watch, intending it to be believed that
Z stole B's watch. This is defamation, unless it fall within one of the exceptions.
First Exception- Imputation of truth which public good requires to be made or published-
It is not defamation to impute anything which is true concerning any person, if it be for
the public good that the imputation should be made or published. Whether or not it is for
the public good is a question of fact.
Second Exception- Public conduct of public servants.-It is not defamation to express in
good faith any opinion whatever respecting the conduct of a public servant in the
discharge of his public functions, or respecting his character, so far as his character
appears in that conduct, and no further.
Third Exception- Conduct of any person touching any public question. -It is not
defamation to express in good faith any opinion whatever respecting the conduct of any
person touching any public question, and respecting his character, so far as his
character appears in that conduct, and no further.
Illustration
It is not defamation in A to express in good faith any opinion whatever resepting Z's
conduct in petitioning Government on a public question, in signing a requisition for a
meeting on a public question, in presiding or attending at such meeting, in forming or
joining any society which invites the public support, in voting or canvassing for a
particular candidate for any situation in the efficient discharge of the duties of which
the public is interested.
Fourth Exception- Publication of reports of proceedings of courts- It is not defamation
to publish a substantially true report of the proceedings of a Court of Justice, or of
the result of any such proceedings.
Explanation.-A Justice of the Peace or other officer holding an enquiry in open Court
preliminary to a trial in a Court of Justice, is a Court within the meaning of the above
section.
Fifth Exception- Merits of case decided in Court or conduct of witnesses and others
concerned. It is not defamation to express in good faith any opinion whatever respecting
the merits of any case, civil or criminal, which has been decided by a Court of Justice,
or respecting the conduct of any person as a party, witness or agent, in any such case,
or respecting the character of such person, as far as his character appears in that
conduct, and no further.
Illustrations
(a) A says-"I think Z's evidence on that trial is so contradictory that he must be stupid
or dishonest." A is within this exception if he says this in good faith, inasmuch as the
opinion which he expresses respects Z's character as it appears in Z's conduct as a
witness, and no farther.
(b) But if A says-"I do not believe what Z asserted at that trial because I know him to
be a man without veracity"; A is not within this exception, inasmuch as the opinion which
expresses of Z's character, is an opinion not founded on Z's conduct as a witness.
Sixth Exception- Merits of public performance.-It is not defamation to express in good
faith any opinion respecting the merits of any performance which its author has submitted
to the judgment of the public, or respecting the character of the author so far as his
character appears in such performance, and no farther.
Explanation- A performance may be submitted to the judgment of the public expressly or by
acts on the part of the author which imply such submission to the judgment of the public.
Illustrations
(a) A person who publishes a book, submits that book to the judgment of the public.
(b) A person who makes a speech in public, submits that speech to the judgment of the
public.
(c) An actor or singer who appears on a public stage, submits his acting or singing to
the judgment of the public.
(d) A says of a book published by Z-"Z's book is foolish; Z must be a weak man. Z's book
is indecent; Z must be a man of impure mind." A is within the exception, if he says this
in good faith, inasmuch as the opinion which he expresses of Z respects Z's character
only so far as it appears in Z's book, and no further.
(e) But if A says-"I am not surprised that Z's book is foolish and indecent, for he is a
weak man and a libertine." A is not within this exception, inasmuch as the opinion which
he expresses of Z's character is an opinion not founded on Z's book.
Seventh Exception- Censure passed in good faith by person having lawful authority over
another.-It is not defamation in a person having over another any authority, either
conferred by law or arising out of a lawful contract made with that other, to pass in
good faith any censure on the conduct of that other in matters to which such lawful
authority relates.
Illustration
A Judge censuring in good faith the conduct of a witness, or of an officer of the Court;
a head of a department censuring in good faith those who are under his orders; a parent
censuring in good faith a child in the presence of other children; a schoolmaster, whose
authority is derived from a parent, censuring in good faith a pupil in the presence of
other pupils; a master censuring a servant in good faith for remissness in service; a
banker censuring in good faith the cashier of his bank for the conduct of such cashier as
such cashier are within this exception.
Eighth Exception- Accusation preferred in good faith to authorised person - It is not
defamation to prefer in good faith an accusation against any person to any of those who
have lawful authority over that person with respect to the subject-matter of accusation.
Illustration
If A in good faith accuses Z before a Magistrate; if A in good faith complains of the
conduct of Z, a servant, to Z's master;if A in good faith complains of the conduct of Z,
a child, to Z's father-A is within this exception.
Ninth Exception- Imputation made in good faith by person for protection of his or other's
interests.-It is not defamation to make an imputation on the character of another
provided that the imputation be made in good faith for the protection of the interest of
the person making it, or of any other person, or for the public good.
Illustrations
(a) A, a shopkeeper, says to B, who manages his business-"Sell nothing to Z unless he
pays you ready money, for I have no opinion of his honesty." A is within the exception,
if he has made this imputation on Z in good faith for the protection of his own
interests.
(b) A, a Magistrate, in making a report to his own superior officer, casts an imputation
on the character of Z. Here, if the imputation is made in good faith, and for the public
good, A is within the exception.
Tenth Exception: Caution intended for good of person to whom conveyed or for public good-
It is not defamation to convey a caution, in good faith, to one person against another,
provided that such caution be intended for the good of the person to whom it is conveyed,
or of some person in whom that person is interested, or for the public good.
Section 304 and 304-A
There is lot of discrepancy while applying these sections in cases of professional
negligence by doctors. Most of the times the police authorities register the cases of
professional negligence deaths under Sec. 304 of IPC. According to this Section the
offence is non-bailable. This causes lot of hardship, bad reputation and mental agony to
the doctors. In fact the police should register the cases of deaths due to medical
negligence under Sec. 304-A of IPC, in which the offence is bailable and the doctor can
be released on bail. The judgment has been passed by Bombay High Court in Criminal
Revision application no. 282 of 1996 (Dr. Mrs. Mrudula S. Deshpandevs State of
Maharashtra) dated 28th November 1998(3). The basic difference is that in Sec. 304 there
is intentional act of negligence while in 304-A the act is never done with the intention
to cause death.
Grievous hurt
Sec. 319-322 of IPC are related to causing grievous hurt for example loss of limbs, loss
of vision, loss of hearing or disfigurement etc. Sec. 336-338 deal with causing grievous
hurt by rash or negligent act.
Examples: (1) While giving IV fluids suppose there is leakage of fluid in surrounding
tissue resulting in spasm of vessels and subsequent necrosis of limbs. (2) A surgical
procedure is done on eye, limbs, face etc. without adequate aseptic precautions resulting
in local infection. This may lead to loss of eyes, limb or disfigurement of face, (3) An
unqualified doctor performing surgical procedure which results in permanent damage to
eyes, limbs, hearing etc.
Wrongful confinement (Sec. 340-342 of IPC)
A patient cannot be detained on the grounds of non-payment of hospital charges. This may
constitute the offense of wrongful confinement under Sec. 340-342 of IPC. Doctors can
take advance or fee from the patient before starting the treatment.
If a police officer is keeping the doctor in detention, in cases of bailable offenses, he
is liable for the offense of wrongful confinement under these Sections of IPC.

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Criminal liability for medical negligence cases in india

  • 1. Criminal liability for medical negligence cases in India Under the Indian Penal Code [IPC], the following provisions deal with medical malpractice. Sections 52 – Good faith Section 80 – Accident in doing a lawful act Section 81 – Act likely to cause harm, but done without criminal intent, and to prevent other harm Section 83 – Act of a child above seven and under twelve of immature understanding Section 88 – Act not intended to cause death, done by consent in good faith for person’s benefit Section 90 – Consent known to be given under fear or misconception Section 91 – Exclusion of acts which are offences independently of harm caused Section 92 – Act done in good faith for benefit of a person without consent Section 304A – Causing death by negligence Section 337 – Causing hurt by act endangering life or personal safety of others Section 338 – Causing grievous hurt by act endangering life or personal safety of others Proving negligence
  • 2. In burden for proving medical negligence lies with the complainant (the patient). The patient must bring forth clear evidence of medical negligence. The National Consumer Disputes Redressal Commission as well as the Supreme Court have held, in various cases, that the standard for proving medical negligence against a doctor is extremely high. A doctor patient relationship is one of trust, and normally, before particularly risky operations, the patient is made to sign a waiver, that excludes any liability the doctor may have if anything goes wrong. Thus, it must be noted that it is extremely difficult to approach a court with a case of medical negligence. Filing a case of medical negligence A patient can approach medical negligence from the perspective of a consumer and go under the Consumer Protection Act, 1986, which is more likely to yield results as opposed to going the IPC and criminal case way. 1. A complaint can be filed in the District Consumer Disputes Redressal Forum if the value of services and compensation claimed is less than 20 lakh rupees, or before the State Commission, if the value does not exceed more than 1 crore rupees. If, however, the value of the goods or services and the compensation exceeds more than 1 crore rupees, the National Commission is to be approached. 2. The Forums have the power to summon the parties before it and make their case. 3. Only monetary damages may be claimed under the Consumer Protection Act, and no criminal liability will fall on the doctor. What is medical negligence? “Negligence” is the failure to exercise a duty of care towards another person. In general, negligence has three ingredients:
  • 3. 1. X owes a duty of care to Y. 2. X has breached this duty. 3. X has suffered some form of injury due to this breach of duty by Y. In the case of medical negligence mostly the doctor is ‘X’. Negligence is predominantly a theory of liability concerning allegations of malpractice by medical professionals. The following Sections of IPC are related to medical professionals: Sec. 29: Deals with documents 29. "Document".--The word "document" denotes any matter expressed or described upon any substance by means of letters, figures or marks, or by more than one of those means, intended to be used, or which may be used, as evidence of that matter. Explanation 1: It is immaterial by what means or upon what substance the letters, figures or marks are formed, or whether the evidence is intended for, or may be used in, a Court of Justice, or not. Illustrations A writing expressing the terms of a contract, which may be used as evidence of the contract, is a document. A cheque upon a banker is a document. A power-of-attorney is a document. A map or plan which is intended to be used or which may be used as evidence, is a document. A writing containing directions or instructions is a document. Explanation 2.: Whatever is expressed by means of letters, figures or marks as explained by mercantile or other usage, shall be deemed to be expressed by such letters, figures or marks within the meaning of this section, although the same may not be actually expressed. Illustration A writes his name on the back of a bill of exchange payable to his order. The meaning of the endorsement as explained by mercantile usage, is that the bill is to be paid to the holder. The endorsement is a document, and must be construed in the same manner as if the words "pay to the holder" or words to that effect had been written over the signature.
  • 4. Sec. 52: Describes "good faith" "Good faith": Nothing is said to be done or believed in "good faith" which is done or believed without due care and attention. Sec. 90: Related to consent: Consent known to be given under fear or misconception: A consent is not such a consent as is intended by any section of this Code, if the consent is given by a person under fear of injury, or under a misconception of fact, and if the person doing the act knows, or has reason to believe, that the consent was given in consequence of such fear or misconception; or Consent of insane person. Consent of insane person- if the consent is given by a person who, from unsoundness of mind, or intoxication, is unable to understand the nature and consequence of that to which he gives his consent; or Consent of child. Consent of child.- unless the contrary appears from the context, if the consent is given by a person who is under twelve years of age. Sec. 176: Failure to inform police whenever essential 176. Omission to give notice or information to public servant by person legally bound to give it: Whoever, being legally bound to give any notice or to furnish information on any subject to any public servant, as such, intentionally omits to give such notice or to furnish such information in the manner and at the time required by law, shall be punished with simple imprisonment for a term which may extend to one month, or with fine which may extend to five hundred rupees, or with both; or, if the notice or information required to be given respects the commission of an offence, or is required for the purpose of preventing the commission of an offence, or in order to the apprehension of an offender, with simple imprisonment for a term which may extend to six months, or with fine which may extend to one thousand rupees, or with both; [or, if the notice or information required to be given is required by an order passed under sub-section (1) of section 565 of the Code of Criminal Procedure, 1898 (5 of 1898), with imprisonment of either description for a term which may extend to six months, or with fine which may extend to one thousand rupees, or with both.] Sec. 269-271: Related to spread of infectious disease and disobedience of a quarantine rule. 269. Negligent act likely to spread infection of disease dangerous to life: Whoever unlawfully or negligently does any act which is, and which he knows or has reason to believe to be, likely to spread the infection of any disease dangerous to life, shall be punished with imprisonment of either description for a term which may extend to six months, or with fine, or with both. 270. Malignant act likely to spread infection of disease dangerous to life: Whoever malignantly does any act which is, and which he knows or has reason to believe to be, likely to spread the infection of any disease dangerous to life, shall be punished
  • 5. with imprisonment of either description for a term which may extend to two years, or with fine, or with both. 271. Disobedience to quarantine rule: Whoever knowingly disobeys any rule made and promulgated for putting any vessel into a state of quarantine, or for regulating the intercourse of vessels in a state of quarantine with the shore or with other vessels, for regulating the intercourse between places where an infectious disease prevails and other places, shall be punished with imprisonment of either description for a term which may extend to six months, or with fine, or with both. Sec. 272-273: Related to adulteration of food and drinks. 272. Adulteration of food or drink intended for sale: Whoever adulterates any article of food or drink, so as to make such article noxious as food or drink, intending to sell such article as food or drink, or knowing it to be likely that the same will be sold as food or drink, shall be punished with imprisonment of either description for a term which may extend to six months, or with fine which may extend to one thousand rupees, or with both. 273. Sale of noxious food or drink: Whoever sells, or offers or exposes for sale, as food or drink, any article which has been rendered or has become noxious, or is in a state unfit for food or drink, knowing or having reason to believe that the same is noxious as food or drink, shall be punished with imprisonment of either description for a term which may extend to six months, or with fine which may extend to one thousand rupees, or with both. Sec. 274-276: Related to adulteration of drugs. 274. Adulteration of drugs: Whoever adulterates any drug or medical preparation in such a manner as to lessen the efficacy or change the operation of such drug or medical preparation, or to make it noxious, intending that it shall be sold or used for, or knowing it to be likely that it will be sold or used for, any medicinal purpose, as it had not undergone such adulteration, shall be punished with imprisonment of either description for a term which may extend to six months, or with fine which may extend to one thousand rupees, or with both. 275. Sale of adulterated drugs.--Whoever, knowing any drug or medical preparation to have been adulterated in such a manner as to lessen its efficacy, to change its operation, or to render it noxious, sells the same, or offers or exposes it for sale, or issues it from any dispensary for medicinal purposes as unadulterated, or causes it to be used for medicinal purposes by any person not knowing of the adulteration, shall be punished with imprisonment of either description for a term which may extend to six months, or with fine which may extend to one thousand rupees, or with both. 276. Sale of drug as a different drug or preparation: Whoever knowingly sells, or offers or exposes for sale, or issues from a dispensary for medicinal purposes, any drug or medical preparation, as a different drug or medical preparation, shall be punished with imprisonment of either description for a term which may extend to six months, or with fine which may extend to one thousand rupees, or with both.
  • 6. Sec. 304-A: Deals with death caused by a negligent act. Causing death by negligence: Whoever causes the death of any person by doing any rash or negligent act not amounting to culpable homicide shall be punished with imprisonment of either description for a term which may extend to two years, or with fine, or with both.] Sec. 306-309: Related with abatement of suicide. 306. Abetment of suicide: If any person commits suicide, whoever abets the commission of such suicide, shall be punished with imprisonment of either description for a term which may extend to ten years, and shall also be liable to fine. 307. Attempt to murder: Whoever does any act with such intention or knowledge, and under such circumstances that, if he by that act caused death, he would be guilty of murder, shall be punished with imprisonment of either description for a term which may extend to ten years, and shall also be liable to fine; and, if hurt is caused to any person by such act, the offender shall be liable either to [imprisonment for life], or to such punishment as is herein before mentioned. Attempts by life-convicts. Attempts by life-convicts: [When any person offending under this section is under sentence of [imprisonment for life], he may, if hurt is caused, be punished with death.] Illustrations (a) A shoots at Z with intention to kill him, under such circumstances that, if death ensued A would be guilty of murder. A is liable to punishment under this section (b) A, with the intention of causing the death of a child of tender years, exposes it in a desert place A has committed the offence defined by this section, though the death of the child does not ensue. (c) A, intending to murder Z, buys a gun and loads it. A has not yet committed the offence. A fires the gun at Z. He has committed the offence defined in this section, and, if by such firing he wounds Z, he is liable to the punishment provided by the latter part of 3*[the first paragraph of] this section. (d) A, intending to murder Z by poison, purchases poison and mixes the same with food which remains in A's keeping; A has not yet committed the offence in this section. A places the food on Z's table or delivers it to Z's servants to place it on Z's table. A has committed the offence defined in this section. 308. Attempt to commit culpable homicide: Whoever does any act with such intention or knowledge and under such circumstances that, if he by that act caused death, he would be guilty of culpable homicide not amounting to murder, shall be punished with imprisonment
  • 7. of either description for a term which may extend to three years, or with fine, or with both; and, if hurt is caused to any person by such act, shall be punished with imprisonment of either description for a term which may extend to seven years, or with fine, or with both. Illustration A, on grave and sudden provocation, fires a pistol at Z, under such circumstances that if he there by caused death he would be guilty of culpable homicide not amounting to murder. A has committed the offence defined in this section. 309. Attempt to commit suicide.--Whoever attempts to commit suicide and does any act towards the commission of such offence, shall be punished with simple imprisonment for a term which may extend to one year 1*[or with fine, or with both.] Sec. 312-314: Related to causing mis-carriage, abortion and hiding such facts. 312. Causing miscarraige.--Whoever voluntarily causes a woman with child to miscarry, shall if such miscarriage be not caused in good faith for the purpose of saving the life of the woman, be punished with imprisonment of either description for a term which may extend to three years, or with fine, or with both; and, if the woman be quick with child, shall be punished with imprisonment of either description for a term which may extend to seven years, and shall also be liable to fine. Explanation.-A woman who causes herself to miscarry, is within the meaning of this section. 313. Causing miscarriage without woman's consent.—Whoever commits the offence defined in the last preceding section without the consent of the woman, whether the woman is quick with child or not, shall be punished with [imprisonment for life], or with imprisonment of either description for a term which may extend to ten years, and shall also be liable to fine. 314. Death caused by act done with intent to cause miscarriage: Whoever, with intent to cause the miscarriage of a woman with child, does any act which causes the death of such woman, shall be punished with imprisonment of either description for a term which may extend to ten years, and shall also be liable to fine; if act done without woman's consent, if act done without woman's consent and if the act is done without the consent of the woman, shall be punished either with [imprisonment for life], or with the punishment above mentioned. Explanation.-It is not essential to this offence that the offender should know that the act is likely to cause death.
  • 8. Sec. 315-316: Deals with act to prevent child being born alive or to cause it to die after birth. Section 315: Act done with intent to prevent child being born alive or to cause it to die after birth: Whoever before the birth of any child does any act with the intention of thereby preventing that child from being born alive or causing it to die after its birth, and does by such act prevent that child from being born alive, or causes it to die after its birth, shall, if such act be not caused in good faith for the purpose of saving the life of the mother, be punished with imprisonment of either description for a term which may extend to ten years, or with fine, or with both. Section 316: Causing death of quick unborn child by act amounting to culpable homicide: Whoever does any act under such circumstances, that if he thereby caused death he would be guilty of culpable homicide, and does by such act cause the death of a quick unborn child, shall be punished with imprisonment of either description for a term which may extend to ten years, and shall also be liable to fine. Illustration A, knowing that he is likely to cause the death of a pregnant woman, does an act which, if it caused the death of the woman, would amount to culpable homicide. The woman is injured, but does not die; but the death of an unborn quick child with which she is pregnant is thereby caused. A is guilty of the offence defined in this section. Sec. 319-322: Related to causing hurt, grievous hurt, loss of vision, loss of hearing or disfigurement. 319. Hurt: Whoever causes bodily pain, disease or infirmity to any person is said to cause hurt. 320. Grievous hurt: The following kinds of hurt only are designated as "grievous":- First, Emasculation. Secondly, Permanent privation of the sight of either eye. Thirdly, Permanent privation of the hearing of either ear. Fourthly, Privation of any member or joint. Fifthly, Destruction or permanent impairing of the powers of any member or joint. Sixthly, Permanent disfiguration of the head or face. Seventhly, Fracture or dislocation of a bone or tooth. Eighthly, Any hurt which endangers life or which causes the sufferer to be during the space of twenty days in severe bodily pain, or unable to follow his ordinary pursuits.
  • 9. 321. Voluntarily causing hurt: Whoever does any act with the intention of thereby causing hurt to any person, or with the knowledge that he is likely thereby to cause hurt to any person, and does thereby cause hurt to any person, is said "voluntarily to cause hurt". 322. Voluntarily causing grievous hurt: Whoever voluntarily causes hurt, if the hurt which he intends to cause or knows himself to be likely to cause is grievous hurt, and if the hurt which he causes is grievous hurt, is said "voluntarily to cause grievous hurt". Explanation - A person is not said voluntarily to cause grievous hurt except when he both causes grievous hurt and intends or knows himself to be likely to cause grievous hurt. But he is said voluntarily to cause grievous hurt, if intending or knowing himself to be likely to cause grievous hurt of one kind, he actually causes grievous hurt of another kind. Illustration A, intending of knowing himself to be likely permanently to disfigure Z's face, gives Z a blow which does not permanently disfigure Z's face, but which causes Z to suffer severe bodily pain for the space of twenty days. A has voluntarily caused grievous hurt. Sec. 336-338: Deals with causing hurt by rash or negligent act. 336. Act endangering life or personal safety of others: Whoever does any act so rashly or negligently as to endanger human life or the personal safety others, shall be punished with imprisonment of either description for a term which may extend to three months or with fine which may extend to two hundred and fifty rupees, or with both. 337. Causing hurt by act endangering life or personal safety of Others: Whoever causes hurt to any person by doing any act so rashly or negligently as to endanger human life, or the personal safety of others, shall be punished with imprisonment of either description for a term which may extend to six months, or with fine which may extend to five hundred rupees, or with both. 338. Causing grievous hurt by act endangering life or personal safety of others.--Whoever causes grievous hurt to any person by doing any act so rashly or negligently as to endanger human life, or the personal safety of others, shall be punished with imprisonment of either description for a term which may extend to two years, or with fine which may extend to one thousand rupees, or with both. Of wrongful restraint and wrongful confinement. Sec. 340-342: Related to wrongful confinement. Section 340: Wrongful confinement: Whoever wrongfully restrains any person in such a manner as to prevent that person from proceeding beyond certain circumscribing limits, is said "wrongfully to confine" that person. Illustrations
  • 10. (a) A causes Z to go within a walled space, and locks Z. Z is thus prevented from proceeding in any direction beyond the circumscribing line of wall. A wrongfully confines z. (b) A places men with firearms at the outlets of a building, and tells Z that they will fire at Z if Z attempts leave the building. A wrongfully confines Z. 341. Punishment for wrongful restraint: Whoever wrongfully restrains any person shall be punished with simple imprisonment for a term which may extend to one month, or with fine which may extend to five hundred rupees, or with both. 342. Punishment for wrongful confinement: Whoever wrongfully confines any person shall be punished with simple imprisonment of either description for a term which may extend to one year, or with fine which may extend to one thousand rupees, or with both. Sec. 491: Related to breech of contract. Breach of contract to attend on and supply wants of helpless Person: Whoever, being bound by a lawful contract to attend on or to supply the wants of any person who, by reason of youth, or of unsoundness of mind, or of a disease or bodily weakness, is helpless or incapable of providing for his own safety or of supplying his own wants, voluntarily omits so to do, shall be punished with imprisonment of either description for a term which may extend to three months, or with fine which may extend to two hundred rupees, or with both. Sec. 499: Related to defamation. Defamation: Whoever by words either spoken or intended to be read, or by signs or by visible representations, makes or publishes any imputation concerning any person intending to harm, or knowing or having reason to believe that such imputation will harm, the reputation of such person, is said, except in the cases hereinafter excepted, to defame that person. Explanation 1- It may amount to defamation to impute anything to a deceased person, if the imputation would harm the reputation of that person if living, and is intended to be hurtful to the fellings of his family or other near relatives. Explanation 2 - It may amount to defamation to make an imputation concerning a company or an association or collection of persons as such. Explanation 3- An imputation in the form of an alternative or expressed ironically, may amount to defamation. Explanation 4- No imputation is said to harm a person's reputation, unless that imputation directly or indirectly, in the estimation of others, lowers the moral or intellectual character of that person, or lowers the character of that person in respect of his caste or of his calling, or lowers the credit of that person, or causes it to be
  • 11. believed that the body of that person is in a loathsome state, or in a state generally considered as disgraceful. Illustrations (a) A says-"Z is an honest man; he never stole B's watch",intending to cause it to be believed that Z did steal B's watch. This is defamation, unless it fall within one of the exceptions. (b) A is asked who stole B's watch. A points to Z, intending to cause it to be believed that Z stole B's watch. This is defamation, unless it fall within one of the exceptions. (c) A draws a picture of Z running away with B's watch, intending it to be believed that Z stole B's watch. This is defamation, unless it fall within one of the exceptions. First Exception- Imputation of truth which public good requires to be made or published- It is not defamation to impute anything which is true concerning any person, if it be for the public good that the imputation should be made or published. Whether or not it is for the public good is a question of fact. Second Exception- Public conduct of public servants.-It is not defamation to express in good faith any opinion whatever respecting the conduct of a public servant in the discharge of his public functions, or respecting his character, so far as his character appears in that conduct, and no further. Third Exception- Conduct of any person touching any public question. -It is not defamation to express in good faith any opinion whatever respecting the conduct of any person touching any public question, and respecting his character, so far as his character appears in that conduct, and no further. Illustration It is not defamation in A to express in good faith any opinion whatever resepting Z's conduct in petitioning Government on a public question, in signing a requisition for a meeting on a public question, in presiding or attending at such meeting, in forming or joining any society which invites the public support, in voting or canvassing for a particular candidate for any situation in the efficient discharge of the duties of which the public is interested. Fourth Exception- Publication of reports of proceedings of courts- It is not defamation to publish a substantially true report of the proceedings of a Court of Justice, or of the result of any such proceedings. Explanation.-A Justice of the Peace or other officer holding an enquiry in open Court preliminary to a trial in a Court of Justice, is a Court within the meaning of the above section.
  • 12. Fifth Exception- Merits of case decided in Court or conduct of witnesses and others concerned. It is not defamation to express in good faith any opinion whatever respecting the merits of any case, civil or criminal, which has been decided by a Court of Justice, or respecting the conduct of any person as a party, witness or agent, in any such case, or respecting the character of such person, as far as his character appears in that conduct, and no further. Illustrations (a) A says-"I think Z's evidence on that trial is so contradictory that he must be stupid or dishonest." A is within this exception if he says this in good faith, inasmuch as the opinion which he expresses respects Z's character as it appears in Z's conduct as a witness, and no farther. (b) But if A says-"I do not believe what Z asserted at that trial because I know him to be a man without veracity"; A is not within this exception, inasmuch as the opinion which expresses of Z's character, is an opinion not founded on Z's conduct as a witness. Sixth Exception- Merits of public performance.-It is not defamation to express in good faith any opinion respecting the merits of any performance which its author has submitted to the judgment of the public, or respecting the character of the author so far as his character appears in such performance, and no farther. Explanation- A performance may be submitted to the judgment of the public expressly or by acts on the part of the author which imply such submission to the judgment of the public. Illustrations (a) A person who publishes a book, submits that book to the judgment of the public. (b) A person who makes a speech in public, submits that speech to the judgment of the public. (c) An actor or singer who appears on a public stage, submits his acting or singing to the judgment of the public. (d) A says of a book published by Z-"Z's book is foolish; Z must be a weak man. Z's book is indecent; Z must be a man of impure mind." A is within the exception, if he says this in good faith, inasmuch as the opinion which he expresses of Z respects Z's character only so far as it appears in Z's book, and no further. (e) But if A says-"I am not surprised that Z's book is foolish and indecent, for he is a weak man and a libertine." A is not within this exception, inasmuch as the opinion which he expresses of Z's character is an opinion not founded on Z's book.
  • 13. Seventh Exception- Censure passed in good faith by person having lawful authority over another.-It is not defamation in a person having over another any authority, either conferred by law or arising out of a lawful contract made with that other, to pass in good faith any censure on the conduct of that other in matters to which such lawful authority relates. Illustration A Judge censuring in good faith the conduct of a witness, or of an officer of the Court; a head of a department censuring in good faith those who are under his orders; a parent censuring in good faith a child in the presence of other children; a schoolmaster, whose authority is derived from a parent, censuring in good faith a pupil in the presence of other pupils; a master censuring a servant in good faith for remissness in service; a banker censuring in good faith the cashier of his bank for the conduct of such cashier as such cashier are within this exception. Eighth Exception- Accusation preferred in good faith to authorised person - It is not defamation to prefer in good faith an accusation against any person to any of those who have lawful authority over that person with respect to the subject-matter of accusation. Illustration If A in good faith accuses Z before a Magistrate; if A in good faith complains of the conduct of Z, a servant, to Z's master;if A in good faith complains of the conduct of Z, a child, to Z's father-A is within this exception. Ninth Exception- Imputation made in good faith by person for protection of his or other's interests.-It is not defamation to make an imputation on the character of another provided that the imputation be made in good faith for the protection of the interest of the person making it, or of any other person, or for the public good. Illustrations (a) A, a shopkeeper, says to B, who manages his business-"Sell nothing to Z unless he pays you ready money, for I have no opinion of his honesty." A is within the exception, if he has made this imputation on Z in good faith for the protection of his own interests. (b) A, a Magistrate, in making a report to his own superior officer, casts an imputation on the character of Z. Here, if the imputation is made in good faith, and for the public good, A is within the exception. Tenth Exception: Caution intended for good of person to whom conveyed or for public good- It is not defamation to convey a caution, in good faith, to one person against another, provided that such caution be intended for the good of the person to whom it is conveyed, or of some person in whom that person is interested, or for the public good.
  • 14. Section 304 and 304-A There is lot of discrepancy while applying these sections in cases of professional negligence by doctors. Most of the times the police authorities register the cases of professional negligence deaths under Sec. 304 of IPC. According to this Section the offence is non-bailable. This causes lot of hardship, bad reputation and mental agony to the doctors. In fact the police should register the cases of deaths due to medical negligence under Sec. 304-A of IPC, in which the offence is bailable and the doctor can be released on bail. The judgment has been passed by Bombay High Court in Criminal Revision application no. 282 of 1996 (Dr. Mrs. Mrudula S. Deshpandevs State of Maharashtra) dated 28th November 1998(3). The basic difference is that in Sec. 304 there is intentional act of negligence while in 304-A the act is never done with the intention to cause death. Grievous hurt Sec. 319-322 of IPC are related to causing grievous hurt for example loss of limbs, loss of vision, loss of hearing or disfigurement etc. Sec. 336-338 deal with causing grievous hurt by rash or negligent act. Examples: (1) While giving IV fluids suppose there is leakage of fluid in surrounding tissue resulting in spasm of vessels and subsequent necrosis of limbs. (2) A surgical procedure is done on eye, limbs, face etc. without adequate aseptic precautions resulting in local infection. This may lead to loss of eyes, limb or disfigurement of face, (3) An unqualified doctor performing surgical procedure which results in permanent damage to eyes, limbs, hearing etc. Wrongful confinement (Sec. 340-342 of IPC) A patient cannot be detained on the grounds of non-payment of hospital charges. This may constitute the offense of wrongful confinement under Sec. 340-342 of IPC. Doctors can take advance or fee from the patient before starting the treatment. If a police officer is keeping the doctor in detention, in cases of bailable offenses, he is liable for the offense of wrongful confinement under these Sections of IPC.