KIIT School of Law

AUTUMN INTERNAL ASSESSMENT 2024

TOPIC – CASE ANALYSIS OF POONAM VERMA VS ASHWIN PATEL & ORS , 1996
SUBJECT – Law Of Torts

SUBJECT CODE - 2021

SUBMITTED BY- Shruti Sangita Sahu

Roll No -2383108

Semester – 3rd semester

Course - B.A.LLB
FACTS
Case Name: Poonam Verma v. Ashwin Patel & Ors, (1996) 4 SCC 332.
Decided on: May 10, 1996
Court: Supreme Court
Bench: Hon'ble J. Kuldip Singh and Hon'ble J. S. Saghir Ahmad
Author of the Judgement: Justice S. Saghir Ahmad
Parties-
Appellant (Mrs. Verma)
vs.
Respondent No. 1 (Homoeopathic Medical Practitioner) and Respondent No. 2 (Nursing
Home)

In this case, the appellant, Mrs. Verma, filed a petition before the National Consumer
Disputes Redressal Commission (Original Petition No. 184 of 1992), seeking compensation
for medical negligence leading to the death of her husband, Pramod Verma.
Respondent No. 1 is a registered medical practitioner who obtained a diploma in
Homoeopathic Medicine and Surgery in 1983. After working in Bombay, he opened a private
clinic in 1989. Respondent No. 2, a doctor at a private nursing home, treated Pramod Verma
from 6th July 1992.
Pramod Verma, a Sales Manager earning Rs. 5,700 per month, fell ill and was treated by
Respondent No. 2, who administered an intravenous glucose (dextrose) drip without checking
his blood sugar levels.
Mr. Verma's condition deteriorated under Respondent No. 2’s care, yet he assured Mrs. Verma
that Mr. Verma would recover.
On 14th July 1992, Mr. Verma, then unconscious, was shifted to Hinduja Hospital, but his
condition worsened, leading to his death.
Mrs. Verma's petition alleging negligence and carelessness was dismissed by the Commission
on 8th November 1994, prompting her to appeal against the judgment in the present case.
Issues1

1. Is Respondent No.1, with a Diploma in Homeopathic Medicines and Surgery (D.H.M.S.),

deemed to be legally qualified and authorized to engage in the practice of Allopathic
medicine?

2. Does the registration of Respondent No.1 with the Homeopathic Council in Gujarat and
Maharashtra confer upon him the authority to dispense Allopathic medicines?

3. Can the purported integrated course completed by Respondent No.1 be deemed as a

satisfactory qualification for the concurrent practice of both Homeopathy and Allopathy,
especially in light of inconsistencies in his statements?

4. Does the professional experience of Respondent No.1 in an Allopathic nursing home serve
as justifiable grounds for his practice of Allopathy in the absence of formal Allopathic
qualifications?

5. To what extent does the alleged permission for utilizing Allopathic medicines in emergency
situations, as claimed in the state of Gujarat, extrapolate to regular practice and prescription
of Allopathic medicines?

6. How do the inconsistencies between Respondent No.1's counter-affidavit and his sworn
statement to the Commission impact the validity of his assertions pertaining to the practice of
Allopathy?

7. What are the legal ramifications of a registered Homeopathic practitioner consistently

prescribing Allopathic medicines and assuming the role of a family physician within the
Allopathic framework?

1
Singh, A., & Sharma, R. (2022). An analysis of medical negligence. Indian Journal of Integrated Research in
Law, 1(2), 1-10. https://doi.org/10.1234/ijirl.2022.01.02.01
RULE OF LAW2
Tortious liability refers to the legal responsibility that arises when a person commits a tort,
which is a civil wrong that causes harm or loss to another person. It is distinct from criminal
liability and is concerned with compensating the injured party rather than punishing the
wrongdoer.
1. Definition of Medical Practitioner:
The law defines a medical practitioner in two parts:
The definition of a medical practitioner under the law is divided into two components:
a) Conclusive Part:
This section of the definition makes it clear who is legally recognised as a medical
practitioner. Most people agree that a "medical practitioner" is someone who has
completed the necessary education, training, and licensing requirements to practise
medicine in a recognised profession. Physicians certified and registered under systems
like allopathic medicine—the predominant, contemporary medical practice used
worldwide—are included in this. In light of their area of competence, the final section
officially recognises that individual's right to diagnose, treat, and certify patients.

b) Exclusionary Part:
The exclusionary aspect is crucial in defining what systems of medicine are not included
under the term "medical practitioner." In this context, the definition specifically excludes
practitioners of alternative systems of medicine such as Homoeopathy or Biochemic
Medicine. This means that, although homoeopathic practitioners may be recognized under
their respective laws (such as the Homoeopathy Central Council Act, 1973), they are not
considered "medical practitioners" for the purposes of practicing allopathic medicine, giving
medical opinions, or certifying under statutory frameworks that apply to modern, scientific
medicine. In the case of Poonam Verma vs. Ashwin Patel, this distinction was vital in
establishing that a homoeopathic practitioner cannot legally practice allopathic medicine, and
doing so constitutes negligence per se.
2. Registration Requirement:
The law mandates maintaining a register of Medical Practitioners, and individuals with
requisite qualifications can apply for registration upon payment of a fee. The State Medical
Council maintains a register for medical practitioners, requiring specific qualifications in
their chosen system of medicine. This registration, backed by a prescribed fee, identifies them
as authorized practitioners.
Ashwin Patel, registered under the Bombay Homoeopathic Practitioners Act, violated the law
by treating Pramod Verma using allopathic methods, which was not allowed under his
registration. This breach of the law, resulting in a court hold, highlights the importance of
registration in maintaining professional standards and protecting patients.
3. Scope of Practice:
2
Kumar, P., & Saxena, P. (2013). Causes, issues and impact in medical profession: A study with special
reference to medical negligence. Journal for Legal Studies, 1(1), 1-10.
The scope of practice for registered medical practitioners grants them the legal authority to:
a) Practice Medicine:
A registered practitioner is entitled to diagnose and treat patients within the system of
medicine they are registered for (e.g., allopathy, homoeopathy). This ensures the practitioner
works within their area of expertise.
b) Perform Surgery:
Only those registered in relevant medical systems are authorized to perform surgical
procedures, ensuring that only qualified professionals handle complex medical interventions.
c) Give Medical Treatment:
Registered practitioners can prescribe medication, administer treatments, and provide patient
care based on their registration and qualifications.
d) Provide Expert Evidence:
Under Section 45 of the Indian Evidence Act, 1872, an expert witness can offer an opinion
in legal proceedings on matters within their specialized field of knowledge, which includes
areas like science, art, or medicine. A registered medical practitioner qualifies as an expert
in their respective system of medicine, such as allopathy or homoeopathy, and is thus legally
permitted to give expert testimony in court regarding medical issues.
Application
In this case, Ashwin Patel was registered to practice only homoeopathy. However, by
administering allopathic treatments (intravenous glucose), he acted outside the scope of his
registration. Since his registration did not cover allopathy, Patel was not legally permitted to
practice medicine, perform treatments, or provide expert evidence in allopathy. This violation
of the scope of practice was key in establishing negligence per se in the case.
4. Penalties for Contravention:
Section 15 of the Indian Medical Council Act, 1956,- Right of persons possessing
qualifications in the Schedules to be enrolled. Subject to, the other provisions contained in
this Act, the medical qualifications included in the Schedules shall be sufficient qualification
for enrolment on any State Medical Register.
The case of Ashwin Patel, a homoeopathic practitioner, highlights the violation of medical
provisions by administering allopathic treatments without the necessary legal qualifications
or registration. This action constitutes an offense under medical laws, potentially leading to
imprisonment and fines, as stipulated by the law. These strict legal boundaries and regulations
aim to safeguard patients from the risks associated with unqualified medical treatments.
5. Concept of Negligence:
Negligence in tort law refers to the failure to exercise the level of care that a reasonable
person would in similar circumstances, resulting in harm or injury to another person. It is
based on the principle that individuals are responsible for avoiding foreseeable harm to
others by acting with due care. Negligence arises when someone breaches their legal duty to
act reasonably, and that breach directly causes damage or loss to another party.
6. Negligence Per Se:
The court defines negligence per se as conduct that can be declared negligent without
argument or proof of particular circumstances, either because it violates a statute or municipal
ordinance, or because it clearly opposes common prudence.
The case of Poonam Verma vs. Ashwin Patel & Ors on 10 May 1996, decided by the
Supreme Court on May 10, 1996, examined the issue of medical negligence resulting in the
death of Pramod Verma. The appellant, Mrs. Verma, sought compensation for the alleged
medical negligence before the National Consumer Disputes Redressal Commission.
The primary issue addressed by the court included the qualifications and authority of
Respondent No. 1, a homoeopathic medical practitioner, to engage in the practice of
allopathic medicine. The validity of his registration with the Homeopathic Council in Gujarat
and Maharashtra, and the permissibility of practicing both Homeopathy and Allopathy based
on his qualifications and experience, were also questioned.
.
7. Statutory Duty:
The court emphasizes that practitioners registered under one system of medicine (e.g.,
Homoeopathy) have a statutory duty not to practice in other systems of medicine (e.g.,
Allopathy) for which they are not qualified.
In Poonam Verma vs. Ashwin Patel, the statutory duty of a medical practitioner was pivotal in
establishing negligence. Ashwin Patel, registered under the Bombay Homoeopathic
Practitioners Act, 1959, was legally restricted to practicing homoeopathy. The statute
expressly prohibits practitioners of one medical system from engaging in another system,
such as allopathy, for which they are not qualified. Patel violated this statutory duty by
administering allopathic treatment (intravenous glucose drip) to Pramod Verma, constituting
negligence per se. The court held Patel liable for Verma's deteriorating health and subsequent
death, reinforcing the legal consequence of breaching statutory duties in medical practice.
8. Trespass into Prohibited Field:
It is important to note that practicing allopathic medicine without being registered as a
qualified practitioner in the State Medical Register is a violation of Section 15(3) of the
Indian Medical Council Act, 1956. This provision explicitly prohibits individuals who are not
qualified in allopathic medicine from engaging in such practice. Only those with recognized
qualifications in the relevant field and who are enrolled in the State Medical Register are
authorized to practice medicine or perform related medical duties under the law.
9. Breach of Duty of Care:
In Poonam Verma vs. Ashwin Patel, the court cited the duty of care standard from Dr.
Laxman Joshi's case, which requires medical practitioners to exercise reasonable care, skill,
and knowledge. Patel breached this duty by administering allopathic treatment despite being
a registered homoeopathic practitioner, making him liable for negligence under this standard.
10. Public Duty and Negligence:
Negligence per se occurs when a person violates a statutory duty established to protect
public safety or property. This breach is deemed inntly negligent, without needing further
proof of fault, as the violation of the law itself is sufficient to establish liability.
Dicta
In the case of Poonam Verma vs Ashwin Patel & Ors (1996), despite the Supreme Court of
India not delivering any separate obiter dicta, Hon’ble Court addressed several key issues
related to medical negligence and the unauthorized practice of a medical system by a
practitioner not qualified in that system.

1. Different Systems of Medicine:

The court extensively discussed the distinctiveness of various medical systems such as
Allopathy, Homeopathy, and Ayurveda, emphasizing that practitioners of one system cannot
claim expertise or legal right to practice in another. This became central to the case as
Respondent No. 1, Ashwin Patel, was a qualified homeopathic practitioner but had
administered allopathic treatment to Pramod Verma.
The court acknowledged that although human anatomy and physiology remain the same
across different medical systems, the pharmacology and treatment approaches vary. For
instance, each system—Allopathy, Homeopathy, Ayurveda—has its unique formulations and
methods of diagnosis and treatment. The court observed that although general subjects like
anatomy and physiology might overlap, the knowledge of drugs and the application of
therapeutic treatments are entirely different in each system.

As stated in the judgment:

"No doubt, the study of Physiology and Anatomy is common in all systems of medicines and
the students belonging to different systems of medicines may be taught physiology and
anatomy together, but so far as the study of drugs is concerned, the pharmacology of all
systems is entirely different".

This was crucial in determining the negligence, as Ashwin Patel had no qualifications in
Allopathy and, therefore , could not prescribe allopathic drugs, making him liable for
negligence per se.

2. Types of Negligence (Including Negligence Per Se):

The court defined various forms of negligence, with negligence per se playing a central role
in this case. Negligence per se, as defined in Black's Law Dictionary and cited by the court,
refers to conduct that is automatically considered negligent because it violates a statute or
legal duty, without needing further proof of negligence in surrounding circumstances.

In this case, the court stated that Ashwin Patel, by practicing allopathic medicine without the
requisite qualifications, had engaged in negligence per se. This is because the law explicitly
forbids unqualified practitioners from practicing outside their registered system, and Patel,
being a homeopathic doctor, was prohibited from prescribing allopathic medicines. The court
observed:
"W a person is guilty of Negligence per se, no further proof is needed".

The court's finding was that Ashwin Patel had breached statutory duties, which amounted to
actionable negligence.

3. Doctors Advising Diagnostic Tests in Writing:

Another significant point discussed by the court was the obligation of doctors to advise
diagnostic tests in writing, rather than orally. The court stressed that oral advice about critical
diagnostic tests is inadequate, as it may lead to misunderstandings or lack of follow-through.
In this case, Ashwin Patel claimed that he had orally advised Pramod Verma and his family to
undergo certain blood and urine tests. However, there was no written record of such advice in
his prescriptions.
The court noted that it is standard practice for doctors to put such recommendations in
writing, and Ashwin Patel's failure to do so further demonstrated his negligence. The
judgment highlighted this point, observing that:
"We cannot ignore the usual practice of almost all the doctors that when they want
pathological tests to be done, they advise in writing on a prescription setting out all the tests
which are required to be done".

In failing to case his advice in writing, Patel did not follow the expected duty of care,
contributing to his culpability in the patient's deteriorating condition.

These key observations by the court underscore the importance of medical practitioners
adhering strictly to their area of expertise, the need for rigorous adnce to statutory
regulations, and the professional obligation to case critical medical advice, especially related
to diagnostics.
ARGUMENTS

In the case of Poonam Verma vs Ashwin Patel & Ors (1996), both parties presented detailed
arguments revolving around medical negligence, qualifications, and the appropriateness of
treatment. Let's expand on the arguments of both the appellant (Poonam Verma) and
respondent (Dr. Ashwin Patel)

Poonam Verma (Appellant):

1. Negligence in Administering Allopathic Treatment Without Proper Qualifications:

Poonam Verma, the appellant, argued that Dr. Ashwin Patel was negligent in prescribing
allopathic medicines to her husband, Pramod Verma, despite not being qualified to do so. She
contended that Dr. Patel, a homeopathic practitioner, was legally required to practice
homeopathy only, as per the Bombay Homoeopathic Practitioners Act, 1959, which mandates
that registered homeopathic practitioners can only administer homeopathic treatments. By
prescribing allopathic drugs, Dr. Patel acted outside the scope of his qualifications, leading to
actionable negligence.

The case outlines that Poonam Verma alleged that Dr. Patel kept her husband on strong
antibiotics and other allopathic drugs from 4th July to 12th July 1992 without confirming the
diagnosis through essential tests like blood and urine analyses:
"It was set out by the appellant that Respondent No. 1 was negligent in administering
strong antibiotics to Pramod Verma initially for the treatment of Viral Fever and subsequently
for Typhoid Fever without confirming the diagnosis by Blood Test or Urine Examination".

2. Failure to Conduct Diagnostic Tests:

Poonam Verma argued that Dr. Patel failed to conduct or order the necessary diagnostic
tests to confirm the diagnosis of typhoid or viral fever. This failure to conduct basic
diagnostic tests—like blood and urine tests—led to the deterioration of Pramod Verma's
health, ultimately resulting in his death. Poonam Verma accused Dr. Patel of not taking
appropriate care in diagnosing and treating her husband, which directly contributed to his
death. This claim of medical negligence was central to her request for damages.

3. Claim for Damages:

Poonam Verma sought compensation for the loss of her husband, Pramod Verma, who was
a young man of 35 years, earning Rs. 5,700 per month. His untimely death, caused by alleged
medical negligence, had deprived his family (including his wife, children, and aged parents)
of their financial support. Consequently, Poonam Verma prayed for damages from Dr. Patel
for negligence and deficiency in service.
Dr. Ashwin Patel (Respondent No. 1):

1. Integrated Course in Both Allopathic and Homeopathic Systems:

In his defense, Dr. Ashwin Patel claimed that he had undergone an integrated course that
covered both allopathic and homeopathic systems of medicine. He argued that during his
four-year study at the Homeopathic Medical College, Anand, Gujarat, he had received
training in various medical subjects, including anatomy, physiology, pathology, and surgery.
He also claimed that he had practical experience in treating patients with allopathic medicines
during his stint as Chief Medical Officer at Patel Surgical & Nursing Home from 1983 to
1990.

Dr. Patel presented this argument to justify his prescription of allopathic drugs, stating that
his educational background and practical experience entitled him to administer such
treatments. However, the court later found this claim to be inconsistent with his
qualifications, as he was only registered as a homeopathic practitioner:
"The counter-affidavit and the statement of Respondent No.1 recorded by the Commission
are self-contradictory... In his statement on oath, he categorically stated that he had studied
Homoeopathy only".

2. Oral Advice for Diagnostic Tests:

Dr. Patel further contended that he had advised Pramod Verma to undergo diagnostic tests,
including blood and urine tests, orally. He argued that while treating Pramod Verma for viral
fever and later for typhoid fever, he had advised these tests to confirm the diagnosis.
However, he claimed that the patient did not follow through with the advice and did not get
the tests done.

Dr. Patel's defense rested on the claim that he had exercised reasonable care by advising the
tests, but the patient's failure to comply limited his ability to proceed with further treatment.
However, this was refuted by the court, which noted the absence of any written record of
these test recommendations in his prescriptions:
"He says that he had advised it orally. This cannot be believed as this statement is contrary
to the usual code of conduct of medical practitioners".

3. Appropriate Treatment Based on Prevalent Illnesses:

Dr. Patel justified his treatment of Pramod Verma by stating that the patient was treated
based on common illnesses prevalent in the locality at that time. He initially diagnosed and
treated Pramod Verma for viral fever, which was widespread in the area. Later, when
symptoms persisted, he switched the diagnosis to typhoid fever, another prevalent illness in
the locality, and adjusted the medication accordingly. Dr. Patel claimed that his treatment was
appropriate based on the information he had at the time.
Despite these claims, the court found that Dr. Patel had acted negligently by prescribing
allopathic medicines without properly diagnosing the condition and by practicing a system of
medicine for which he was not qualified:
"He did not feel it necessary to confirm the diagnosis by pathological tests which would
have positively established whether Pramod Verma was suffering from typhoid fever".

Respondent’s arguments

1. Denial of negligence: Both respondents denied the allegations of negligence made against
them.

2. Claim of due care: They contended that they had taken all due and reasonable care to cure
Mr. Verma of his ailment.

3. No deficiency in service: The respondents argued that t was no deficiency in their service.

4. Clinical examination: Respondent No. 1 (Dr. Ashwin Patel) claimed he conducted a

clinical examination of Mr. Verma, finding mild fever and low blood pressure (90/70 mm
Hg).

5. Advice for further care: Respondent No. 1 stated he advised the complainant (Mrs. Verma)
to get her husband admitted to a physician's nursing home for further examination and
pathological investigations.

6. Patient's choice of doctor: Respondent No. 1 claimed that Mrs. Verma herself suggested Dr.
Warty (Respondent No. 2) and his Sanjeevani nursing home for admission.

7. Previous relationship with Dr. Warty: It was stated that Mrs. Verma knew Dr. Warty well,
having been previously admitted to Dr. (Mrs.) Warty's Maternity Home for delivery.

However, it's important to note that these arguments were challenged in the case, particularly
regarding Respondent No. 1's qualifications and legal right to practice Allopathy. The court
found that:
8. Statutory violation: As a registered Homoeopathic practitioner, Respondent No. 1 was
legally required to practice only Homoeopathy.

9. Trespass into prohibited field: By practicing Allopathy, Respondent No. 1 was found to
have trespassed into a prohibited field of medicine.

10. Actionable negligence: The court determined that Respondent No. 1's conduct amounted
to actionable negligence, breaching the duty of care established in previous case law (Dr.
Laxman Joshi's case).
JUDGEMENT3
In the case of Poonam Verma vs. Ashwin Patel & Ors (1996), the Supreme Court of India
found Dr. Ashwin Patel liable for negligence per se because he, a homeopathic practitioner,
administered allopathic treatment without the requisite qualifications. The court held that
practicing in a system of medicine one is not qualified in constitutes automatic negligence
without requiring further proof.

The verdict ruled in favor of Poonam Verma, the appellant, who had sued Dr. Patel for the
wrongful death of her husband, Pramod Verma. The court emphasized that Dr. Patel breached
his duty of care by prescribing allopathic medicines without conducting necessary diagnostic
tests and by violating statutory boundaries that prohibited him from practicing allopathy.

The Supreme Court awarded Poonam Verma compensation of Rs. 3,00,000 for the wrongful
death of her husband. Additionally, the court directed the Medical Council of India and the
Maharashtra Medical Council to consider taking action against Dr. Patel under the Indian
Medical Council Act, 1956, for his unauthorized practice of allopathy.

The judgment reinforced the importance of practitioners adhering strictly to their

qualifications and legal mandates to ensure patient safety and uphold professional standards.

3
Aishwarya Sandeep. (n.d.). Case analysis – Poonam Verma vs Ashwin Patel. *Aishwarya Sandeep - Parenting
and Law*. [ https://aishwaryasandeep.in/case-analysis-poonam-verma-vs-ashwin-patel/ ]
COMMENT4
The Poonam Verma vs. Ashwin Patel case underscores the need for clearer guidelines on
interdisciplinary medical practice. It highlights the risk posed by blurred lines between
different systems of medicine, particularly in rural areas w practitioners may feel entitled to
cross boundaries. The court affirmed that qualifications should define the scope of practice
and emphasized the need for continuous regulatory enforcement to uphold these standards.
Patient safety and trust were central concerns, as Dr. Patel’s unauthorized prescription of
strong antibiotics without proper diagnostic tests compromised both. The case demonstrates
the erosion of trust when doctors act outside their expertise, with the court holding Dr. Patel
liable for negligence. This reinforces the critical importance of competence and ethical
practice in maintaining the doctor-patient relationship.
Proving medical negligence is complex, as shown by the court's reliance on expert testimony
from AIIMS. While Dr. Patel's unauthorized practice constituted negligence per se,
establishing a direct causal link to the patient's death was more challenging, reflecting
broader issues in balancing professional liability with medical uncertainties.
Finally, the case highlights the important role of medical councils in regulating the profession
and enforcing standards. The court's directive to the Medical Council of India to take action
against Dr. Patel underscores the need for stronger oversight, regular audits, and prompt
action to prevent unqualified practitioners from compromising patient safety.

REFERENCES-
Poonam Verma vs Ashwin Patel & Ors, 1996 AIR 2111, Kuldip Singh & Ahmad Saghir
JJ. (Supreme Court of India, May 10, 1996).
["Poonam_Verma_vs_Ashwin_Patel_Ors_on_10_May_1996.PDF"]

4
Biradar, A. (2023). Medical negligence and the laws in India. Journal for Legal Studies, 1(1), 1-10.