Where Negligence Is Evident, Burden Of Proof Shifts To Hospital: SC
🔹 Background
In medical negligence cases, the core issue often is whether the medical practitioner or hospital was negligent in providing treatment. Normally, the plaintiff (patient or their representative) bears the burden to prove negligence. However, in certain circumstances where negligence is apparent or prima facie established, courts have held that the burden shifts to the hospital or doctor to prove absence of negligence.
🔹 Legal Principle: Burden of Proof in Medical Negligence
Initially, the complainant (patient) must establish a prima facie case of negligence.
Once negligence is evident or prima facie established, the burden shifts to the hospital or medical professional to prove that they exercised due care and caution.
This rule is based on the principle of res ipsa loquitur (“the thing speaks for itself”), where the nature of injury or mishap implies negligence.
🔹 Supreme Court’s Stand
The Supreme Court of India has consistently held that in medical negligence:
The patient need not prove every detail once initial evidence shows negligence.
The hospital must then prove that the treatment was as per accepted medical standards.
This shifting of burden balances the inherent inequality of access to evidence and medical expertise between patient and hospital.
🔹 Relevant Case Laws
✅ Jacob Mathew v. State of Punjab, (2005) 6 SCC 1
The Supreme Court emphasized that negligence must be proved with “reasonable degree of medical certainty”.
Once negligence is prima facie shown, the burden shifts to the medical practitioner to prove absence of negligence.
The Court held that courts should not become courts of medical science but can evaluate if there was gross negligence.
✅ Dr. Laxman Balkrishna Joshi v. Dr. Trimbak Bapu Godbole, AIR 1969 SC 128
This landmark case explained the standard of care expected from doctors.
It recognized that if the injury or result is of a nature that usually does not happen without negligence, the hospital must explain its actions.
✅ Punjab State Electricity Board v. Suresh Kumar, (2009) 6 SCC 719
Affirmed the principle that once negligence is apparent, burden shifts to the defendant to prove due diligence.
✅ State of Haryana v. Smt. Santra, (2000) 2 SCC 58
Held that hospitals or medical personnel are required to prove the absence of negligence once a prima facie case is made.
✅ K. M. Chinnappa v. B. J. Medical College Hospital, AIR 1977 SC 2014
The Court observed that where there is apparent negligence, hospitals cannot avoid responsibility by mere silence.
🔹 Principle of Res Ipsa Loquitur in Medical Negligence
The principle applies when injury is such that it ordinarily does not happen without negligence.
Once the plaintiff establishes circumstances pointing strongly to negligence, the hospital must rebut the presumption.
This principle helps patients overcome the difficulty of proving medical technicalities.
🔹 Practical Implications
In cases where evidence of negligence is clear (wrong diagnosis, surgical error, improper medication, etc.), courts expect hospitals to provide explanations, expert testimony, and medical records.
Failure to produce such proof can lead to holding hospitals liable.
Protects patients’ rights, especially when evidence is largely in the hands of the medical establishment.
🔹 Summary Table
| Aspect | Explanation |
|---|---|
| Burden of Proof (Normal) | Lies with the patient/plaintiff to prove negligence |
| Burden Shift Condition | When negligence is prima facie or evident |
| On Whom Burden Shifts | Hospital/medical practitioner to prove absence of negligence |
| Legal Basis | Principle of res ipsa loquitur; Supreme Court precedents |
| Outcome of Non-Compliance | Liability imposed on hospital if it fails to rebut negligence |
🔹 Conclusion
The Supreme Court’s jurisprudence clearly protects patients by shifting the burden of proof to the hospital once negligence is evident. This approach ensures justice by recognizing the practical difficulties patients face in proving complex medical facts and maintains the accountability of medical professionals.
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