Deficiency in Service Not the Same as Medical Negligence: Supreme Court Upholds WB Clinical Commission’s Power to Award Compensation for Deficiency in Patient Care

"Commission empowered to scrutinize staff qualifications and patient care standards under WBCE Act" – In a significant judgment that strengthens the rights of patients and reaffirms the regulatory powers of the West Bengal Clinical Establishment Regulatory Commission, the Supreme Court set aside the Calcutta High Court's Division Bench decision and restored a ₹20 lakh compensation order to the appellant, whose mother died allegedly due to deficiency in patient care services at the hospital.

The Bench comprising Justice Sanjay Karol and Justice Manoj Misra held that the Commission had acted well within its statutory mandate under the West Bengal Clinical Establishments (Registration, Regulation and Transparency) Act, 2017, particularly Sections 33, 36 and 38, by scrutinizing the qualifications of the hospital staff and awarding compensation for patient care lapses.

“Deficiency in service is distinct from medical negligence; Commission did not overstep its jurisdiction”

Addressing the core contention of jurisdiction, the Supreme Court firmly ruled that the Commission’s examination of staff qualifications and procedural lapses in non-invasive cardiac care did not amount to adjudicating medical negligence, which remains the exclusive domain of the State Medical Council. The Court observed:

“The Commission expressly states that they are not entering into the question of negligence. We find that the Commission indeed had not. What it had done was consider a complaint of deficiency in patient care service… The same is expressly permitted by Section 38.”

The Apex Court found that the Division Bench of the High Court had conflated the two concepts, thereby “leaving almost no room for the Commission to function,” and warned that accepting such an interpretation would defeat the very legislative intent of the WBCE Act, 2017.

Death of Patient, Qualifications of Doctors and Technicians Under Scrutiny

The case arose from a complaint filed by Kousik Pal, whose mother Arati Pal died on May 8, 2017, shortly after being shifted from B.M. Birla Heart Research Centre to Calcutta Medical Research Institute. She had been under treatment at the former for five days but showed no improvement. Her son alleged delayed referral, improper diagnosis, and serious deficiency in care.

A complaint filed before the West Bengal Clinical Establishment Regulatory Commission under the WBCE Act, 2017, resulted in a detailed inquiry. The Commission found that:

• Dr. Ashok Giri, Head of the Non-Invasive Cardiology Department, held a Post-Graduate Diploma in Clinical Cardiology from IGNOU, which was not recognized by the Medical Council of India (MCI) or the West Bengal Medical Council (WBMC).
• Ms. Chaitali Kundu, the ECG technician, had pursued a course from an unrecognized institute, and official records showed her as merely a “female attendant.”

The Commission concluded that both lacked legally recognized qualifications to perform or interpret ECG and echocardiographic procedures and held that this constituted deficiency in patient care service and unethical trade practice.

Accordingly, the Commission awarded ₹20 lakh compensation, citing Sections 33 and 38 of the WBCE Act, 2017.

High Court Division Bench Set Aside Compensation: Supreme Court Restores It

The learned Single Judge of the Calcutta High Court upheld the Commission’s findings. However, the Division Bench reversed this decision, ruling that:

• Only the State Medical Council had the authority to assess whether a doctor or technician was unqualified.
• Patient care issues were “inextricably linked” to medical negligence, and therefore beyond the Commission’s jurisdiction.
• The Commission erred in awarding compensation without establishing a causal link between the deficiency and the patient’s death.

The Supreme Court rejected each of these findings, stating:

“If the findings of the Division Bench are accepted, that deficiency in patient care service and medical negligence… cannot be separated, the functionality of the Commission would be rendered impossible.”

"Commission has a mandate to ensure only properly trained personnel are employed": Court reads Sections 36 and 38(1)(x) widely

The Court interpreted the Commission’s mandate under Section 38(1)(x)—to ensure the employment of “properly trained medical and paramedical personnel”—as a broad supervisory power enabling scrutiny of qualifications and standards in clinical establishments. It further observed:

“Supervision would necessarily include ensuring that all personnel within a clinical establishment are entitled by way of their education and certification to be employed there.”

On the role of Section 33, the Court made a crucial clarification:

“The power to grant compensation as given under this Act is separate and distinct from the power of the State Medical Council to examine medical negligence… it nowhere interferes with the Medical Council’s power.”

MCI Letter Confirmed Lack of Qualification – Commission’s Findings Not Perverse

The Supreme Court took note of a June 2019 communication from the MCI, which clearly stated:

“The minimum qualification required for clinical interpretation of an echocardiogram is MD (Medicine)... Therefore, the petitioner (Dr. Giri) was not entitled to perform and interpret the data of echocardiogram.”

The Court pointed out that the Division Bench had overlooked this crucial evidence, and its finding—that Dr. Giri was qualified until the WBMC ruled otherwise—was erroneous.

“Transparency in patient information vital; wrongful 'stable' remark not a mere clerical error”

The Apex Court further addressed the issue of Dr. Tanmoy Chakraborty, who issued a discharge summary labeling the patient’s condition as “stable” despite evident deterioration. The Court found that this misrepresentation deprived the patient’s family of informed decision-making and stated:

“Making a simple statement that the mother of the appellant had erroneously been described as ‘stable’ cannot and should not absolve the concerned doctor of responsibility.”

Commission's Order Restored, Compensation Reinstated

Upholding the original order of the Commission and the Single Judge, the Supreme Court concluded:

“The Commission was well within its jurisdiction in giving the findings that were challenged… The High Court gave too wide a berth to the State Medical Council… defeating the legislative intent behind this Act.”

The Court restored the Commission’s award of ₹20 lakhs to the appellant, with 6% interest, to be paid within 8 weeks, reinforcing that the Commission is not subordinate to medical councils when assessing service-level failures.

Date of Decision: December 19, 2025