Delhi District Court
Pramod Kumar Chaudhary vs The State Of Nct Of Delhi on 12 December, 2023
IN THE COURT OF MS. SHIVALI SHARMA, ADDITIONAL
SESSIONS JUDGE - 03: WEST DISTRICT,
TIS HAZARI COURTS, DELHI
CNR No. DLWT-01-007528-2022
CR. REV. NO. 223/2022
PS - Ranjit Nagar
U/s. 397 Cr.P.C.
IN THE MATTER OF:
Pramod Kumar Chaudhary,
S/o Sh. Arjun Chaudhary,
R/o C-42, Palika Niketan,
Rama Krishna Ashram Marg,
New Delhi.
REVISIONIST
VERSUS
1. State of National Capital Territory of Delhi
State (Govt. of NCT of Delhi)
Through Public Prosecutor
2. Dr. Sunil Sareen
S/o Sh. Satkrishan Panjee,
R/o 8A/100, Second Floor, WFA Karol Bagh,
New Delhi- 110 005
3. Dr. Vivek Singh,
S/o Raj Narayan Singh,
CD-17B, Hari Nagar,
New Delhi - 110 064.
4. Gurdass Gurdani (since deceased)
S/o Sanmukh Dass
CC-8B, Ground Floor,
DDA Flat, Hari Nagar,
New Delhi - 110 064.
....RESPONDENTS
Pramod Kumar Chaudhary
Vs. State & Anr. CR No. 223/2022 Page No.1/31
Other Details :
Date of Institution : 04.08.2022
Date of Reserving Order : 28.11.2023
Date of Order : 12.12.2023
REVISION PETITION U/s. 397 Cr.P.C. FOR SETTING
ASIDE THE ORDER DATED 17.11.2021 OF LD. ACMM,
WEST, DELHI IN FIR NO. 328/2017 PS- RANJIT NAGAR
TITLED AS STATE Vs. SUNIL SAREEN AND ORS.
WHEREBY THE PROTEST PETITION FILED BY THE
COMPLAINANT SEEKING CONGNIZANCE OF
OFFENCES UNDER SECTION 177/192/419/420/304/120B OF
IPC WAS DISMISSED AND SUMMONS WERE DIRECTED
TO BE ISSUED AGAINST THE ACCUSED PERSONS FOR
OFFENCE UNDER SECTION 304A/34 IPC
ORDER:
1. The present revision petition is filed challenging the impugned order dated 17.11.2021 of Ld. ACMM, West, Delhi in FIR No. 328/2017 PS- Ranjit Nagar titled as State vs. Sunil Sareen and ors. whereby the protest petition filed by the complainant seeking cognizance of offences under section 177/192/419/420/304/120B of IPC was dismissed and summons were directed to be issued against the accused persons for offence under section 304A/34 IPC. The revisionist herein is the complainant before Ld. Trial Court while the respondents no. 2 to 4 are accused no. 1 to 3 before Ld. Trial Court. Respondent no. 1 is the State being represented through Ld. Addl. PP. For the sake of convenience, parties shall be referred to by their nomenclature before Ld. Trial Court.
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2. Respondent no. 4 Sh. Gurdas Gurdani who was accused no. 3 before Ld. Trial Court has already expired and proceedings qua him have already been abated.
BRIEF FACTS:
3. Brief facts of the case necessary for disposal of the present revision petition are that on the basis of directions issued by Ld. ACMM, West vide order dated 30.08.2017 under Section 156 (3) Cr. P. C. on a complaint under Section 200 Cr. P. C. filed by complainant Pramod Kumar Chaudhary FIR No. 328/2017 U/s 304A/34 IPC PS- Punjabi Bagh was registered on 17.11.2017.
4. The allegations in the complaint are that on 21.10.2011, patient baby Ritu aged about 10 years (daughter of the complainant) was admitted at RLKC Hospital, in General Female Ward for fever. She was assigned to Dr. Sunil Sareen/accused no. 1 for treatment. He prescribed injection Monocef, Injection Rentac in addition to tablet Crocin on SOS basis. Various pathology Test for Dengue Serology were also carried out on the patient on 21.10.2011. The pathology report revealed " Dengue for NSI-
Antigen as positive". Platelet count was 2.1 lacs as against normal range of 1.5 to 4.5 and SGOT and SGPT were 36 and 43 respectively as against normal range of 0-37 for both. As per do's and don'ts for managing Dengue fever issued and circulated by Ministry of Health and Family Welfare, Antibiotics, Aspirin or Brufen are not to be given for managing Dengue Fever. On the next day i.e. 22.10.2011, the temperature of the patient varied between Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.3/31 98 degree F to 100 degree F. However, Dr. Sunil Sareen/accused no. 1 continued with treatment i.e. Injection Monocef and Injection Rantac besides tablet Crocin and Injection MOI. Patient was also given Injection Unitrax and Injection Rantax (both antibiotics) despite positive Dengue Pathology.
5. For the next two days, doctors continued with same line of treatment giving heavy doses of antibiotics to the patient ignoring the guidelines of Govt. for treatment of Dengue patients. Consequently, on 24.10.2011 at about 09.00 PM, patient complained of severe pain in stomach and problem in passing urine. Request for calling Dr. Sunil Sareen to check the patient did not yield any result and Dr. Sunil Sareen/accused no. 1 visited the patient only on 25.10.2011 at about 08.00 AM. Patient was given Voveran tablet/Injection which are fatal in Dengue fever as per medical evidence. The pathology report dated 25.10.2011 showed disturbing trend and revealed that platelet count had gone down to 0.4 lacs and SGOT and SGPT has sharply increased to 970 and 1205 respectively. These were clear indicators that the condition of the patient was deteriorating. On 25.10.2011, the hospital authority and Dr. Sunil Sareen advised the complainant to shift the patient to RML Hosptial or Kalawati Saran Hsopital since RLKC Hospital did not have Paediatrics ICU facility.
6. On 25.10.2011, complainant took the patient to RML Hospital and was informed that the condition of patient was very critical and she was in shock and her BP was very low. Patient was diagnosed as DSS with Thrombocytopenia Grade-III. Despite Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.4/31 platelet transmission and other necessary treatment, patient developed preliminary Hemorrhage, Renal failure and GCS-3 and went in Cardiac Arrest resulting in her demise. It is alleged that the the death of the patient had occurred due to gross negligence on the part of Dr. Sunil Sareen / accused no. 1 and hospital authority who had resorted to heavy dose of antibiotics despite clear medical guidelines to the contrary. Thus, they were guilty of committing criminal medical negligence in the treatment of the patient and are thus, liable for offence under Section 304 (Part-II) IPC.
7. On receipt of directions passed by Ld. ACMM, West vide order dated 30.08.2017 for registration of FIR and investigation, present FIR was registered under Section 304A/34 IPC.
8. After completion of investigation, IO filed the charge-sheet on 20.07.2020. The charge sheet was filed against three accused persons namely Dr. Sunil Sareen/ accused no. 1, Dr. Vivek Singh/accused no. 2 and Sh. Gurdas Gurnani/accused no. 3 (the then MS- RLKC Hospital) under Section 304A/ 34 IPC without arrest of the accused persons.
9. Since, complaint case filed by the complainant under Section 200 Cr. P. C. was also pending, the complainant filed a protest petition against the challan alleging that the accused persons were not charge-sheeted under appropriate sections. It is this protest petition which was dismissed by Ld. Trial Court vide impugned order dated 17.11.2021 and the accused persons charge-sheeted were directed to be summoned for offences under Section 304A/34 IPC.
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10. During the course of the arguments before Ld. Trial Court accused no. 3 namely Sh. Gurdas Gurdani who has been impleaded as respondent no. 4 in the present revision petition expired and proceedings against him were abated before Ld. Trial Court.
11. In the protest petition filed by the complainant, summoning of the accused persons has been sought for offences under Section 177/192/419/420/304/120B IPC. It is stated that Section 177 IPC is attracted in the matter on account of furnishing false information by the accused persons to Delhi Medical Council (DMC) as recorded vide its order dated 22.08.2013 that entire treatment record of the patient was not available especially for the period when such drugs were administered upon the patient. As per regulation 1.3 of Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002, the doctors are bound to record every single procedure, observation, administration, treatment, advice etc. and maintain the record properly for a period of three years, however, in the present case, no record from ICU were maintained by the accused persons. Offences under Section 192/193 IPC were attracted as the records of the general ward is also altered at a later stage by over writing as is recorded in the order of DMC dated 22.08.2013. It is further alleged that offence under Section 419 IPC is also attracted against Dr. Vivek Singh/accused no. 2 as he had appeared before Delhi Medical Council with a fake identity of Dr. Vivek Sharma son of Late Sh. H. C. Sharma and it was observed by Delhi Medical Council vide its letter dated 12.05.2016 that Dr. Vivek Singh son of Sh. Raj Narayan Singh was never registered Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.6/31 with Delhi Medical Council.
12. It is also alleged in the protest petition that offence of cheating punishable under section 420 IPC is also attracted in the present matter as Dr. Vivek Singh/accused no. 2 without having any involvement in the treatment of the patient had signed the discharge summary specifically noting " referred to higher paediatric centre for management". Later on, the same discharge summary was freshly signed by Dr. Sunil Sareen with the recording of platelet count to be 4.5 lacs while the platelet count of the patient even at time of her admission was 2.1 lac. The accused persons with deliberate and dishonest intention had produced false and fabricated discharge summary before Authorities to project themselves to be absolutely correct about the treatment given to the patient. This wrong representation by the accused persons led to misrepresentation to RML Hospital as it projected the patient to be in an absolutely stable condition.
13. It is also alleged that the accused persons are liable for offence of culpable homicide not amounted to murder, punishable under Part-II of Section 304 IPC. The death of the patient was clearly due to an act of Dr. Sunil Sareen/accused no. 1 which he knew that it was likely to cause death. After admission of patient on 21.10.2011, the treating doctor, Dr. Sunil Sareen/accused no. 1 did not visit the patient on 22.10.20211, 23.10.2011 and 24.10.2011. Patient reported extreme pain in the abdomen in the intervening night of 24-25.10.2011 which was duly informed to the Duty staff, who in consultation with Dr. Sunil Sareen/accused no. 1 gave tablet Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.7/31 Aziwok 250 mg to the patient. Dr. Sunil Sareen/accused no. 1 visited the patient during his morning shift on 25.10.2011 till which time the patient kept on suffering from sever abdominal pain and trouble in passing urine. Dr. Sunil Sareen/accused no. 1 failed to monitor proper platelet counts and adhere to the guidelines for Dengue Fever Management. Despite knowing the fact that patient was suffering from Dengue, she was administered antibiotic Aziwok, Tramazac and pain killer Voveran which durgs are absolutely barred for Dengue patients. When the condition of the patient deteriorated the accused persons presented fabricated discharge documents while transferring the patient to RML Hospital and also delayed the transfer of the patient despite being in knowledge of her critical condition. The patient was neither given proper treatment nor kept under proper monitoring. Despite knowing about the consequences of their failure to follow the protocols for Dengue Fever Management, the accused persons ignored those protocols which resulted in death of the patient. Thus, it is alleged in the protest petition that the accused persons are liable to be tried for offence under Section 304 (Part-II) IPC.
IMPUGNED ORDER:
14. The accused persons were not summoned by Ld. Trial Court at the time of hearing of the protest petition. After hearing the submissions of the complainant, the protest petition was disposed off vide impugned order dated 17.11.2021. After appreciating the facts of the case, the complaint made by the complainant and Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.8/31 findings of various authorities on the point of medical negligence, Ld. Trial Court observed that there is nothing on record to prove prima facie that the accused persons were guilty for the offence punishable u/s 304 (II) IPC as there was no clear evidence or record to show that Voveran injection was actually administered to the patient. Even admittedly, no prescription for the same was available on record and it had only surfaced in the bill generated by the pharmacist of the hospital mentioning its purchase. Ld. Trial Court also took note of the reports of Delhi Medical Council (DMC) and Medical Council of India (MCI) to the effect that no medical negligence could be attributed or found on the part of the treating doctors. Ld. Trial Court also observed that no prima facie material was available on record to prosecute the accused persons for offences u/s 420/177/416/419 IPC.
15. Ld. Trial Court observed that no provision of IPC provides for booking any doctor specifically for medical negligence, however, Section 304 A IPC provides for initiation of a criminal proceeding against such a doctor for medical negligence leading to death of a patient. On the basis of these reasons, Ld. Trial Court dismissed the protest petition and directed summoning of the accused persons to be tried for offence u/s 304A/34 IPC.
GROUNDS FOR REVISION/ARGUMENTS ON BEHALF OF COMPLAINANT:
16. The impugned order dated 17.11.2021 is challenged on the following grounds:
Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.9/31
(a) That the impugned order is devoid of any reasoning and the observation of Ld. Trial Court to the effect that charges from IPC cannot be attributed against the doctors and limited reliance upon Section 304A IPC is erroneous and wrong interpretation of law and criminal jurisprudence.
(b) That the Ld. Trial Court has wrongly relied upon the reports of Disciplinary Committee of DMC and Ethics and Executive Committee of MCI making observations that no medical negligence was attributed on the part of Dr. Sunil Sareen and Dr. Vivek while ignoring the report issued by the committee duly approved on 30.10.2018 by Hon'ble Chief Minister of Delhi under chairmanship of Secretary, Department of Health and Welfare, Govt of NCT of Delhi wherein discrepancies have been explicitly recorded. Ld. Trial Court failed to consider the observations in the committee report to the effect that standard operating procedures were not followed by the hospital and proper medical records of the patient were not maintained. Similar submissions made by DMC in its order dated 22.08.2013 have also been ignored by Ld. Trial Court. Even the report of DMC records that proper medical records were not maintained and accordingly, giving the clean chit to the doctors on the basis of improper medical records was in itself arbitrary, irrational, unjust and bad in law. Thus, reliance of Ld. Trial Court on the said reports is again bad in law.
(c) That the Ld. Trial Court wrongly opined that there was no evidence or clear record to show that injection Voveran was administered to the patient. This is despite the fact that the medical Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.10/31 requisition form dated 25.10.2011 was issued by Dr. Sunil Sareen/Accused no.1 under his signatures from General ICU ward wherein injection Voveran was indented and the same has been administered and billed. Administration of injection Voveran to a dengue patient by a medical practitioner having knowledge of its probable effects is sufficient to attract the provision as contained in Section 304 (II) IPC.
(d) That the Ld. Trial Court failed to appreciate that the order passed by Civil Authorities are not binding upon criminal courts of law and thus, Ld. Trial court was not bound by the reports of DMC and MCI which are nothing but arbitrary reports prepared for protecting the offending doctors.
(e) That the Ld. Trial court failed to appreciate that even DMC in its order dated 22.08.2013, not only records missing of the medical documents but also overwriting in the remaining medical documents to such an extent that even after transfer of the patient from RLKC Hospital to RML Hospital, the preparation of medical records continued. These observations coupled with not furnishing of true information with the authorities for fair investigation clearly attracts offence under Section 177 IPC.
(f) Ld. Trial Court failed to appreciate that there was clear evidence on record that Dr. Vivek Singh/Accused no.2 is not a qualified doctor and does not possess a certificate of practice from DMC which is mandatory for practicing medicine in Delhi. Ld. Trial court also failed to appreciate that Dr. Vivek Singh/Accused no. 2 had appeared before DMC and MCI as Dr. Vivek Sharma S/o Late Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.11/31 Sh. HC Sharma while he had given his statement in the present FIR under the name of Dr. Vivek Singh, S/o Sh. Raj Narayan Singh.
This clearly shows that he had impersonated himself while using certificate of another doctor namely Dr. Vivek Sharma before DMC and MCI which clearly attracts offence u/s 419 IPC against him. The other accused persons are also liable as they had supported Dr. Vivek Singh/Accused no.2 in tempering with the evidence.
(g) That the Ld. Trial court had wrongly placed reliance upon the precedent laid down by the Apex Court in GV Rao Vs LHV Prasad & Ors. 2000 (3) SCC 693.
(h) That the Ld. Trial Court had failed to appreciate that Dr. Vivek Singh/Accused no.2 practicing medicine within the territory of Delhi without being registered with DMC is guilty of fraud and cheating not only towards the complainant but also to every citizen of the State and is also liable for action u/s 26 and 27 of DMC Act, 1997.
(i) That the Ld. Trial Court had failed to appreciate that there was clear evidence on record to show that the accused persons had deliberately removed the records to conceal the true facts, thereby causing disappearance of the evidence punishable u/s 201 IPC.
(j) That the Ld. Trial Court had failed to appreciate that the accused persons were liable for fabricating false documents as the same were made with dishonest intention to protect themselves from criminal action. Not only this, fabrication of false discharge summary showing platelet count of 4.5 lacs resulted in non-receipt of timely and appropriate treatment by the patient even at RML Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.12/31 Hospital.
(k) That the Ld. Trial Court had wrongly dismissed the protest petition filed by the complainant and declined summoning of the accused persons for offences u/s 177, 416, 419, 420 and 304 (II) IPC.
17. Ld. Counsel for the Revisionist has argued in line with grounds of revision. Written submissions have also been filed by the Revisionist. Various guidelines for treatment of Dengue patient issued by various hospitals and authorities are also relied upon by the revisionist/complainant.
ARGUMENTS ON BEHALF OF RESPONDENT NO. 2/ACCUSED DR. SUNIL SAREEN:
18. Per contra, the present revision petition is strongly opposed on behalf of respondent no. 2/accused Dr. Sunil Sareen. A detailed written reply to the revision petition has been filed. It is submitted that the present revision petition is nothing but a tactic to harass respondent no. 2. Respondent no. 2 is well educated person and doctor by profession who has dedicated his entire life to his patients. He had done his level best and provided the best possible treatment to the patient i.e. daughter of the complainant/revisionist. However, despite his best efforts the child could not be saved.
19. Complainant's daughter aged about 10 years was brought to the Emergency Department of the hospital on 21.10.2011 with complaint of high fever. As per normal procedure prescribed, the duty doctor in consultation with treating physician started the Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.13/31 presumptive treatment which included intravenous fluids, antibiotics and antipyretics i.e. paracetamol and sent her blood for test for identifying the cause of fever. All the medicines were given as per prescribed procedure. After the treatment was started and blood sample were taken, the patient was shifted to ward under the care of respondent no2/accused Dr. Sunil Sareen as her BP, Urine output and other vitals were normal. On the first blood count, the platelet counts and SGOT and SGPT counts were found to be within a normal range, however, the serological test reported negative. Appropriate treatment was given to the patient as per her diagnosis for Dengue. In the morning of 25.10.2011, the patient complained of abdomen pain and had had low blood pressure. Immediately, appropriate treatment of the patient was started by Duty Doctor in consultation with respondent no. 2/Dr. Sunil Sareen. The patient was shifted to ICU as her platelets dropped and she entered DSS (Dengue Shock Syndrome). While the patient was in ICU, her vitals were stabilized. Since, the hospital did not have the facility of PICU (Pediatric Intensive Care Unit), respondent no. 2/Dr. Sunil Sareen guided the complainant for shifting the patient to a hospital having PICU and also shared a list of such hospitals with him. The complainant decided to shift the patient to RML hospital which was closer to his residence. When the patient was discharged from the hospital, her vitals were stable.
20. At RML Hospital, the patient was not admitted to PICU for reasons best known to the complainant and RML Hospital Authorities despite clear instructions by respondent no. 2/Dr. Sunil Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.14/31 Sareen that the patient needed PICU. The patient expired at RML hospital on 26.10.2011. No autopsy of dead body was conducted. Accordingly, there was nothing to conclude that the patient died due to wrong administration of medicines. It was also mentioned in the admission form of RML hospital that patient required PICU but they won't be able to provide PICU to the patient and admitted her to a general ward. The complainant who could not bear the loss of his daughter, filed criminal complaints against respondent no.2/Dr. Sunil Sareen and other doctors alleging their negligence to be reason for demise of his daughter.
21. The allegation of medical negligence made on respondent no.2/Dr. Sunil Sareen by the complainant is two fold. Firstly, it is alleged that respondent no. 2 had prescribed antibiotics to the patient due to which her condition deteriorated and resulted in her death. Secondly, it is alleged that patient was administered medicine Voveran which resulted in her demise.
22. It is submitted that the contentions of the complainant in this regard are based on wrong guidance and knowledge. The patient was not administered any medicine which was not necessary and part of medical protocol or could in any manner be responsible for the death of the patient. The complainant is relying on advisory issued by the Govt. wherein it is mentioned that antibiotics should not be given to Dengue patient. However, the said advisory is not a fool proof document and cannot overturn the guidelines issued nationally and internationally by WHO.
23. Respondent no. 2/Dr. Sunil Sareen has relied upon various Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.15/31 guidelines issued by various hospital and medical institutes on antibiotic administration and guidelines of clinical management of Dengue fever to stress upon the point that antibiotics have not been prohibited, contraindicated or considered fatal in Dengue fever. Rather they have been advised in cases of Dengue when Typhoid is also suspected.
24. As regards medicine Voveran it is submitted that Ld. Trial Court has rightly recorded in the impugned order that there is no prima facie record to prove that Voveran injection was prescribed by respondent no. 2/ accused Dr. Sunil Sareen or administered to the patient. The said drug has only surfaced in the bills generated by the Pharmacist. The prescription, nursing chart of the patient and hospital records clearly point towards the fact that the said medicine was never prescribed or administered to the patient. Even the enquiry conducted by the Medical Council also came to the same conclusion and respondent no. 2/ accused Dr. Sunil Sareen was exonerated on the same ground.
25. It is also submitted that the Disciplinary Committee, Delhi Medical Council had approached for medical opinion regarding the death of the patient by the IO. They also analyzed and examined the report and came to the conclusion that there was no medical negligence on the part of respondent no. 2/ accused Dr. Sunil Sareen. The said conclusion was confirmed by Delhi Medical Council (DMC) vide its order dated 22.08.2013. Complainant challenged the said order before Medical Council of India (MCI). The said appeal was referred to the Ethics Committee. After Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.16/31 consideration of the statements and depositions of all the parties, the Ethics Committee also came to the same conclusion vide order dated 11.11.2014. The fact that the antibiotics were administered to the patient during treatment were duly disclosed before all these authorities. Still they came to the conclusion that there was no medical negligence on the part of respondent no. 2/ accused Dr. Sunil Sareen.
26. After registration of the FIR, again the matter was referred to Medical Council to constitute a Board of Doctors for legal opinion on the case, however, DMC vide its letter dated 05.12.2018, denied conducting any further enquiry in this matter. An enquiry was also conducted by Department of Health and Family Welfare, Govt. of NCT of Delhi in which also, respondent no. 2/ accused Dr. Sunil Sareen was exonerated and no truth was found in the allegations of the complainant.
27. It is further submitted that the contentions of complainant regarding falsification of medical records are highly farfetched and not based on any material available on record. The allegations of cheating made against the respondent no. 2/ accused Dr. Sunil Sareen are again baseless and without support of any material available on record or collected during the investigation. The discharge summary signed by respondent no. 2/ accused Dr. Sunil Sareen categorically mentions "Dengue Shock Syndrome with Thrombocytopenia Grade-III" which clearly means that the patient's condition was deteriorated and she immediately required PICU. It also clarifies that the platelet counts is less than one lac.
Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.17/31 Accordingly, the wrong mentioning of the platelet count in the discharge summary is merely a typographical error and makes no difference when the condition of the patient in medical terms reproduced above is already mentioned on page 1 of the discharge summary. Even the admission slip of RML Hospital categorically records that patient needed PICU, however, at their own wish, the patient was being admitted to general ward. Accordingly, the hospital authority of RML was not misguided in any manner by wrong noting of the platelet count on subsequent pages of discharge summary. There is nothing on record to show that respondent no. 2/ accused Dr. Sunil Sareen was guilty of deliberate medical fault and accordingly, Ld. Trial Court has rightly observed that no prima facie case under Section 304 IPC was made against respondent no. 2/ accused Dr. Sunil Sareen.
28. All the grounds of revision have been refuted by Respondent no.2/ accused Dr. Sunil Sareen in reply to the revision petition. It is submitted that the impugned order dated 17.11.2021 is a well reasoned order and does not deserve any interference by this Court.
29. Ld. counsel for respondent no.2/accused Dr. Sunil Sareen has argued in line with his reply. Written submissions have already been filed on his behalf. He has also relied upon some literature regarding the protocols for Dengue fever management.
ARGUMENTS ON BEHALF OF RESPONDENT NO. 3/ACCUSED DR. VIVEK SINGH:
30. Respondent no.3/Accused Dr. Vivek Singh has also filed a Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.18/31 detailed reply to the revision petition. It is submitted that the impugned order is a well reasoned order and does not suffer from any illegality or infirmity. The entire revision petition is silent about the alleged negligence of the concerned doctors and fictitious assertions are made about the same. The matter before Ld. Trial Court is still at the stage of framing of charges and in case, any sufficient allegation with supporting material is placed before Ld. Trial Court at the stage of recording of evidence, Ld. Trial court will be well within its power to add more relevant sections for which the accused persons are required to be tried. However, at this stage, on the basis of materials which are already on record, Ld. Trial Court has rightly rejected the protest petition of the complainant as there is no material available on record for proceeding against the accused persons for the offences alleged by the complainant. It is further submitted that in the present case, multiple medical authorities have examined the treatment papers of the patient and various medical records and have come to a conclusion that no medical negligence can be attributed to the treating doctors. The expert medical bodies have exonerated the treating doctors from any medical negligence. The complainant does not have any additional document or submissions in addition to what were made before the medical authorities and accordingly, no ground is made out to conclude that the treating doctors were guilty of medical negligence or should be tried for the offences like 304 IPC (culpable homicide not amounting to murder).
31. In addition to this, there is nothing on record to indicate or Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.19/31 show that Respondent no.3/Dr. Vivek Singh was involved in the treatment of the patient in any manner alongwith Respondent no.2/Dr. Sunil Sareen. Respondent no.3/Dr. Vivek Singh did not play any role in the treatment of the patient and nothing was advised by him in the treatment plan of the patient. Accordingly, no negligence, if any, can be attributed towards him. In addition, there is no record whatsoever, to the effect that injection Voveran was administered to the patient by any doctor. Respondent no.3/Dr. Vivek Singh had only prepared the rough discharge summary on the directions/dictation of Respondent no.2/Dr. Sunil Sareen and the final discharge summary was countersigned by Dr. Sunil Sareen, who was the treating doctor of the patient.
32. It is further submitted that Respondent no.3/Dr. Vivek Singh had never placed his signatures in the name of Dr. Vivek Sharma before anyone or any authority. The written statements before the authorities were submitted by the hospital and not by Dr. Vivek Singh. Dr. Vivek Singh was never summoned for personal appearance by any medical authority. Hence, the signatures shown to be forged by the complainant on different papers are not related to or placed by Respondent no.3/Dr. Vivek Singh.
33. Ld. Counsel for Respondent no.3 has argued in line with the grounds taken in reply to the revision petition. Written submissions have already been filed on behalf of Respondent no.3/Dr. Vivek Singh. The same are carefully perused.
ARGUMENTS ON BEHALF OF THE STATE:
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34. Ld. Additional PP for the State has duly supported the impugned order dated 17.11.2021. It is submitted that the impugned order is a well reasoned order, passed on the basis of material available on record. Ld. Trial Court has closely perused the entire record before coming to the conclusion that at that stage, there was no ground for invoking offence u/s 304 Part II IPC against the treating doctors/accused persons. The material collected during investigation was also insufficient for summoning the alleged accused persons to be tried for offences u/s 420/177/416/419 IPC. Considering the overall material collected during investigation and chargesheet filed on record, Ld. Trial Court had rightly summoned the accused persons to be tried for offences u/s 304A/34 IPC. No infirmity or illegality is observed in the impugned order. Accordingly, it does not deserve any interference from this court. Hence, dismissal of the present revision petition is sought.
FINDINGS:
35. Arguments on the revision petitions have been heard at length. I have also carefully perused the TCR, the pleadings of the parties, their written submissions, the medical literature relied upon by them as well as the citations relied upon by each of the party. The impugned order is also carefully perused.
36. In the present case, the respondents/accused persons have been chargesheeted for offence u/s 304A/34 IPC. After filing of chargesheet, complainant filed a protest petition seeking summoning of the accused persons for offences u/s Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.21/31 177/192/419/420/304/120B IPC. I will be dealing with the contentions of the complainant on each of these criminal offences one by one.
37. Summoning of the accused persons/treating doctors of the patient for offence u/s 304 (part II) IPC has been sought on the ground that they had administered antibiotics and medicine Voveran to the patient despite having knowledge that it was likely to cause death considering the medical condition of the patient who was suffering from dengue fever. As regards administration of antibiotics to the patient is concerned, the said fact is not disputed even by the accused persons. There are also medical records filed along with the chargesheet which clearly show that certain antibiotics were administered to the patient. Whether or not, administration of these antibiotics was likely to cause death of the patient as per the knowledge of the accused persons is a question which is required to be considered before the accused persons can be summoned to be tried for offence u/s 304 (part II )IPC qua these allegations. Both the parties that are the complainant and concerned doctors have relied upon various medical literatures, guidelines and papers published by various medical authorities including hospitals and Institutes to buttress their arguments regarding the effect of administration of antibiotics to a patient suffering from dengue fever. The medical literature filed on record by the complainant support his argument that it is not advisable to administer antibiotics to a dengue patient. On the other hand, the medical literature relied upon by the accused doctors is to the effect that Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.22/31 there is no clear finding that administration of antibiotics to a dengue patient can be fatal and there is no advisory that they should not be administered to Dengue patients under any circumstances. Rather, they indicate that administration of antibiotics to dengue patients under certain circumstances is advisable. During the course of arguments, Ld. Counsels for complainant as well as the accused doctors have blamed the other party for relying upon incomplete or outdated guidelines in this regard. But the fact remains that there are contradictory guidelines regarding administration of antibiotics to dengue patients issued by various competent authorities. None of these guidelines, however, categorically state that administration of antibiotics to dengue patients can be fatal.
38. It is pertinent to note that in the present case, after the demise of the patient, no post mortem of the dead body was conducted and accordingly, there is no conclusive finding on record that the death was due to reaction of or administration of any kind of medicine to her. It is also important to note that the matter has been considered and appreciated by various medical councils such as Disciplinary Committee of Delhi Medical Council vide their report dated 22.08.2013, Ethics Committe of Medical Council of India vide report dated 11.11.2014 and Department of Health and Family Welfare, Govt of NCT of Delhi vide their report dated 02.01.2020. All these authorities after consideration of the statements made before them and the records produced before them came to a unanimous finding that no medical negligence can be attributed on the part of the treating doctors. At this stage, there is Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.23/31 nothing on record to ignore these findings given by these competent authorities or to hold that only the medical literature being relied upon by the complainant/revisionist can be considered as the gospel truth and the medical literature relied upon by the accused persons/concerned doctors is liable to be rejected. In the absence of any additional record or document to support the contention of the complainant that administration of antibiotics to the patient was likely to cause her death within the knowledge of the accused persons, the accused persons cannot be summoned to be tried for offence u/s 304 (Part II) IPC on this sole allegation of administration of antibiotics to the patient.
39. As regards the administration of injection Voveran to the patient, parties are again not in dispute on the point that injection Voveran should not be administered to a patient suffering from dengue fever. However, on this aspect, the dispute between the complainant and treating doctors is on the point whether injection Voveran was actually administered to the patient or not. In case the record prima facie shows that any of the accused persons/concerned doctors had prescribed or administered injection voveran to the patient during her treatment, the said doctor can be summoned to be tried for offence u/s 304 IPC. Again, there is no medical record in the form of an autopsy report to support the contention of the complainant that injection Voveran was actually administered to the patient. The complainant/Revisionist has based his arguments in this regard on the bill of the hospital dated 25.10.2011 in which injection Voveran has been mentioned. However, the concerned Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.24/31 doctors/accused persons are relying upon relevant treatment papers,medical prescriptions and nursing notes of the patient collected during investigation, none of which mentions prescription or administration of injection Voveran. Ld. Trial Court has dealt with this aspect in paragraph no. 24 of impugned order dated 17.11.2021 and observed that there was no clear record or evidence to show that injection Voveran was actually administered to the patient. Admittedly, there was no prescription for the same and name of injection Voveran surfaced only in the bill generated by the pharmacist. Relying upon this, Ld. Trial Court came to a conclusion that the material on record is not sufficient for summoning the accused persons for offence u/s 304 (Part II) IPC on the allegations of administration of injection Voveran to the patient.
40. I find no infirmity or illegality in these observations of Ld. Trial Court. Merely because a medicine has been mentioned in the bill, it is not sufficient to conclude that the said medicine was also administered to the patient. In the absence of any clear record of prescription of the said medicine to the patient by either of the accused doctors or its administration to the patient reflected in the nursing notes and medical records, it cannot be concluded that injection Voveran was in fact administered to the patient. Thus, there is no sufficient material available on record for summoning the accused persons to be tried for offence punishable u/s 304 (Part II) IPC on the allegation that the patient was administered injection voveran during treatment of dengue fever.
41. Complainant has also relied up a Medicine Requisition Form Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.25/31 dated 25.10.2011 (page 117 of the charge sheet and page 463 of present appeal) to stress upon the point that Injection Voveran was requisitioned by Dr. Sunil Sareen/Respondent no. 2 to be administered to the patient. I have perused the said requisition form. There is no corresponding prescription by respondent no. 2/Dr. Sunil Sareen prescribing Injection Voveran to the patient. Again although Medicine Requisition Form dated 25.10.2011 mention the name of Dr. Sunil Sareen as Consultant but does not bear his signatures showing that the medicine requisition was authorized by him. Complainant has pointed towards an initial placed in the Coloum "Form Sent By" and submitted that similar signatures are also found on Plan of Care annexed at page no. 74 of the charge sheet and thus, it is clearly authorized by Dr. Sunil Sareen. Again, there is no evidence that even signatures on Plan of Care at page no. 74 of the charge-sheet are of respondent no. 3/Dr. Sunil Sareen. Thus, it is difficult to conclude on the basis of material available on record that Injection Voveran was actually requisitioned by Dr. Sunil Sareen to the administering to the patient. Again, there is no evidence of administration of Injection Voveran to the patient. Thus, the material on record is insufficient for summoning the accused. Dr. Sunil Sareen/Respondent no. 3 or any other accused to be tried for offence under Section 304 (Part-II) IPC. Needless to say, in case, any additional evidence surfaces during trial regarding administration of injection Voveran to the patient during her treatment on the advice or prescription of any of the treating doctors, the relevant provision can be invoked at any Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.26/31 later stage.
42. As regards Section 177 IPC, it provides punishment for providing false information to any public servant. Section 195 Cr. P. C. categorically provides that cognizance under section 177 IPC cannot be taken by any Court except on the complaint in writing of the public servant concerned or of some other public servant to whom he is administratively subordinate. The contention of the complainant regarding offence under Section 177 IPC is that the concerned doctor/accused persons had provided false information to the various Medical Boards/Authorities during enquiry into the matter and thus, were liable for being prosecuted for offence under Section 177 IPC. However, admittedly no such complaint of providing any false information has been made by any of the medical councils or any person on their behalf. There is no finding of either Medical Council of India or Delhi Medical Council that any false information has been furnished to them by either of the accused persons. In the absence of any such complaint, the Court cannot take cognizance of offence under Section 177 IPC and summon the accused persons to be tried for the said offence.
43. As regards Section 192 IPC, it provides the definition of fabricating false evidence. The punishment for the offence under Section 192 IPC is provided in section 193 IPC. It is the contention of the complainant that there is an observation in the report of Delhi Medical Council dated 22.08.2013 to the effect that there are no notes of any ICU doctor on the case sheet. It is alleged that this observation clearly points towards the fact that the medical records Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.27/31 of the patient were fabricated by the accused persons. Accordingly, the accused persons are liable to be prosecuted for offence under Section 192 IPC. I have carefully perused the order of DMC dated 22.08.2013. It does not have any clear finding to the effect that medical record/nursing note in respect of the patient while she was admitted in ICU was not produced before the Authorities rather the complete reading of paragraph one on page no. 8 of the report gives a meaning that there was no separate note of any ICU doctor on the case sheet and the only available notes were of Dr. Sunil Sareen (Padriatic In charge) who continued to look after the patient even after she was shifted to ICU. Perusal of the chargesheet also shows that various medical records of the patient including the medicine requisition form, medical chart, plan of care etc. have been placed on record. Accordingly, at this stage, there is nothing on record to presume that either of the accused persons had fabricated any false evidence as alleged by the complainant. Accordingly, material on record is not sufficient for summoning either of the accused persons to be tried for offence under Section 192 IPC.
44. As regards, offence under Section 419/420 IPC, the contention of the complainant is that respondent no. 2/accused Dr. Vivek Singh had appeared before Delhi Medical Council under the fake identity of Dr. Vivek Sharma son of Sh. H. C. Sharma with a view to cheat the Medical Council to give a clean chit to him. This contention of the complainant does not find support from the report of DMC dated 22.08.2013 which simply records the name of Dr. Vivek and not Dr. Vivek Sharma son of H. C. Sharma. As regards Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.28/31 the report of the Ethics Committee dated 21.08.2014, it record statement of one Dr. Vivek Sharma but from that order there is no clarity if respondent no. 3/accused Dr. Vivek herein had appeared before the Ethics Committee of MCI impersonating as Dr. Vivek Sharma or not. Thus, even this report is not sufficient to summon respondent no. 3/accused Dr. Vivek to be tried for offence under Section 419 IPC. This is more so as there is no complaint from the Ethics Committee, MCI to this effect, nor any submissions were made by complainant before MCI that Dr. Vivek Sharma appearing before MCI was wrongly providing his name and impersonating as someone else. Complainant has also relied upon a letter dated 12.05.2016 sent by Secretary, DMC to MS (Nursing Homes-II), Directorate of Health Services (DHS) wherein it has been informed that Dr. Vivek Sharma is a registered Doctor with DMC while is Dr. Vivek Singh son of Sh. Raj Narain Singh is not registered with DMC. However, there is no document on record to show if that was the situation what action was taken against the said Dr. Vivek Singh for practicing medicine without registration with DMC. There is also no clarity as to whether Dr. Vivek Singh son of Sh. Raj Narain Singh resident of 99, Neela Kamal Apartments, H- Block, Vikas Puri, New Delhi mentioned in letter dated 12.05.2016 is the same Dr. Vivek Singh son of Sh. Raj Narayan Singh resident of CD-178, Hari Nagar, New Delhi impleaded as accused no. 2 in the present FIR as the addresses of both doctors and spellings of their father's name are different. In addition, even letter dated 12.05.2016 nowhere states that accused Vivek Singh/respondent no. 3 Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.29/31 impleaded herein had impersonated himself as Dr. Vivek Sharma before any authority/medical Council. Thus, the material and evidence on record is highly insufficient for summoning accused no. 2 Dr. Vivek Singh (respondent no. 3 herein) to be tried for offence of impersonation under Section 419 IPC.
45. Further, as regards offence of cheating under Section 420 IPC, it is alleged by the complainant that multiple discharge summaries of the patient by various doctors were prepared and the platelet count of the patient was recorded as 4.5 lac/Cumm mm which was a wrong information projecting that the patient was in an absolute stable condition at the time of her discharge. This misled the authorities at RML Hospital in not providing immediate medical attention to the patient as was required. Thus, it is contended that the concerned doctor/accused persons are liable to be prosecuted under Section 420 IPC. I do not find any merit in this contention of Ld. Counsel for the complainant as although, the platelet count on the discharge summary of the patient dated 25.10.2011 is mentioned as 4.5 lac but the report in this regard has been attached which clearly show a lesser platelet count. Moreover, discharge summary dated 25.10.2011 records diagnosis as "Dengue Shock Syndrome with Thromobocytopenia Grade- III" which technically mean platelet count of less than 1 lac cells per Cumm. Accordingly, it is difficult to believe that the concerned doctor/accused persons had any malafide intention to mislead the other doctors in this regard by mentioning wrong platelet count in the discharge summary. There is also no evidence on record that the Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.30/31 doctors of RML Hospital were actually mislead by the platelet count of 4.5 lac cells per Cumm recorded on the second page of the discharge summary dated 25.10.2011 in place of acting upon the main diagnosis mentioned on the very first page of the discharge summary. Considering these facts, it is difficult to presume any dishonest or fraudulent intention on the part of the accused persons as alleged by the complainant. Thus, the material on record is highly insufficient for summoning the accused persons to be tried for offence under Section 420 IPC on the basis of these allegations.
46. In view of the reasons given above, I have no hesitation in holding that the protest petition filed by the complainant seeking summoning of accused persons for additional offences under Section 177/192/419/420/304/120B IPC has been rightly dismissed by Ld. Trial Court. No infirmity or illegality is observed in the impugned order dated 17.11.2021. It is a well reasoned order passed on the basis of material available on record. I find no reason for interfering in the same. No merit is found in the present revision petition. The same is, accordingly, dismissed and impugned order dated 17.11.2021 is upheld.
47. TCR be sent back to the Ld. Trial Court alongwith a copy of this order.
48. Revision file be consigned to Record Room.
Digitally signed SHIVALI by SHIVALI SHARMA Announced in open Court SHARMA Date: 2023.12.12 Dated: 12.12.2023 14:35:33 +0530 (Shivali Sharma) Addl. Sessions Judge-03 (West)/ Tis Hazari Courts, Delhi/12.12.2023. Pramod Kumar Chaudhary Vs. State & Anr. CR No. 223/2022 Page No.31/31