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Gujarat High Court

Chandravadan Rangildas Dhruv vs State Of Gujarat & 1....Opponent(S) on 25 April, 2017

Author: R. Subhash Reddy

Bench: R.Subhash Reddy, Vipul M. Pancholi

                 C/WPPIL/182/2016                                             ORDER




                  IN THE HIGH COURT OF GUJARAT AT AHMEDABAD

                           WRIT PETITION (PIL) NO. 182 of 2016
                                            With
                           CIVIL APPLICATION NO. 3283 of 2017
                                              In
                            WRIT PETITION (PIL) NO. 182 of 2016
                                            With
                           CIVIL APPLICATION NO. 12008 of 2016
                                              In
                            WRIT PETITION (PIL) NO. 182 of 2016
         ==========================================================

CHANDRAVADAN RANGILDAS DHRUV....Applicant(s) Versus STATE OF GUJARAT & 1....Opponent(s) ========================================================== Appearance:

PARTY-IN-PERSON, PERSONAL CAPACITY for the Applicant(s) No. 1 MS MANISHA SHAH, G.P., ADVANCE COPY SERVED TO GP/PP for the Opponent(s) No. 1 MR KAMAL B. TRIVEDI, SENIOR ADVOCATE WITH MS SK VISHEN, ADVOCATE for the Opponent(s) No. 2 NOTICE SERVED for the Opponent(s) No. 1 ========================================================== CORAM: HONOURABLE THE CHIEF JUSTICE MR. R.SUBHASH REDDY and HONOURABLE MR.JUSTICE VIPUL M. PANCHOLI Date : 25/04/2017 ORAL C.A.V. ORDER (PER : HONOURABLE MR.JUSTICE VIPUL M. PANCHOLI)
1. This writ petition, in the nature of public  interest   litigation,   has   been   filed   seeking   the  following reliefs;
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HC-NIC Page 1 of 13 Created On Mon Aug 14 06:45:56 IST 2017 C/WPPIL/182/2016 ORDER "(A) Your   honor   may   kindly   accept   this  appeal.

(B) Your   Lordships   may   be   pleased   to  consider   the   facts   and   contents   of   this  application and to issue notice to the State  Government   to   constitute   new   inquiry  committee   of   experts   of   three   Doctors   from  the Department of Health and Family Welfare,  Govt.   of   Gujarat   and   submit   the   neutral  report at the earliest.

(C) Your   Lordships   may   be   pleased   to   give  necessary   direction   to   take   appropriate  action against the negligence by Doctors and  staff   in   the   blindness   issue   as   per   law  prevailing.

(D) Your   Lordship   may   be   pleased   to   issue  necessary direction for stern action against  three Doctors panel those who have not made  proper   inquiry   and   misused   the   power  delegated   as   Expert   Doctors   and   gave   clean  chit to all Doctors and staff without going  into the merits.

(E) In   this  blindness   issue,   a  departmental  inquiry   and   criminal   offence   may   please   be  registered  against  all  those   who  are  liable  for   causing   such   loss   to   the   victims  permanently   and   put   their   families   in  unavoidable trouble.

(F) Your   Lordships   may   be   pleased   to   issue  necessary   direction   to   Ahmedabad   Municipal  Corporation to take proper care for treatment  and to protect patient's rights.

(G) to (I) ..."




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HC-NIC                        Page 2 of 13     Created On Mon Aug 14 06:45:56 IST 2017
                 C/WPPIL/182/2016                                          ORDER




2. The facts in a nutshell are as under;   On 13.01.2016 a news item was published in a  local   daily   that   about   16   patients,   who   had  undergone   treatment   of   the   eyes   at   M/s.   C.H.  Nagri   Eye   Hospital   [hereinafter   referred   to   as  "the Hospital" for short], had lost their vision,  after   being   administered   a   drug,   named,  Avastin   100 Mg (Bevacizumab)  during a follow­up visit on  12.01.2016.   On   the   very   same   day,   all   the  patients   were   admitted   and   given   necessary  treatment.   For   the   purpose   of   investigating   the  incident,   the   respondent­Corporation   constituted  a three member Inquiry Committee. The Directorate  General   of   Health   Services,   Central   Drugs  Standard   Control   Organization,   New   Delhi   issued  an Alert Notice dated 21.01.2016 restricting the  use   of   the   drug   -  Avastin  for   ophthalmic  treatment   in   the   country   as   a   precautionary  measure. 

2.1 It is the say of the petitioner that he had  filed   a   complaint   against   the   Hospital  authorities before the Gujarat State Human Rights  Commission.   However,   vide   communication   dated  01.03.2016,   the   Gujarat   State   Human   Rights  Commission   refused   to   take   any   action   in   the  matter on the ground that the petitioner was not  a victim in the alleged incident and that he had  not  been  authorized  by the  victims  to represent  their case.




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HC-NIC                             Page 3 of 13     Created On Mon Aug 14 06:45:56 IST 2017
                 C/WPPIL/182/2016                                          ORDER




2.2 Being aggrieved by the inaction on the part  of the respondent­authorities, the petitioner has  preferred   the   present   writ   petition   before   this  Court. 

3. It is contended by the petitioner, party­in­ person,   that   the   Doctors   and   para­medics,   who  gave treatment to the patients on 12.01.2016, had  not  exercised  the required  degree  of  care while  treating   them.   They   acted   in   a   negligent   and  careless manner, which resulted into the loss of  vision of the patients. It was submitted that if  a   medical   practitioner   fails   to   exercise  reasonable   skill   and   care,   then   he   would   lose  immunity from an action in tort and he could be  sued   on   such   ground.   However,   the   respondent­ authorities shielded the Doctors and para­medics  and did not take any action against them. Hence,  appropriate   action   deserve   to   be   taken   against  the Hospital authorities for their negligence and  inaction.

3.1 The   petitioner   further   submitted   that   the  Inquiry Committee constituted by the respondent­ Corporation gave a clean chit to the Doctors and  para­medics,   though   it   was   found   that   the  patients   had   lost   their   vision,   after   being  administered   the   drug   by   the   Doctors   of   the  Hospital on 12.01.2017. It was contended that the  Report   submitted   by   the   Inquiry   Committee  Page 4 of 13 HC-NIC Page 4 of 13 Created On Mon Aug 14 06:45:56 IST 2017 C/WPPIL/182/2016 ORDER constituted   by   the   respondent­Corporation   does  not   reveal   the   true   facts,   as   the   Members   were  hand­picked   by   the   respondent­Corporation   and  were not independent. Further, the Gujarat State  Human Rights Commission also refused to take any  action   in   the   matter.   It   was,   therefore,  submitted that appropriate directions deserve to  be issued in the matter to safeguard the interest  of the public at large and to restore trust in a  Government managed Hospital.

4. Mr.   Kamal   Trivedi,   learned   Senior   Advocate  appearing   on   behalf   of   respondent   no.2­ Corporation, submitted that the present petition  is   filed   on   the   basis   of   newspaper   reports  published   on   13.01.2016.   The   alleged   incident  took   place   on   12.01.2016   whereas,   the   captioned  petition was filed in the month of August 2016.  If the petitioner was concerned about the health  of the victims, then he ought to have filed the  petition   immediately   after   the   incident   was  reported.   The   fact   that   the   writ   petition   was  filed belatedly speaks volumes about the conduct  of the petitioner. This shows that the petitioner  has not come before the Court with clean hands.  It   was,   therefore,   submitted   that   the   present  petition  deserves  to be dismissed  on  the ground  of delay itself.

4.1 Learned   Senior   Advocate   contended   that   the  patients   were   given   treatment   after   obtaining  Page 5 of 13 HC-NIC Page 5 of 13 Created On Mon Aug 14 06:45:56 IST 2017 C/WPPIL/182/2016 ORDER written   consent   and   by   following   the   standard  protocol   of   treatment.   Further,   to   ascertain  whether   the   drug   in   question   was   of   standard  quality,   the   Food   and   Drugs   Control  Administration had sent the entire Batch of drug  for   Lab   Testing.   On   such   testing,   it   was   found  that the drug was of standard quality. Therefore,  no fault can be found with the Doctors concerned  or   the   medicine   that   was   administered   to   the  patients. The patients, who complained of loss of  vision and other related issues, were diabetics,  hypertensive,   etc.   and   also   suffered   from   age  related issues. It was, therefore, submitted that  Doctors and para­medics of the Hospital could not  be held guilty in any manner whatsoever. 

4.2 Learned   Senior   Advocate   Mr.   Trivedi   further  submitted   that   all   the   three   members   of   the  Inquiry   Committee   were   independent   and   none   of  them   were,   in   any   manner,   affiliated   or  associated   with   the   Hospital.   Therefore,   it  cannot   be   said   that   the   report   of   the   Inquiry  Committee   was   influenced   or   that   it   was   not  impartial.   It   was,   therefore,   prayed   that   the  present petition deserves to be dismissed.

5. Ms. Manisha Shah, learned G.P. appearing for  respondent no.1­State, adopted the arguments made  by   learned   Senior   Advocate   Mr.   Kamal   Trivedi  appearing for the respondent­Corporation. 





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HC-NIC                              Page 6 of 13     Created On Mon Aug 14 06:45:56 IST 2017
                 C/WPPIL/182/2016                                          ORDER




6. We   have   heard   learned   counsel   for   both   the  sides   and   perused   the   material   on   record.   The  main  grievance  raised  by  the petitioner  is  that  the   16   patients,   who   took   treatment   at   the  Hospital   on   12.01.2016,   suffered   loss   of   eye­ sight owing to the drug administered to them. 

7. Before   we   proceed   further,   it   would   be  pertinent to note that in this matter, Notice was  issued   on   07.09.2016,   making   it   returnable   on  28.09.2016. Thereafter, the matter was listed on  different   dates.   In   February   2017,   the  petitioner,   party­in­person,   filed   Civil  Application   No.3283   of   2017   with   the   prayer   to  direct the respondent­authorities to file reply­ affidavit  in  the main  mater  and other  ancillary  reliefs.   In   the   said   Civil   Application,   this  Bench passed the following order on 08.03.2017;

"Today, when the matter is called, additional  affidavit   is   filed   on   behalf   of   respondent  no.2   in   the   main   petition.  In   the   said  additional   affidavit,   it   is   categorically  stated   that   all   the   sixteen   patients   are  fully   recovered   from   the   temporary   drop   in  the vision and nobody is blind amongst them.  The same is disputed by the party­in­person,  Mr.   Chandravadan  R.   Dhruv  and   seeks  time   to  file   further   affidavit.   Stand   over   to  22.03.2017 in the caption "for orders"."
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HC-NIC Page 7 of 13 Created On Mon Aug 14 06:45:56 IST 2017 C/WPPIL/182/2016 ORDER 7.1 On  22.03.2017  the  petitioner   sought  time   to  file further affidavit. However, the fact remains  that   until   the   matter   was   finally   heard   on  29.03.2017, no further affidavit was filed by the  petitioner   disputing   the   averment   that   the  patients   had   completely   recovered   from   the  temporary   drop   in   vision   and   that   none   of   them  had become blind. 

8. In view of the aforesaid factual scenario, we  find no merit in the allegation levelled by the  petitioner that the 16 patients had become blind  owing to the drug administered by the Hospital on  12.01.2016.   In   fact,   the   record   shows   that   the  Hospital   authorities   took   prompt   action   in   the  matter   by   giving   necessary   treatment   to   the  patients on the very same day. All the patients  regained   their   eye­sight   by   the   time   they   were  discharged from the Hospital after about a week,  which   is   evident   from   the   additional   affidavit  filed  by  respondent  no.2  and which  has  remained  uncontroverted.   Though   some   of   the   patients  complained   of   temporary   loss   of   vision   at   the  relevant   time   but,   none   of   them   lost   it   on  permanent basis. Further, the record also reveals  that   the   patients   were   suffering   from   different  ailments   like   diabetes,   hypertension,   etc.   and  other   age­related   issues,   which   would   have   a  Page 8 of 13 HC-NIC Page 8 of 13 Created On Mon Aug 14 06:45:56 IST 2017 C/WPPIL/182/2016 ORDER considerable bearing on the effect of the drug on  the   human   body.   All   the   patients   had   given  written consent for undergoing the treatment and  they were appraised about the side­effects of the  medicine  and  the course  of  treatment.  Hence,  we  find   no   substance   in   the   allegation   that   the  patients  lost  their  eye­sight  on account   of the  drug   administered   to   them   by   the   Hospital  authorities on 12.01.2016.

9. The   petitioner   has   also   alleged   that   the  Report   submitted   by   the   three   member   Inquiry  Committee   constituted   by   the   respondent­ Corporation is not independent and is influenced.  The   petitioner   has   not   produced   any   documentary  evidence  on record   to substantiate   the same.  In  fact, it appears from the record that no Member  of   the   Inquiry   Committee   is/was   associated   with  the   Hospital   in   any   manner   whatsoever.   All   the  Members   were   independent   and   were   employed   with  different   Hospitals/Medical   Colleges.   Therefore,  it   cannot   be   said   that   the   report   submitted   by  the Inquiry Committee is biased or is influenced  by the respondent­Corporation. 

10. It   is   pertinent   to   note   that   the   Inquiry  Committee,   after   thorough   examination,   found   no  short­fall   or   lacunae   in   the   procedure   of  standard   protocol   followed   by   the   medical   and  Page 9 of 13 HC-NIC Page 9 of 13 Created On Mon Aug 14 06:45:56 IST 2017 C/WPPIL/182/2016 ORDER para­medic   staff   of   the   Hospital.   The   Committee  opined that after the incident was reported, the  response of the Hospital was very prompt. This is  evident from the fact that the affected patients  were   admitted   in   the   Hospital   on   13.01.2016  itself   and   were   kept   under   constant   supervision  and were given necessary treatment. The services  of Expert Doctors in the field was also taken on  the   same   day   and   on   subsequent   dates   and   after  about   a   week,   all   the   patients   were   discharged  from the Hospital with proper vision in both the  eyes.   The   record   also   shows   that   on   15.01.2016  the   officials   from   the   Food   and   Drugs   Control  Administration   collected   informal   samples   from  the   Batch   of   Injections   for   analysis.   After  carrying out the tests, the authority opined that  the   Injection   vial   was   of   standard   quality.  Hence,   it   cannot   be   said   that   the   drug  administered   by   the   Hospital   authorities   was   of  sub­standard quality.

11. Further,   vide   Notice   dated   09.03.2016,   the  Directorate General of Health Services, Office of  the   Drugs   Controller   General   (India),   withdrew  the  Alert  Notice  dated  21.01.2016,   on the basis  of   the   recommendations   of   the   Expert   Committee  constituted   by   the   Government   of   India   in  pursuance   of   the   incident   in   question.   The  relevant   portion   of   the   Notice   dated   09.03.2016  Page 10 of 13 HC-NIC Page 10 of 13 Created On Mon Aug 14 06:45:56 IST 2017 C/WPPIL/182/2016 ORDER reads as under;

"..The Committee examined and deliberated on  the   use   of   Bevacizumab   Injection   in  Ophthalmologic   conditions   as   an   off­label  indication   and   following   observations   were  made by the Committee:­
1. Bevacizumab Injection is not approved by  global   regulatory   authorities   for  intravitreal   use   due   to   non­application   by  the Innovator for this purpose. However, WHO  (April   2015)   has   recommended   Bevacizumab  Injection   by   including   in   the   list   of  essential medicines prepared as anti­vascular  endothelial   growth   factor   in   ophthalmic  section   based   on   recommendation   of  International Council of Ophthalmology (ICO).  Further,   regulatory   agencies   of   France   and  Italy   have   allowed   its   off­label   use   as   a  Temporary Recommended Use (TRU).
2. The   safety   and   efficacy   of   Bevacizumab  injection in intravitreal use is stated to be  proven   by   various   independent   studies   (over  2500   studies   published)   conducted   globally.  It was discussed that rate of endophthalmitis  is significantly lower after the injection of  Bevacizumab Injection as compared to standard  cataract surgery.
3. The   Bevacizumab   Injection   is   40   times  cheaper   than   other   available   drug  (Ranibizumab   Injection)   for   same   use   and  equally   effective   in   India.   This   would   put  less financial burden on patients and prevent  blindness of many.
Based   on   the   above   facts,   following  recommendations were made by the Committee:
  The   Office   of   DCG(I)   was   requested   to  Page 11 of 13 HC-NIC Page 11 of 13 Created On Mon Aug 14 06:45:56 IST 2017 C/WPPIL/182/2016 ORDER take necessary measures to withdraw the Alert  Notice   issued   on   21.01.2016   which   was  primarily   issued   as   a   precautionary   measure  in the light of the incidences of blindness  reported in Gujarat. Further, it was proposed  that   All   India   Ophthalmological   Society  (AIOS)   and   Vitreo   Retinal   Society   of   India  (VRSI) will formulate guidelines for safe and  effective   use   of   Bevacizumab   Injection   for  Ophthalmic   purpose   based   on   the   written­ informed   consent   as   practiced   globally   for  off­label use under appropriate environmental  conditions   by   skilled   ophthalmic   surgeons  based   on   risk­benefit   analysis.   They   will  further ensure that appropriate training and  awareness may be imparted to its members.

The   Ministry   of   Health   and   Family   Welfare,  Government   of   India   has   accepted  recommendations   of   the   Committee.  Accordingly, this notice is issued."

12. In view of the above discussion, we find no  substance   in   the   allegations   made   by   the  petitioner   in   this   petition.   The   Report   of   the  Foods   and   Drugs   Control   Administration   proves  that the Drug administered to the patients was of  standard quality. The record also shows that the  Hospital   authorities   took   prompt   action   in   the  matter   by   giving   necessary   treatment   to   the  patients   and   though   the   patients   complained   of  temporary   loss   of   vision   but,   all   of   them  regained   their   eye­sight   by   the   time   they   were  discharged   from   the   Hospital,   which   is  established   from   the   additional   affidavit   filed  Page 12 of 13 HC-NIC Page 12 of 13 Created On Mon Aug 14 06:45:56 IST 2017 C/WPPIL/182/2016 ORDER by respondent no.2. The above aspect has not been  controverted   by   the   petitioner   by   filing   any  further affidavit or by producing any material on  record to that effect. Hence, we do not find any  merits in the present petition.

13. In   the   result,   the   petition   is   dismissed.  Notice   is   discharged.   Consequently,   the   Civil  Applications stand disposed of.

(R. SUBHASH REDDY, CJ) (VIPUL M. PANCHOLI, J.) Pravin/* Page 13 of 13 HC-NIC Page 13 of 13 Created On Mon Aug 14 06:45:56 IST 2017