CASE NAME	Jacob Mathew v. State of Punjab, (2005) 6 SCC 1
CITATION	AIR 2005 SC 3180, 2005 AIR SCW 3685, 2005 CRILR(SC&MP) 2 667, (2005) 3 RAJ CRI C 753, (2005) 4 CTC 540 (SC), (2005) 122 DLT 83, 2005 CRILR(SC MAH GUJ) 2 667, (2005) 33 ALLINDCAS 1 (SC), 2005 (6) SLT 1
COURT	Supreme Court of India
BENCH	Hon’ble Justice  R.C. Lahoti, Justice G.P. Mathur, Justice P.K. Balasubramanyan
PETITIONERS	Jacob Matthew
RESPONDENT	State of Punjab and Others
DECIDED ON	decided on 5th August, 2005

INTRODUCTION

In Indian medical law, the seminal case of Jacob Mathew v State of Punjab addressed medical negligence and the duty of care that physicians had to their patients. Important guidelines on the level of care that physicians should provide and the significance of informed consent in medical treatment were established in this case. The concept of negligence in tort law originated in English law, and Indian criminal and civil law also largely reference this corpus of work. Medical negligence, defined as when a patient passes away after receiving the incorrect treatment—possibly due to the doctor’s or the hospital staff’s negligence—was added to the tort law as a basic tort. Prior to now, medical carelessness was not considered a crime.

FACTS OF THE CASE

the late Sharma Jeevan Lal, The informant’s father, reported breathing difficulties after going beyond 11 p.m. on February 22, 1995, while he was a patient in the private ward of the CMC hospital in Ludhiana. While the informant’s older brother, Vijay Sharma, was there, he made contact with the room’s duty nurse. The informant’s older brother requested her to call a doctor to see the patient, but the doctor didn’t show up for roughly twenty to twenty-five minutes. Afterward, physicians Allen Joseph and Jacob Mathew visited the patient’s room. The patient’s mouth was fitted with an oxygen cylinder, but the breathing issue persisted. When Jeevan Lal attempted to stand up, the medical personnel urged him to stay in bed. 

The cylinder was discovered to be empty, and the room had no further gas cylinders. After going to the adjacent room, Vijay Sharma returned with a gas cylinder. Five to seven minutes were lost since there was no plan in place to turn on the gas cylinder. By this point, a different physician had arrived and declared the patient dead. The fir goes on to say that the informant’s father’s death was brought on by the nurses’ and doctors’ negligence as well as the lack of an oxygen cylinder. His breathing completely stopped as a result of the empty cylinder being fixed in his mouth, and he passed away. The first-class judicial magistrate in Ludhiana filed a complaint against the two doctors under section 304A of the IPC. The accused individuals submitted a revision petition to the learned session judge challenging the charge framing order, but it was denied. 

The accused then filed a motion with the Hon’ble High Court under section 482 of the Code of Criminal Procedure, requesting that the FIR and all related proceedings be quashed.

ISSUES RAISED

• The Hon’ble Supreme Court’s first question concerned whether there was a standard by which one could judge whether or not a doctor had acted negligently while carrying out their duties.
• The Hon’ble Supreme Court’s second question concerned whether the definition of carelessness in criminal and civil law differed in any way.

ARGUMENTS FROM BOTH SIDES

Argument from the side of the petitioner

• The petitioner’s attorney contended that this case should not fall under Section 304A of the Indian Penal Code because that section deals with cases involving deaths brought about by negligence, and medical negligence should not be included in the same context. The petitioner contends that rather than being handled under Section 304A of the Indian Penal Code, it ought to be handled independently under the ethics and professions of medicine. 
• The petitioner emphasized that medical practitioners ought to be held to the level of care and caution that is expected of them in their line of work. Even while there is a potential for mistakes in treatment, this does not entail that those mistakes should result in criminal charges. It was argued that criminal legislation shouldn’t penalize these kinds of incidents. 
• Concerns over the ceiling effect on criminal culpability for physicians and other medical professionals were brought up by the petitioner’s attorney. The petitioner claims that a legal action phobia can have an impact on a doctor’s willingness to take risks when treating a patient. Additionally, because medical professionals will prioritize their own survival while providing care, it will impair their capacity to make decisions during emergencies.

Argument from the side of the respondent

• The respondent’s attorney contended that Dr. Mathew’s negligence was the primary cause of the patient’s death, making him accountable. As a result, the case should have been included in the category of negligence in criminal law. The respondent’s attorney contended that the patient’s death was caused by inadequate care and caution. 
• The respondent’s attorney brought up the argument that a medical professional should be held accountable for his acts if they cause a patient to pass away. As a result, physicians can guarantee that their patients receive excellent care while receiving treatment. 
• It was argued that a hospital’s patient admission constitutes a breach of trust as the medical professional has a duty to give the patient the best treatment possible. 
• The respondent’s attorney contended that public confidence in the medical community will decline if physicians are free to act carelessly or recklessly. Maintaining the patient’s trust in the medical profession can be achieved by punishing the offender for their careless actions during the patient’s medical treatment. 

JUDGMENT

In Jacob Mathew v. State of Punjab, the Supreme Court of India ruled that there was no allegation in the complaint that Dr. Mathew was not a licensed physician to treat the patient. Furthermore, there were claims that an oxygen cylinder was missing, and the hospital administration was held accountable for this. According to the court, the hospital can be held accountable for these mistakes under civil law. The Indian Penal Code (IPC) Section 304A deals with causing death by negligence; however, the court decided that Dr. Mathew could not be found guilty under this section since there was insufficient evidence to link his conduct to the patient’s death. The court emphasized that physicians ought to be shielded against arbitrary or baseless prosecution. Additionally, it specified that a higher threshold requirement must be satisfied before a physician can be charged with medical negligence. The prosecution will now proceed under Section 304A/34 of the IPC, which addresses activities carried out by multiple people in pursuit of a similar aim, if at all, the Supreme Court decided after accepting the appeals.

CONCLUSION

The Jacob Mathew v. State of Punjab case is a seminal case in Indian medical law that profoundly affected the country’s medical practice. The case emphasized the significance of informed consent in medical treatment and established significant guidelines about physicians’ duty of care to their patients. The case reminds medical professionals of their duties to their patients and patients of their entitlement to quality care. The Bolam test states that a physician cannot be held accountable for medical negligence if they follow the guidelines set forth by the responsible body of their profession in a particular circumstance. Given that the doctors in question carried out their duties with diligence, they were not held accountable in the aforementioned situation. However, the hospital administration’s carelessness was the reason for the patient’s unfavorable outcome. In a technical sense, the hospital staff’s actions can be considered medical negligence. 

The hospital administration has an obligation to offer patients high-quality services, hence this circumstance might be covered by the Consumer Protection Law. In this instance, they did not fulfill their obligation to provide their patients with superior care. As a result, the harmed party may also use consumer forums to pursue justice. The legal notion of carelessness in tort law has its roots in English law and is widely acknowledged in India’s legal system. Medical negligence is not a simple tort to understand. When a patient obtains the wrong care and experiences mild discomfort, it changes from a straightforward tort to a potentially fatal scenario where the patient may pass away from a small wound or fracture. A doctor of acceptable competence is expected to practice a noticeably high level of care in medical negligence cases. Rather than comparing the doctor in question to the average sensible person, the standard of care is established by comparing them to peers in the same medical specialty. 

Negligence can have two possible causes: either the staff or the doctor acted carelessly, or in certain cases, both the staff and the doctor may have done carelessly. Generally speaking, joint and several liabilities apply, meaning that the doctor and the hospital will each decide how much liability they bear separately based on their agreement. Expert testimony is typically used by courts to evaluate carelessness, with the exception of clear-cut protocol violations and behavior judged to be irrational and reckless. The law seeks specificity and precision, but it can be difficult to attain because of the great degree of subjectivity in these decisions. Since the Hon’ble Apex Court has defined the law on medical negligence, a well-established legislative framework is required for consumer protection in India, not just in the medical area but also in other businesses.