Ultrasound Practice in India: Legal Risks Every Doctor Must Know

 

Every doctor practising in India knows that medicine does not operate in a vacuum. Clinical judgment, patient trust, and ethical responsibility exist alongside a dense regulatory framework that governs how care is delivered. Few laws embody this reality more sharply than the Pre-Conception and Pre-Natal Diagnostic Techniques Act. Designed to curb the deep-rooted social evil of sex-selective practices, the Act places an extraordinary level of accountability on doctors, especially gynaecologists and radiologists. A recent judgment of the Gujarat High Court brings this accountability into sharp focus, serving as a reminder that even a single procedural lapse under the PCPNDT law can have consequences that reach far beyond the consultation room.

The case arose from a challenge by a practising gynaecologist whose registration under the PCPNDT Act was suspended following a sting operation. The suspension was accompanied by the sealing of all sonography machines at his hospital, effectively bringing a key part of his clinical practice to a halt. The doctor approached the High Court seeking relief, arguing that the action taken against him was excessive, procedurally flawed, and violative of natural justice. The court, however, was unconvinced. After examining the records and the sequence of events, it declined to interfere, holding that the authorities had acted within the law and followed due process.

The judgment is unsettling because it does not revolve around an abstract legal debate. It touches the daily realities of clinical practice, documentation pressures, emergency decision-making, and the ever-present fear of regulatory scrutiny. At the centre of the dispute was Form F, a document that many clinicians view as an administrative obligation rather than a clinical tool. The court made it clear that such a view is dangerously misplaced.

The gynaecologist in question had been practising for over a decade and ran a hospital equipped with multiple ultrasound machines. Following a sting operation conducted by the district authorities, allegations were made that he had demanded money to disclose the sex of a foetus. Alongside these allegations were findings related to non-compliance with mandatory record-keeping requirements under the PCPNDT Act. Acting on these findings, the District Appropriate Authority suspended his registration and sealed the ultrasound machines. An appeal before the State Appropriate Authority failed, prompting the doctor to move the High Court.

Before the court, the doctor raised several arguments familiar to many practitioners who have faced regulatory action. He questioned the manner in which the sting operation was conducted, denied any demand for money, and argued that there was no recovery of cash or conclusive proof of wrongdoing. He contended that Form F had not been filled immediately because the patient was an emergency case and asserted that the law does not prescribe a rigid timeline for such entries. He also claimed that he was not supplied with all relevant documents, including statements and seizure records, thereby undermining his ability to defend himself.

These arguments, while understandable from a practitioner’s perspective, failed to persuade the court. The bench emphasised that the PCPNDT Act is a special legislation with a clear social objective. Its provisions must be interpreted strictly, particularly those relating to documentation and record maintenance. The court reiterated that Form F is not a minor procedural formality. It is a central mechanism through which the law seeks to monitor and prevent sex determination. Failure to complete it for every ultrasound conducted on a pregnant woman is treated as a serious offence, regardless of the clinical context.

What makes this judgment particularly significant is the court’s rejection of the “emergency” defence. In clinical practice, emergencies are often invoked to justify deviations from routine documentation. Doctors are trained to prioritise patient care over paperwork when lives are at stake. Yet, the court’s view was unambiguous. The obligation to fill Form F exists in all circumstances. Emergencies do not dilute this requirement. From a legal standpoint, the rationale is clear. Allowing exceptions based on subjective assessments of urgency could create loopholes that undermine the very purpose of the Act.

The court also addressed the argument that non-filling of Form F should be treated as a technical or clerical lapse. This is a belief quietly held by many practitioners who see documentation errors as correctable oversights rather than grounds for punitive action. The judgment dispels this notion decisively. It categorises non-compliance with Form F requirements as a cognizable and non-bailable offence under the PCPNDT framework. This classification reflects the legislature’s intent to deter violations through strict enforcement rather than post hoc explanations.

Equally important is the court’s approach to natural justice. Doctors often feel that regulatory actions under the PCPNDT Act are swift and unforgiving, leaving little room for explanation or rectification. In this case, however, the court noted that the authorities had issued notices, provided opportunities for hearing, and followed the prescribed process before suspending the registration. The absence of arbitrariness or procedural unfairness weighed heavily in the court’s decision to dismiss the petition.

For the medical community, this aspect of the judgment carries a critical lesson. Courts are generally reluctant to interfere with administrative actions when procedures are followed correctly. Once due process is established on record, the scope for judicial relief narrows significantly. This places an even greater burden on doctors to ensure compliance at the operational level, long before any dispute reaches a courtroom.

The sealing of ultrasound machines was another point of contention. The doctor argued that sealing multiple machines disrupted patient care and that authorities could have extracted data without shutting down services. While this argument appeals to clinical logic, the court prioritised statutory enforcement over operational inconvenience. From a regulatory perspective, sealing equipment is seen as a preventive measure to halt potential violations during the pendency of proceedings. The judgment suggests that patient inconvenience, while regrettable, does not override the enforcement powers granted under the Act.

Beyond the specifics of this case, the judgment reflects a broader judicial attitude toward the PCPNDT Act. Courts across India have consistently underscored that the fight against sex selection requires zero tolerance for deviations. The social harm the law seeks to prevent is considered so grave that individual hardships faced by practitioners are often viewed as secondary. For doctors, this creates a professional environment where ethical lapses, perceived or real, carry disproportionately high risks.

It is also worth noting that allegations of demanding money for sex determination, even when disputed, cast a long shadow. In this case, the authorities relied on audio-visual recordings and witness statements obtained during the sting operation. The court did not delve deeply into evidentiary nuances at this stage, focusing instead on the legality of administrative action. This exposes another reality for practitioners: once a criminal case is initiated, parallel administrative penalties under the PCPNDT Act can proceed independently, compounding the impact on a doctor’s career.

For young doctors and postgraduate trainees clinical competence alone is no longer sufficient to sustain a practice. Regulatory literacy has become an indispensable part of professional survival. Understanding the PCPNDT Act, maintaining meticulous records, training staff in compliance protocols, and conducting regular internal audits are no longer optional safeguards. They are fundamental responsibilities.

Senior practitioners, too, must reflect on the systems within their institutions. Delegating documentation to junior staff or assuming that compliance is someone else’s responsibility can prove disastrous. The law ultimately fixes accountability on the registered practitioner and the facility. In the eyes of the regulator and the court, ignorance, oversight, or workload pressures do not mitigate liability.

At a deeper level, the judgment invites introspection within the profession. The PCPNDT Act exists because of a collective failure to prevent sex-selective practices through ethical self-regulation. While many doctors practise with integrity, the actions of a few have necessitated a regime of strict oversight. Courts, therefore, view rigorous enforcement as a necessary corrective rather than an overreach.

This does not mean that the system is beyond critique. Many doctors argue that the Act’s implementation often feels adversarial rather than collaborative. Inspections are feared, not welcomed. Compliance is seen as a minefield, not a shared commitment to social good. Yet, judgments like this make one reality clear. Until trust is rebuilt through demonstrable adherence to the law, enforcement will remain uncompromising.

The Gujarat High Court’s refusal to interfere sends a powerful signal. The judiciary will not dilute statutory safeguards meant to protect societal interests, even when individual practitioners face severe professional disruption. For the medical community, this judgment is less about one doctor’s misfortune and more about a collective reminder. Ethical practice is inseparable from lawful practice.

Medicine demands vigilance at multiple levels. Clinical vigilance saves lives. Regulatory vigilance protects careers. In an era where scrutiny is intense and tolerance for lapses is low, doctors must recognise that compliance is no longer a background task. It is central to the privilege of practising medicine itself

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