This case analysis examines the decision of the High Court of Delhi in Johnson & Johnson v. Pritamdas Arora t/a M/s Medserve & Anr., 2025, a significant ruling addressing large-scale counterfeiting of surgical medical devices. The dispute arose after counterfeiting hemostatic products bearing the registered trademarks ‘SURGICEL’ and ‘ETHICON’ were traced to an organised distribution network linked to the Defendants in New Delhi. The counterfeit goods involved expired products that were repackaged, relabelled with falsified expiry dates, and distributed domestically and internationally, posing serious public health risks. The principal legal issues before the Court concerned: (i) infringement of registered trademarks under Section 29 of the Trade Marks Act, 1999; (ii) passing off in respect of non-registered marks and trade dress; (iii) the grant of permanent injunctive relief; and (iv) the assessment of compensatory and exemplary damages in cases of deliberate and calculated counterfeiting involving medical devices. The Court held that the Defendants were guilty of trademark infringement, passing off, and organised counterfeiting. Relying on documentary evidence, including electronic communications and findings of Local Commissioners, the Court established deliberate falsification, fraudulent misrepresentation, and transnational commercial operations. A decree of permanent injunction was granted, counterfeit goods were ordered to be destroyed, compensatory damages of ₹2.34 crore and exemplary damages of ₹1 crore were awarded, along with costs. The judgment is significant in trademark infringement jurisprudence for its structured damages framework, integration of proportionality principles, recognition of trade dress protection, and its strong articulation of the public health dimension in cases involving counterfeit medical products.