Medical Negligence in Nepal: Legal Remedies and Court Procedure

Medical negligence, or medical malpractice, occurs when a healthcare provider fails to deliver the level of care reasonably expected in their field, leading to injury or harm to a patient.

 

It is, in fact, a sensitive and complex area of law that affects both patients and healthcare professionals. It arises when medical care falls below accepted standards, potentially causing harm. However, not every poor outcome is the result of negligence, and both patients and medical practitioners may face confusion or legal uncertainty in such situations. In this article, we explore what medical negligence means, how the law addresses it, and what legal options are available including the proceedings required.

 

In Nepal, only the medical practitioners listed in the register book by the Nepal Medical Council under Nepal Medical Council Act, 2020 (1964) (“Medical Council Act”) can actually practice medicines and provide health care services.

 

Although the term ‘medical negligence’ or ‘medical malpractices’ is not mentioned in statutory laws of Nepal, this particular offence is governed by the following laws:

 

S.N.	Law/Regulation	Details
1	Muluki Criminal Code, 2017 (2074)	It defines gross negligence as a criminal offense and provides for punishment of fine and imprisonment based on the gravity of the hurt and the offense.
2	Nepal Medical Council Act, 2020 (1964)	It establishes the Nepal Medical Council (NMC), that governs primarily the registration, regulation, and discipline of medical professionals in Nepal.
3	Medical Council Regulations, 2024 (1968)	It establishes the framework for the Nepal Medical Council's (NMC) operations to ensure the council functions effectively.
4	Consumer Protection Act, 2075 (2018)	It recognizes patients as consumers and health care services as a type of service under the Act. If the medical services are deemed deficient, the victims are given the right to seek the remedy before the court.

 

Chapter 19 of the National Penal (Code) Act has a separate chapter in regard to ‘Offence relating to the Medical Treatment’, which labels following acts of medical practitioners as offence and prescribes sanctions for the same.

 

Sections	Offences	Punishment
Sec. 230(1)	Conducting medical treatment without a valid license	Up to 3 years imprisonment and up to NPR 30,000 fine
Sec. 230(4)	If such unauthorized treatment causes death or grievous hurt	Death – Life imprisonment Grievous hurt – Up to 15 years imprisonment
Sec. 231(1), 231(2)	Malicious treatment intending to cause death or harm (e.g., wrong surgery, harmful drug)	Same punishment as for murder (if death) or grievous hurt (if injury)
Sec. 232(1), 231(2)	Reckless or negligent treatment by authorized person	If death – Up to 5 years imprisonment + up to NPR 50,000 fine If grievous hurt – Up to 3 years imprisonment + up to NPR 30,000 fine
Sec. 233(1), 233(4), 233(5)	Unauthorized medical experimentation or procedures without informed consent	Basic – Up to 3 years imprisonment and up to NPR 30,000 fine If caused death or grievous hurt – Same punishment as for murder or grievous hurt

 

2.1 Provision on Statute of Limitation

If the offender is charged with serious offences causing death, then there is no statute of limitation for filing the case. In regard to conducting medical treatment without obtaining licenses, the case must be filed within 1 year of the date of knowledge. Lastly, for the remaining cases under Chapter 19 of the Code, it must be done within 6 months from the date of knowledge.

Moreover, the Supreme Court in the case of Janahit Sanrakchan Manch v. Dr. Dinesh Bikram Shah, NKP 2066 (2010), DN 8262,  has held that the calculation of the limitation period starts from the date the symptoms and effects of the negligence appear after taking the medicine daily, rather than the date of medical examination. 

Similarly, in the case of minors, the limitation period is calculated after the age of his/her maturity as per the Supreme Court in Subba Pulami Magar v. Dr. Sudha Thapa et al., NKP 2075 (2018), DN 9927.

 

 

The act of providing medical services without being duly registered is strictly prohibited, and could lead up to 3 years’ imprisonment or a fine of up to NPR 3,000, or both under Section 26 of the Medical Council Act. So does the act of misusing the medical qualifications. Under this Act, the following conducts are strictly prohibited and may result in punishment as well as having the license revoked:

 

a. Misdiagnosis or delayed diagnosis    

b. Surgical errors   (wrong site surgery, leaving instruments inside the body)  

c. Medication errors   (wrong prescription, overdose)  

d. Failure to obtain informed consent    

e. Negligent post operative care    

f. Anesthesia errors    

g.Lack of proper medical attention in emergencies    

 

The medical practice is covered within the definition of service under Section 2(q) of the Act. Such services are labeled as defective if it is carried out without minimum sufficient safety measures or ‘precaution to control potential risk or hazard as per the nature of the produced goods or services.’  The consumer has to make a complaint to the concerned Court for compensation, within six months from the date of harm and injury caused owing to the defective service. 

 

Medical negligence cases are often complex and hard to prove. They usually require expert opinions and detailed investigation. The standard of care can differ based on the patient's condition, the type of facility, and local medical practices. Sometimes, it's challenging to tell if the harm was due to negligence or a known risk of the treatment. Following elements must be satisfied in order to prove the offence of ‘medical negligence’ or ‘medical malpractices’:

 

a. A doctor-patient relationship must be established—showing the doctor agreed to provide care.

b. The doctor must have breached their duty of care by not meeting accepted medical standards (e.g., misdiagnosis, surgical error, wrong medication, or inadequate treatment).

c. The breach must directly cause harm or injury to the patient.

d. The patient must have suffered damages—physical, emotional, or financial—as a result.

 

Nepal Medical Council:

Nepal Medical Council is  an autonomous body established under Section 3 of the Medical Council Act with numerous functions including the regulation, monitoring and management of the medical practitioners and medical services. Under Section 7A of the Act, they have the power to:

 

a. Cancel approval if medical colleges don’t follow rules.

b. Set rules for running medical practice.

c. Give license after checking qualifications and exams.

d. Prepare code of conduct for the medical practitioners and suspend those who break them.

 

Moreover Rule 22 of the Medical Council Regulations outlines the code of conduct, the violation of which may result in punishments and other actions against the medical practitioners.

 

a. Code of Conduct towards the Patients and their Family Members

b. To treat disease with his fullest intelligence and capability

c. Not to charge unreasonable fees and exploit patients for money

d. Refer to specialists when needed

e. Truthfully inform patients/families about the seriousness of their illness

f. Not to deny treatment except when patient:

     i. Refuses to pay fair fees

    ii. Refuses prescribed treatment

   iii. Pressures to prescribe unnecessary drugs

   iv. Demands illegal actions

g. Advise family members to arrange constant care if the patient is seriously ill

h. Not to neglect/ignore a patient

i. Not to issue fake medical certificates or give false statements about a patient’s health

j. Not to breach the confidentiality of patient’s secrets, and so on.

 

Step 1: Filing a Complaint    

The victim (or their family) can file a complaint at the complaint hearing committee in the hospital or the Nepal Medical Council directly. Besides, the victims can also file the complaint at:

i. Police   (for criminal negligence)  

ii. District Court   (for civil compensation)  

iii. Consumer Court   (under Consumer Protection Act)  

 

Step 2: Investigation    

The Nepal Medical Council has the power to investigate, and even suspend, remove the medical personnel from the registration or take any other actions against such medical practitioners. When taking any such actions, the medical practitioner will have the reasonable opportunity to present clarifications or prove his/her innocence. If the complaint has been filed to the Police, then they will make the arrest and  proceed with the investigation by taking the accused into custody for 25 days if it seems from the prima facie evidence that the malpractice has been committed in the preliminary hearing.

 

Step 3: Prosecution & Trial    

The general court proceedings will follow after the completion of investigation. The accused (doctor/hospital) can present defenses (e.g., patient’s contributory negligence, unavoidable complications).  Most importantly, one needs to prove that the harm or injury has been the direct effect of negligence or malpractices of medical practitioners, to prove the offence.

 

Step 4: Judgment and Appeal    

The court delivers a verdict which can be compensation or imprisonment or both. Either party can appeal to an appeal hearing court within 30 days from the date of knowledge of the judgment by the court having original jurisdiction. Section 19(2) of the Medical Council Act also provides that if anyone is dissatisfied with the decision made by the Council, they can file an appeal before the Court of Appeal within 35 days  of the date of decision. The High Court has the jurisdiction to hear the appeal of the decision made by the Medical Council under Section 8(3) of the Administration of Justice Act 2073 (2016).

 

 

a. Time usually taken by the Medical Council to investigate and give decision upon the issue- 3 to 4 months

b. Time taken by the Appeal Hearing Court to revise the decision of Medical Council- 6 to 58 months

c. In the Consumer Court, the court will provide a 15- day period for the respondent to appear, a 7 day investigation period and it aims to resolve the cases within 3 months.

 

The Supreme Court of Nepal has acknowledged the role of doctors as divine figures in Sushma Thapa v. Dr. Bulanda Thapa, NKP 2074 (2017), DN 9814,  but has also pointed out the increasing commercialization of the health services. Hence, it has recognized the right of patients, as consumers, to seek compensation under the Consumer Protection Act for the substandard services  in numerous cases including in Sushma Thapa Case , Jyoti Baniya v. Dr. Buddha Basnet, NKP 2077 (2021), DN 10621, and so on. Additionally, the court also distinguishes between civil liability and criminal liability in cases of medical negligence, emphasizing accountability of medical practitioners while also avoiding the stigmatization of medical practitioners who act with care and caution.

 

Medical negligence remains a legally and emotionally sensitive issue in Nepal, involving multiple dimensions of civil, criminal, and professional accountability. While there is no single statute defining “medical negligence,” several laws collectively address the responsibilities and liabilities of healthcare providers. The legal framework seeks to balance the rights of patients with the professional autonomy of medical practitioners, offering avenues for both redress and defense. As medical practice becomes more complex, courts and regulatory bodies continue to interpret and apply these provisions in ways that uphold both justice and professional integrity.

 

Date of Publication: May 11, 2025 

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