Central Information Commission
Ms.Sudha Rani Aggarwal vs Ministry Of Health And Family Welfare on 27 January, 2012
CENTRAL INFORMATION COMMISSION
Club Building (Near Post Office)
Old JNU Campus, New Delhi - 110067
Tel: +91-11-26161796
Decision No. CIC/SG/A/2011/003420/17121
Appeal No. CIC/SG/A/2011/003420
Relevant Facts emerging from the Appeal
Appellant : Ms. Sudha Rani Aggarwal,
B1A175-B, MIG Flats,
Janak Purl,
New Delhi-i 10058.
.Respondent : Public Information Officer
Delhi Medical Council
3rd Floor, Pathology Block,
Maulana Azad Medical College,
New Delhi-110002.
RTI application filed on : 07/10/2011
PIO replied : 13/10/2011
First Appeal : 25/10/2011
First Appellate Authority order : 03/11/2011
Second Appeal received on : 28/11/2011
Information sought:
1. Copy of the document may please be provided wherein Dr. Sudhir Khanna had recorded that I had consulted him on 31.1.2005 with complaints of difficulty in passing urine and with a folly's catheter in position. The prescriptions and the hospital record available with me do not have this reference.
2. DMC may please confirm if Dr. Sudhir Khanna had recorded my prevailing health history i.e. "I was a patient of Diabetic since 1995 and depending on Insulin, also diagnosed with Hypertension and on medication when I consulted him on 31 .01 .2005." I had also told him that it was for the first time I was facing this difficulty after taking some medicines for the treatment for eyes infection", if yes, the copy of the said document may please be provided. If no, the reasons for not recording the same may please be explained. The prescriptions and the hospital record available with me do not have this reference recorded.
3. DMC may please confirm whether a male surgeon can plan a surgical procedure and operate on the genital organs of his female patient, without any diagnose.
4. DMO may please confirm if Dr. Sudhir Khanna had recorded that the X-ray abdomen (KUB) did not reveal any stone, Folly's catheter was removed and urethral dilatation was carried out under local anesthesia, if yes, a copy of the said document may please be provided. If no, the reasons for not recording the same may please be explained. The prescriptions and the hospital record available with me do not have this reference recorded.1
5. DMC may please provide the details of all those protocols Dr. Sudhir Khanna should have had observed and confirm if he had actually observed those protocols and provide a copy of documentary evidence in confirmation to the above mentioned statement of Delhi Medical Council.
6. DMC may please confirm if Dr. Sudhir Khanna got me registered in the hospital for carrying out Urethca Dilatation procedure, if yes, please provide the Registration No., if no, the reasons for not getting me registered may be explained.
7. DMC may please confirm if Dr. Sudhir Khanna had recorded that Urethral dilatation to be done under local anesthesia and also confirm if he had obtained any written consent either from me or from my brothers for performing the procedure under Local Anesthesia, if yes, a copy of the said document may please be provided. If no, the reasons for not obtaining written consent may please be explained. The prescriptions and the hospital record available with me do not have this reference recorded.
5. DM0 may please justify, how, Dr. Sudhir Khanna was right in taking me to the Urodynamic lab of the hospital under the pretext to perform Urethral Dilatation procedure which was actually a procedure to be performed in the Operation Theatre only.
6. DMC may please define Urethral Dilatation in females.
7. DM0 may please confirm that KUB X-Ray (abdomen) is always advised to rule out stone in the urinary system and for nothing else. Please also define KUB X-Ray (Abdomen).
8. DMC may please provide the full report of my KUB X-Ray, as the report was not given to me by the X-ray department of the hospital.
DMC in its Order has stated and I quote that: - 'an uroflometry was done as a routine practice assess the success of the dilatation, however as the amount of urine passed was not sufficient, the report was not of any significance, hence not recorded'. Subsequently, the patient developed retention of urine again and hence she was once again catheterized on the same day and Cystoscopy was planned under general anaesthesia as a second step. Necessary tests were carried out for pie-anaesthetic check up'.
confirm the authenticity of the above mentioned decision, DM0 may please provide the following information along with documentary evidence, under the Right to Information Act 2005.
1. DM0 may please provide a copy of the document wherein Dr. Sudhir Khanna had advice for uroflometry to assess the success of dilatation. The prescriptions and the hospital record available with me do not have this reference recorded.
2. DM0 may please confirm whether Dr. Sudhir Khanna got me registered in the hospital for carrying out uroflometry, If yes, please provide the Registration No., if no, the reasons for not getting me registered may be explained. -
3. DM0 may please provide a copy of the document wherein Dr. Sudhir Khanna had recorded that, as the amount of urine passed was not sufficient, the report was not of any significance. Please also confirm if he had asked for to repeat uroflometry, if yes, a copy of the said document along with uroflometr-y report if any, may please be provided, if no, the reasons may please be explained.
4. DM0 may justify the wrong statement given by DMC in its Order, in spite of knowing that, Dr. Sudhir Khanna had actually recorded uroflometry report as 156/21.1/7.7.24 On the prescription dated 31.01 .2005.
5. DM0 may please define Uroflometry in detail and also confirm if there is any condition of a minimum quantity of urine output required for an Uroflometry, is stipulated in the Medical Literature.
6. DM0 may please provide a copy of the docuijient wherein Dr. Sudhir Khanna had recorded that, I was developed with retention of urine again and hence I was once again catheterized on the 2 same day. The prescriptions and the hospital record available with me do not have this reference recorded.
7. DM0 may please provide a copy of the document wherein Dr. Sudhir Khanna had recorded that, cystoscopy was planned under general anesthesia and necessary tests he had advice, were carried out for pre-anesthetic check up'. The prescription and the hospital record available with me do not have this reference recorded.
8. DM0 may please confirm if Dr. Sudhir Khanna had recorded the findings of Chest XRay he had advice, also provide the full report of my Chest X-Ray, as the report was not given to me by the X-ray department of the hospital.
9. Please define 'Cystoscopy Proceed' and also confirm, whether it was a Day Care Procedure" or a procedure to be performed by admitting the patient in the hospital.
10. DM0 may please confirm whether 'Cystoscopy Proceed' is included in the Schedule of Charges, issued by Sir Ganga Ram Hospital. If yes, the Code No. allocated to this procedure and charges defined under different category of patients, may please be provided along with a copy of such document.
Delhi Medical Council has stated in its Order that, I quote DM0: - 'On 4.2.2005 Cystoscopy was done under G.A. and was discharged on 5.2.2005. During Cystoscopy a small urethral carauncle was found and removed'.
To confirm the authenticity of the above mentioned decision, DM0 may please provide the following information along with documentary evidence, under the Right to Information Act 2005.
1. The above mentioned statement of DM0 is not based on the actual description recorded by Dr. Sudhir Khanna, the description recorded on the documents provided by the hospital, confirms that, I was clinically diagnosed with Urethral Stricture, Bladder Outlet Obstruction and Caruncle before the procedure itself and the procedure ws performed as pie-diagnosed. DMC may justify its decision in view of actual description recorded on the hospital document. .c
2. DM0 may please confirm the time and place, where Dr. Rakesh Saxena has carried out pre- anesthetic check-up.
3. DM0 may also confirm whether I was alone or my brothers were also present at the time of pre- anesthetic check-up.
DM0 has stated in its Order that I Quote DMC: -- Subsequently the complainant consulted the respondent on 11th 14th 24th February and 5th & 7th March, 2005 and was free from her urinary symptoms.
To confirm the authenticity of the above mentioned decision, DM0 may please provide the following information along with documentary evidence, under the Right to Information Act 2005.
1. The above mentioned statement of DM0 was not based on the description recorded by Dr. Sudhir Khanna on the various prescriptions when I visited him on the above mentioned dates. Dr. Sudhir Khanna without recording my prevailing health conditions advice medicines and also got uroflometry without getting me registered in the hospital for carrying out uroflometry, without asking me to deposit the uroflometry charges and destroyed the uroflometry findings after recording the same on the respective prescriptions. DMC may please justify these illea acts of Dr. Sudhir Khanna.
2. DM0 may please confirm if Dr. Sudhir Khanna had recorded my prevailing health condition when I visited the hospital OPD on 1 February 2005 for follow-up and for the removal of Folly catheter on his advice at the time of discharging me from the hospital on 5th February 2005. An uroflometry was conducted by the Urodynamic Lab Attendant on the verbal instructions of Dr. Sudhir Khanna without getting me registered in the hospital and also without asking me to deposit the charges in the hospital account. Findings were destroyed without any recording. DM0 may please justify these illegal acts of Dr. Sudhir Khanna.
33. DM0 may please confirm if Dr. Sudhir Khanna had recorded my prevailing health condition when I visited the hospital OPD on 14th & 24 February 2005, as I was in discomfort while urinating and also feeling pain while urinating. Medicines were prescribed without assigning any reasons. An uroflometry was conducted by the Urodynamic Lab Attendant on the verbal instructions of Dr. Sudhir Khanna without getting me registered in the hospital for that uroflometry and also without asking me to deposit the charges in the hospital account. Findings were destroyed after recording the same on the respective prescriptions. DM0 may please justify these illegal acts of Dr. Sudhir Khanna.
4. DM0 may please confirm if Dr. Sudhir Khanna had recorded my prevailing health condition when I visited the hospital OPD on 5th March 2005 as I was in discomfort while urinating and also feeling some pain in the lower abdomen while urinating. If yes, a copy of the said document may please be provided, if no, the reasons for not recording the same may please be explained. UroflometrY and Ultrasound were also advices without assigning any reason.
5. DM0 may please justify the illegal act of Dr. Sudhir Khanna referring me to Psychiatrist without assigning any reason when visited the hospital OPD 5th March 2005. Delhi Medical Council in its Order has stated and I quote that, 'Delhi Medical Council observes that: - Urethral dilatation is carried out for the treatment of such clinical conditions when X-ray does not show stone in KUB in a patient with repeated urinary retention. The procedure adopted by the respondent was n accordance with the accepted professional practice.' To confirm the authenticity of the above mentioned decision, DMC may please provide the following information along with documentary evidence, under the Right to Information Act 2005.
1. DMC may please confirm and provide a copy of that document on which Dr. Sudhir Khanna had recorded the findings of KUB X-Ray as stated above. The prescriptions and record provided by the hospital do not have this reference recorded.
2. DM0 may please confirm and provide a copy of that document on which Dr. Sudhir Khanna had recorded that, I was diagnosed with repeated urinary retention. The prescriptions and record provided by the hospital does not have this reference recorded.
3. DM0 may please elaborate that procedure adopted by Dr. Sudhir Khanna in accordance with the accepted professional practice as stated above in the Order of DM0.
DM0 in its Order has further stated and I quote that:-The Delhi Medical Council observes that:
- It was alleged by the complainant that no female attendant was present whilst the urethral dilatation was carried out. The respondent in his reply refused the allegation by stating that the said procedure was carried out in me presence of a fema'e attendant from 2nd CD ward and one Raj Kumar a urodynamic Assistant at the said Hospital. Ms Pushpa Rani, purportedly the female attendant from 2nd CD ward referred to in reply of respondent was examined. Ms Pushpa Rani submitted before the Delhi Medical Council that she in fact was present in the urodynamic lab of the said Hospital during the period complainant underwent urethral dilatation. The complainant, however, vehemently denied the presence of Ms Pushpa Rani.
The Delhi Medical Council could not reconcile this issue.
To confirm the authenticity of the above mentioned decision, DM0 may please provide the following information along with documentary evidence, under the Right to Information Act 2005.
1. DM0 may please provide a copy of the document if any, submitted by Dr. Sudhir Khanna, supporting his claim that, Ms. Pushpa Rani, Staff Nurse was present wth him in the Urodynamic Lab.
DMC in its Order has further stated and I quote that: - It is also alleged by the complainant that because of extraneous consideration no charges were levied by the said Hospital for the urethral dilatation done on 1.2.2005. The respondent in his reply stated that since the voided volume (urine) was not adequate and the uroflometry report was inconclusive, no charges were levied as 4 per the said Hospital practice. The Delhi Medical Council found the explanation forwarded by the respondent to be reasonable.
To confirm the authenticity of the above mentioned decision, DM0 may please provide the following information along with documentary evidence, under the Right to Information Act 2005.
1. DMC may please provide a copy of the docuinent if any, submitted by Dr. Sudhir Khanna, confirming the hospital policy that, the uroflometry charges are always levied after verifying the uroflometry report.
CPIO's reply:
Ref. No. : I.D. No. 410With reference to your application received in this office on 7th October, 2011, on the subject noted above, it is informed that complaint No. 251 of Ms. Sudha Rani Aggarwal against Dr. Sudhir Khanna of Sir Ganga Ram Hospital was examined and determined by Delhi Medical Council in discharge of its quasi-judicial functions vide Order no. DMC/F.14/DC/Comp.251/2/2001/29993 to 29997 dated 30th April, 201 1(copy enclosed as annexure 'A'). It is observed that queries raised in the R.T.1. application are in nature of grievance redressal which is outside the purview of R.T.I. Act. It is informed that in terms of Regulation 8.8 of Indian Medical Council (Professional Conduct, Etiquette and Ethics) 2002 "Any person aggrieved by the decision of the State Medical Council on any complaint against a delinquent physician, shall have the right to file an appeal to the Medical Council of Indian within a period of sixty days from the date of receipt of the order passed by the said Medical Council. Provided that the Medical Council of India may, f it is satisfied that the appellant was prevented by sufficient cause from presenting the appeal within the aforesaid period of sixty days, allow it to be presented within a/under period of sixty days ". It is further observed that the information sought by the applicant through various queries is beyond the scope of R.T.I. Act in terms of Section 2(f) &(j) of the said Act as the applicant is seeking explanations and clarifications in respect of matter connected with or incidental to the Order passed by Delhi Medical Council in complaint no. 251, which the PIO. cannot comment upon.
It is further informed that the applicant may inspect the case file pertaining to complaint number 251 19th October, 2011 (Wednesday) at 11.00 a.m. in the office of the Delhi MedicaL Council, Room no. 366, 3rd Floor, Pathology Block, Maulana Azad Medical College, Bahadur Shah Zafar Marg, New Delhi-110002 for seeking answer to his queries and may also identify the documents from the case file which he desires, so that the same may be made available to him on remittance of requisite fee by way of cash , demand draft , postal order or banker's cheque payable to Delhi medical council.
Grounds for the First Appeal:
Information provided is incomplete and unsatisfactory.
Order of the FAA:
It is observed that complaint no. 251 of Ms. Sudha Rani Agggarwal against Dr. Sudhir Khanna of Sir Ganga Ram Hospital, in respect of which the appellant is seeking information/documents, was examined and determined by Delhi Medical Council in discharge of its quasi-judicial functions vide Order no. DMC/F.l4/DC/Comp.251/2/2001/29993 to 29997 dated 30th April. 2011. It is further observed that queries raised in the R.T.J. application are in nature of grievance redressal which is outside the purview of R.T.I. Act. It is further observed that the P.l.O. has rightly informed that in terms of Regulation 8.8 of Indian Medical Council (Professional Conduct, Etiquette and Ethics) 2002 "Any person aggrieved by the decision of the State Medical Council on any complaint against a delinquent physician, shall have the right to file an appeal to the Medical Council of Indian within a period of sixty days from the date of receipt of the order passed by the said Medical Council. Provided that the Medical Council of India may, i/it is satisfied that the appellant was prevented by sufficient cause from presenting the appeal within the aforesaid period of sixty days, allow it to be presented within a further period of sixty days.5
(2) It is further observed that the information sought by the applicant through various queries is beyond the scope of R.T.1. Act in terms of Section 2(f) &(j) of the said Act as the applicant is seeking explanations and clarifications in respect of matter connected with or incidental to the Order passed by Delhi Medical Council in complaint no. 251, which the P.l.O. cannot comment upon (3) The information provided to the appellant by the Public Information Officer was based on the information available in the records of DMC and in terms of Section 2(f) & (j) of RTI Act (4) In light of the willingness expressed by the appellant for inspecting the case file pertaining to complaint no. 251 of Ms. Sudha Rani Agggarwal against Dr. Sudhir Khanna of Sir Ganga Ram Hospital and specifying/identifying the documents which she desires in respect of complaint no. 251, Ms. Sudha Rani Aggarwal was allowed to inspect the case file pertaining to complaint no. 251 in the presence of undersigned. It was also directed that the appellant be provided a copy of all the documents which she may specify/identify in respect of complaint no. 251, on payment of requisite fee, within ten days.
Grounds for the Second Appeal:
Information provided is incomplete and unsatisfactory Relevant Facts emerging during Hearing:
The following were present Appellant: Ms. Sudha Rani Aggarwal along with Mr. Prabodh Chandra Aggarwal. Respondent: Mr. LD Singh, PIO & Assistant Secretary along with Mr. Praveen Khattar, Advocate and Mr. Ganesh Prasad, Record Keeper.
The PIO has given the inspection of all the relevant records as admitted by the Appellant. The Appellant believes that the decision of the enquiry committee of the Delhi medical Council has not been taken with adequate basis. The Appellant wants to know the justification on which conclusion has been reached. The PIO can only provide the information available on record of which he has. The Appellant believes that the conclusion has been reached without adequate justification. The Appellant will have to approach the appropriate forum Decision:
The Appeal is disposed.
The information as per available record has been provided.
This decision is announced in open chamber.
Notice of this decision be given free of cost to the parties.
Any information in compliance with this Order will be provided free of cost as per Section 7(6) of RTI Act.
Shailesh Gandhi Information Commissioner 27 January 2012 (In any correspondence on this decision, mention the complete decision number.) (PG) 6