A full page interview cum advertisement under the heading “In a League of no Ordinary Men”- Dr. R.K. Gupta [1] and many more advertisements in India’s leading News Papers mentioning the names of former CJI, [2] Former President of India, many allopathic doctors, foreign patient’s statements in his favour was a regular feature till December 2003 by infamous doctor and owner of ‘Neeraj Clinic” of Rishikesh, Uttranchal, claiming ‘miraculous cure for epilepsy’. These advertisements were also shown on many T.V. Channels like: ‘Aaj Tak’, Sahara Samay’, ‘Sadhna’, ‘NDTV India’, ‘Zee T.V.’, ‘SAB T.V.’, etc. between 9.00 PM to 11.00 PM. Even a Website under the name of www.epilepsyglobal.com was launched to advertise and attract patients of epilepsy from all over the globe. [2] Even discount of Rs.200/ was offered to patients showing the cutting of the advertisement. A raid carried out by health department officials at Neeraj Clinic on August 2, 2004 led to the recovery of a large cache of banned allopathic drugs, which Gupta is accused of prescribing to his patients as Ayurvedic Medicine. The ‘doctor’ went missing, till his arrest ten days later. Several patients who are now alleging that Gupta had duped them told the Uttarnchal Police that they were carried away by large colour advertisements by Neeraj Clinic in prominent news papers and details on his website. [11] Incidentally, a complaint from one of Gupta’s foreign clients in Canada to the Indian Government turned the tide against the quack. The complaint forced the Centre to direct the Uttranchal Government to initiate proceeding against him. [11]

Abstract Patient was having history of hypertension and diabetes visited the opposite party No.1: Hospital and consulted Doctor, (OP-2) who advised the Metabolic Surgery. It was advised on the basis of weight and height of the patient. The patient’s height was 5’10” and the weight was 95 kg., but, it was not so abnormal. Accordingly, on 5.11.2013, the operation of ‘Gastric bypass’ was performed in OP-1/Hospital. Patient was discharged on 9.11.2013. After discharge patient did not get complete relief but started feeling uneasiness. The opposite party assured that patient will be recovered fully within a span of time. Thereafter, in January, 2014, the patient had developed Diabetic foot and deep burns. The treating doctor (OP-2) advised for daily dressing and medicines but ultimately on 20.8.2015 his foot was amputated in DMC Hospital, Ludhiana, subsequently, patient died on 16.9.2015. NCDRC quoted the observations of Hon’ble Supreme Court in the case of Jacob Mathews Case, (2005)6 SCC 1, which read thus: “When a patient dies or suffers some mishap, there is a tendency to blame the doctor for this. Things have gone wrong and, therefore, somebody must be punished for it. However, it is well known that even the best professionals, what to say of the average professional, sometimes have failures. A lawyer cannot win every case in his professional career but surely he cannot be penalized for losing a case provided he appeared in it and made his submissions.” [Para 8] Relying on above judgment of Hon’ble Supreme Court of India NCDRC summarized that therefore, blaming OP-2 necessarily for the patient’s diabetic foot is not correct. Thus, the appeal was dismissed on the point of limitation as well as on merits. NCDRC observed that on the basis of foregoing discussion, it is clear that the complainant filed a complaint before the State Commission after huge delay of 10 months without any application for condonation of delay. Therefore, delay does not deserve to be condoned. Even on merits, the gastric bye-pass and subsequent suffering of the patient was due to diabetic foot and Septicemia. Both are totally different issues. The purpose of gastric bye-pass surgery was for the obesity i.e. reduce the body weight. Nowhere, it was mentioned as a treatment for diabetes. The patient developed diabetic foot due to his uncontrolled diabetic status, which was clearly evident from the various laboratory reports. [Para 7]

Patient was admitted to opposite party No.1 Hospital on 27.6.2012 in a very critical condition with complaint of severe abdominal pain for last six days and nausea and vomiting for two days. At the time of admission, her BP was not recordable and she was shivering. Before taking her to the Mahesh Hospital, the complainant had taken her for an ultrasound test at Diagnostic Centre, which had found a well-defined Heterogenous Adnexal mass of 60x47 cm in the right Adnexa. She was admitted in emergency and exploratory laparotomy was performed on her at 12.00 noon. As per the finding in the procedure, she was suffering from miliary Tuberculosis all over her intestine with plastic adhesions and multiple perforations in the intestine. She was discharged from Hospital on 28.6.2012 and was admitted to LNJP hospital. She died in LNJP hospital on 14.7.2012. Alleging medical negligence in the treatment of patient, the complainant is before National Commission seeking compensation quantified at Rs.1.00 crore. It is inter-ala alleged in the complaint that the relative of the complainant had objected to the opening of the stomach of the deceased without conducting proper medical test and ultrasound. It was also alleged that ICU and ventilator facility was not available in the hospital nor was there proper light in the operation theatre. It was also alleged that the hospital did not have proper nursing staff and ward boys. [Para 1] National commission rejected the claim of medical negligence against doctor/hospital relying on medical record, expert opinion and peculiar facts and circumstances of the case. Following issues were discussed: • Issue of ICU • Issue of Investigations • Diagnosis after proper Examination • Exploratory Laparotomy without Investigations • Is any investigation required before undertaking exploratory laparotomy? • Is it correct that on account of MRI Scan and CT scan having become available, these investigations should have been done before undertaking exploratory laparotomy procedure? • Considering the record of the treatment of this patient at the previous hospital, do you find any negligence in her treatment in the previous hospital? • What is the meaning of Miliary Tuberculosis?

Executive Summary Important questions raised and discussed by Hon’ble Allahabad High Court in a recent judgment dated: 29th Nov 2017: • How the working of the government hospitals can be improved for the betterment of the general public? • Why doctors are opting for voluntary retirement every day? • Who can manage day to day administration of hospitals? • Issue of posting of clinicians/Specialist on Administrative Posts: • Issue of wastage of human resources • How efficiency of public hospitals can be improved?

The Complainant who was suffering from upper abdominal pain visited the OP No.1-Doctor on 3.5.2006 with USG report dated 29.4.2006 which reported “A big intraluminal CALCULUS (Diameter 2.6 cms) seen casting distal acoustic shadow”, when the OP No.1-Doctor diagnosed “CHOLELITHIASIS” and performed LAP-CHOLEY on 16.6.2006 at OP No.2-Hospital and discharged the patient on 18.6.2006 as revealed from the Discharge Certificate dated 18.6.2006 of OP No.2-Hospital being duly signed by the OP No. 1-Doctor. Five years after such Lap-Choley, i.e. in the month of February, 2011, the Complainant felt severe pain in upper abdomen in course of treatment of which by the local doctors, Jaundice was diagnosed. It was alleged in the Petition of Complaint that the presence of two cholescystectomy clips in CBD since the day of Lap-choley on 16.6.2006 which caused upper abdominal pain and jaundice indicates negligence on the part of the OP No.1-Doctor. Perusal of medical record it was found that nowhere in the concerned treatment documents is there any noting about intimation to the patient concerned in respect of possibility of adverse effect or reaction of Lap-Choley as is required as per standard medical ethics and that such lapse on the part of the OP No.1-Doctor also contributed to the negligence. DCDRC, W.B awarded compensation.

Quality of Medical Education & Healthcare depends on Quality of Decisions, which only Quality persons (Doctors, Medical Teachers) can take. Entry of Quality persons in composition and constitution of Apex Medical Education Regulatory Body i.e. MCI is possible only through participatory and democratically elected process in unbiased, uninfluenced, fair and transparent manner. Competent and experienced members, who are of high moral value and integrity is the need of the hour. Autonomy of professional’s body can only be possible through its members who are acting with their wisdom without any influence of whatever nature. It is expected that elected members are able to take decisions in unbiased manner, keeping in mind the prime objective of quality of medical education and quality healthcare and above all the service of humanity.

Death of patient alleged to be due to medical negligence. DCDRC, Nellore allowed complaint and awarded Rs.1 lakh compensation. Appeal dismissed by SCDRC, A.P. on the ground of Bar of Limitation. Revision petition before NCDRC revert case for consideration on merit. NCDRC relied on cases law and discussed reasons in the interest of justice.

With increasing woman workforce at workplace and more and more awareness about rights chances of misuse of law related to sexual harassment at workplace cannot be ruled out. Delhi High Court observed that undoubtedly, physical contact or advances would constitute sexual harassment provided such physical contact is a part of the sexually determined behaviour. Court further added that such physical contact must be in the context of a behaviour which is sexually oriented. Plainly, a mere accidental physical contact, even though unwelcome, would not amount to sexual harassment. Similarly, a physical contact which has no undertone of a sexual nature and is not occasioned by the gender of the complainant may not necessarily amount to sexual harassment. [Para 15]

In a peculiar case brought before the Division Bench of the HP High Court for directions for MTP of a rape survivors with 32 weeks pregnancy. Hon’ble Division Bench issued following directions: In view of what has been said hereinabove, we allow the present writ petition and dispose of the same with the following directions: i) The 5th respondent i.e. Medical Superintendent, Kamla Nehru Hospital, Shimla is directed to arrange for termination of the pregnancy of petitioner by the expert Gynaecologist(s) under the supervision of the Medical Board constituted pursuant to the orders passed by this Court at the earliest possible and without any further loss of time. ii) Since in the opinion of the Medical Board, the petitioner is mild to moderate mentally retarded mother, therefore, in addition to her own affidavit in support of the writ petition, consent of her father or mother, as the case may be, be obtained before she is subjected to surgical intervention (ceasarean) enabling her to deliver the baby prematurely. iii) The DNA of the newly born baby be preserved by the team of doctors for being used during the course of investigation, inquiry and trial in criminal case stated to be registered in Police Station, Banjar, District Kullu, H.P. under Sections 376(2) (L) of the Indian Penal Code and also in other civil consequences which may follow after premature delivery and survival of the newly born. iv) Other consequential issues if crop-up on the surgical intervention and birth of newly born baby are left open to be considered and decided by the competent forum in appropriate proceedings, if initiated in accordance with law. [Para 10]

Questions need answer 1. Can medical profession have analogy with immoral trafficking /Prostitution? Judicial Perception 2. How to avoid wastage of scarce resources? 3. Can another doctor allowed to Use the sealed USG Machine/can it be sailed to another Doctor/Hospital? 4. Can machine be shifted to another premises / Hospital /Centre? 5. What is the legal procedure?