Legal Review and Analysis of Kousik Pal vs B M Birla Heart Research Centre & Ors 2025 INSC 1487

Case Synopsis

Kousik Pal vs. B.M. Birla Heart Research Centre & Ors., 2025 INSC 1487

Institutional Accountability Upheld: Supreme Court Clarifies that Regulating Clinical Establishments for Deficiency in Service and Employing Unqualified Staff is Distinct from Adjudicating Individual Medical Negligence

1. Heading of the Judgment

Kousik Pal vs. B.M. Birla Heart Research Centre & Ors., 2025 INSC 1487 (Supreme Court of India).

2. Related Laws and Sections

• The West Bengal Clinical Establishments (Registration, Regulation and Transparency) Act, 2017 (WBCE Act, 2017):
  Preamble & Section 2: Definitions of "clinical establishment", "service provider", "service recipient", and "trade practice".
  Section 29: Penalties for minor and major deficiencies.
  Section 33: Compensation for injury or death due to negligence or deficiency in service.
  Section 36: Establishment and objectives of the West Bengal Clinical Establishment Regulatory Commission.
  Section 38: Powers and functions of the Commission, including examining complaints related to patient care service and unethical trade practice.

• Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002:
  Chapter 7 (Regulation 7.20): Misconduct relating to claiming to be a specialist without special qualification.
  Chapter 8: Disciplinary action by the appropriate Medical Council.

3. Basic Judgment Details

Facts of the Case
The Appellant's mother was admitted to the Respondent hospital. After five days, she was referred to another hospital. The discharge summary described her as 'stable', but she passed away approximately 16 hours after transfer. The Appellant filed a complaint with the West Bengal Clinical Establishment Regulatory Commission, alleging negligence and deficiency in service. The Commission found that a doctor (Dr. Ashok Giri) and a technician (Ms. Chaitali Kundu) involved in the patient's Echo Cardiogram procedure were not qualified as their certifications were not recognized. It held this constituted a major deficiency in patient care and unethical trade practice, awarding Rs. 20 lakhs as compensation. The High Court's Single Judge upheld the order. However, the Division Bench set it aside, holding that the Commission lacked jurisdiction to adjudicate on qualifications or deficiency in service, as these issues were inextricably linked to medical negligence, which falls exclusively under the State Medical Council's domain.

Issues in the Judgment
Whether the West Bengal Clinical Establishment Regulatory Commission, constituted under the WBCE Act, 2017, has the jurisdiction to:

1. Examine the qualifications of medical and para-medical personnel employed by a clinical establishment.

2. Adjudicate upon a complaint of deficiency in patient care service and award compensation, or whether such powers are vested solely in the State Medical Council.

Ratio Decidendi (Court's Reasoning)
The Supreme Court allowed the appeal and restored the Commission's order. The Court reasoned that:

1. Distinct Jurisdictions: The jurisdiction of the Commission under the WBCE Act and that of the State Medical Council under the IMC Regulations are distinct and operate in different spheres. The first proviso to Section 38(1)(iii) of the WBCE Act explicitly states that complaints of "medical negligence" against medical professionals will be dealt with by the respective State Medical Councils. The Commission's order expressly stated it was not entering into the question of medical negligence.

2. Commission's Mandate: The Preamble and provisions of the WBCE Act, especially Sections 36 and 38, empower the Commission to regulate clinical establishments, ensure transparency, and preserve minimum standards of facilities and services. This inherently includes the power to ensure that a clinical establishment employs only properly trained and qualified personnel [Section 38(1)(x)].

3. Examining Qualifications is Central to Regulating Service: To adjudicate a complaint regarding "deficiency in patient care service" and "unethical trade practice" [Section 38(1)(iii)], the Commission must be able to examine whether the personnel providing the care were qualified. This is a prerequisite for determining if the service met the expected standard. This function is administrative and regulatory, not an adjudication of professional misconduct.

4. Power to Award Compensation: Section 33 of the Act explicitly authorizes the Commission to award compensation for injury or death caused due to "negligence or any deficiency in providing service". The legislative intent is to provide a swift forum for redressal to service recipients, which operates parallel to the Medical Council's role in disciplinary matters against individual practitioners.

4. Core Principle of the Judgment

Delineating Parallel Jurisdictions under Consumer Protection and Medical Ethics Frameworks

Issue and Subject Matter
This judgment resolves a critical conflict regarding the overlapping jurisdictions of a state-level commission regulating clinical establishments and the professional medical council regulating individual practitioners. It defines the boundary between investigating systemic deficiencies in service by an institution and adjudicating individual professional misconduct or negligence.

Analysis and Explanation of the Core Principle
The Supreme Court performed a harmonious construction of two specialized statutes to clarify their respective domains, preventing the nullification of a beneficial consumer protection law.

• Separation of Institutional Accountability from Professional Conduct: The Court established a clear dichotomy:
  Commission's Domain (WBCE Act): Focuses on the clinical establishment as an institution. Its mandate is to ensure the establishment maintains minimum standards, employs qualified staff, is transparent, and provides services without unethical trade practices. A "deficiency in service" under this Act relates to the institution's failure in its systemic obligations.
  Medical Council's Domain (IMC Regulations): Focuses on the individual medical professional. Its mandate is to adjudicate "medical negligence" or "professional misconduct" by a specific doctor, which pertains to the breach of a duty of care owed by the professional to the patient.

• Qualification Check vs. Negligence Adjudication: The Court held that the Commission's examination of whether a doctor or technician holds a qualification recognized by the appropriate council is a fact-finding administrative act necessary to check the establishment's compliance with Section 38(1)(x). This is fundamentally different from the Medical Council's process of deciding whether an action (or inaction) by a qualified professional amounts to negligence or misconduct. The former is about the legitimacy of the provider's presence in the system; the latter is about the quality of actions taken within that role.

• Upholding Legislative Intent: The Supreme Court criticized the Division Bench's view that "patient care" and "medical negligence" are inseparable. It held that accepting this would render the Commission dysfunctional, as almost every complaint involves some element of care, thereby defeating the legislative intent behind creating a dedicated, accessible forum for patients to seek redress against institutional failures. The Court emphasized that the powers are complementary, not exclusive.

• Composite Committee as an Expert Body: The Court noted that the Commission includes medical experts in its composition, which lends credibility to its findings on technical aspects like the relevance of specific qualifications for performing procedures, as evidenced by its reliance on the MCI's opinion.

5. Final Outcome of the Judgment
The Supreme Court allowed the appeal. It set aside the impugned judgment of the Division Bench of the Calcutta High Court. The order of the West Bengal Clinical Establishment Regulatory Commission dated 02.02.2018, as confirmed by the Single Judge, was restored. The Respondent hospital was directed to pay the compensation of Rs. 20 lakhs awarded by the Commission within eight weeks, along with interest at 6% per annum from the date of the Commission's award.

6. MCQ Questions Based on the Judgment

Question 1: In Kousik Pal vs. B.M. Birla Heart Research Centre (2025 INSC 1487), the Supreme Court primarily interpreted the relationship between the West Bengal Clinical Establishment Regulatory Commission and the State Medical Council as?
A. Hierarchical, with the Medical Council's decisions overriding the Commission's.
B. Parallel and distinct, with each having separate areas of authority under different laws.
C. Identical, with both bodies having concurrent jurisdiction over all medical service complaints.
D. Advisory, where the Commission must seek the Medical Council's opinion before passing any order.

Question 2: According to the aforementioned judgment, the Commission's authority to examine the qualifications of a doctor employed by a hospital stems from its power to?
A. Adjudicate charges of medical negligence against individual practitioners.
B. Cancel the medical license of an unqualified practitioner.
C. Ensure the clinical establishment employs properly trained and qualified personnel.
D. Fix the rates for medical procedures conducted in hospitals.