State Consumer Disputes Redressal Commission
Chandra Bhushan Mishra & Ors. vs Dr. Raj Kishan Sharma(M.S.) & Ors. on 12 May, 2017
NRrhlx<+ jkT;
miHkksDrk fookn Áfrrks"k.k vk;ksx] iaMjh] jk;iqj ifjokn izdj.k Øekad% lhlh@2013@33 lafLFkr fnukad: 25.01.2014.
1- pUnz Hkw"k.k feJk vk- Jh ukjk;.k izlkn feJk] mez&37 o"kZ] tkfr&czkEg.k] is'kk ukSdjh] fuoklh&u`flag eafnj] dks"Vk ikjk] iSysl jksM] rglhy o ftyk&jk;x<+ ¼N-x-½ 2- ek- mRd"kZ feJk ¼ukckfyx½] mez yxHkx&04 o"kZ] vk-@oyh firk&pUnz Hkw"k.k feJk] 3- ek- vkn'kZ feJk ¼ukckfyx½] mez yxHkx 02 o"kZ] vk-@oyh firk&pUnz Hkw"k.k feJk] }kjk&pUnz Hkw"k.k feJk] fuoklh&u`flag eafnj] dks"Vk ikjk] iSysl jksM] rglhy o ftyk&jk;x<+ ¼N-x-½ [email protected]
fo:)
1- MkW- jktd`".k 'kekZ ¼,e- ,l-½
esVªks gkWfLiVy ,.M Mk;fcVht fjlpZ lsaVj] igkM+ eafnj ds ikl] pdz/kj uxj] jk;x<+ ¼N-x-½ fiu&496001 2- esVªks gkWfLiVy ,.M Mk;fcVht fjlpZ lsaVj] }kjk&lapkyd@izca/kd] igkM+ eafnj ds ikl] pdz/kjuxj] jk;x<+ ¼N-x-½ fiu&496001 3- MkW- vt; 'ks"k ¼,e- Mh-½ vk- MkW- vfuy 'ks"k] vk;q&43 o"kZ] js.kqdk Mk;XuksfLVDl iSFkkykWth] ikWoj gkÅl jksM] vfHkuanu dkEiysDl ds ikl] dksjck ¼N-x-½ fiu&495678 --------vukosndx.k@fojks/kh i{kdkjx.k- le{k% ekuuh; U;k;ewfrZ Jh vkj- ,l-'kekZ] v/;{k-
ekuuh; Jh Mh- ds- iksn~nkj] lnL;-
ekuuh; Jh ujsanz xqIrk] lnL;-
i{kdkjksa ds vf/koDrk ifjoknhx.k dh vksj ls ifjoknh dz-1 pUnzHkw"k.k feJkA vukosnd dz-1 o 2 dh vksj ls Jh Mh- nRrk ,oa Jh th- Ogh- ds- jko]vf/k- vukosnd dz-3 dh vksj ls Jh ch- ds- ik.Ms;] vf/koDrkA // 2 // vkns'k fnukad% 12@05@2017 }kjk%&ekuuh; U;k;ewfrZ Jh vkj- ,l- 'kekZ] v/;{k- Ikfjoknhx.k us ;g ifjokn /kkjk&17 miHkksDrk laj{k.k vf/kfu;e] 1986] ds varxZr vukosndx.k ds fo:} fuEukuqlkj vuqrks"k fnyk;s tkus gsrq izLrqr fd;k gS%& v- ;g fd vukosndx.kksa }kjk ejht dks iznRr fpfdRldh; lsokvksa esa [kkeh ds QyLo:Ik vkosndx.kksa dks gqbZ {kfr dh HkjikbZ vukosndx.k djsaA c- ;g fd izdj.k dh ifjfLFkfr;ksa vuqlkj ekuuh; vk;ksx }kjk fu/kkZfjr vU; mfpr lgk;rk Hkh iznku dh tkosA l- orZeku vkosnu izLrqr fd;s tkus esa gq, O;; dks Hkh vkosndx.kksa dks vukosndx.kksa ls iznku dh tkosA** 02- ifjoknhx.k dk ifjokn laf{kIr esa bl izdkj gS fd ifjoknhx.k Lo- Jherh 'kqHky{eh feJk ds fof/kd okfjlku gSa ,oa ifjoknh dz-1 mldk ifr ,oa ifjoknh dz-2 ,oa 3 mlds iq= gSaA Jherh 'kqHky{eh feJk dh e`R;q fnukad&13-10-2012 dks gks xbZ FkhA Jherh 'kqHky{eh feJk ds isV esa gYdk nnZ gksus ij og fnukad&06-02-2011 dks L=h jksx fo'ks"kK MkW- lqfp=k f=ikBh ls ijke'kZ yh rks mUgksaus lksuksxzkQh djkus dh lykg nh rc fnukad&08-02-2011 dks MkW- T;ksRluk feJk ¼,e- ch- ch- ,l½ fo|k lksuksxzkQh fDyfud] jk;x<+ ls lksuksxzkQh djkbZ Fkh ftlesa MkW- T;ksRluk feJk }kjk vksojh esa flLV gksdj mls ?kqeh gqbZ gksuk crk;kA mDr fjiksVZ dks MkW- lqfp=k f=ikBh dks fn[kk;s tkus ij mUgksaus MkW- vkyksd dsfM;k ¼,e- Mh- jsfM;ks Mk;Xuksfll½ ls Hkh ijke'kZ fy;s tkus dh lykg nh Fkh // 3 // ftl ij ifjoknh dz-1 }kjk ejht dh nksckjk vYVªk lksuksxzkQh MkW- dsfM;k ls djk;k Fkk vkSj MkW- dsfM;k }kjk crk;k x;k fd e`frdk Jherh 'kqHky{eh feJk dks 11.5 cm x 8.4 cm sized solid cystic lesion seen in the pelvis? Etiology esa gS vkSj FNAC djkus dh lykg fn;k FkkA bl ij ifjoknh dz-1 viuh iRuh dks vukosnd dz-1 MkW- jktd`".k 'kekZ esVªks gkWfLiVy jk;x<+ ds ikl fnukad&09-02-2011 dks ys x;k Fkk vkSj ftlus fjiksVZ dk voyksdu dj HkrhZ gksus dk funsZ'k fn;k Fkk vkSj e`frdk Jherh 'kqHky{eh feJk dks vLirky esa HkrhZ djok;k FkkA vukosnd dz-1 }kjk fnukad&10-02-2011 dks ejht dh 'kY; fdz;k fd;k x;k vkSj 'kY; fdz;k okys LFky ls fudkys x, ÅRrdksa dh tkap gsrq vukosnd dz-3 ds ikl Hkstk x;k vkSj fnukad&13-02-2011 dks fMLpktZ fd;k x;k FkkA ifjoknh dz-1 us vukosnd dz-1 ,oa 2 vLirky ls ejht dh fod`fr foKku izfrosnu dh ekax dh xbZ rks crk;k x;k fd mls Lisflesu eqEcbZ Hkstk x;k gS vkSj fod`fr foKku izfrosnu esa dksbZ vlkekU;rk ugha vkbZ gSA vukosnd dz-1 ds }kjk ejht dks fMLpktZ djus ds ckn Hkh e`frdk Jherh 'kqHky{eh feJk ds isV esa nnZ dh f'kdk;r djrs jgh gS vkSj vukosnd dz- 1 }kjk fy[kh xbZ nokbZ fn;k tkrk FkkA e`frdk Jherh 'kqHky{eh feJk tqykbZ 2011 esa f}rh; ckj xHkZ /kkj.k dh ftldh xHkkZoLFkk dh tkap dj jgh fpfdRld MkW- lqfp=k f=ikBh ls tkap djk;s tkus ij mUgksaus lksuksxzkQh djkus dh lykg nh Fkh vkSj lksuksxzkQh tkap dj jgs fpfdRld MkW- vkyksd dsfM;k us Hkh FNAC/BIOPSY of the meternal lesion & MRI Abdomen dh lykg nh xbZ Fkh rc e`frdk Jherh 'kqHky{eh // 4 // feJk dks ifjoknh dz-1 us lacaf/kr fpfdRlk vfHkys[kksa ds lkFk fnukad&05- 12-2011 dks MkW- ohuk i.Mk ¼L=h jksx fo'ks"kK½ Hkqous'oj ¼mM+hlk½ esa fn[kkdj muls ijke'kZ fy;k rks mUgkaus Hkh FNAC/USG djkus dh lykg nh rc e`frdk Jherh 'kqHky{eh feJk dks dfyaxk vLirky esa fnukad&07- 12-2011 dks ys tk;k x;k tgka e`frdk Jherh 'kqHky{eh feJk dks dSalj gksuk ik;k x;k vkSj MkW- lq'khy dqekj fxjh dVd us Hkh tkap fjiksVZ ds voyksdu ds Ik'pkr~ e`frdk Jherh 'kqHky{eh dks CA-125 tkap djk;s tkus dh lykg fn;k Fkk rc Cure well Laboratory Cuttack esa tkap djk;k x;k tgka dSalj III-IV Stage dh iqf"V dh xbZA ifjoknh dz-1 us vukosnd dz-1 ,oa 2 ls fgLVksiSFkkykWth fjiksVZ ,oa vukosnd dz-3 ls LykbZM dh ekax fd;k x;k ijUrq mls miyC/k ugha djk;k x;kA ifjoknh dz-1 ds }kjk dbZ ckj dgk x;k fd mM+hlk ds fpfdRld }kjk LykbZM dh ekax fd;k tk jgk gS] LykbZM miyC/k djkbZ tkos ijUrq dksbZ LykbZM miyC/k ugha djk;k x;kA js.kqdk Mk;XuksfLVDl iSFkkykWth dksjck dh fjiksVZ D;k gS ;g LykbZM ds vHkko esa fu/kkZfjr ugha fd;k tk ldrkA ,El ubZ fnYyh esa ejht dks HkrhZ fd;k x;k vkSj ejht dh xHkkZoLFkk o dSalj dh chekjh dh xaHkhjrk dks ns[krs gq, vfoyac bZykt izkjaHk fd;k x;k o esVªks vLirky jk;x<+ ls 'kY; fdz;k ds nLrkost o LykbZM ekaxk x;k ijUrq nLrkost miyC/k ugha djk;k x;k vkSj uk gh LykbZM iznku fd;k x;kA ,El ubZ fnYyh ds fpfdRldksa us mldk mipkj tkjh j[kk o mls xk;fud okMZ esa HkrhZ j[kk vkSj xHkkZoLFkk ds nkSjku gh ejht dks Chemotherapy nh xbZ o fu;fer varjky esa 03 Mkst Chemotherapy nh // 5 // xbZ vkSj ejht dh 'kY; fdz;k gsrq iwoZ ds 'kY; fdz;k ds nLrkost o LykbZM dh ekax dh xbZ ftl ij ifjoknh dz-1 us vukosnd ls nwjHkk"k ij laidZ dj LykbZM dh ekax dh vkSj ,El ubZ fnYyh }kjk i= Hkh izsf"kr fd;k x;k mlds ckn Hkh LykbZM o esfMdy fgLVªh iznku ugha dh xbZ vkSj bl izdkj vukosndx.k }kjk fpfdRlh; mis{kk cjrk x;kA vYVªk lksuksxzkQh dh fjiksVZ i`Fkd&i`Fkd gksus ds ckn Hkh MkW- 'kekZ }kjk FkMZ vksfifu;u ugha fy;k x;k vkSj fo'ks"kK dh fjiksVZ dks fdafpr ek= Hkh egRo u nsdj vko';d Exam & Tests, Imaging test and Blood test, dSalj ekdZj dh tkap u djuk vukosnd dz-1 MkW- 'kekZ dk mis{kk dk |ksrd gS vkSj FNAC (Fine needles aspiration cytology) VsLV Hkh ugha djk;k x;k vkSj fcuk tkap fd, fpfdRlh; mis{kk cjrh xbZ vkSj ftlds dkj.k ls e`frdk Jherh 'kqHky{eh feJk dh e`R;q dkfjr gqvk gS vkSj bl izdkj vukosndx.k }kjk fpfdRlh; mis{kk cjrk x;k gSA vr% ifjoknhx.k] fpfdRlh; mis{kk ds fy, vukosndx.k ls ifjokn&i= esa of.kZr vuqlkj {kfriwfrZ izkIr djus ds vf/kdkjh gSa] vr% mDr jkf'k ifjoknhx.k dks vukosndx.k ls fnykbZ tkosA 03- vukosnd dz-1 ,oa 2 us fyf[kr dFku izLrqr djrs gq, ;g vfHkopu fd;k gS fd vukosnd dz-1] vukosnd dz-2 vLirky dk lapkyd gSA e`frdk Jherh 'kqHky{eh feJk dks vukosnd dz-1 ds le{k yk;k x;k Fkk ml le; mlds isV esa dkQh nnZ FkkA MkW- T;ksRluk feJk o MkW- vkyksd dsfM;k dh fjiksVZ vyx&vyx Fkh rc vukosnd dz-1 us Mk;XuksfLVd ysizksLdksfid tkap dj oLrqfLFkfr ls fHkK gks ik;k fd MkW-
// 6 // T;ksRluk feJk dh fjiksVZ lgh gS o rRdky ejht dk vkWijs'ku djus dk fu.kZ; fy;k x;k D;ksafd ejht dh tks fLFkfr Fkh mlesa FNAC tkap fu"ksf/kr gS vkSj FNAC tkap djus ls chekjh ds QSyus dk Hkh vans'kk cuk jgrk gSA vukosnd dz-1 }kjk fnukad&10-02-2011 dks 'kY; fdz;k fd;k x;k vkSj mlds Ik'pkr~ 'kY; fdz;k okys LFky ls fudkys x, Årdksa dh tkap gsrq vukosnd dz-3 ds ikl Hkstk x;k Fkk vkSj fnukad&13-02-2011 dks mls fMLpktZ fd;k x;k Fkk vkSj tkap Ik'pkr~ vukosnd dz-3 us mu Årdksa ij ml le; dSalj ugha ik;k Fkk vkSj fMLpktZ djrs le; ejht dks fgnk;r nh xbZ Fkh fd f}rh; xHkZ/kkj.k u djs vkSj fMLpktZ djus ds ckn mls vukosnd dz-1 ,oa 2 ds ikl ugha yk;k x;k FkkA esVªks vLirky esa ejht ds 'kY; fdz;k ds nLrkost dh Nk;kizfr vukosnd dz-1 }kjk ifjoknh dz-1 dks iznku dj fn;k x;k Fkk] pwafd ikorh ugha fy;k x;k blfy, tku&cw>dj ijs'kku djus ds fy, ckj&ckj ekax fd;k tk jgk gSA fgLVksiSFkkykWth fjiksVZ o LykbZM ds fo"k; esa vukosnd dz-3 }kjk gh tkudkjh fn;k tkuk laHko gSA vukosnd dz-1 ,oa 2 ds tkudkjh dh fo"k;&oLrq ugha gS rFkk esfMDy fgLVªh ,oa 'kY; fdz;k ls lacaf/kr laiw.kZ nLrkost ifjoknh dz-1 dks iznku dj fn;k x;k FkkA ejht dh vksojh esa flLV gksus ds dkj.k og ?kweh gqbZ Fkh ftls vukosnd dz-1 }kjk vkWijs'ku dj iwoZ esa fudky fn;k x;k Fkk vkSj fu;ekuqlkj bZykt fd;k x;k FkkA fdlh izdkj dh dksbZ fpfdRlh; mis{kk ugha cjrk x;k gS vkSj ifjoknhx.k vuqfpr rjhds ls vukosndx.k ls jde olwy djus dh fu;r ls iwoZ esa >wBh f'kdk;rsa Fkkus ls ysdj NRrhlx<+ efgyk vk;ksx // 7 // rd dh xbZ Fkh ftlesa ifjoknhx.k dh f'kdk;rksa dks feF;k o vuqfpr ik;k x;k gSA NRrhlx<+ vk;qfoZKku laLFkku ifj"kn jk;iqj dk tkap fu"d"kZ tks pkj fpfdRldksa dze'k% MkW- vkj- ,y- eaMkoh] MkW- ,- ds- dq'kokgk] MkW- lq"kek ,Ddk] MkW- ih- ds- xqIrk }kjk iznku fd;k x;k gSA LykbZM o ck;ksIlh ds fy, mfpr iSFkksySc ftldk lapkyu ;ksX; o ekU;rk izkIr fpfdRld }kjk dh tkrh gS ds ikl Hkstk x;k Fkk ftldh Qhl ifjoknh dz-1 ugha nsuk pkgrk Fkk vkSj mDr tkap djkus gsrq Hkh rS;kj ugha Fkk vkSj cgqr eqf'dy ls vukosnd dz-2 ds ikl tkap ds fy, Hkstk tk ldk FkkA vukosnd dz-1 ,oa 2 ds d`R; ls ifjoknhx.k dks fdlh izdkj dh {kfr dkfjr ugha gqvk gSA ck;ksIlh dh tkap esa lk/kkj.k V~;wej dh fjiksVZ vkbZ Fkh ftlds fy, ejht dks ,d lky rd izsXusalh ugha ysus dh lykg nh xbZ FkhA jk;x<+ esa flQZ js.kqdk Mk;XuksfLVd gh ,d ,slh iSSFkkykWth Fkh tgka ij ck;ksIlh dh tkap gksrh Fkh ,oa vf/kdka'k gkWfLiVy }kjk ogha ck;ksIlh dh tkap Hksth tkrh Fkh vkSj esVªks gkWfLiVy dh lHkh ck;ksIlh ,oa vU; tkap js.kqdk Mk;XuksfLVd Hksth tkrh FkhA eqacbZ Hkstus dh ckr dguk eux<ar gSA ejht tc vukosnd dz-1 ds ikl ykbZ xbZ Fkh rc og vkikrdkyhu voLFkk esa Fkh] ;fn rRdky mls fpfdRlk ugha nh tkrh rc xaHkhj {kfr vo'; laHkkoh Fkh vkSj blfy, laiw.kZ tkap djus ds Ik'pkr~ 'kY; fdz;k fd;k x;k FkkA vukosnd dz-1 ,oa 2 }kjk fdlh izdkj dh dksbZ fpfdRlh; mis{kk ugha cjrk x;k gSA ifjoknhx.k] vukosnd dz-1 ,oa 2 ls fdlh izdkj dh {kfriwfrZ ikus ds vf/kdkjh ugha gSaA vr% ifjoknhx.k dk ifjokn fujLr fd;k tkosA // 8 // 04- vukosnd dz-3 dh vksj ls fyf[kr dFku izLrqr djrs gq, ;g vfHkopu fd;k x;k gS fd ifjoknhx.k us ;g fof'k"V :Ik ls ugha crk;k gS fd fdl fpfdRld ds }kjk iqujkoyksdu fd;s tkus dh ekax dh xbZA vukosnd dz-3 }kjk viuh tkap fjiksVZ vukosnd dz-1 dks izsf"kr fd;k x;k Fkk] rRi'pkr~ fdl izdkj vukosnd dz-3 ls mDr ekax lh/ks fd;k tkuk vk'p;Ztud gS D;ksafd ejht o iSFkkykWftdy tkap fd;s tkus okys fpfdRld ds e/; izR;{k :Ik ls fdlh Hkh izdkj dk ysu&nsu o ifjppkZ ugha gqbZ gSA dfFkr fjiksVZ dks vukosnd dz-3 }kjk dHkh Hkh u rks Nqik;k x;k gS vkSj uk gh nsus ls badkj fd;k x;k gSA vukosnd dz-1 ds }kjk funsZf'kr gksus ds dkj.k fjiksVZ mUgsa iwoZ esa lkSai nh xbZ FkhA ;fn e`frdk Jherh 'kqHky{eh feJk dk fnYyh esa fdeksFksjsih djk;k x;k gksxk rks bldh tkudkjh vukosnd dz-3 dks ugha gSA vukosnd dz-3 }kjk LykbZM iznku ugha djuk lsok esa deh ds varxZr ugha gS] tkap izfrosnu vukosnd dz-1 dks fn;k x;k FkkA ifjoknhx.k }kjk cukoVh rF;ksa dk lekos'k dsoy yksHk&ykypo'k {kfriwfrZ izkIr djus ds nqjk'k; ls ;g ifjokn izLrqr fd;k x;k gSA vukosnd dz-3 }kjk fdlh izdkj dh dksbZ fpfdRlh; mis{kk ugha cjrk x;k gSA vukosnd dz-3 ds le{k izLrqr fd, x, tkap ds uewus dh izfdz;kRed fof/k vuqlkj iSFkkykWftdy dk;Z l{ke ,oa ;ksX;rkiw.kZ <ax ls fd;k x;k rFkk viuk izfrosnu funsZf'kr fpfdRld ,oa laLFkk dks izsf"kr fd;k x;k Fkk vkSj mDr izfrosnu ds cukoVh :Ik ls ys[k dkfjr djus dk dksbZ iz'u gh mRiUu ugha gksrk vkSj iSFkkykWftdy dk;Z djrs gq, vukosnd dz-3 ds }kjk fdlh Hkh izdkj dk nqjk'k;iwoZd ykHk o viuh // 9 // lsok esa deh ugha dh xbZ gSA ifjoknhx.k] vukosnd dz-3 ls fdlh izdkj dk vuqrks"k izkIr djus ds vf/kdkjh ugha gSaA vr% ifjoknhx.k dk ifjokn vukosnd dz-3 ds laca/k esa fujLr fd;k tkosA 05- ifjoknhx.k dh vksj ls vius i{k leFkZu esa ifjoknh d-1 dk 'kiFk&i= rFkk Jherh 'kqHky{eh feJk dk e`R;q izek.k&i=] ifjoknh dz-3 ek- vkn'kZ feJk dk tUe izek.k&i=] vYVªklkÅ.M fjiksVZ fnukad&08-02- 2011] vks- ih- Mh- fVdV fnukad&08-02-2011] fMLpktZ fVdV] lsjksykWth fjiksVZ] ,p- vkbZ- oh- tkap fjiksVZ] iSFkksykWth fjiksVZ] bZykt dk [kpZ] ds- ;w- ,l- th- dh fjiksVZ] MkW- ohuk i.Mk }kjk fy[kk x;k gsM uksV] lsFkksykWth fjiksVZ fnukad&08-12-2011] iSFkksykWth fjiksVZ fnukad&09-12- 2011] dfyaxk gkWfLiVy dh fjiksVZ fnukad&06-12-2011] nokbZ iphZ fnukad&12-12-2011] D;wj osy yscksjsVjh fjiksVZ fnukad&13-12-2011] bZykt esa gq, [kpZ dh ikorh] izlwfr ,oa L=h jksx foHkkx dh fjiksVZ fnukad&29- 03-2011] fMLpktZ fLyi fnukad&28-12-2011] jsfM;ksykWth fjiksVZ fnukad&11-06-2012] fMLpktZ lejh fnukad&04-02-2012] fgLVks iSFkksykWth fjiksVZ fnukad&09-03-2012] bZykt iphZ fnukad&03-08-2012] esVªks gkWfLiVy ls eaxk, x, nLrkost dk vkosnu] Lej.k i= fnukad&09-02-2012] js.kqdk Mk;XuksfLVd dksjck ls ekaxs x, LykbZM dk vkosnu] Lej.k i= fnukad&09-02-2012] iksLVy lfoZlsl ls vkj- Vh- vkbZ- ds rgr ekaxh xbZ tkudkjh dk tokc fnukad&15-05-2013] efgyk vk;ksx dks Hkstk x;k tokc fnukad&25-11-2012] Hkkjrh; vk;qfoZKku ifj"kn }kjk iznku dh xbZ tkudkjh] ftyk fpfdRlky; jk;iqj ls vkj- Vh- vkbZ- ds rgr ekaxh xbZ // 10 // tkudkjh] Hkkjrh; vk;qfoZKku ifj"kn ls vkj- Vh- vkbZ- ds rgr ekaxh xbZ tkukjh fnukad&10-06-2013] Hkkjrh; vk;qfoZKku ifj"kn }kjk nh xbZ tkudkjh] Hkkjrh; vk;qfoZKku ifj"kn }kjk iznku dh xbZ tkudkjh fnukad&21-07-2013] Hkkjrh; vk;qfoZKku ifj"kn ls vkj- Vh- vkbZ- ds rgr ekaxh xbZ tkudkjh fnukad&27-07-2013] Hkkjrh; vk;qfoZKku ifj"kn }kjk iznku dh xbZ tkudkjh fnukad&10-02-2011] 30-08-2013] 10-02-2011] ifjoknh dz-1 }kjk esfMdy fjdkMZ ,oa b'kw'k esa usfXytsal ds laca/k esa izkIr tkudkjh] Hkkjrh; vk;qfoZKku ifj"kn }kjk iznku dh xbZ tkudkjh fnukad&30-09-2013] e`frdk ds bZykt gsrq vkus&tkus esa gqvk gokbZ ,oa jsYos esa [kpZ dk dk fooj.k] e`frdk ds bZykt gsrq fuokl esa gq, [kpZ dk fooj.k rFkk e`frdk ds bZykt esa fd, x, [kpZ dh ikorh] MkW- Hkhejko vEcsMdj bafLVV~;wV jksVjh dSalj gkWfLiVy dh ikorh fnukad&28-04-2012 ,oa 21-05-2012] bZ&esy }kjk vukosnd dz-3 }kjk vukosnd dz-1 dks izsf"kr lans'k fnukad&17-12-2011] lwpuk ds vf/kdkj ds rgr yksd tu lwpuk vf/kdkjh ftyk fpfdRlky; jk;x<+ dks isf"kr i= ,oa muds }kjk izsf"kr tokc fnukad&13-02-2013] lwpuk ds vf/kdkj ds rgr Hkkjrh; vk;qfoZKku ifj"kn ls izkIr xkbZM ykbZu fnukad&12-03-2013] dk;kZy; iqfyl v/kh{kd jk;x<+ }kjk lapkyd LokLF; lsok,a N-x- 'kklu jk;iqj dks izsf"kr i= fnukad&20-03-2013 ,oa 21-06-2013] lwpuk ds vf/kdkj ds rgr dsUnzh; yksd lwpuk vf/kdkjh ubZ fnYyh dks izsf"kr i= ,oa tokc fnukad&21-03-2013] esfMdy fjdkMZ O;ofLFkr djus ds laca/k esa N-x- 'kklu }kjk tkjh vf/klwpuk fnukad&20-08-2013] lwpuk ds vf/kdkj ds // 11 // rgr izlwfr ,oa L=h jksx foKku foHkkx vf[ky Hkkjrh; vk;qfoZKku laLFkku ubZ fnYyh ls izkIr tkudkjh fnukad&^23-04-2014] lwpuk ds vf/kdkj ds rgr izlwfr ,oa L=h jksx foKku foHkkx vf[ky Hkkjrh; vk;qfoZKku laLFkku ubZ fnYyh ls izkIr tkudkjh] bZ&esy ls izkIr ,l- vkj- ,y- Mk;XuksfLVd ySc lsaiy ,oa CykWd fiztoZ djus ds laca/k esa fnukad&03-05-2014 ,oa bZ&esy ls izkIr esVªksiksfyl ySc lsaiy ,oa CykWd fiztoZ djus ds lac/ak esa funsZ'k ,oa xkbZM ykbZu fnukad&07-07-2014] VkVk eseksfj;y vLirky eqacbZ esa ifjoknh dz-3 dk jftLVªs'ku fnukad&04-08- 2016] bZykt gsrq iznRr dkLV lfVZfQdsV fnukad&12-08-2016] v.Mj VªhVesaV lfVZfQdsV fnukad&12-08-2016] ifjoknh dz-3 ds VkVk eseksfj;y vLirky esa gq, oa'kkuqxr VsLV laca/kh nLrkost fnukad&11-11-2016] dk;kZy; mi lapkyd dk i= fnukad&13-04-2017] vksQksjsDVkWeh dh ifjHkk"kk ,oa izfdz; laca/kh nLrkost] esfMdy fjdkMZ O;ofLFkr j[ks tkus ds lac/ak esa fn'kk&funsZ'k] esfMdy Lisflesu fjtsD'ku fjdkMZ ds laca/k esa cus xkbZM ykbZu rFkk esfMdy fjdkMZ ,oa b';wl bu usfXytsal laca/kh izi= dh Nk;kizfr izLrqr fd;k gSA 06- vukosnd dz-1 ,oa 2 dh vksj ls vius i{k leFkZu esa MkW- jktd`".k 'kekZ dk 'kiFk&i= ,oa vukosnd dz-1 }kjk Fkkuk izHkkjh dks izsf"kr i= lg tkap izfrosnu o xkbZM ykbZu fnukad&13-03-2013] vukosnd dz-1 dk Fkkuk izHkkjh dks fy[kk x;k i= fnukad&14-03-2013] vukosnd }kjk flfoy ltZu jk;x<+ dks fn;k x;k izfrosnu fnuka&08-11-2012] jftLVªkj N-x- esfMdy dkSafly }kjk N-x- jkT; efgyk vk;ksx dks izsf"kr i= // 12 // fnukad&25-06-2013] laiw.kZ csM gsM fVdV fnukad&09-02-2011] fcfyax 'khV fnukad&09-02-2011] fMLpktZ fcy fnukad&13-02-2011 rFkk tkap izfrosnu fnukad&05-05-2014 dh Nk;kizfr izLrqr fd;k gSA 07- vukosnd dz-3 dh vksj ls vius i{k leFkZu esa NRrhlx<+ vk;qfoZKku ifj"kn jk;iqj dk i= fnukad&05-05-2014 e; vkns'k ,oa Hkkjrh; vk;qfoZKku ifj"kn dh xkbZM ykbZu fnukad&10-02-2011 dh Nk;kkizfr izLrqr fd;k gSA 08- ifjoknhx.k dh vksj ls ifjoknh dz-1 pUnz Hkw"k.k feJk us fyf[kr rdZ izLrqr fd;k gS vkSj lkFk gh lkFk ;g Hkh rdZ fd;k gS fd e`frdk Jherh 'kqHky{eh feJk ifjoknh dz-1 dh iRuh ,oa ifjoknh dz-2 ,oa 3 dh ekrk FkhA Jherh 'kqHky{eh feJk us isV esa gYdk nnZ gksus dh f'kdk;r dh rc mls fnukad&06-02-2011 dks L=h jksx fo'ks"kK MkW- lqfp=k f=ikBh jk;x<+ dks fn[kk;k x;k ftUgksaus lksuksxzkQh djkus dh lykg fn;k Fkk rc fnukad&08-02-2011 dks MkW- T;ksRluk feJk ¼,e- ch- ch- ,l-½ fo|k lksuksxzkQh jk;x<+ esa lksuksxzkQh djk;k Fkk rks mUgksaus ;g vfHker~ fn;k Fkk fd vksojh ?kweh gqbZ gS vkSj mDr fjiksVZ MkW- f=ikBh dks fn[kk;s tkus ij mUgkasus MkW- vkyksd dsfM;k ¼,e- Mh- jsfM;ks Mk;Xuksfll½ ls ijke'kZ fy;s tkus dk funsZ'k fn;k vkSj nksckjk MkW- vkyksd dsfM;k ls lksuksxzkQh djok;k Fkk ftlesa 11.5 cm x 8.4 cm lkbZt dk Solid Cystic Lesion ¼fdlh jksx ds dkj.k Årdksa dk VwV tkuk ;k mldh fo{kfr½ ikbZ xbZ Fkh vkSj FNAC djk;s tkus dh lykg nh xbZ FkhA nksuksa fjiksVZ dks lkFk ysdj // 13 // ifjoknh dz-1 us viuh iRuh dks vukosnd dz-1 dks fn[kk;k Fkk vkSj ftls ljljh rkSj ij ns[kdj HkrhZ djus dk funsZ'k fn;k Fkk rc Jherh 'kqHky{eh feJk dks vukosnd dz-2 vLirky esa HkrhZ fd;k Fkk vkSj vU; lHkh 'kqYd tek fd;k x;k Fkk vkSj fnukad&10-02-2011 dks 'kYd fdz;k ds Ik'pkr~ ejht ds 'kY; fdz;k okys LFky ls fudkys x, Årdksa dh tkap gsrq vukosnd dz-3 dks Hksts tkus laca/kh vfHkdFku fd;k x;k vkSj ;g Hkh crk;k x;k fd ck;ksIlh ds fy, Hkstk x;k gS vkSj mldk 'kqYd Hkh ifjoknh dz-1 ls tek djok;k x;k FkkA vLirky ls NqV~Vh nsus ds ckn Hkh Jherh 'kqHky{eh ds isV esa nnZ cuk jgk vkSj vukosnd dz-1 }kjk fn, x, vkS"kf/k nh xbZ mlds ckn Hkh nnZ cuk jgk vkSj tqykbZ 2011 esa f}rh; ckj xHkZ/kkj.k dh ftls tkap gsrq iqu% MkW- lqfp=k f=ikBh ds ikl ifjoknh dz-1 }kjk ys tk;k x;k rks mUgksaus ;w-,l-th-@lksuksxzkQh dh lykg nh rc MkW- vkyksd dsfM;k ls lksuksxzkQh djk;k rks mUgksaus iqu% FNAC/BIOPSY of the meternal lesion & MRI Abdomen djkus dh lykg fn;k Fkk vkSj iwNs tkus ij mUgksaus crk;k fd ejht dh vksojh o 'kjhj ds vU; Hkkx esa dSalj dh vk'kadk gSA bl ij ifjoknh dz-1 us viuh iRuh dks 05-12-2011 dks MkW- ohuk i.Mk ¼L=h jksx fo'ks"kK½ Hkqous'oj ¼mM+hlk½ dks fn[kkdj muls ijke'kZ fy;k rks mUgksaus FNAC/USG dh lykg fn;k rc dfyaxk vLirky esa mDr ijh{k.k fnukad&07-12-2011 dks djk;k rc ik;k x;k fd e`frdk Jherh 'kqHky{eh dSalj jksx ls ihfM+r gS vkSj mls r`rh; voLFkk dk dSalj vksojh esa FkkA ejht dh fpfdRlk dj jgs fpfdRldksa }kjk iwoZ ds 'kY; fdz;k ds nLrkost vkSj fgLVksiSFkksykWth // 14 // fjiksVZ dh ekax dh xbZA bl ij ifjoknh dz-1 us vukosndx.k dks mDr nLrkost ,oa LykbZM miyC/k djk;s tkus gsrq dbZ vkosnu fn;k ijUrq nLrkost o LykbZM iznku ugha fd;k x;k vkSj blls ;g ugha tkuk tk ldk fd okLro esa dksjck dh fgLVksiSFkksykWth fjiksVZ D;k Fkh vkSj uk rks mls fjiksVZ iznku fd;k x;k vkSj uk gh LykbZM iznku fd;k x;kA ,El ubZ fnYyh }kjk Hkh iwoZ ds 'kY; fdz;k ds nLrkost o LykbZM dh ekax dh xbZ ijUrq vukosndx.k }kjk mDr nLrkost o LykbZM iznku ugha djus ds dkj.k ls ;g irk ugha py ldk fd okLro esa vukosnd dz-1 }kjk vksojh dh 'kY; fdz;k dh xbZ Fkh ;k ugha rFkk lSaiy tkap gsrq Hkstk x;k Fkk ;k ughaA NRrhlx<+ vk;qfoZKku laLFkku fcykliqj ls izkIr fpfdRlh; vfHker~ ls Li"V gksrk gS fd vukosndx.k }kjk fpfdRlh; mis{kk cjrk x;k gS rFkk LykbZM dks ck;ksIlh fjiksVZ gsrq mfpr iSFkksykWth ugha Hkstuk Hkh fpfdlh; lsok esa deh ekuk tkosxkA vukosnd dz-1 }kjk ;fn vius fpfdRlh; nkf;Roksa dk fuoZgu mfpr :Ik ls fd;k tkrk rks ejht dh jksxxzLr vksojh fudky nh tkrh ijUrq muds }kjk ejht dh iwjh tkap ugha djk;s tkus ds QyLo:Ik ejht dk thou ladVkiUu gqvk FkkA vukosnd dz-1 ,oa 2 }kjk ;g dFku fd;k x;k fd ejht dh jksxxzLr vksojh dks fudky fn;k x;k gS ijUrq flEl fcykliqj ls izkIr vfHker~ esa mDr rF;ksa ds laca/k esa fo'ks"kKksa }kjk lansg O;Dr fd;k x;k gSA vYVªk lskuksxzkQh dh fjiksVZ i`Fkd&i`Fkd gksus ls vukosnd dz-1 dk ;g drZO; Fkk fd og fdlh vU; fpfdRld ls Hkh vfHker~ izkIr djrk rFkk dSalj dh tkap uk djkdj Hkh =qfV dkfjr fd;k gSA besftax VsLV ds varxZr // 15 // Pelvic ultrasound djk;s tkus dk izko/kku gS vkSj Computed tomography (CT) scan or Magnetic resonance imaging (MRI) Hkh djk;s tkus dk izko/kku gS ijUrq bl izdkj dh dksbZ tkap ugha djk;k x;k gS vkSj FNAC Hkh ugha dh xbZ tks fd vukosndx.k ds fpfdRlh; mis{kk dk |ksrd gSA vukosnd dz-3 }kjk Histopathology report Clinical Info-(R) Ovarian mass, left sidedmass with ovary and tube sent for HPE examinations ys[k fd;k x;k gS ftlls ,slk izrhr gksrk gS fd MkW- vt; 'ks"k us Ovarian mass ds lkFk&lkFk vksojh o V~;wc lkFk esa izkIr dj mldk Hkh ijh{k.k fd;k gS vkSj mldh fjiksVZ vius vki esa fojks/kkHkk"kh gSA vukosndx.k }kjk LykbZM o fjiksVZ dks lqjf{kr ugha j[kk x;kA lwpuk ds vf/kdkj ls izkIr tkudkjh tks fd ,El ubZ fnYyh }kjk fnukad&30-09-2013 dks iznku dh xbZ gS ftlds vuqlkj LykbZM 05 o"kZ rd lqjf{kr j[ks tkus laca/kh tkudkjh nh xbZ gSA vukosnd dz-3 ,d futh iSFkkSySc lapkfyr djrk gS ijUrq mlus LykbZM dks lqjf{kr ugha j[kk gS tcfd LykbZM dks 10 o"kZ ,oa 05 o"kZ rd lqjf{kr j[ks tkus dk izko/kku gS vkSj LykbZM dks lqjf{kr ugha j[kdj vukosnd dz-3 }kjk fpfdRlh; mis{kk cjrk x;k gS vkSj vukosndx.k ds fpfdRlh; mis{kk ds ifj.kke Lo:Ik gh Jherh 'kqHky{eh feJk dk le; ij chekjh dh tkudkjh ugha gks ikbZ vkSj dSalj jksx QSyrs x;k vkSj ftlls mldh e`R;q gqbZ gS vkSj bu lc ifjfLFkfr;ksa dks ns[krs gq, ifjoknhx.k] vukosndx.k ls {kfriwfrZ ikus ds vf/kdkjh gSaA vr% ifjoknhx.k dks vukosndx.k ls fpfdRlh; mis{kk ds ifj.kke Lo:Ik {kfr ds laca/k esa ifjokn&i= esa of.kZr vuqlkj vuqrks"k iznku dh tkosA // 16 // 09- ifjoknhx.k dh vksj ls fpfdRlh; ekeyksa esa O;olkf;d nqjkpj.k ds laca/k esa Dr. M. Aiyappan and Others Vs. Lakshmi 2008 (2) CPR 9 (NC) and Savita Garg (Smt.) Vs. Director, National Heart Institute (2004) 8 Supreme Court Cases 56 dk voyacu fy;k gSA mlh izdkj ltZjh ,oa fpfdRlh; mis{kk ds laca/k esa Dr. G. Vivekananda Varma Vs. Chinta Bharamaramba & Ors. III (2006) CPJ 104 (NC), Kedarnath Sethia Vs. Dr. P.S. Hardia 2000 (3) CPR 438, Anjali Shrivastava Vs. Dr. Sheela Pahlajani I (2006) CPJ 67, T. Rama Rao Vs. Vijay Hospital and Anr. 2008 (2) CPR 16 (NC), Mangla L. Paradkar (Dr.) & Anr. Vs. Shailendra Singh III (2011) CPJ 64 (NC) and K. N. Lal Vs. R. K. Akhaury III (1997) CPJ 112 dk voyacu fy;k gS rFkk bZykt esa lsok esa deh ds ekeys esa izfrdj ds laca/k esa Geetu Sapra & Ors. Vs. Dr. B. L. Kapoor Memorial Hospital & Ors. III (2006) CPJ 1 (NC), Force (Society No. 596/88), New Delhi Vs. M. Ganeswara Rao & Ors. III (1997) CPJ 228, St. Gregorious- Mission Hospital Vs. Roji George & Ors. I (2008) CPJ 68 (NC) dk voyacu fy;k gS rFkk fu'psrd ds nkf;Ro ds laca/k esa Mumbai Grahak Panchayat Vs. DR. (Mrs.) Rashmi B. Fadnavis & Ors. I (1998) CPJ 49 (NC) dk voyacu fy;k gS rFkk fpfdRld ds fo:} izsfDVl u djus dk vkns'k ds laca/k esa Surendra Bhargava Vs. Surendra Sharma 2011 (3) CPR 164 (NC) dk voyacu fy;k gSA 10- vukosnd dz-1 ,oa 2 dh vksj ls milatkr gksus okys fo}ku vf/koDrk Jh Mh- nRrk ,oa Jh th- Ogh- ds- jko dk rdZ gS fd ifjoknh dz-1 us viuh iRuh dks bZykt ds fy, muds ikl yk;k Fkk vkSj lHkh // 17 // iSFkkSykWftdy VsLV djk;k x;k Fkk] ml le; mlds isV esa dkQh nnZ Fkk vkSj MkW- T;ksRluk feJk o MkW- vkyksd dsfM;k dh fjiksVZ esa fHkUurk Fkh rc vukosnd dz-1 us Mk;XuksfLVd ysizksLdksfid tkap dj oLrqfLFkfr ls fHkK gks ik;k fd MkW- T;ksRluk feJk dh fjiksVZ lgh gS vkSj ejht dk rRdky vkWijs'ku fuf'pr Fkk vkSj ejht dh tks fLFkfr Fkh mls ns[krs gq, rRdky vkWisj'ku fd;k x;k vkSj ,slh ifjfLFkfr esa FNAC tkap fu"ksf/kr gksus ds dkj.k ls FNAC ugha fd;k x;k vkSj FNAC fd;k tkrk rks tks Cystic Lesion gS mlesa jIpj gksus dh laHkkouk Fkh vkSj ,slh fLFkfr esa dSalj vkSj vcqZn ds QSyus dh laHkkouk vf/kd jgrh gSA fnukad&13-02- 2011 dks ejht dks iw.kZ LoLFk gksus ij fMLpktZ fd;k x;k vkSj mls funsZf'kr fd;k x;k fd og f}rh; xHkkZ/kkj.k u djs ijUrq funsZ'kksa dk ikyu ugha fd;k x;k vkSj og xHkZ/kkj.k dh FkhA 'kY; fdz;k ls lacaf/kr leLr nLrkost ifjoknh dz-1 dks 2&3 ckj iznku dj fn;k x;k Fkk ijUrq ikorh ugha yh xbZA lkekU;r% tc ejht dks nLrkost nsrs gSa rks mldh ikorh ugha yh tkrh gS vkSj fgLVksiSFkksykWth fjiksVZ vkSj LykbZM vukosnd dz-3 ds vkf/kiR; esa Fkk blfy, vukosnd dz-1 ,oa 2 }kjk iznku fd;k tkuk laHko ugha Fkk vkSj mls vukosnd dz-3 ls laidZ djus ds fy, dgk x;kA NRrhlx<+ vk;qfoZKku ifj"kn jk;iqj dh tkap fu"d"kZ tks fd MkW- vkj- ,y- eaMkoh] MkW- ,- ds- dq'kokgk] MkW- lq"kek ,Ddk ,oa MkW- ih- ds- xqIrk }kjk fn;k x;k gS mlls Li"V gS fd vukosnd dz-1 ,oa 2 }kjk fdlh izdkj dh dksbZ fpfdRlh; mis{kk ugha cjrk x;k gS vkSj vukosnd dz-1 ,oa 2 }kjk vius drZO;ksa dk mfpr :Ik ls fuoZgu fd;k gS vkSj // 18 // mfpr bZykt fd;k x;k gSA vukosnd dz-1 ,oa 2 }kjk fdlh izdkj dh dksbZ fpfdRlh; mis{kk ugha cjrk x;k gSA vr% ifjoknhx.k dk ifjokn fujLr fd;s tkus ;ksX; gS] vr% fujLr fd;k tkosA 11- vukosnd dz-3 dh vksj ls milatkr gksus okys fo}ku vf/koDrk Jh ch- ds- ik.Ms; dk rdZ gS fd fdl fpfdRld ds }kjk iqujkoyksdu fd;s tkus dh ekax dh xbZ Fkh] ;g Li"V ugha fd;k x;k gS rFkk vukosnd dz- 3 }kjk viuh tkap fjiksVZ vukosnd dz-1 dks izsf"kr dj fn;k x;k Fkk vkSj ,slh fLFkfr esa vukosnd dz-3 ls tkap fjiksVZ ekaxk tkuk vk'p;Ztud gS D;ksafd ejht vkSj vukosnd dz-3 ds e/; dksbZ laca/k ugha FkkA vukosnd dz-1 }kjk Hksts tkus ij vukosnd dz-3 }kj fjiksVZ rS;kj fd;k x;k gS vkSj fjiksVZ vukosnd dz-1 ,oa 2 dks Hkst fn;k x;k Fkk rFkk LykbZM ds laca/k esa vukosnd dz-3 dks dksbZ tkudkjh ugha Fkk vkSj fu;ekuqlkj 06 ekg ds Hkhrj LykbZM u"V dj fn;k tkrk gS vkSj bl izdkj LykbZM vukosnd dz-3 ds ikl miyC/k ugha Fkk vkSj ,slh fLFkfr esa vukosnd dz-3 }kjk LykbZM miyC/k djk;k tkuk laHko ugha Fkk vkSj vukosnd dz-3 }kjk fdlh izdkj dh dksbZ fpfdRlh; mis{kk ugha cjrk x;k gSA 12- geus ifjoknh dz-1 ,oa vukosndx.k ds fo}ku vf/koDrkx.k dk rdZ Jo.k fd;k rFkk ifjokn&i= dk voyksdu fd;k x;kA 13- ;g vfookfnr gS fd e`frdk Jherh 'kqHky{eh feJk tks fd ifjoknh dz-1 dh iRuh ,oa ifjoknh dz-2 ,oa 3 dh ekrk Fkh dks fnukad&09-02-2011 dks vukosnd dz- 2 vLirky eas yk;k x;k Fkk vkSj // 19 // tgka vukosnd dz-1 ds funsZ'k ij mls HkrhZ fd;k x;k FkkA ifjoknhx.k us vukosnd dz-2 vLirky dk fMLpktZ uksV izLrqr fd;k gS ftlds vuqlkj Jherh 'kqHky{eh feJk fnukad&09-02-2011 ls 13-02-2011 rd HkrhZ jgh gS vkSj mls Overian Cyst dh chekjh gksuk crk;k x;k gSA tgka rd fMLpktZ lejh dk laca/k gS mlesa iwjh chekjh dk mYys[k ugha gS vkSj D;k VªhVesaV fd;k x;k gS] bldk Hkh mYys[k Li"V :Ik ls ugha fd;k x;k gS] dsoy Clinical Findings esa Abdomen Pain Since 4 days fy[kk gqvk gS tcfd fMLpktZ lejh ds fy, ;g vko';d gS fd%& "Discharge Summary :
A document that outlines the details of hospitalization of a patient. Patient Care It is prepared when the patient is released from a health care facility and incorporated in her permanent medical records. It should ideally include the explanation for the patient's admission : a record of her complaints, physical findings, laboratory results and radiographic studies while hospitalized; a list of changes in her medications at discharge; and recommendations for follow up care. For optimal care it should be transmitted to or reviewed with her outpatient primary care provider."
ijUrq bl fMLpktZ lejh esa Åij of.kZr vuqlkj tks fooj.k fn;k tkuk pkfg, og fooj.k ugha fn;k x;k gSA 14- ifjoknhx.k dh vksj ls ;g vk{ksfir fd;k x;k gS fd FNAC VsLV ugha djk;k x;k ftlds laca/k esa vukosnd dz-1 ,oa 2 dh vksj ls vius fyf[kr dFku esa ;g crk;k x;k gS fd%& // 20 // "Routine use of FNA for evaluation of a pelvic mass suspected to be ovarian in origin is generally contraindicated, particularly is cystic lesions, secondary to concerns of rupture and potential iatrogenic spread of an isolated malignancy."
bl izdkj ;g Li"V gS fd vukosnd dz-1 }kjk FNAC VsLV ugha djk;k x;k gSA 15- Dr. M. Aiyappan and Others Vs. Lakshmi (Supra) esa ekuuh; jk"Vªh; vk;ksx }kjk ;g fu/kkZfjr fd;k x;k gS fd%& "The practice of covering up their act and scoring off the medical notes should be discouraged by the hospitals and medical profession. The confidence and trust, which the patients have towards doctors and hospitals, will completely be shaken if this is allowed." 16- tgka rd fpfdRlh; mis{kk dk laca/k gS] izFke n`"V;k lkfcr djus dk Hkkj fd MkWDVj us fpfdRlh; mis{kk cjrk gS] ifjoknh dk gksrk gS vkSj ;fn ifjoknh izFke n`"V;k lkfcr dj nsrk gS fd MkWDVj }kjk vius drZO; ds fuoZgu esa mis{kk cjrk x;k gS rc ;g flf} Hkkj lacaf/kr fpfdRld ij pyk tkrk gS fd og lkfcr djs fd MkWDVj }kjk mis{kk cjrk x;k gSA 17- bl laca/k esa Savita Garg (Smt.) Vs. Director, National Heart Institute (Supra) esa ekuuh; loksZPp U;k;ky; }kjk ;g fu/kkZfjr fd;k x;k gS fd%& // 21 // "D. Consumer Protection Act, 1986- Ss. 22, 18, 12 and 13- Medical negligence- Burden of proof- Held, once a claim petition is filed and the complainant has successfully discharged the initial burden that the hospital/clinic/doctor was negligent, and that as a result of such negligence the patient died, then in that case the burden lies on the hospital and the doctor concerned who treated the patient to show that there was no negligence involved in the treatment- Reasons for, given- Torts- Medical negligence- Burden of proof." 18- blh izdkj e/; izns'k jkT; miHkksDrk fookn izfrrks"k.k vk;ksx us Kedarnath Sethia Vs. Dr. P.S. Hardia (Supra) esa ;g fu/kkZfjr fd;k gS fd%& "In case of medical negligence where a general duty of care arises and there is failure to take a recognised precaution and failure has followed by the very beginning. Burden of proof would lay on doctor to show that there he was not in breach of any duty." 19- vc ;g ns[kuk gS fd D;k bl izdj.k esa ifjoknhx.k us izFke n`"V;k vius i{k dks lkfcr fd;k gS\ 20- ifjoknhx.k ds vuqlkj vukosnd dz-1 us FNAC VsLV ugha djok;k gSA ifjoknhx.k dh vksj ls lwpuk ds vf/kdkj ds rgr dsUnzh; yksd lwpuk vf/kdkjh ubZ fnYyh dks ,d vkosnu&i= fnukad&21-03-2013 dks izsf"kr fd;k Fkk ftlds laca/k esa MkW- lqus'k dqekj izksQslj lhihvkbZvks ds }kjk tkudkjh nh xbZ Fkh fd%& // 22 // "If there is clinical diagnosis of ovarian cyst, Pelvic Ultrasound remains the primary, and in most cases the preferred, imaging modality to evaluate cysts. The majority of adnexal masses can be correctly categorized based on gray scale and color or power. Doppler Ultrasound features. Doppler Ultrasound is needed for evaluation of most complex cysts to differentiate between benign and malignant cysts. Transvaginal Ultrasound is preferred to evaluate cysts. Imaging techniques like computed tomography (CT) scan and MRI have roles in management.
Fine-needle aspiration is also used in ovarian tumors and with the advent of accurate imaging techniques like ultrasonography (USG) and computed tomography (CT) scan in detecting the ovarian lesions, guided fine needle aspiration cytology (FNAC) has a limited role in diagnosis and management.
If there is a significant cyst in the ovary which requires intervention as per strict established medical criteria, there are certain enzymes, markers that need to be evaluated besides ultrasound, CT scan, MRI if required and FNAC.
If there is need for surgical intervention then all preoperative investigations required prior to anaesthetic check up are done.
Depending on availability, cytology, histopathology and genetic and molecular studies are done on the ovarian tissue.
All these tests are done to differentiate between benign and malignant ovarian cysts and depending upon the report the management differs."
mlh izdkj ,d vU; tkudkjh MkW- uhrk flag dsUnzh; tu lwpuk vf/kdkjh izlwfr ,oa L=h jksx foKku foHkkx vf[ky Hkkjrh; vk;qfoZKku // 23 // laLFkku ubZ fnYyh }kjk tkudkjh fn;k x;k gS ftlesa ;g crk;k x;k gS fd%& **vkids fnukad&09-09-2014 ds vkj- Vh- vkbZ- vkosnu ds lanHkZ esa miyC/k fjdkMZ ds vuqlkj lwpuk fuEukuqlkj gS% Ikz'u la-&1- ejht dh 'kY; fdz;k ds nkSjku 'kjhj ls dkSu&dkSu ls Hkkx rRdkyhu le; ij fudkyk x;k\ mRrj- jksxh VksVy ,Cmksfeu fglVsªDVkWeh ,oa ckbysVªy lsyfiaxks vksjjhVkWeh$baQzkdksfyd vksesuVsDVkWeh ds }kjk vkikr 'kY; fdz;k djuh iM+hA ;g f'k'kq ds tUe ds Ik'pkr~ fd;k x;k] xHkkZ'k; nksuksa V~;wc baQzkdksfyd vksesuVe ds lkFk vksojh ,oa 4x4 ikjk vksosfj;u ekl ckgj fudkyk x;kA iz'u la-2- mDr gbZ 'kY; fdz;k ds nkSjku ejht dh nksuksa v.Mk'k; ¼Both ovary½ Hkh fudkys x, Fks\ mRrj- gka] nksuksa vksojh fudkyh xbZA iz'u la-3- mDr gqbZ 'kY;fdz;k ds vkWijs'ku uksV~l dh Nk;kizfr iznku djus dh d`ik djsaA (The Indian Medical Council (Professional conduct, Etiquette and Ethics Regulation, 2002 ds v/;k; 1-3 ds varxZr½ mRrj- layXuA** 21- ifjoknhx.k dh vksj ls ;g crk;k x;k gS fd vukosnd dz-1 us ;g crk;k Fkk fd e`frdk Jherh 'kqHky{eh feJk dh ,d vksojh dks fudkyk x;k Fkk] ijUrq vukosnd dz-1 }kjk fjiksVksZa esa fHkUurk gksus ij Hkh // 24 // r`rh; vfHker~ ugha fy;k vkSj uk gh vko';d ijh{k.k djk;k] dSalj ekdZj dh tkap ugha djk;k x;k gS vkSj uk gh computed tomography] flVh Ldsu o ,e-vkj-vkbZ- djk;k x;k gS] tcfd ;g tkap vko';d gSA vukosnd dz-3 }kjk ys[k fd;k x;k gS fd Ovarian mass ds lkFk&lkFk vksojh o V~;wc lkFk esa izkIr dj mldk Hkh ijh{k.k fd;k gS ftlds voyksdu ls ;g izdV gksrk gS fd =qfViw.kZ fjiksVZ rS;kj fd;k x;k gSA vky bafM;k bafLVV~;wV vkWQ esfMdy lkbZalsl fMikVZesaV vkWQ iSFkksykWth dh fjiksVZ layXu gS ftlesa ;g mYysf[kr gS fd%& "Uterus shows multiple tumor deposits on the serosal aspect. Endomyometruim measures 0.8 and 3.5 cm respectively. Cervix could not be identified separately.
Multiple sections, examined from the tumor show features of a immature mixed germ call tumor comprising sheets of immature cells along and yolk rac differentiation.
There are large areas of necrosis and high mitotic activity." 22- ifjoknh dz-1 dh vksj ls dsUnzh; yksd lwpuk vf/kdkjh izlwfr ,oa L=h jksx foKku foHkkx vf[ky Hkkjrh; vk;qfoZKku laLFkku ubZ fnYyh ls lwpuk ds vf/kdkj ds rgr tkudkjh pkgk Fkk ftlesa ;g crk;k x;k gS fd 'kY; fdz;k ds nkSjku ejht ds nksuks v.Mk'k; ¼Both ovary½ fudkyh xbZ FkhA bl izdkj Li"V gS fd e`frdk Jherh 'kqHky{eh feJk ds nksuksa v.Mk'k; vf[ky Hkkjrh; vk;qfoZKku laLFkku esa fudkyh xbZ Fkh uk fd vukosnd dz-1 }kjk vkSj bl izdkj vukosnd dz-1 }kjk tks 'kY; fdz;k // 25 // fd;k x;k] mlds laca/k esa Li"V tkudkjh ugha fn;k x;k gS vkSj uk gh bldk mYys[k fMLpktZ lejh esa fd;k x;k gSA 23- P.B. Desai (Dr.) vs. State of Maharashtra & Anr. IV (2013) CPJ 63 (SC), esa ekuuh; loksZPp U;k;ky; }kjk ;g fu/kkZfjr fd;k x;k gS fd%& "39. It is not necessary for us to divulge this theoretical approach to the doctor-patient relationship, as that may be based on model foundation. Fact remains that when a physician agrees to attend a patient, there is an unwritten contract between the two. The patient entrusts himself to the doctor and that doctor agrees to do his best, at all times, for the patient. Such doctor-patient contract is almost always an implied contract, except when written informed consent is obtained. While a doctor cannot be forced to teat any person, he/she has certain responsibilities for those whom he/she accepts as patients. Some of these responsibilities may be recapitulated, in brief :
(a) to continue to treat, except under certain circumstances when doctor can abandon his patient;
(b) to take reasonable care of his patient;
(c) to exhibit reasonable skill: The degree of skill a doctor undertakes is the average degree of skill possessed by his professional brethren of the same standing as himself. The best form of treatment may differ when different choices are available. There is // 26 // an implied contract between the doctor and patient where the patient is told, in effect, "Medicine is not an exact science. I shall use my experience and best judgment and you take the risk that I may be wrong.
I guarantee nothing."
(d) Not to undertake any procedure beyond his control:
This depends on his qualifications, special training and experience. The doctor must always ensure that he is reasonably skilled before undertaking any special procedure/treating complicated case.
(e) Professional secrets: A doctor is under a moral and legal obligation not to divulge the information/ knowledge which he comes to learn in confidence from his patient and such a communication is privileged communication.
Conclusion: The formation of a doctor-patient relationship is integral to the formation of a legal relationship and consequent right and duties, forming the basis of liability of a medical practitioner, due to the very nature of the medical profession, the degree of responsibility on the practitioner is higher than that of any other service provider. The concept of a doctor- patient relationship from the foundation of legal obligations between the doctor and the patient.
// 27 // In the present case, as already held above, doctor-patient relationship stood established, contractually, between the patient and the appellant.
(2) Duty of Care which a doctor owes towards his patient.
40. Once, it is found that there is 'duty to treat' there would be a corresponding 'duty to take care' upon the doctor qua/his patient. In certain context, the duty acquires ethical character and in certain other situations, a legal character. Whenever the principle of 'duty to take care' is founded on a contractual relationship, it acquires a legal character. Contextually speaking, legal 'duty to treat' may arise in a contractual relationship or Governmental hospital or hospital located in a public sector undertaking. Ethical 'duty to treat' on the part of doctors is clearly covered by Code of Medical Ethics, 1972. Clause 10 of his Code deals with 'Obligation to the Sick' and Clause 13 cast obligation on the part of the doctors with the captioned "Patient must not be neglected". Whenever there is a breach of the aforesaid Code, the aggrieved patient or the party can file a petition before relevant Disciplinary Committee constituted by the concerned Stated Medical Council."
24- Kusum Sharma & ORS. Vs. Batra Hospital & Research Centre & ORS., I (2010) CPJ 29 (SC) esa ekuuh; loksZPp U;k;ky; }kjk ;g fu/kkZfjr fd;k x;k gS fd%& // 28 // 'Para" 90" In Jacob Mathew's case (supra), conclusions summed up by the Court were very apt and some portions of which are reproduced hereunder:
(1) Negligence is the breach of a duty caused by omission to do something which is a reasonable man guided by those considerations which ordinarily regulate the conduct of human affairs would do, or doing something which a prudent and reasonable man would not do. The definition of negligence as given in Law of Torts, Ratanlal & Dhirajlal (edited by Justice G.P. Singh) referred to hereinabove, holds good. Negligence becomes actionable on account of injury resulting from the act or omission amounting to negligence attributable to the person sued. The essential components of negligence are three: 'duty', 'breach' and 'resulting damage'.
(2) Negligence in the context of medical profession necessarily calls for a treatment with a difference. To infer rashness or negligence on the part of a professional, in particular a doctor, additional considerations apply. A case of occupational negligence is different from one of professional negligence. A simple lack of care, an error of judgment or an accident, is not proof // 29 // of negligence on the part of a medical professional. So long as a doctor follows a practice acceptable to the medical profession of that day, he cannot be held liable for negligence merely because a better alternative course or method of treatment was also available or simply because a more skilled doctor would not have chosen to follow or resort to that practice or procedure which the accused followed.
(3) The standard to be applied for judging, whether the person charged has been negligent or not, would be that of an ordinary competent person exercising ordinary skill in that profession. It is not possible for every professional to possess the highest level of expertise or skills in that branch which he practices. A highly skilled professional may be possessed of better qualities, but that cannot be made the basis or the yardstick for judging the performance of the professional proceeded against on indictment of negligence.
Para "94'. On scrutiny of the leading cases of medical negligence both in our country and other countries especially United Kingdom, some basic principles emerge in dealing with the cases of medical // 30 // negligence. While deciding whether the medical professional is guilty of medical negligence following well known principles must be kept in view:
I. Negligence is the breach of a duty exercised by omission to do something which a reasonable man, guided by those considerations which ordinarily regulate the conduct of human affairs, would do, or doing something which a prudent and reasonable man would not do.
II. Negligence is an essential ingredient of the offence. The negligence to be established by the prosecution must be culpable or gross and not the negligence merely based upon an error of judgment.
III. The medical professional expected to bring a reasonable degree of skill and knowledge and must exercise a reasonable degree of care. Neither the very highest nor a very low degree of care and competence judged in the light of the particular circumstances of each case is what the law requires.
IV. A medical practitioner would be liable only where his conduct fell below that of // 31 // the standards of a reasonably competent practitioner in his field.
V. In the realm of diagnosis and treatment there is scope for genuine difference of opinion and one professional doctor is clearly not negligent merely because his conclusion differs from that of other professional doctor.
VI. The medical professional is often called upon to adopt a procedure which involves higher element of risk, but which is honestly believes as providing greater chances of success for the patient rather than a procedure involving lesser risk but higher chances of failure. Just because a professional looking to the gravity of illness has taken higher element of risk to redeem the patient out of his/her suffering which did not yield the desired result may not amount to negligence.
VII. Negligence cannot be attributed to a doctor so long as he performs his duties with reasonable skill and competence.
Merely because the doctor chooses one course of action in preference to the // 32 // other one available, he would not be liable if the course of action chosen by him was acceptable to the medical profession.
VIII. It would not be conducive to the efficiency of the medical profession if no Doctor could administer medicine without a halter round his neck.
IX. It is our bounden duty and obligation of the civil society to ensure that the medical professionals are not unnecessary harassed or humiliated so that they can perform their professional duties without fear and apprehension.
X. The medical practitioners at times also have to be saved from such a class of complainants who use criminal process as a tool for pressurizing the medical professionals/hospitals or clinics for extracting uncalled for compensation.
Such malicious proceedings deserve to be discarded against the medical practitioners.
XI. The medical professionals are entitled to get protection so long as they perform // 33 // their duties with reasonable skill and competence and in the interest of the patients. The interest and welfare of the patients have to be paramount for the medical professionals."
25- bl izdj.k esa ifjoknhx.k dh vksj ls ;g vk{ksfir fd;k x;k gS fd vukosndx.k }kjk fpfdRlh; nLrkost ,oa LykbZM ekaxs tkus ij iznku ugha fd;k x;k rFkk vukosndx.k }jk ;g crkus dk iz;kl fd;k x;k gS fd LykbZM u"V dj fn;k x;k gS vkSj mls 06 ekg rd fiztoZ djds j[kk tk ldrk gSA vukosndx.k us tks cpko fy;k gS og Lohdkj ;ksX; ugha gSA 26- Anjali Shrivastava Vs. Dr. Sheela Pahlajani (Supra) esa bl vk;ksx }kjk vkns'k dh dafMdk&28] 29 ,oa 30 esa ;g fu/kkZfjr fd;k x;k gS fd%& "28. District Forum in para 6 of the impugned order concluded that the O.P. failed to preserve and produce records for 2 years as per the GOI Notification referred to in the said parayraph. We find ourselves in agreement with the said conclusion and also note that para 1.3.1 of Code of Medical Ethics laid down by the Medical Council of India, reads as under:
'Every physician shall maintain the medical records pertain to his/her patients for a period of 3 years from the date of commencement of the treatment in a standard proforma laid // 34 // down by the Medical Council of India or the State Medical Council as the case may be.'
29. In view of the above provisions the O.P. was under obligation to preserve the records for 3 year from the commencement of treatment which she has failed to discharge.
30. The State Commission of Madhya Pradesh has in the matter of SA Quereshi v. Padode Memorial Hospital and Research Centre, II (2000) CPJ 463, Bhopal observed that 'The plea of destroying the case history appeared to the Court to be an attempt to suppress certain facts likely to be revealed from the history sheet." 27- T. Rama Rao Vs. Vijay Hospital and Anr. (Supra) esa ekuuh; jk"Vªh; vk;ksx }kjk ;g fu/kkZfjr fd;k x;k gS fd%& "(1) If a request is made for medical records either by the patient or his/her authorized attendant or the legal authority involved and they are not delivered, it would amount to deviation from expected professional conduct and ethics amounting to deficiency in service.
24. .................................
1.1.1. ...........................
1.1.2 .........................
1.2 Maintenance of medical records 1.3.1. Every physician shall maintain the medical records pertaining to his/her indoor patients for a period of 3 years from the date of commencement of the treatment in a standard proforma laid down by the Medical Council of India and attached as appendix 3.
// 35 // 1.3.2. If any request is made for medical records either by the patients/authorised attendant or legal authorities involved, the same may be duly acknowledged and/ documents shall be issued within the period of 72 hours."
28- vukosndx.k dh vksj ls vius cpko eas tkap vf/kdkjh MkW- vkj- ,y- eaMkoh] MkW- ,- ds- dq'kokgk] MkW- lq"kek ,Drk ,oa MkW- ih- ds- xqIrk }kjk fn, x, fjiksVZ dks vk/kkj cuk;k x;k gS ftlesa ;g mYysf[kr gS fd%& **1- miyC/k nLrkostksa ls ;g izekf.kr gksrk gS fd Jherh 'kqHky{eh feJk vksosfj;u flLV chekjh ls ihfM+r FkhA ;g ,d ihfM+rk ds ifr dh lgefr ds ckn MkW- vkj- ds- 'kekZ ds }kjk igys ysijksLdksih ds }kjk Twisted Ovaries dk vkWijs'ku fd;k x;kA ;g ,d vkikrdkyhu fLFkfr Fkh rFkk blesa rRdky vkWijs'ku t:jh FkkA vkWijs'ku ds ckn Ård dks tkap gsrq js.kqdk Diagnostic Hkstk x;kA js.kqdk Diagnostic Lab dksjck ds ikWoj gkÅl jksM] vfHkuUnu dkEiysDl ds ikl Hkst fn;k x;k ftlesa vksojh esa dSalj ugha ik;k x;kA MkW- 'ks"k ds vulkj Ård esa vksojh dSalj ds y{k.k ugha feykA Slide dk Image View Hkh MkW- 'ks"k us miyC/k djk;h gSA ,e- lh- vkbZ- ds fu;ekuqlkj 6 eghus ds ckn Slide u"V dj fn;k tkrk gSA ihfM+r ds ifjtu us Slide 6 ekg ckn ekaxk FkkA vr% miyC/k ugha djk;h tk ldhA Nk;kizfr layXuA // 36 // 2- Twisted Ovaries ,d vkikrdkyhu fLFkfr gSA 'kh?kz vkWijs'ku ugha gksus ij izk.k?kkrd gks ldrk gSA vr% FNAC ;k fdlh Hkh vU; tkap ds fy, izrh{kk ugha fd;k tk ldrk gSA oSls Hkh Twisted Ovaries esa FNAC oftZr gS vr% Radio Logist MkW- dsfM;k ds }kjk nh x;h FNAC dh lykg vuqfpr gSA 3- fpfdRld }kjk MkW- vkj- ds- 'kekZ ,oa MkW- 'ks"k ds }kjk vius Kku ,oa vuqHko dk mfpr mi;ksx fd;k x;k gS ,oa fpfdRlh; fu;eksa dk mYya?ku ugha fd;k x;k gSA** 29- blds foijhr MkW- vkj- lh- vk;Z] MkW- vpZuk flag] MkW- ,l- ih- dqtqj ,oa MkW- ehuk vkeksZ us tks vfHker fn;k gS og fuEukuqlkj gS%& **1- miyC/k nLrkostksa ds vk/kkj ij rFkk ejht dh mez dks ns[krs gq, ,oa **Dyhfudy Mk;Xuksfll** Twisted Ovarian cyst dk bZykt dk izk:Ik blh dze esa gksrkA 2- Histopathology Report esa eSfyaxuSlh ds izek.k ugha Ikk;s tkus ij Hkh ejht dk Follow up gksuk pkfg, FkkA ¼ Follow up lacaf/kr nLrkot vuqiyC/k gSA½ 3- ejht ds tkap@ltZjh ds nLrkostksa esa fojks/kkHkk"k gS rFkk dgha ij Right rks dgha ij Left ovary fy[kk x;k gSA 4- esVªks gkWfLiVy ,oa Mk;fcVht fjlpZ lsaVj jk;x<+ esa gq, ySizksLdksfid ltZjh fnukad&10-02-2011 ds vkWijs'ku uksV~l esa Twisted ovarian cyst, left side dh vksojh esa gksuk crk;k x;k ftlds QyLo:Ik left oophorectomy fd;k x;k] tcfd mlh // 37 // vLirky ds fMLpktZ fVfdV esa Twisted ovarian cyst o operation right side gksuk crk;k x;kA AIIMS esa gq, ltZjh fnukad&07-03- 2012 ls lacaf/kr vkWijs'ku uksV~l esa vafdr fp= esa Hkh nksuksa vksofjl H (Healthy) crk;k x;k gS tks fojks/kkHkk"kh fooj.k gSA mYys[kuh; gS fd ,El dh fgLVksiSFkksykWth fjiksVZ esa bE;ksP;ksj feDl tEl lsy V~;wej vkWQ jkbZV vksojh ik;k x;kA 5- tkap o mipkj ls lacaf/kr dbZ egRoiw.kZ nLrkostksa ds vHkko ,oa fojks/kkHkk"kh uksV~l ds dkj.k chekjh dh 'kq:okr o fujUrjrk ds laca/k esa Li"V vfHker fn;k tkuk laHko ugha gSA** 30- ifjoknh dz-1 us vukosnd dz-1 ,oa 3 ls nLrkost ,oa LykbZM iznku fd;s tkus gsrq dbZ vkosnu&i= Hkh izLrqr fd;k gSA fnukad&09-02- 2012 dks lapkyd] esVªks gkWfLiVy ,.M Mk;fcVht fjlpZ lsaVj jk;x<+ dks vkWijs'ku ls lacaf/kr esfMdy dkxtkr iznku fd;s tkus ckor~ rFkk fnukad&27-02-2012 dks iqu% ,d vkosnu&i= rFkk lapkyd js.kqdk Mk;XuksfLVDl dksjck dks fnukad&09-02-2012 ,oa 27-02-2012 dks vkosnu&i= izLrqr fd;k FkkA mlds Ik'pkr~ Hkh uk rks nLrkost iznku fd;k x;k vkSj uk gh LykbZM iznku fd;k x;k tcfd LykbZM fiztoZ djds j[kuk pkfg, Fkk vkSj vukosnd dz-1 }kjk LykbZM dks fiztoZ ugha fd;k x;k gSA NRrhlx<+ jkti= ds vuqlwph&7 ds fu;e&14 esa esfMdy fjdkMZ ds ckjs esa tks xkbZM ykbZu fn;k x;k gS mls Hkh ifjoknhx.k }kjk izLrqr fd;k x;k gS ftlesa ;g crk;k x;k gS fd%& **esfMdy fjdkMZ // 38 // izR;sd uflZax gkse@fDyfudy LFkkiuk] vLirky esa ejht ds vkus@mldk mipkj vkjaHk gksus dh rkjh[k ls iakp o"kZ dh vof/k ds fy, esfMdy fjdkMksZa ¼vfHkys[kksa½ dk vuqj{k.k djsxh vkSj lqjf{kr jgsxhA fuEufyf[kr fjdkMksZa ¼vfHkys[kksa½ dk vuqj{k.k fd;k tk,xk%& 1- vksihMh fjdkMZ%& vks- ih- Mh- esa vkus okys ejht dh **vks- ih- Mh- iphZ** esa MkWDVj dk uke foLr`r fDyfudy uksV ¼fpfdRlh; Vhi½ ds lkFk gh ejht dk uke] mez] O;olk;] eq[; f'kdk;r] chekjh dk vkjaHk@chekjh dh vof/k@chekjh esa lq/kkj] fiNyk bfrgkl] O;fDrxr ¼oS;fDrd½ bfrgkl] ifjokfjd bfrgkl] foLr`r ijh{k.k fu"d"kZ] rkRdkfyd funku vkSj lykg rFkk fn;k x;k mipkj vkfn ds fooj.k vUrfoZ"V gksus pkfg,A 2- var% jksxh foHkkx ¼vkbZih-Mh½ fjdkMZ%& uflZax gkse gks] var% jksxh ejht ds :Ik esa uflZax gkse esa HkrhZ gq, ejhtksa ds fuEufyf[kr fooj.k j[kus gksaxs%& ¼,d½ HkrhZ dk fjdkMZ ¼nks½ fMLpktZ@Mhvksvkj@,y,,e,@,CldkWfMax@ejht dh e`R;q ¼rhu½ mipkj dk fjdkMZ ¼pkj½ bu jftLVjksa dks lE;d :Ik ls vuqjf{kr vkSj dzekuqlkj] v|ru djuk gksxk] ftudh izfr;ksa dks de ls de ikap o"kksZa dh vof/k ds fy, uflZax gkse ds fjdkMZ :e // 39 // esa j[kuk gksxkA bl laca/k esa tkudkjh] Ik;Zos{kh izkf/kdkjh dks tSlk vkSj tc vko';d gks] iznk; fd;k tk;sxkA 3- vuqjf{kr fd, tkus okys vU; jftLVj%& vuqjf{kr fd, tkus okys vU; jftLVj gSa%& ¼,d½ izl{k d{k ¼yscj :e½ jftLVj ¼nks½ vkWijs'ku fFk,Vj jftLVj ¼rhu½ ,e- Vh- ih- jftLVj ¼;fn xHkZ dk fpfdRlh; lekiu vf/kfu;e] 1971 ds v/khu iathd` gS½ ¼pkj½ esfMdks yhxy jftLVj ¼ikap½ ySc jftLVj ¼N%½ jsfM;ksykWth vkSj besaftax jftLVj ¼lkr½ vYVªklksuksxzkQh jftLVj ¼vkB½ PC-PNDTjftLVj ¼ukS½ esfMdy izek.k&i= jftLVj] izek.k&i= lfgr] nks izfr;ksa esaA ¼nl½ f'kdk;r jftLVj ¼X;kjg½ tUe jftLVj ¼;Fkk izkf/kd`r ,sls fpfdRlk vf/kdkjh dks vf/klwfprA ¼ckjg½ 'kklu@jkT; Lrjh; izkf/kdkjh }kjk ;Fkk fu/kkZfjr izk:i esa e`R;q jftLVj ¼rsjg½ 'kkldh; dk;Zdzeksa@dk;Z{ks=ksa ¼tSls ekr`Ro LokLF;] f'k'kq LokLF;] Vhdkdj.k] ifjokj fu;kstu] jksxokgd tfur // 40 // chekjh] jk"Vªh; d`"B fuokj.k dk;Zdze jftLVj] la'kksf/kr jk"Vªh; {k; jksx fu;a=.k dk;Zdze] ,dhd`r jksx fuxjkuh ifj;kstuk] jk"Vªh; xzkeh.k LokLF; fe'ku ls lEc} lkekftd LokLF; xfrfof/k;ka] tuuh lqj{kk ;kstuk ds laca/k esa tkudkjhA** 31- mijksDr leLr nLrkostksa ds ifj'khyu ls Li"V gS fd vukosnd dz-1 }kjk vksojh esa tks vkWijs'ku fd;k tkuk crk;k tk jgk gS og iw.kZr% =qfViw.kZ gS tcfd e`frdk Jherh 'kqHky{eh feJk ds nksuksa vksojh dk vkWijs'ku ,El ¼vf[ky Hkkjrh; vk;qfoZKku laLFkku½ }kjk fd;k tkuk ik;k tkrk gS rFkk vkWy bafM;k bafLVV~;wV vkWQ esfMdy lkbZal us e`frdk Jherh 'kqHky{eh feJk ds fDyfudy fgLVksiSFkksykWth fMVsYl ,oa iwoZ ds fgLVksiSFkkSykWth fjdkMZ dh ekax fd;k Fkk vkSj mlh vk/kkj ij ifjoknh dz- 1 us vkosnu&i= vukosndx.k dks izsf"kr fd;k Fkk ijUrq vukosndx.k }kjk fjdkMZ miyC/k ugha djk;k x;k tks fd fuf'pr gh lsok esa deh gS vkSj fpfdRlh; mis{kk dk |ksrd gS rFkk vukosnd dz-1 }kjk 'kY; fdz;k ds iwoZ tks vko';d tkap gS tSls dSalj ekdZj dh tkap] FNAC]ck;ksIlh rFkk lh,&125 Cyd VsLV vkfn dh tkap ugha djok;k x;k gS vkSj uk gh ck;ksIlh ds laca/k esa mfpr iSFkkykWth dks Hkstk x;k gS vkSj mlh izdkj vukosnd dz-3 us LykbZM dks lqjf{kr uk j[kdj Hkh lsok esa deh fd;k gS vkSj bl izdkj ifjoknhx.k }kjk ;g lkfcr dj fn;k x;k gS fd vukosndx.k }kjk e`frdk Jherh 'kqHky{eh feJk ds bZykt esa mis{kk cjrk x;k gS vkSj tks fd fpfdRlh; mis{kk dh ifjf/k esa vkrk gSA bl izdkj // 41 // Li"V gS fd vukosndx.k }kjk fpfdRlh; mis{kk cjrk x;k gSA QyLo:Ik ifjoknhx.k] vukosndx.k ls {kfriwfrZ izkIr djus ds vf/kdkjh gSaA 32- vc ;g ns[kuk gS fd ifjoknhx.k fdl lhek rd {kfriwfrZ izkIr djus ds vf/kdkjh gSa\ 33- ifjoknhx.k us vius ifjokn&i= esa ifjoknh dz-1 dks mfpr lykg ugha fn;s tkus ds dkj.k e`frdk dks vuko';d :Ik ls xHkZ/kkj.k djuk iM+k vkSj ftlds fy, 50]00]000@&¼ipkl yk[k :Ik;s½] mfpr lykg ugha fn;s tkus ds dkj.k vlkef;d fpfdRlk esa {kfr ds laca/k esa 5]00]000@&¼ikap yk[k :Ik;s½ ,oa viuh vk; o fof/kd lykg izkIr vk; ls oafpr jguk iM+k ftlds dkj.k 2]34]190@&¼nks yk[k pkSarhl gtkj ,d lkS uCcs :Ik;s½ rFkk ifjoknh dz-2 ,oa 3 dks viuh eka ds ykyu&ikyu ls oafpr jguk iM+k mlds fy, 5]00]000@&¼ikap yk[k :Ik;s½ vkSj lgp;Z ls oafpr jgus ds laca/k esa 1]00]000@&¼,d yk[k :Ik;s½] cqtqxksZa }kjk O;; fd;k tkus okyk vfrfjDr le; dh {kfriwfrZ gsrq 5]00]000@&¼ikap yk[k :Ik;s½ rFkk fpfdRlk lsok esa [kkeh ds QyLo:Ik gqbZ vlhe 'kkjhfjd] ekufld o ikfjokfjd =kl ds fy, 5]00]000@&¼ikap yk[k :Ik;s½ bl izdkj dqy&73]34]190@&¼frgRrj yk[k pkSarhl gtkj ,d lkS uCcs :Ik;s½ vuqrks"k fnyk;s tkus dh ekax fd;k gSA 34- ifjoknhx.k dh vksj ls fcy izLrqr fd, x, gSa ftlds vuqlkj ifjoknhx.k }kjk esfMdy fcy ds laca/k esa yxHkx 46]813@&¼fNa;kyhl // 42 // gtkj vkB lkS rsjg :Ik;s½] gokbZ tgkt ds laca/k esa 13]821@&¼rsjg gtkj vkB lkS bDdhl :Ik;s½] Vsªu ds laca/k esa 14]935@&¼pkSng gtkj ukS lkS iSarhl :Ik;s½ rFkk ykWt ds laca/k esa 31]430@&¼bdrhl gtkj pkj lkS rhl :i;s½ dqy&1]06]999@&¼,d yk[k N% gtkj ukS lkS fuU;kucs :Ik;s½ gksrk gSA 35- ifjoknhx.k dh vksj ls e`frdk Jherh 'kqHky{eh feJk ds vk; ds laca/k esa dksbZ nLrkost izLrqr ugha fd;k x;k gS rFkk tks fpfdRlh; nLrkost izLrqr fd;k x;k gS mlesa e`frdk dh vk;q 25 o"kZ crk;k x;k gS rFkk e`frdk Jherh 'kqHky{eh feJk dh e`R;q vDVwcj 2012 esa gqbZ gS vkSj vDVwcj 2012 esa izfrfnu gksus okys vk; dk vuqeku djrs gq, vkSj e`frdk dh vk;q dks /;ku esa j[krs gq, ifjoknhx.k dks {kfriwfrZ dh jkf'k ,deq'r 12]00]000@&¼ckjg yk[k :Ik;s½ fnyk;k tkuk mfpr gksxkA mDr 12]00]000@&¼ckjg yk[k :Ik;s½ esa ls 9]00]000@&¼ukS yk[k :Ik;s½ vukosnd dz-1 MkW- jktd`".k 'kekZ ,oa vukosnd dz-2 esVªks gkWfLiVy ,.M Mk;fcVht fjlpZ lsaVj ifjoknhx.k dks vnk djsaxs vkSj 'ks"k 3]00]000@&¼rhu yk[k :Ik;s½ vukosnd dz-3 MkW- vt; 'ks"k }kjk ifjoknhx.k dks Hkqxrku fd;k tkosxkA vukosndx.k tks jkf'k mUgsa ifjoknhx.k dks iznku fd;s tkus gsrq vknsf'kr fd;k x;k gS ij 09 izfr'kr okf"kZd C;kt dh nj ls C;kt Hkh ifjoknhx.k dks nsus ds fy, nkf;Rok/khu gSaA // 43 // 36- mijksDr foospuk ds ifjizs{; esa ifjoknhx.k dh vksj ls izLrqr ifjokn vkaf'kd :Ik ls Lohdkj fd;k tkrk gS vkSj ;g vknsf'kr fd;k tkrk gS fd%& 1- vukosnd dz-1 MkW- jktd`".k 'kekZ ,oa vukosnd dz-2 esVªks gkWfLiVy ,.M Mk;fcVht fjlpZ lsaVj ifjoknhx.k dks {kfriwfrZ ds :Ik esa 9]00]000@&¼ukS yk[k :Ik;s½ ,oa vukosnd dz-3 MkW- vt; 'ks"k ifjoknhx.k dks 3]00]000@&¼rhu yk[k :Ik;s½ dh jkf'k {kfriwfrZ ds :Ik esa vnk djsaxsA 2- vukosndx.k ftrus jkf'k ds laca/k esa mUgsa nkf;Rok/khu Bgjk;k x;k gS] mDr jkf'k ij ifjoknhx.k dks ifjokn&Ik= izLrqfr fnukad&25-01-2014 ls jde dh vnk;xh fnukad rd 09 izfr'kr okf"kZd C;kt dh nj ls C;kt dk Hkh Hkqxrku djsaxsA 3- vukosndx.k i`Fkd&i`Fkd ,oa la;qDr :Ik ls 15]000@&¼iUnzg gtkj :Ik;s½ oknO;; ds :Ik esa Hkh ifjoknhx.k dks vnk djsaxsA ¼U;k;ewfrZ vkj-,l-'kekZ½ ¼Mh- ds- iksn~nkj½ ¼ujsanz xqIrk½ v/;{k lnL; lnL;
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