Peshawar High Court

Lady Doctor Nargis Vs The State and others

Outcome The writ petition was allowed and FIR No. 216 dated 15.05.2023 was quashed, with liberty to pursue the grievance through the statutory channel.

Case
W.P No. 994-A of 2025
Type
Criminal
Length
26 pages

Summary

AI-generated · quotes checked against the text

The petition challenged an FIR registered against a doctor for alleged medical negligence after the death of a patient and her child during delivery. The High Court held that, in Khyber Pakhtunkhwa, such complaints must first go to the Healthcare Commission under the special statutory scheme, so the FIR and later proceedings were unlawful and had to be quashed.

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Written by AI from the judgment's text and may miss nuance. Rely on the full judgment below and the court's official copy. Court's own note: a) Any inadequate care provided to a patient by a healthcare provider that results in harm or injury or worsens a pre-existing medical condition might qualify as a breach of the duty of care required of the healthcare provider in the given conditions and on the generally acceptable and applied standard. However, for it to qualify as criminal negligence, something more is required; the severity of harm and the degree of negligence has to be so high that it takes the conduct of the delinquent out of the bounds of mere ‘negligence’ into the realm of ‘gross negligence’ or ‘recklessness’. b) In all professional negligence cases (not just medical/healthcare), the standard/test seems to be: what a reasonable, competent professional in the same field would do in similar facts and circumstances? This question can only be answered by a body of experts and until it is answered it cannot be said whether a doctor or any healthcare service provider has been negligent or even whether the death or harm has been caused due to his act or omission. Thus the causation or even actus reus constituting any offence cannot be determined. It is for this reason that the legislature decided to route the complaint of any aggrieved party through the Healthcare Commission and first determine the existence and extent of any negligence on part of the Healthcare service provider and then recommend the appropriate disciplinary, civil or criminal action(s) against the delinquent. This was done through the KP Health Care Commission Act, 2015 (‘Act of 2015’) and the Complaint Management Regulations made thereunder. c) The KP Healthcare Commission Act, 2015 has established a specialized expert body, and has created a self-contained mechanism under section 13 of the Act for the investigation and adjudication of complaints against medical practitioners and establishments. A cornerstone of this legislative scheme is its overriding effect (section 33) and immunity (section 19), explicitly stated to supersede any contrary provision in any other existing law. This establishes a clear legal hierarchy, affirming the well-settled jurisprudential principle that a special law, crafted to govern a specific subject matter with expert precision, must prevail over general laws when there is a conflict. The ‘Act of 2015’ does not leave the procedure for redress to conjecture; it meticulously outlines the process. It provides a transparent and structured pathway for inquiry/investigation into allegations of medical negligence by a body possessing the requisite expertise. d) Quite independent of any other reason, the legal effect of the enactment of ‘the Act of 2015’ is that it occupies, to the exclusion of all other laws, the field of negligence and malpractice in the area of Healthcare. So, where the allegation concerns acts/omissions of a healthcare provider ‘in the course of professional duties’, the complaint must first go to the Commission under section 13 of ‘the Act of 2015’; the police are not to bypass this statutory filter by directly registering an FIR, for instance under section 322 PPC, as in the instant case. Hence, the law is clear: (i) No FIR can be registered against a healthcare service provider or a healthcare institution on the allegations of malpractice or negligence except at the instance of the commission; (ii) Any person aggrieved of any malpractice or negligence by a healthcare service provider or institution may file a complaint u/s 13 of ‘the Act of 2015’ before the KP Healthcare Commission; (iii) It is the duty and responsibility of the commission to expeditiously and diligently pursue and take the complaint to its legal and logical conclusion, which may also, after due process, include lodging of FIR under the relevant provisions of PPC (including section 322); (iv) It therefore follows that any such FIR registered directly without first approaching the Healthcare Commission would be without lawful authority and liable to be quashed. e) The existence of a tailored statutory remedy renders the concurrent use of the general criminal process impermissible. Consequently, to allow these proceedings to continue would violate the clear intent of the legislature and undermine the specialized regulatory system it created. Thus, the FIR and all subsequent proceedings stemming from it are unsustainable in law and required to be quashed.

Full judgment

Official copy

JUDGMENT SHEET

PESHAWAR HIGH COURT

ABBOTTABAD BENCH

(Judicial Department)

WP No. 994-A/2023.

Lady Doctor Nargis.

Petitioner(s)

V e r s u s.

The State and others.

Respondent(s)

For Petitioner(s): Mr. Azeemullah Tahirkheli, Advocate.

For Respondent(s) Mr. Shoaib Ali, Asst: AG.

Date of hearing: 17.09.2025.

JUDGMENT

SYED MUDASSER AMEER, J.- Lady

Doctor Nargis has filed this petition, under Article 199 of The Constitution of Islamic Republic of Pakistan, 1973 (‘The Constitution’), seeking the quashment of FIR No. 216 dated: 15.05.2023 registered against her under section 322 PPC at Police Station, Ghazi, Haripur.

2.On 15.05.2023, Respondent No.3 Shahrukh S/o Allahdad, along with the dead body of his deceased wife Mst. Alisha, reported to the local police at THQ Ghazi that his wife was on

family way and remained under treatment of the Petitioner at Al-Hamza Hospital; that two days prior to the occurrence his wife’s delivery was due;

that Petitioner was negligent in her treatment which complicated the situation and resulted in the death of his wife as well as his child. Thus, a criminal case was registered against the petitioner vide FIR No. 216, dated 15.05.2023, under section 322 of the Pakistan Penal Code, 1860 (‘PPC’) at Police Station Ghazi in Haripur. Although section 322 PPC is punishable with Diyat only and no imprisonment therefor has been provided in law, petitioner was taken into custody and subsequently produced before the court of a Judicial Magistrate for the purpose of obtaining physical remand. The learned Magistrate granted bail to the petitioner vide his order dated: 15.05.2023. Subsequent to this release, respondent No. 3 initiated further legal action by filing a revision petition under Section 439-A of the Criminal Procedure Code (‘Cr.PC’), read with Section 497(5) of the Cr.PC, seeking the cancellation of the bail granted to the petitioner.

This revision petition was allowed by the Additional Sessions Judge in Ghazi vide order dated 19.06.2023, petitioner's bail was cancelled, and she was ordered to be sent to judicial lock-up.

Thus the instant petition.

3.Arguments heard and record perused.

4.The tragic demise of Mst. Alisha and her child during the delivery process is a profound human tragedy, and the court expresses its deepest sympathies to the aggrieved family. However, the solemn duty of this court is to adjudicate the matter strictly in accordance with law. The central legal question before this court is whether the registration of FIR and the subsequent invocation of the general criminal justice system under the Cr.P.C. is a legally sustainable course of action for allegations of medical negligence, given the existence of a specific, comprehensive legislative framework enacted for this precise purpose.

5.There is no denial and is admitted in the very contents of the first information report that Al- Hamza hospital is a private health care institution and petitioner Dr. Nargis is qualified healthcare service provider in that hospital. It is the petitioner’s case that where a special law has been enacted to deal with a particular subject, it ousts the application of general law to that matter. More-so, when the special enactment expressly ousts the application of, and bars assumption of jurisdiction under, any other law.

6.The matter pertains to negligence particularly medical negligence as alleged against the petitioner. Negligence, in legal parlance, is one of the most significant concepts of the law of tort and refers to the breach of a duty of care imposed by law which results in harm to another, and it essentially rests upon four foundational elements:

the existence of a duty of care, breach of that duty, a causal connection between the breach and the damage suffered, and actual damage resulting therefrom. Medical negligence emerges as a specialized category wherein doctors, hospitals, and healthcare professionals are held accountable for failing to exercise reasonable skill and care expected of them. Such liability arises once a doctor-patient relationship is created, imposing upon the doctor a legal and moral duty to provide treatment in accordance with established medical standards, and breach occurs when the professional falls below the standard of a reasonably competent practitioner of similar skill and standing, causing harm to the patient.

7.Globally, medical negligence can lead to both civil claims for compensation and, in some cases, criminal prosecution, depending on the

severity of the claim. Each jurisdiction has its own laws dealing with the subject. In England, medical negligence remains under the general ambit of tort law, supplemented by statutory measures like the NHS Redress Act, 2006; the defenses available to medical practitioners include informed consent, contributory negligence of the patient, and the recognition that an error of judgment, if honestly made and within acceptable medical practice, does not per se constitute negligence; remedies available to aggrieved patients encompass civil compensation for damages, criminal liability in cases of gross negligence leading to death or serious harm, and disciplinary actions such as suspension or cancellation of license by medical regulatory bodies.

8.In Pakistan, though the law of tort remains largely uncodified, medical negligence was always recognized both in civil and criminal spheres, with the PPC providing criminal liability for rash or negligent acts under sections 319, 320 and 322, while civil remedies are pursued through suits for damages under the Civil Procedure Code, 1908, and some regulatory oversight was provided by the Pakistan Medical and Dental Council Ordinance, 1962 (now Pakistan Medical and

Dental Council Act, 2022). After the deletion of the ‘Concurrent Legislative List’ by virtue of the Eighteenth Amendment, ‘Health’ became a predominantly, if not wholly, a Provincial subject.

Accordingly, each province enacted its own laws regulating the provision of healthcare services.

Islamabad Capital Territory has ‘Islamabad Health Regulation Act, 2018’, Punjab enacted ‘The Punjab Healthcare Commission Act, 2010’, Sindh enacted ‘The Sindh Healthcare Commission Act, 2014’ and Balochistan enacted ‘The Balochistan Healthcare Commission Act, 2019’. Similarly, the Khyber Pakhtunkhwa (‘KP’) Provincial Assembly enacted the KP Health Care Commission Act, 2015.

9.Loss of human life, in any form or manner, is most tragic. However, occurrence of death or harm during medical treatments is neither new, nor unheard of. It is quiet common. In fact, many deaths do occur inside hospitals as almost every critical patient is rushed to the hospital in an effort to save his/her life. The doctors and the medical staff are on their toes 24 hours a day and 7 days a week, trying hard to save lives and treat patients to the best of their abilities. But try is all they can. It is all that is promised and expected.

There is never any guarantee of life or cure.

Therefore, it is this effort, that is to be measured to determine whether a medical professional or healthcare provider has been negligent or not. The mode, manner and level of this effort generally provided by the healthcare providers in that specific area and in similar circumstances sets ‘the standard of care’ required. Anything short of that may incur liability and the lesser the effort or the further below the ‘standard of care’, the greater the liability. In other words, every healthcare provider owes a duty to his patient to provide care according to ‘the standard of care’. Else, he could be found to be in breach of the said ‘duty of care’. Courts, while adjudicating such cases, have consistently sought to strike a balance between protecting patients from reckless or careless treatment and preserving the autonomy of medical professionals so that fear of litigation does not discourage necessary medical risk-taking, thereby ensuring that liability is imposed only when the conduct in question falls egregiously below accepted standards of practice; in sum, medical negligence represents the intersection of tortious liability, statutory regulation, and professional ethics, ensuring that while doctors are not made insurers of life, they are nonetheless bound to uphold a standard of reasonable care and competence,

failing which the law provides multiple avenues civil, criminal, and regulatory to secure justice for the victims of such negligence.

10.Medical negligence can have numerous manifestations. This may include misdiagnosis or delayed diagnosis, incorrect treatment, surgical error, improper anesthetic application, prescription error, negligent medical advice, injuries during pregnancy or birth, dental errors, negligent cosmetic care or even non-disclosure of important information or competing options. However, most such cases are civil in nature and do not qualify as ‘criminal negligence’. Any inadequate care provided to a patient by a healthcare provider that results in harm or injury or worsens a pre-existing medical condition might qualify as a breach of the duty of care required of the healthcare provider in the given conditions and on the generally acceptable and applied standard. However, for it to qualify as criminal negligence, something more is required; the severity of harm and the degree of negligence has to be so high that it takes the conduct of the delinquent out of the bounds of mere ‘negligence’ into the realm of ‘gross negligence’ or ‘recklessness’.

11.Lord Denning in Roe and Woolley vs.

The Ministry of Health and An Anaesthetist (1954) 2 All ER 131, said:

“Every surgical operation is attended by risks. We cannot take the benefits without taking the risks. Every advance in technique is also attended by risks. Doctors like the rest of us, have to learn by experience; and experience often teaches in a hard way.”

Justice Mc Nair, in Bolam vs. Friern Hospital Management Committee (1957) 2 All ER 118, observed:

“...there may be one or more perfectly proper standard; and if a medical man confirms to one of those proper standards then he is not negligent.”

This principle was further refined in the case of Bolitho v City & Hackney Health Authority [1997] 4 All ER 771 by adding a further requirement that the standard proclaimed must be justified on a logical basis and must have considered the risks and benefits of competing options. Thus, their combined effect would be that ‘a doctor is not negligent if he acts in accordance with a responsible body of medical opinion, provided that the Court finds such an opinion to be logical’. The Supreme Court of UK, in the case of Montgomery v. Lanarkshire Health Board (2015 SCMR 663), held as follows:

“61. Superficially, this resembles the qualification of the Bolam test subsequently stated by Lord Browne-Wilkinson in Bolitho v City and Hackney Health Authority [1998] AC 232, 243: that notwithstanding the views of medical experts, the court may conclude that their opinion is incapable of withstanding logical analysis. Lord Browne- Wilkinson however expressly confined his observations to cases of diagnosis and treatment, as distinct from disclosure of risk. In cases of the former kind, the court is concerned with matters of medical skill and judgment, and does not usually find a doctor guilty of negligence if she has followed a practice accepted as proper by a responsible body of doctors skilled in the relevant field. That is however subject to Lord Browne- Wilkinson's qualification where the court is satisfied that the professional practice in question does not meet a reasonable standard of care. In cases concerned with advice, on the other hand, the application of the Bolam test is predicated on the view that the advice to be given to the patient is an aspect of treatment, falling within the scope of clinical judgment. The "informed choice" qualification rests on a fundamentally different premise: it is predicated on the view that the patient is entitled to be told of risks where that is necessary for her to make an informed decision whether to incur them.”

12.In India, in the case of Suresh Gupta v.

Government of NCT, Delhi, (AIR 2004 SC 4091), when a patient died while being operated for removing his nasal deformity, a case was registered under section 304 of Indian Penal Code against the doctor/surgeon performing the surgery. High Court declined but the Indian Supreme Court, while

quashing the criminal proceedings against the doctor, held as under:

“For fixing criminal liability on a doctor or surgeon, the standard of negligence required to be proved should be so high as can be described as “gross negligence” or “recklessness”. It is not merely lack of necessary care, attention and skill. The decision of the House of Lords in R. Vs. Adomako (Supra) relied upon on behalf of the doctor elucidates the said legal position and contains following observations:

“Thus a doctor cannot be held criminally responsible for patient's death unless his negligence or incompetence showed such disregard for life and safety of his patient as to amount to a crime against the State.” Thus, when a patient agrees to go for medical treatment or surgical operation, every careless act of the medical man cannot be termed as ‘criminal’. It can be termed ‘criminal’ only when the medical man exhibits a gross lack of competence or inaction and wanton indifference to his patient's safety and which is found to have arisen from gross ignorance or gross negligence. Where a patient’s death results merely from error of judgment or an accident, no criminal liability should be attached to it. Mere inadvertence or some degree of want of adequate care and caution might create civil liability but would not suffice to hold him criminally liable.

For every mishap or death during medical treatment, the medical man cannot be proceeded against for punishment. Criminal prosecutions of doctors without adequate medical opinion pointing to their guilt would be doing great disservice to the community at large because if the courts were to impose criminal liability on hospitals and doctors for everything that goes wrong, the doctors would be more worried about their own safety than giving

all best treatment to their patients. This would lead to shaking the mutual confidence between the doctor and patient. Every mishap or misfortune in the hospital or clinic of a doctor is not a gross act of negligence to try him for an offence of culpable negligence.”

13.Nonetheless, no matter what the standard, there is no departure from the established and consistently followed principle of ascertainment and determination of liability by the experts in the same field. Obviously this would be a specialized exercise that could only be undertaken by someone who knows and understands the provision of the said particular healthcare. Thus, in all professional negligence cases (not just medical/healthcare), the standard/test seems to be: what a reasonable, competent professional in the same field would do in similar facts and circumstances? This question can only be answered by a body of experts and until it is answered it cannot be said whether a doctor or any healthcare service provider has been negligent or even whether the death or harm has been caused due to his act or omission. Thus the causation or even actus reus constituting any offence cannot be determined. It is for this reason that the legislature decided to route the complaint of any aggrieved party through the Healthcare Commission and first determine the existence and

extent of any negligence on part of the Healthcare service provider and then recommend the appropriate disciplinary, civil or criminal action(s) against the delinquent. This was done through the KP Health Care Commission Act, 2015 (‘Act of 2015’) and the Complaint Management Regulations made thereunder.

14.To further appreciate the case in hand, it is important to examine sections 321 and 322 of PPC and relevant sections of ‘the Act of 2015’ as well as the Regulations made thereunder. For convenience, these are reproduced below:

Pakistan Penal Code, 1860:

321.Qatl-bis-Sabab. Whoever, without any intention to cause death of, or cause harm to, any person, does any unlawful act which becomes a cause for the death of another person, is said to commit qatl-bis-sabab".

322.Punishment for qatl-bis-sabab. Whoever commits qatal-bis-sabab shall be liable to Diyat.

Khyber Pakhtunkhwa Health Care Commission Act, 2015.

1(2). It shall apply to all the health care establishments in public and private sectors;- (a). owned, managed or administered by Government or non-profit organizations, charities, trusts, corporate sector or by any person, or group of persons incorporated or not; and

(b). operated and managed under allopathic system, complementary and alternative medical treatment system recognized in Pakistan.

2(n) “prescribed” means prescribed by rules or regulations made under this Act;

6 (2) Without prejudice to the generality of the provisions of sub-section (1), the Commission shall:

(g)enquire and investigate into mal-administration, malpractice and failures in the provision of private healthcare services and issue consequential advice and orders;

13.Complaints--- (1) An aggrieved person may, within sixty days from the date of knowledge of the cause of action, file a complaint against a healthcare service provider or healthcare establishment by submitting an application in writing supported by an affidavit, national identity card number and address of the aggrieved person.

(2)The Commission shall not entertain an anonymous or pseudonymous complaint against a private health care service provider or healthcare establishment.

(3)The Commission shall investigate in a transparent manner, the complaints relating to quality of health services, health services or system and medical negligence.

(4)The Commission shall prescribe the procedure for the conduct of investigation to be carried out by the Commission under this Act.

19.Immunity--- No suit, prosecution or other legal proceedings related to provision of private health care services shall lie against a health care establishment except under this Act. (Underlining supplied)

33.Overriding effect---Notwithstanding anything to the contrary contained in any other law, the provisions of this Act shall have an overriding effect and the provisions of any such law to the extent of inconsistency to this Act shall cease to have effect.

Khyber Pakhtunkhwa Healthcare Commission (Complaint Management) Regulations, 2022:

6.Scope of the Complaint:

The Commission may, for the purpose of hearing and passing appropriate orders and for taking such remedial steps as are required and warranted by the law, receive complaints regarding:

(1)Medical negligence, including criminal negligence;

(2)Maladministration & malpractice;

(3)Quackery, in all its forms and manifestations;

(4)Failure in the provision of health care services or providing sub-standard services;

(5)Operating a Health Care Establishment without registration and/or Licence by the Khyber Pakhtunkhwa Health Care Commission or providing health care services, beyond the scope of licence;

(6)Obstruction, hindrance or impedance in the performance of functions or execution of duty of the Commission, including the inspection and investigation team;

(7)Furnishing or causing to furnish wrong information;

(8)Harassment of health care service provider, which includes but not limited to verbal and psychological harassment, and improper conduct. (Underlining supplied)

13.Penalties:

(1)In case of Medical negligence including criminal negligence, the health care establishment and

service provider found guilty shall be liable to fine which may extend to one million rupees and compensation to the aggrieved person which shall not be less than the amount of actual damage caused to the aggrieved person. In addition to the fine and compensation, the competent authority may also recommend lodging of FIR under the relevant Law. For the purpose of this clause, the cases of medical negligence shall be categorized as: Severe Causing or Fine which may contributing to extend to death 1,000,000/- Rupees Moderate Causing or Fine which may contributing to extend to permanent loss 500,000/- Rupees of function of body or part of body Mild Temporary Fine which may disability and extend to delayed 300,000/- Rupees process of recovery (Underlining supplied)

15.It is clear from the above provisions of ‘the Act of 2015’ that it is applicable to all persons and institutions/health care establishments in public and private sectors operated and managed under allopathic system, complementary or alternative medical treatment system recognized in Pakistan.

The Commission constituted under section 3 of the Act is charged with responsibility under section 6(2)(g) to enquire and investigate into mal- administration, malpractice and failures in the provision of healthcare services and issue consequential advice and orders. Any aggrieved person can file a complaint against a healthcare

service provider or healthcare establishment under section 13 of the Act, which shall be investigated by the commission in the prescribed manner as required under section 13(4) of the Act. This procedure has been elaborately provided in the Regulations as reproduced above. Moreover, section 19 provides absolute immunity to persons attached with medical profession or medical institution/establishment from any suit, prosecution or other legal proceedings related to provision of private healthcare services except under ‘the Act of 2015’ and while giving overriding effect to the ‘Act of 2015’, section 33 thereof starting with non- obstante clause expressly ousts the application of any other law to the extent of its inconsistency with the provisions of the Act.

16.The ‘Act of 2015’ creates a complete, specialized mechanism to deal with alleged medical negligence and malpractice by healthcare providers and establishments in KP. Section 13 expressly provides a forum and route for “any person aggrieved” to file a complaint before the Khyber Pakhtunkhwa Health Care Commission, which then processes the matter through inspection/investigation and further proceedings within the Commission’s framework. The

Commission’s functions and powers, set out across Chapters III–VI, inter-alia, include:

 receiving and deciding complaints, conducting inspections and investigations, and issuing directions and orders to healthcare providers;

 taking regulatory/penal action under the Act; and

 where criminality is made out, referring the matter for prosecution or lodging a complaint with the police/competent forum under the Pakistan Penal Code (PPC).

17.In furtherance of the ‘Act of 2015’ regulations are made and improved from time to time. First there were the KP Healthcare Commission Conduct of Business Regulations, 2016, which were later replaced by KP Healthcare Commission (Complaint Management)

Regulations, 2022. Both these regulations provide elaborate mechanism for receipt and scrutiny of complaints; preliminary inquiry, expert/peer review where needed; hearing and decision by the Commission or its authorized bodies; and where prima facie criminal negligence is established, the Commission’s referral of complaint to the police under relevant PPC provisions (which may include s. 322).

18.The ‘Act of 2015’ has been enacted by the provincial legislature, in its wisdom, with the explicit objective of transforming the regulatory landscape of healthcare in KP. Its aims are multifaceted: to enhance patient safety, to systematically improve the quality of healthcare services across both public and private sectors, and to eradicate the menace of quackery. Most critically for the present matter, it has established a specialized expert body, and has created a self- contained mechanism under section 13 of the Act for the investigation and adjudication of complaints against medical practitioners and establishments. A cornerstone of this legislative scheme is its overriding effect (section 33) and immunity (section 19), explicitly stated to supersede any contrary provision in any other existing law. This establishes a clear legal hierarchy, affirming the well-settled jurisprudential principle that a special law, crafted to govern a specific subject matter with expert precision, must prevail over general laws when there is a conflict. The ‘Act of 2015’ does not leave the procedure for redress to conjecture; it meticulously outlines the process. It provides a transparent and structured pathway for inquiry/investigation into allegations of medical

negligence by a body possessing the requisite expertise.

19.Undoubtedly, the ‘Act of 2015’ is a “special law” dealing with medical negligence in KP. It needs no elaboration that in case of conflict between a special and general law, the former shall prevail. Similarly, in case of conflict between two special laws the one more specific and more relevant to the matter has to prevail. To ascertain this, the object, purpose and policy of both statutes as well as the intention of the legislature has to be seen. Furthermore, under the principle ‘generalia specialibus non derogant’, a special statute and its prescribed process will prevail over general procedure for matters within its field. In Mst.

Parveen Ara v. Muhammad Hanif (PLD 2025 SC

612)the apex Court observed:

“19. ...It is a well-known exposition of law that special law prevails and outweighs general law, as encapsulated in the Latin maxim "generalia specialibus non derogant", which denotes that general provisions do not derogate from special provisions. This principle signifies that specific or detailed provisions of a legal instrument should prevail over more general or conflicting provisions. When the provisions of a general law and a special law addresses the same issue or matter, the general law is impliedly repealed to the extent that the special law applies.”

Further reliance can be placed on Muhammad Iqbal and others v. Nasrullah (2023 S C M R 273) and Syed Mushahid Shah and others v. Federal Investment Agency and others (2017 SCMR 1218).

Thus, quite independent of any other reason, the legal effect of the enactment of ‘the Act of 2015’ is that it occupies, to the exclusion of all other laws, the field of negligence and malpractice in the area of Healthcare. So, where the allegation concerns acts/omissions of a healthcare provider ‘in the course of professional duties’, the complaint must first go to the Commission under section 13 of ‘the Act of 2015’; the police are not to bypass this statutory filter by directly registering an FIR, for instance under section 322 PPC, as in the instant case.

20.Dealing with similar situations, almost all the High Courts have taken similar views and there seems to be judicial consensus on the point that in cases of medical negligence registration of FIR should not be resorted to at the very outset, rather the appropriate Healthcare Commission or Authority must first inquire into the facts and circumstances of the case and, if at all, on the basis of expert medical opinion, the facts so require, the case may be proceeded on the criminal side.

Reliance is placed on Muhammad Aslam v. Dr.

Imtiaz Ali Mughal (PLD 2010 Kar. 134), Shifa International Hospitals Ltd. v. PMDC and others (2011 CLC 463), Naseem Akhtar and another v.

Ex-Officio Justice of Peace (PLD 2018 Lah. 903), Dr. Khair Muhammad Sahowal and 3 others v.

Province of Sindh and others (2022 YLR 63), Lady Dr. Nafeesa Saleem v. Justice of Peace/ASJ, Multan and others (PLD 2022 Lah. 18), Riaz Ahmad v. ASJ/Ex-Officio Justice of Peace Rojhan District Rajanpur (2022 PCr.LJ 1067), Dr. Saiqa Yousaf v. The State and 2 others (2024 PCr.LJ 1852), Dr. Shahid Karim and 3 others v. The CEO, Sindh Health Care Commission and others (PLD 2024 Sindh 320) and Dr. Farhat Ullah Bakhsh v.

Ex-Officio Justice of Peace/ASJ-III (East), Islamabad and 4 others (PLD 2025 Isl. 106).

Likewise, this Court, in the case of Lady Doctor Getman Alla alias Aliya Wahab v. The State and others (WP No.744-M of 2023), quashed an FIR registered under section 322 PPC against a doctor for alleged medical negligence, holding that the special mechanism provided under ‘the Act of 2015’ must be followed and that the police cannot directly register such FIRs without the Commission’s process. Thus the Courts have treated the Commission’s scheme as a necessary

filter, recognizing that questions of professional/clinical negligence need the Commission’s expert-led scrutiny before criminal process like section 322 PPC is set in motion.

21.Hence, the law is clear:

(i)no FIR can be registered against a healthcare service provider or a healthcare institution on the allegations of malpractice or negligence except at the instance of the commission;

(ii)any person aggrieved of any malpractice or negligence by a healthcare service provider or institution may file a complaint u/s 13 of ‘the Act of 2015’ before the KP Healthcare Commission;

(iii)it is the duty and responsibility of the commission to expeditiously and diligently pursue and take the complaint to its legal and logical conclusion, which may also, after due process, include lodging of FIR under the relevant provisions of PPC (including section 322);

(iv)it therefore follows that any such FIR registered directly without first approaching the Healthcare Commission would be without lawful authority and liable to be quashed.

22.In the present case, the complainant, undoubtedly aggrieved by a devastating loss,

bypassed this entire statutory mechanism as provided under section 13 of the ‘Act of 2015’.

Instead of availing the remedy specifically designed by the legislature for such grievances, he initiated proceedings with the local police, leading to the registration of an FIR for an offence under the PPC. This action, while understandable from an emotional standpoint, constitutes a fundamental legal error. The ‘Act of 2015’ expressly bars the initiation of such parallel legal proceedings including criminal prosecutions in any forum other than the one it establishes, unless such action is itself recommended by the Commission following its own expert inquiry. Therefore, the very foundation of the criminal case against the petitioner is legally flawed. The process of registering the FIR and investigating the petitioner under the general criminal law was conducted without lawful authority, as it directly contravenes the specific and mandatory procedure prescribed by the special law. The existence of a tailored statutory remedy renders the concurrent use of the general criminal process impermissible.

Consequently, to allow these proceedings to continue would violate the clear intent of the legislature and undermine the specialized regulatory system it created. Thus, the FIR and all

subsequent proceedings stemming from it are unsustainable in law and required to be quashed.

Recently in the case of Ayesha Tayyab v. SHO, PS Cantt., Sialkot (2025 SCMR 1117) the apex Court reiterated the grounds recognized for quashing an FIR under Article 199 of the Constitution as follows:

“...The High Court can quash an FIR under Article 199, in cases where no offence is made out against the accused from the facts on record, or where the registration of FIR reflects misuse of legal authority or lacks sound legal justification because prosecution under such conditions would be tantamount to abuse of the process of law, or where FIR is registered without proper authority or in clear violation of established laws However, if a prima-facie case is made out against the accused from the facts of FIR, High Courts should refrain from invoking their constitutional powers under Article 199 of the Constitution. Reliance can be placed on Ajmeel Khan v. Abdul Rahim and others (PLD 2009 SC 102), FIA, Director General FIA, and others v. Syed Hamid Ali Shah and others (PLD 2023 SC 265) and The State through Prosecutor General Punjab, Lahore v. Chaudhry Mohammad Khan and others (PLD 2025 SC 254).

It is also pertinent to mention that where any of the aforementioned exceptional circumstances justifying the quashment of an FIR are established,

the mere submission of a police report under section 173 Cr.P.C. before the trial court does not constitute a bar to the exercise of constitutional jurisdiction of the High Court.”

23.In view of the above discussion and exposition of law, we allow this petition and as a result thereof, the FIR No.216 dated: 15.05.2023 registered under section 322 PPC at Police Station, Ghazi, Haripur is hereby quashed. However, the complainant may, if so advised, pursue his grievance through the appropriate statutory channel as prescribed by law.

Announced.

Tahir PS

Sd/Judges

sd

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