1) Smt. Lakshmi Santhosh died after experiencing respiratory problems following treatment at Parabrahma Specialty Hospital in 2004. 2) Several committees investigated her death and found collective negligence by the doctors involved, including the petitioner Dr. Ravikumar. 3) Dr. Ravikumar is alleged to have falsely assured the deceased's relatives of her recovery after seeing her in critical condition at VSM Hospital. 4) The court must determine the petitioner's liability and negligence during trial, and cannot quash proceedings against him based on the available evidence.

1. Sc 1675/201{ of I ADDL. SESSIONS COURT' KOLLAM'
CP 1OSI2O11 Of JUDICIAL FIRST CLASS MAGISTRATE COURT,KARUNAGAPPALLY.
IN THE HIGH COURT OF KERALAAT ERNAKULAM
PRESENT:
THE HONOURABLE MR.JUSTICE PBHAVADASAN
TUESDAY, THE 23RD DAY OF .IULY 2OI3/1ST SRAVANA' 'I935
crl.Mc.No. 1394 o12013 {)
PETITIONER(S}/4TH ACCUSED:
DR.B.RAVIKUMAR.
KOZHIKOTE HOUSE, TC-9/2',160
SASTHA"IANGALAM P.O. THIRWANANTHAPURAM
BY ADVS.SRI.NAGARAJ NARAYAMN
SRI"SAIJO HASSAN
SRI,PRATHAP PILLAI
SRI.BENOJ C AUGUSTI}t
SRI.SEBiN THOMAS
SRI.I.J.AUGUSTINE
SMT.J "KASTHU RI
RESPONDENT(S)/STATE:
STATE OF KERALA
REPRESENTED BY THE PUBLIE PROSECUTOR'
HIGH COURT OF KEMLA, ERNAKULAM.
.ADDL. R2IUPLEADED.
2. SMT3.T"MANI, W/O.K.V.UNNIKRISHNAN
RESIDING AT KUTTIPAMi'BL'THEKKETHIL VEEDU,
MAHADEVIKADU, KARTHI(APPILLY TALUK,
ALAPPUZIIA DISTRICT 690 516.
.ADDL.R2 IS IMPLEAOED AS PER ORDER DTD. 26/03/2013 IN
CRL.MA 273712013 lN CRL.MC 1394/2013.
ADOL.2 BY ADVS. SRI.SUMAN GHAKMVARTHY
SRI.SANDEEP T'GEORGE
BY PUBLIC PROSECUTOR SRI.DHANESH MATHEW MANJOOMN
THIS CRIMINAL MISC" CASE HAVING BEEN FINALLY HEARD ON
iz-oz-zoii" rHe counr oN 23/07/2013 PASSED THE FoLLowNG:

2. P. BHAVADASAN, J'
Crl.M.C. No. 1394 of 2013
Dated this the 23'd day of July' 2013'
OBPEB
This is a petition filed Section 482 of the Code of
Criminal Procedure seeking to have Annexure Al final report
quashed as far as the petitioner is concerned' who is arrayed
as the fourth accused in Crime No' 57i CR/Klm/09 of CBCID'
Kollam, which has been taken on file as C'P' 108 of 20]1'
which on committal was cam(' to lre numbered as S'C''1 675 of
20'l I and is pending before the First Additional Sessions
Court, Kollam.
2. Little did Smt Lakshmi Santhosh know what fate
had in store for her when she walked into the Parabrahma
Specialty Hospital, Ochira at aSout 8 a m on l4^ l 2'2004' She
was carrying at the relevant time' lt appears that she felt a
slight abdominal pain and thcrefore' theY decided to have a
routine check up. Smt. Lakshmi Santhosh was a ltafi Nurse
of VSM tlospital, Mavelikkara and her mother was the Head
*'-t'

3. -EErra6:J!9*:
*.
crt.M.c.1394/2013.
,: . "* ,
Nurse in the said Hosp jtal
"no'
n",, ,o,nu," n", o"U"i,;"*rrr"
for the iast 40 years. T
'he
Casualty doctor ln the parabrahma
Hospital examined Smt. Lakshmi Santhosh and gave Cyclopam
tnjunction and digene g
As she was coming out
rci and she was allowed to go home'
rf the hospital, she was informed that
she should meet the :iurqeon also. The Surgeon after
examinatron, found nothing wrong with Smt.Lakshmi
Santhosh, but he, by way of abundant caution asked her to
consult the Cynecologist also. As per the said advrse,
Smt.t-akshmi Santhosh m
hospita rhoush the .;:il:::;,:;X:'r"J;
Santhosh is not suffering t
found trrinary probrems uno"ot
'o' gynecology probiem, she
therefore, she was acimitted in the
5aid hospital" She was a
which resurted in causing
istered Ampicillin iniunction
smt.Lakshmi sanrhosh, , ,.":::
respiratorv problems ro
{ondirion medieally described
anaphylactic shock. The Casualty doctor, whc is the firsr
-*--

4. Crl.M.C. 1394/2013.
' :ja
r,. 'r'! -
" .ry','
' -,
accused in the case, was contacted and he attended to
Smt.Lakshmi Santhosh and she was given Efcorlin and Dexona
irUunction and as the situation did not improve, it so
happened that Dr"Ajith gave Diazepam injunction. That
worsened the condition of Smt.Lakshmi Santhosh who went
into a morbid stage" The petitioner herein was called in to
attend the patient. Having found that Smt.Lakshmi Santhosh
had gone into a morbid stage, she was asked to be shifted to
VSM Hospital which harj ventilaror facility and which is
absolutely necessary for the resurrection of Smt"Lakshmi
Santhosh. She was taken to VSIV1 Hospital and taken to ihe ICU
immediately. The petitioner herein followed Smt.Lakshmi
Santhosh in his vehicle and as soon as he reached the VSM
Hospital, he went to the ICU and eame out and assured the
relatives that she will get better soon and he left the hospital.
A short while thereafter, the doctor informed the relatives of
Smt. Lakhsm i Santhosh that she was no more.
f'-

5. Crl.M.C. 1394/2013.
4
3. lnitially, no one suspected the mode oftreatment
administered to Smt.Lakshmi Santhosh. But larer, rhe mother
of the victim seems to have sent a complaint which resulted in
registration of the crime and ultimately resulted in the
investigation being handed over to CBCID. During
investigation, it was revealed that the doctors who had
attended to and treared Smt. Lakshmi Santhosh were grossly
negligent, the case sheet of Smt.Lakshmi Santhosh was not
properly maintained ancl she was administered medicines
without ascertaininq her medical history and finally thal there
was gross negligence on .the part of the dottors in taking
necessary steps when Smt_Lakshmi Santhosh went into coma
After investigation, final report was laid before the JFCM Coun,
Karunagappally for offence pr_:nishable under Section .104 read
with Section 34 of lndian penal eode, in whlch the pelitioner ts
shown as the fourth accused. Cognizance of the offence was
taken by the JFCM Court, Karunagappally as C.p.t0g of 201I
I

6. Lrl.M.C. 1394/2013.
and find in g that the
Sessions, committed
made over the case
1 675 of 20t t.
offence is exclusively triable by a court of
the case to Sessions Court, Kollanr, which
to First Additional Sessions Court as S.C_
i
I
4" The petilioner would say that even assuming all
what is stated is true, and the entire evidence collected during
investigation is taken as established, there is nothing to show
that the petitioner was in any way responsible or had rn any
manner contributed to the cleaih of Smt.Lakshmi Sanihosh.
There is nothing to shr.rw thar: he had attended Io the patient,
treated her or administered any medicine to her. All that the
prosecution has against the petitioner is Annexure A7 report
drawn up by the aper body constituted as per Circular
No.7330415583 12007 lHome dated 16.6.2008 jn which rhere
rs a vague asserfion that the eause of death of Smt"Lakshmi
Santhosh was due to the collective negligence on the part of
the doctors who had attended to her including the pelittoner.

7. .!*l:aE
Crl.M.C. 1394/2013
. :
"4'.
5. The peritioner would point out rhat,.itxi;:,.js
nothing to show that either he had not done what he should
have done or he had done something which he should not
have done when he was called upon to attend to Smt.Lakshmi
Sanrhosh. An expert committee of the doctors constituted to
ascertain the cause of death met on 23.6.200g and gave an
opinibn that the cause of death could be ascertained after the
final opinion of the forensic department and the said
committee again mer orr .1.2.20A9
and ,l2.t.2010.
Ihe
committee formed rhe opiniun thal there was no negligence
on the part of the doctors who had attended to the patient and
the said report is produced as Annexure A5. Subsequently, a
medical Board was constitured under the Convenorshi.o of
Director of Heaith Services whreh had met on 27.2"2010 anrl
opined thar there is collective negligence
mentioned.
as already
i
l

8. Crl.M.C. l394l2O1i
6. The peritioner would say that no;e of the
committees met for conducting enquiry into the death of
Smt.Lakshmi Santhosh had attributed any role to the peritioner
and the only material that is now available against the
petitioner is Annexure AZ report of the Expert Committee.
That.being vague and there being no o,h"r, material against
the petitioner, it may not be in the interests ofjustice to direct
him to face trial. Even assuming that the petitioner had
informed the relatives of Smt.Lakshmi Santhosh when
Smt.Lakshmi Santhosh had reaehed VSM Hospital and was in
the ICU that Srnt.Lakshmi Santhosh would get better soon,
which he knew ro be false, still that by itself is jnsufficjent to
create any criminal liability on him. None of the ingredients
necessary to ronstitute offence under Section 304 of l,pC. is
available as against ihe petitioner and therefore, he prays that
proceedings as far as he is concerned may be quashecl.
I
Y

9. Cl:l.NL.C. 1394/2013. ,. ,,
8 !; ,':,!'
Z" Learned public prosecutor
very
'u"freirre,uli
opposed the petition. lt u/as pointed out by him that the
petitioner cannot so easily wash off his hands and he had a
role to play in the incident. It was pointed out that when he
was called upon to attend th€ patient, he did not do anything
and he remained satisfied by seeing.that that the patient is
shifted to VSM Hospjral
the hospitar and jusr
- l-'ie did not accompany the patient to
r,lowed the patient in his car. Aft€r
reaching VSM Hospital, the patient was raken to the iCU and
the pelitioner had occasion to see the patient in the lCU.
Knowing fully well that rhe patient would.not survive or that
the patient was aiready dead, he chose to inform the
relatives of the patient that she would get very well soon. This
deiiberate false statement by the petitioner shows his
complicity in the incident" At any raie, the invo,vement of the
petitioner ancl the extent of hjs iiabiiity and the deqree of
negligence anci lack of carr: on his part are to be determined
v"

10. Crl.M.C. I194120t3
I
during trial and it may not be proper
its power under Section 4g2 of
proceedings as against the petitioner.
for this court
Cr"P.C. and quash the
g. The defacto compiainant, who is none other than
the mother of the deceased was impreaded as additionar
second respondent. She has entered appearance through a
counsel and informed the court that she has not much
grievance as against the petitioner. gut that is not the ease as
against the other accused pcrrsons_ lt was also pointed out
that infact the petitioner should figure as a witness for the
prosecution and if this court
be quashed as asainst rr" r"r:::":::"rTffi:;"rt;
be cited as a prosecution witness in the case.
v. lhrs case reveals yet another story of
carelessness, indifference an
doctors of a hospita, by nam
callous attitude displayed by the
e Parabrahma Hospital at Oaehira.
A lady who had no particular disease and who had qone for a

11. CrlM.C. 1394/201).
l0
'i.
routine check up with a sl;^hr _LJ
breathing her rast ,n
""nnt abdominai pain enaea tifih
the hospital. lt is true that seyeral
committees were constituted and all the Contmittees hayecome to the conclus ion
rhe part of the doctor
that there is no wilfui neqligence on
fJowever, Annexure u, o
*no had attended to the patient.
is the report of the ape)
ced along with the petition which
that there was corective
I body already made mention of says
who had artended ,o ,I"'"nuot"
on the part of the d6q16r5
5urprisingry enough, ,, oo,"
'ootn'i
santhersh' the parient"
by each of the ,o.,or, ,n.u
i']ot mention abour the role played
action taken o, ,nu ."rr'
the credibility or correctness ofthe
moments. The husband.n]"tt''"
doctors at the respective
I the daughter of the deceased hadapproached the Consumer
eompensation for the death
sputes Redressal Forum seeking
sard forum passed Annexu,
of smt'Lakshmi santhosh and rhe
thar the first and the sec.r
A10 order wherein it was f,rund
,
d accusetJ herein were negligent
<-..
a

12. Crl.M C. 1394/201f
which caused the death of
i: ..*,"
J-
Ir '', .
Smt. Lakshmi Santhosh and
awarded a sum of Rs_15,00,000/_ as compensation.
exonerated rhe petitioner from all liability.
10. tt is nor in dispute rhat initially Smt.Lakshmi
Santhosh was seen by the duty doctor and then she was
refurred to the Surgeon and then to the Gynecologist. lt was
Dr.Cirija, who had admirted the parient in the hospital. lr
appears that Dr. Cirija, a
x-ay to be taken and brrfter
examining the patient' directed
'od lest to be conducted. lV drip was
also given. As per the records, Smr.Lakshmi Santhosh was
administered Ampicilrin injunctron and she soon began to
struggle and developed severe respiratory problems. The first
accused was caflecr and he initialy gave dexona and efcorlin
injunction. lt is claimed that the patient developed fits and
dtazepam tnjuncrron was q lven to the patient. The condition
of Smt.Lakshmi Santhosh worsener, and she was iemov€d to
lCU lt was thereafter that.Dr.Mathew, the Anesthetist, and

13. Ctl.N4.C. t394/2013.
' .,i; i 't''
t2
Dr. Ravikumar were called to attend to the patient. Dr.Mathew
intubated the patient and finding rhat the patient lvas in a
critical condition, Dr.Ravikumar, rhe petitioner herein, advised
that she be taken to a hospital where there was ventilator
facility. lt was then Smt.Lakshmi Santhosh happened to be
removed to VSM Hospital, Maveltkkara. There is consit1erable
controversy regarding the question as to whether
Smr.Lakshmi Santhosh had already died or she had breathed
her iast at VSM Hospiial Mavelikkara. The fact remains that
the death certrfr(ate was
parabrahma
Hospitar. ,r ,r't"u'
by the petitioner from the
who had accompanierJ smt.
in dispute that the petitioner,
Lakshmi Santhosh to VSM Hospital
and who had visited rhe deceased in the ICU at VSM Hospirai,
after coming out from the lCU, informed the relatives that her
condition will improve soon. this was misleading because jf
one has to go by the records, there was no chance of survival
as far as the deceased was concernecl and the petitioner rnust