Choosing one recognized treatment over another with reasonable skill does not constitute medical negligence.

The petitioners, Dr. Jaydeep Date and Dr. Munir Mhaskar, challenged an order dated 24 August 2013 passed by the Medical Council of India (“MCI”), which reversed the Maharashtra Medical Council’s exoneration order and directed removal of Dr. Date’s name from the medical register for six months and Dr. Mhaskar’s name for three years.

The proceedings arose from a complaint by Murad Hasan Mulla alleging medical negligence in the treatment of his urinary-tract and urethral-stricture condition. The Maharashtra Medical Council had found that the complainant’s condition was chronic, that appropriate treatment had been administered, and that the doctors had not violated medical ethics.

In the appeal before the MCI, the petitioners asserted that they had not received copies of the complainant’s appeal or accompanying documents and had been heard only on 23 March 2013. The MCI’s Ethics Committee also considered the matter in meetings held on 24 and 25 May 2013, without notice to the petitioners, and ultimately recommended disciplinary action.

During the pendency of the writ petitions, the Indian Medical Council Act, 1956 was repealed and the National Medical Commission Act, 2019 came into force.

Whether the MCI’s disciplinary order was vitiated by violation of the principles of natural justice because the petitioners were not supplied the appeal materials, were not heard at all relevant stages, and were not given notice of the subsequent Ethics Committee meetings.

Whether the absence of a urologist on the Ethics Committee, while determining allegations concerning urological procedures, further rendered the disciplinary process procedurally unfair.

Whether the MCI’s cryptic and unreasoned findings of medical negligence and professional misconduct were legally sustainable.

Whether, applying the settled principles governing medical negligence, the petitioners could be held liable merely because they adopted a particular recognized treatment or because the treatment did not produce the desired result.

Whether the proceedings could be remanded under the changed statutory regime introduced by the National Medical Commission Act, 2019.

The Court applied the principles of natural justice, particularly the right to notice, disclosure of adverse material, a meaningful opportunity of hearing, and a reasoned decision.

It considered Section 30 of the National Medical Commission Act, 2019, which provides an appellate remedy to an aggrieved medical practitioner or professional, and Section 60 concerning repeal and savings.

On medical negligence, the Court relied principally on Jacob Mathew v. State of Punjab, Martin F. D’Souza v. Mohd. Ishfaq, and Kusum Sharma v. Batra Hospital and Medical Research Centre, which adopt the Bolam standard: a doctor is judged by the skill and care of an ordinarily competent practitioner in the relevant field, not by the highest possible standard.

A doctor is not negligent merely because another recognized course of treatment could have been adopted, because an error of judgment occurred, or because the treatment failed, unless the adopted course was one that no ordinarily competent professional would have followed.

The Court also distinguished Samira Kohli v. Dr. Prabha Manchanda, which concerns unauthorized treatment materially beyond the patient’s consent.

The Court found that the petitioners were not supplied copies of the complainant’s appeals or accompanying documents, leaving them materially disadvantaged in presenting their defence.

It further held that the Ethics Committee’s meetings on 24 and 25 May 2013 were conducted behind the petitioners’ backs, contrary to the explanation that their matters had not been considered on those dates; the minutes showed that all appeals had already been considered on 23 March 2013.

The absence of a urologist was also considered significant because the Committee had to assess specialized urological procedures.

The impugned order merely stated that Dr. Mhaskar had failed to diagnose properly, lacked the necessary skill, and ought to have referred the patient to a urologist, while concluding that Dr. Date should have used a mucosal graft instead of scrotal skin.

It supplied no adequate reasoning or analysis, despite reversing the State Medical Council’s findings and imposing serious professional sanctions.

Applying the Bolam principles, the Court held that Dr. Mhaskar had produced material showing that cystoscopy and urethral dilatation formed part of his MS General Surgery training, that general surgeons performed such procedures, and that he had relevant experience.

His bladder-neck incision was therefore treated as a professional decision made during the procedure and within his training and competence; recurrence of the complainant’s condition could not itself establish negligence.

As to Dr. Date, the Court held that the scrotal-skin procedure was a recognized treatment, even if some medical literature regarded it as a later or less-preferred option.

Choosing one recognized procedure over another did not establish negligence in the absence of proof that the chosen procedure fell below the standard of an ordinarily competent practitioner.

Since both doctors had obtained the complainant’s consent and the record did not establish unauthorized treatment of the kind considered in Samira Kohli, the MCI’s findings were unsustainable.

Although remand was theoretically possible under the repeal-and-savings framework, the Court exercised its writ jurisdiction and decided the matter because the parties sought a final determination and the MCI’s findings were both procedurally defective and contrary to settled negligence principles.

It further held that neither Dr. Mhaskar nor Dr. Date could be found negligent merely because of the treatment choices made or the recurrence and unsuccessful outcome of the complainant’s condition.

Both writ petitions were allowed; the MCI’s order directing removal of Dr. Date’s name for six months and Dr. Mhaskar’s name for three years was quashed and set aside.

Rule was made absolute, and the pending civil applications and notices of motion were disposed of.