Jharkhand High Court
Lalu Prasad @ Lalu Prasad Yadav vs The State Of Jharkhand Through Cbi (Ahd) on 11 May, 2018
Author: Aparesh Kumar Singh
Bench: Aparesh Kumar Singh
IN THE HIGH COURT OF JHARKHAND AT RANCHI
Cr. Appeal (S.J.) No. 668 of 2018
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Lalu Prasad @ Lalu Prasad Yadav ..... Appellant vs.-
The State of Jharkhand through CBI (AHD) ...... Respondent
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CORAM: HON'BLE MR. JUSTICE APARESH KUMAR SINGH
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For the Appellant : Mr. Abhishek Manu Singhvi, Sr. Adv.
Mr. Chittaranjan Sinha, Sr. Adv.
M/s. Prabhat Kumar, Debarsis Mandal, Advs.
For the Respondent : M/s. Rajiv Sinha, A.S.G.I
Rajiv Nandan Prasad & Niraj Kumar.
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4/11.5.2018 Heard learned Senior Counsel for the appellant and learned A.S.G.I
representing the C.B.I
2. Appellant has sought provisional bail for twelve weeks through I.A. No. 4009 of 2018 in connection with his conviction dated 19th March, 2018 and order of sentence dated 24th March, 2018 passed by learned Court of Additional Judicial Commissioner-I-cum Special Judge-VII, CBI (AHD Scam), Ranchi in R. C Case No. 38(A)/1996 Pat, whereby he has been convicted and sentenced to undergo R.I. for 7 years for the offences under Sections 120B r/w Sections 420, 467, 468, 471, 477-A of Indian Penal Code and a fine of Rs. 30,00,000/- and in default thereof S.I. for 1 year. He has been further sentenced to undergo R.I. for 7 years for the offence under Section 13(2) r/w Section 13(1) (c) & (d) of Prevention of Corruption Act and a fine of Rs. 30,00,000/- and in default thereof, S.I. for one year each. The appellant is in custody since 23rd December, 2017 in connection with his conviction in R.C Case No. 64(A)/1996 Pat and sentence of 3½ years rendered by learned Court of Additional Judicial Commissioner-I- cum Special Judge-VII, CBI (AHD Scam), Ranchi.
The appellant has also made a prayer for provisional bail on Medical Grounds in Cr. Appeal (S.J.) No. 138 of 2018 and Cr. Appeal (S.J) No. 207 of 2018 (arising out of R.C Case No. 64(A)/1996 Pat and R.C. Case No. 68(A)/1996) through I. A Nos. 3507 of 2018 and 3506 of 2018 respectively on common grounds.
3. Appellant was referred to RIMS, Ranchi on 17th March, 2018 on complaint of several health issues. The Medical Board of RIMS, Ranchi vide their opinion contained in Letter No. 1483 dated 20th March, 2018, 2. referred the appellant to AIIMS, Delhi for better treatment. Appellant was admitted in emergency ward of AIIMS, New Delhi on 29th March, 2018. After undergoing treatment there for 4 weeks, he has been discharged on 30th April, 2018 for further treatment at RIMS, Ranchi.
For the convenience sake, facts as borne out from the I.A. No. 3506/2018 in Cr. Appeal (SJ) No. 207/2018 have been referred to by the learned Senior Counsel for the appellant.
4. In this chronology of facts, learned Senior Counsel for the appellant has submitted that appellant is 71 years old person. He has undergone Aortic Valve Replacement (A.V.R) with 21 mm Magna Ease Aortic Tissue Valve and ascending aortoplasty with closure of patent foremen ovale at Asian Heart Institute and Research Center Pvt. Ltd. in Mumbai on 27th August, 2014.
5. Learned Senior Counsel has also made reference to the discharge- sheet dated 28th March, 2018 of RIMS, Ranchi, which contains the brief clinical history and findings at the time of admission and Pathology Reports i.e., Hemoglobin, T.C, Urea level, Uric Acid, HBA1C (index of diabetic conditions of the appellant), daily blood sugar level of different dates and the treatment prescribed. As per the discharge-sheet of the same date of RIMS, Ranchi appellant was suffering from:
(i) Uncontrolled Diabetes Mellitus Type-2
(ii) CKD stage III (eGFR 38)
(iii) Renal Calculus (right)
(iv) Benign Prostatic Hyperplasia (46gm)
(v) Hypertension
(vi) Bio-prosthetic Aortic Valve Replacement
Aortoplasty done in 2014
(vii) Fatty liver (steatohepatitis)
(viii) Hyperuricemia
(ix) Healing perianal abscess
(x) Depression
6. Appellant was admitted in AIIMS on 29th March, 2018 and as per report of 13th April, 2018 of Medical Team of doctors comprising the Acting Head Department of Medicine, consultant Nephrology, consultant 3. Medicine and Professor of Cardiology, inter alia, he was found suffering from:
(i) Uncontrolled Type 2 diabetes Mellitus,
(ii) Labile Hypertension with postural drop,
(iii) Peri-Anal abscess, (healing),
(iv) Sepsis (now controlled),
(v) Acute kidney injury on chronic kidney disease,
(vi) Benign prostatic hyperplasia(BPH) with lower urinary tract symptoms,
(vii) Right lower pole kidney stone (size=0.9 cm),
(viii) Secondary depression,
(ix) Lower backache(Diffuse disc bulge with moderate narrowing of bilateral neural foramina at L4-L5 level without nerve compression),
(x) Vitamin D Deficiency,
(xi) Grade 1 fatty liver,
(xii) Glaucoma and left immature senile cataract. The doctors found his past history suggestive of known case of diabetic and hypertensive for 20 years, Bio-prosthetic aortic valve replacement for Severe Aortic Stenosis (2014), Recurrent Peri-anal abscess.
7. Learned Senior Counsel has also placed the discharge summary of the appellant issued by AIIMS on 30th April, 2018 which is part of supplementary affidavit filed on 2nd May, 2018. Learned counsel has pointed that AIIMS doctors have reaffirmed the following diseases which were also found by RIMS Authorities.
Type 2 Diabetes Mellitus (Controlled) Labile Hypertension with significant Postural Hypotension Peri-anal abscess (healing) Acute kidney injury on chronic kidney disease Post aortic valve replacement (bio-prosthetic- 2014) Symptomatic Benign Prostatic hyperplasia(BPH) 4. Right lower pole renal calculus(0.9 cm) Secondary depression Low backache-diffuse disc bulge with moderate narrowing of bilateral neural foramina at L4-L5 level Left eye-Immature Senile Cataract with Nuclear Sclerosis III with Posterior Subcapsular Cataract Primary Open Angle Glaucoma (controlled) Heterozygous beta thalassemia Vitamin D deficiency Grade-I fatty liver Small Umbilical Hernia
8. Learned counsel has placed the details of Pathological Investigation Reports of the appellant in specific relation to his Hemoglobin level, Platelet Count, TLC, Urea level, Creatinine, HBAIC etc. The Echocardiography Reports referred to in discharge summary has also been referred to. Learned Senior Counsel has endeavoured to make the comparison of medical condition of the appellant as borne out from the discharge summary report of 28th March, 2018, medical report of the appellant at AIIMS dated 13th April, 2018 and discharge summary report of AIIMS Authorities dated 30th April, 2018 when he was referred back to RIMS, Ranchi for treatment.
9. The thrust of the argument of learned Senior Counsel for the appellant is that the medical condition of the appellant has not undergone any significant improvement after treatment at AIIMS. He has placed more emphasis on four serious ailments which the petitioner has been suffering i.e, (i) chronic kidney diseases (ii) uncontrolled diabetes (iii) Peri-anal abscess (iv) Concentric LVH, Grade II diastolic dysfunction. He submits that doctors at RIIMS found HBAIC: -9.2% on 17th March, 2018 and 8.7 on 28th March, 2018. At the time he was discharged from AIIMS on 30th April, 2018, it was 8.7 as such this has not improved. As per medical text, it should be within 6.7 to 7. He further submits that Hb count, has, in fact, gone down from 11.3 on 28th March, 2018 to 10.8, the normal range in case of an adult male should be 14 and above. Platelet 5. count has also gone down from 2.32 lakh on 28th March, 2018 to 1.7 lakh on 28th April, 2018 two days before his discharge from AIIMS. TLC has gone down from 12,200 to 11,100 in the corresponding period whereas normal range is 6000. Level of urea in blood has undergone only slight improvement from 63 to 55. Creatinine level have not undergone any improvement from 1.4 as last investigated on 23 rd April, 2018 at AIIMS. The Medical authorities at AIIMS should not have discharged the appellant if his medical conditions had not undergone any significant improvement. The (Glomerular Filtration Count) G.F.R count of the appellant as progressively monitored from 2015 has gone down to 38 in 2018, March whereas its normal range is 100. Appellant has been diagnosed with Chronic Kidney Disease. If his G.F.R comes below 30 he will be in Stage-IV which would indicate serious Kidney Damage, leading to End State Renal Disease. Learned counsel has referred to the Texts of Clinical Medicines, 8th Edition by Kumar & Clarks, Chapter 12; Harrison's Principles of Internal Medicines, Page 2308, extracts of which are enclosed to convenience volume. Emphasis is made on the seriousness of his kidney condition. It is submitted that as per the medical text, if G.F.R count goes below 30, it entails further complications such as Bone disease; Renal osteodystrophy, Gastrointestinal complications, Metabolic abnormalities, Endocrine abnormalities, Muscle dysfunction etc. It becomes life threatening if the patient is suffering from Ventricular hypertrophy and/or systolic and diastolic dysfunction. The Echocardiography Report of AIIMS shows that he is suffering from Grade-II Diastolic Dysfunction. Left ventricular hypertrophy is a risk factor for early death in Chronic Kidney Disease.
10. On the basis of the aforesaid comparison of the Discharge Summary Reports of RIMS and AIIMS, learned Senior Counsel has sought to emphasize that the condition of the appellant has undergone no significant improvement. It defies reason as to why did the AIIMS authorities referred him back to RIMS, Ranchi in such medical condition. He submits that appellant, in such circumstances, is entitled to seek indulgence of this Court for better medical treatment at reputed Super Specialty Hospitals within the country such as Medanta Hospital at Gurugram which is known for its expertise in treatment of Chronic Kidney Disease; and/or BGS 6. Gleneagles Global Hospital, Bengaluru. Appellant has undergone Aortic Valve Replacement in the year 2014 at Asian Heart Institute and Research Centre Pvt. Ltd., Mumbai. He would also seek permission for treatment at the said Hospital in Mumbai in order to ensure that there is no further deterioration in his health. He submits that in such circumstances, it would be well within the powers of this Court to lay down any such conditions while allowing permission to the appellant to avail better medical treatment at all or any of these Hospitals within a strict time frame.
11. This approach would be in the larger public interest by allowing a seriously ailing person to have the best of treatment to save human life without in any manner diluting the effect of his conviction or sentence.
12. Learned Senior Counsel for the appellant on strong objection being taken by learned ASGI has submitted at the bar that the statements made in last line of para-17 of supplementary affidavit to Interlocutory Application should not be read beyond the sentence which ends up at the word 'nature'.
13. Learned ASGI has strongly opposed the submission of learned counsel for the appellant for grant of provisional bail on medical grounds. He submits that both the doctors of RIMS and AIIMS who are experts in their fields have examined the appellant on all parameters of his medical conditions borne out from the investigation and Pathological Reports. There is no reason to doubt or discard the opinion of the experts in the field. The reports in themselves do not convey a life threatening picture as painted out on behalf of the appellant. It is also indisputable that AIIMS is one of the Premier Medical Institutions of the country where specialized and super specialized treatments are availed of by common persons as well as VVIP's. It is not that the appellant has been sent to jail custody on being referred back to RIMS. RIMS Authorities have been keeping constant watch on the health condition of the appellant. In such circumstances, prayer for provisional bail on medical grounds of the appellant is fit to be rejected.
14. I have considered the submission of learned Senior Counsel for the appellant and learned ASGI representing the CBI.
7.The medical condition of the appellant during custody and while undergoing treatment at RIMS and AIIMS are borne out from the reports of RIMS Authorities contained in the discharge-sheet (Annexure-1) to Interlocutory Application (I. A. No. 3506 of 2018) dated 28th March, 2018, the report of AIIMS dated 13th April, 2018 noted above and Discharge Summary Report dated 30th April, 2018 of AIIMS while referring him back for treatment at RIMS, Ranchi. A bare perusal of the Chart contained in the Discharge Summary of AIIMS dated 30th April, 2018 (investigation from 29th March, 2018 to 28th April, 2018) shows that the Pathological Reports of the appellant do not appear to have undergone any significant change. For example, his Hemoglobin Level has gone down from 11.3 to 10.8 (normal range being 14 and above), platelet count has also gone down from 2.32 lakh on 29th March 2018 to 1.7 lakh. TLC Count from 12,200 to 11,100, Urea level have undergone some improvement from 63 to 55. The creatinine levels have undergone no change from 1.4 as was existing on 29th March, 2018 while being referred from RIMS to AIIMS and during his treatment at AIIMS. The normal range of creatinine is stated to be 1.2 mg. Urea level are supposed to be less than 40. The normal level of TLC should be less than 6000. HBAIC count reflective of the status of the diabetic conditions of the patient remained at 8.7. GFR count of the appellant is stated to be 38 as per the diagnosis and investigation report contained in the discharge-sheet dated 28th March, 2018 of RIMS Authorities. This level of GFR is said to be indicative of Chronic Kidney Disease Stage-III. The Report of AIIMS dated 30th April, 2018 also indicates Acute Kidney Injury or Chronic Kidney Disease and Labile Hypertension with postural drop. As per the medical text relied upon by learned Senior Counsel for the appellant, if the GFR goes down below 30 it entails more serious complications and is considered a risk factor for a person suffering from Diastolic Dysfunction. The Echocardiography Report of AIIMS show him to be suffering from Grade-II Diastolic Dysfunction. Appellant had undergone Aortic Valve Replacement in the year 2014 at Asian Heart Institute and Research Centre Pvt. Ltd., Mumbai.
15. What emerges from the aforesaid discussions is that the appellant appears to be suffering from a number of ailments. Some of the ailments 8. like Chronic Kidney Disease are stated to be of such a nature which on further deterioration may have serious complications on the overall health of the appellant. If the appellant is in a position to afford treatment at any Super Specialty Hospital where such conditions are treated in particular, he can be allowed to avail it. It would rather be safe from the point of view of the life and overall health of an individual, even if he is a convict undergoing sentence of an offence of serious nature, to avail of any better treatment in the Super Specialty Hospitals within the country. Such a course appears to be advisable at this stage before his medical condition may become more serious or critical.
16. I am, therefore, inclined to enlarge the above-named appellant on provisional bail to undergo medical treatment at all or any of these three Super Specialty Hospitals named above for a period of 6 weeks from the date of release, during pendency of appeal, on furnishing bail bond of Rs. 50,000/- (fifty thousand) with two sureties of the like amount each to the satisfaction of Additional Judicial Commissioner-I-cum Special Judge- VII, CBI (AHD Scam), Ranchi in R. C Case No. 38(A)/1996 Pat. Appellant would not indulge in any political rally or political statements during this period. Appellant would not leave the country. As per the statement of learned counsel for the appellant, his passport has already been deposited before the Court below. Appellant will avail of provisional bail only for the purposes of medical treatment and would submit the report of his treatment before this Court on or before expiry of the period of 6 weeks. Needless to say any misuse of privilege of provisional bail would entail its cancellation any time earlier.
Accordingly, the instant I.A. stands disposed of. Let the case appear on 22nd June, 2018 as unfixed case under appropriate heading.
(Aparesh Kumar Singh,J) jk