ORDER S.C. Vyas, J. This criminal revision is directed against the judgment of 1st Additional Sessions Judge, Ujjain in Criminal Appeal No. 107/1999 dated 26-6-2000 confirming the conviction and sentence passed by JMFC, Ujjain in Cr. C. No. 645/1997 on 6-8-1999 convicting the applicant for the offence punishable u/s 304A of the Indian Penal Code and sentencing her with R.I. for 2 years and fine of Rs. 1000/-. Short facts of the case are that on 8-9-1990 police station Jivajiganj, Ujjain had received information from the control room that the condition of some babies who had been vaccinated on 7-9-1990 at Government Dispensary Piplinaka had became critical and crowd of people had been gathered in that dispensary. On receiving such information inspector D. K. Vyas reached at spot and on inquiry found that as a result of reaction of vaccine five babies named Mahesh, Sunil, Pankaj, Pukhraj, Javed, Ranjana died and other seven babies had been admitted in the District Hospital, Ujjain for treatment, so he registered FIR and conducted investigation against the applicant and other co-accused persons. After investigation charge-sheet was filed before the learned Judicial Magistrate who after completing the trial passed judgment of conviction against the applicant and two other persons and sentenced them with rigorous imprisonment for two years and fine of Rs. 1,000/-. Applicant and other co-accused persons filed separately appears before learned 1st Additional Sessions Judge, Ujjain who by judgment dated 26-2-2000 while allowing the appeals of Dr. Shishir Kumar Sitoke and Mansukhlal acquitted them but the appeal preferred by present applicant was disallowed by him and the conviction and sentence passed against applicant by the learned Magistrate was confirmed. The case of the prosecution as per charge-sheet was this that one Dr. Shishir Kumar Sitoke was in-charge of the hospital, Mansukhlal was working in the hospital as head assistant, Shambhu s/o Wardichand was working as ward boy and one Gita w/o Dungarsingh and the present applicant were working as staff nurse in the Jivajiganj Civil Hospital. On the date of incident the work of vaccination of babies was going on in that civil dispensary and the babies who died in the incident were vaccinated by the present applicant. Other co-accused persons were responsible for supervising the vaccination work and for sterilization of the syringe and injection to be used for vaccination.
On the date of incident the work of vaccination of babies was going on in that civil dispensary and the babies who died in the incident were vaccinated by the present applicant. Other co-accused persons were responsible for supervising the vaccination work and for sterilization of the syringe and injection to be used for vaccination. It was also a case that the in-charge physician of the hospital and other employees who were working in that hospital committed gross negligence in the vaccination work which resulted into the death of five babies. Out of five accused persons staff nurse Gita w/o Dungar Singh and ward boy Shambhu were acquitted by learned Magistrate and in-charge of the hospital Dr. Shishir Kumar Sitoke as well as Health Assistant Mansukhlal were acquitted by the learned Sessions Judge in appeal and only the present applicant was convicted on the charge of gross negligence in administering vaccine to the babies who ultimately died. Learned counsel for the applicant Sr. Advocate Shri A. M. Mathur assisted by Shri Brijesh Pandiya submitted that this was a case of medical negligence and in such a case prosecution was required to prove beyond all reasonable doubts that the applicant caused death of some human being and the death was the direct result of rash and negligent act of the applicant. He has further submitted that it was further required to be proved that the act of the applicant must be the proximate cause of death without intervention of others negligence. He has very strongly placed reliance on the pronouncement of the Hon'ble Supreme Court in the case of Jacob Mathew Vs. State of Punjab and Another, . Learned Sr. Advocate drawn attention of this Court towards the statement of PW-19 Shamim Bano who stated in her examination-in-chief before trial Court that the applicant who kept the injection in a cooker took it from there and then administered it to her daughter. On the basis of this statement learned counsel submitted that the syringe and needle of the injection were properly boiled before administering the vaccine to the babies and on the basis of the statement he submitted that there is no negligence on the part of the applicant. He has further submitted that as per the report of post-mortem conducted by Dr. Prehlad Bhargava (PW-26) and Dr.
He has further submitted that as per the report of post-mortem conducted by Dr. Prehlad Bhargava (PW-26) and Dr. Ajay Nigam (PW-25) all the babies died due to Asphyxia and no definite cause of death could be ascertained by them. It has further been contended by learned counsel for the applicant that the viscera of babies were sent for chemical examination, but nothing was found in chemical examination of the viscera. It has also been submitted that the vaccine, which was administered to the babies was also sent for examination to Central Drug Laboratory and as per report Ex.P-14 the sample was positive for measles vaccine and was found free from abnormal toxicity in mice and guineapigs. Therefore, it has been contended by learned counsel for the applicant that there is no evidence on record suggesting that the applicant committed some act of rashness or negligence while administering vaccine to the babies and there is absolutely no evidence suggesting that death of the babies was direct result of any act of the applicant. Learned Government Advocate Shri G. S. Chouhan, per contra, submitted that applicant vaccinated babies without proper sterilization, which resulted into some infection to the babies and became ultimate cause of their death. It has further been submitted by learned Government Advocate that Dr. N. K. Naik PW-20 has proved that the cause of death of babies was the reaction of the measles vaccine and because the present applicant had administered that vaccine to the babies who died, therefore, the two Courts below have rightly concluded that the babies died due to rash or negligent act of the applicant. The record of the trial Court and the judgment of the appellate Court perused and the arguments advanced by learned counsel for both the parties considered. Dr. Ajay Nigam PW-25 who conducted post-mortem of Pukhraj has stated that all internal organs of the body were congested and the cause of death was Asphyxia. For final confirmation of the cause of death he preserve viscera of the deceased and sent them for chemical examination. Similarly, same witness conducted post mortem of Javed s/o Jameel Khan Ranjana d/o Narayan and Mahesh s/o Madanlal and opined that they all died due to Asphyxia and viscera were sent for confirmation of cause of death. Dr.
For final confirmation of the cause of death he preserve viscera of the deceased and sent them for chemical examination. Similarly, same witness conducted post mortem of Javed s/o Jameel Khan Ranjana d/o Narayan and Mahesh s/o Madanlal and opined that they all died due to Asphyxia and viscera were sent for confirmation of cause of death. Dr. Prahlad Bhargava PW-26 conducted post-mortem of the dead body of Richa d/o Pradeep Yadav he also found her internal organs congested and gave no definite opinion regarding the cause of death, therefore, these two surgeons who conducted post mortem of the deceased did not give any definite opinion regarding cause of death of the babies. On the basis of statements given by these two persons nothing could be inferred against the applicant. The chemical examination report of the visera reveals that no chemical poison was found on the viscera of the babies. The report of the Central Drug Laboratory shows that the sample of measles vaccine was upto the mark and there was nothing wrong in it and, therefore, the report of post mortem, chemical examination of viscera and report of Central Drug Laboratory do not give any clue regarding the cause of death of the babies. Learned Additional Sessions Judge in Paragraph 11 of the impugned judgment after considering these reports came to the conclusion that as there was no chemical poison in the viscera of the deceased babies and the vaccine was also upto the prescribed standard, so only cause of death of the babies was act of negligent on the part of the applicant, while vaccinating the babies. This conclusion drawn by learned Additional Sessions Judge appears to be baseless, there is not foundation for such conclusion when expert witnesses who conducted post-mortem have positively stated in their statement that the cause of death of babies was unknown, then such conclusion could not be drawn. Dr. M. K. Naik PW-20 Civil Surgeon of Ujjain District Hospital has also stated in very specific words in Paragraph 3 of his statement that no cause of reaction of the vaccine was known to him. He had also stated that the work of vaccination was going on satisfactorily in Jiwaji dispensary. Dr. Girish PW-10 was working as District Vaccination Officer at the relevant time in Jiwajiganj dispensary.
He had also stated that the work of vaccination was going on satisfactorily in Jiwaji dispensary. Dr. Girish PW-10 was working as District Vaccination Officer at the relevant time in Jiwajiganj dispensary. He has admitted that there was no refrigerator to keep vaccine in Jiwajiganj dispensary and usually vaccine were provided from the cold storage of district hospital to Jiwajiganj dispensary in the vaccine carrier box. He has also stated that in such vaccine carrier box the vaccine is kept in ice box. The vaccine is supplied in the form of dry powder, separate liquid is also supplied which is required to be mixed with the powder to prepare the vaccine and after mixing the liquid with vaccine it should be used within one hour. He has further stated that all the syringes and needles are kept in sterilization condition for the purpose of vaccination. The statement given by this witness shows that there was no facility of refrigerator in Jiwajiganj hospital. As refrigerator has not been provided by the Government, in absence of such refrigeration facility this possibility cannot be ruled out that the injections were kept in hospital in higher temperature for more than prescribed time, which may result in some complication or something of that sort. None of the witnesses who were examined before Trial Court, had deposed that some act of rashness or negligence was committed by present applicant. The present applicant was not in-charge of the hospital. It was not her duty to keep the vaccine in standard ideal conditions. It was the duty of the in-charge of the hospital. The needles and the syringes which were provided for vaccine were sterilized as per the statement given by Dr. Girish PW-10 and such needles and syringes were taken from the cooker by the applicant as per the statement given by PW-19 Shamim Bano. The pressure cooker is commonly used for sterilization of syringes and vaccines. Learned Additional Sessions Judge in paragraph 13 of the impugned judgment has observed that when five babies died and other fell ill then it was the duty of the Assistant Surgeon to know the real cause of death of the babies, but they failed to perform their duty and simply sent one sample of the vaccine for examination to Central Drug Laboratory.
It has further been observed in Paragraph 14 of the impugned judgment that the prosecution witnesses being medical professionals are trying to save the culprits and thereafter it has been inferred that the babies died due to some reaction and infection of a vaccine, but again there is no foundation for such inference drawn by learned Appellate Court. There is no evidence to suggest that the babies died due to some reaction of the vaccine or some infection caused due to vaccination. Applicant was held guilty only on the evidence that she was the person who administered vaccine to the babies. If this fact is believed even then it is not sufficient to prove that such an administration of vaccine was done by the applicant negligently. It is true that babies became ill after administration of injection, but that illness and thereafter death was direct result of any negligent act of the applicant was required to be proved by the prosecution and in the present case there is no evidence to suggest that the act of administration of vaccine was performed by the applicant negligently. As discussed above the reaction could have been caused because of improper storage of vaccines in higher temperature, or use of the vaccine solution after more than an hour and so on, so there could be number of causes. In a criminal case before convicting a person it is the duty of the Court to see that guilt of accused is proved beyond all reasonable doubts and benefit of every reasonable doubt is required to be given to the accused. If the entire prosecution evidence which has been produced before the trial Court is believed even then it only proves that applicant administered vaccine to the babies who later on died and nothing more than that. As the cause of death is unknown and as no evidence is laid to prove that the applicant conducted the work of vaccination with gross negligence then it is difficult to hold that the death of the babies was direct result of the act of the present applicant.
As the cause of death is unknown and as no evidence is laid to prove that the applicant conducted the work of vaccination with gross negligence then it is difficult to hold that the death of the babies was direct result of the act of the present applicant. Hon'ble Supreme Court in the Case of Jacob Methew vs. State of Punjab in paragraph 49 (3) held as under :- A professional may be held liable for negligence on one of the two findings; either he was not possessed of the requisite skill which he professed to have possessed, or, he did not exercise, with reasonable competence in the given case, the skill which he did possess. The standard to be applied forjudging, whether the person charged has been negligent or not, would be that of an ordinary competent person exercising ordinary skill in that profession. It is not possible for every professional to possess the highest level of expertise or skills in that branch which he practices. A highly skilled professional may be possessed of better qualities, but that cannot be made the basis of the yardstick for judging the performance of the professional proceeded against on indictment of negligence. When we apply the above test in the facts of the present case then it can easily be concluded that present applicant who is staff nurse of a Government Hospital was possessing requisite skill as per the statements given by the District Medical Officer and District Vaccination Officer and there is no evidence to suggest that she did not exercise her skill with reasonable competence. The requisite skill which she did possess, the syringes and needles were kept in pressure cooker which is meant for boiling them. She took out the syringes and needles from pressure cooker as per statement of PW-19 Shamim Bano, and administered the vaccine, which shows that she exercised with reasonable competence, the skill which she did possessing. In the facts of the present case, the cause of death itself is unknown it is difficult to say that the death of the deceased was direct result of the act of the applicant. In the case of Ghanshyamdas vs. The State of Madhya Pradesh, 1997 Cri.LJ. 1373 injection of Coramine was administered to a patient who was already suffering from bronchial asthma.
In the case of Ghanshyamdas vs. The State of Madhya Pradesh, 1997 Cri.LJ. 1373 injection of Coramine was administered to a patient who was already suffering from bronchial asthma. It was held by the High Court that - Requirements of section 304A of the Indian Penal Code are that the death of any person must have been caused by accused by doing any rash or negligent act. In other words, there must be proof that the rash or negligent act of the accused was the proximate cause of the death. There must be direct nexus between the death of a person and the rash or negligent act of the accused. In that case also the post mortem report was not showing that the Coramine injection was the proximate cause of the death, therefore, the accused of that case was not found guilty for the offence punishable u/s 304A of the Indian Penal Code and the charge framed against him was quashed. In the present case also the applicant bonafidely administered vaccine, provided by the Government, to babies. She is a trained nurse and there is nothing to infer that she performed her skill negligently. As discussed hereinabove the two Courts below have committed grave error in finding applicant guilty for the offence punishable u/s 304A of the Indian Penal Code, therefore, this revision succeeds and is allowed. The judgment passed by Additional Sessions Judge is set aside and the applicant is acquitted from the charge of the offence punishable u/s 304A of the Indian Penal Code. Final Result : Allowed