National Consumer Disputes Redressal
Shri Subhash Chand vs M. D. Jaipur Golden Hospital on 25 August, 2011
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI ORIGINAL PETITION NO. 203 OF 2000 Shri Subhash Chand S/o late Sh. Birbal R/o H. No. 724, Pocket 6-2, Sector -2 Rohni, Delhi .Complainant Versus 1. M.D. Jaipur Golden Hospital, 2, Institutional area Sector 3 Rohni, Delhi-85 2. Dr. V.Jaiswal (Neuro Surgeon) Jaipur Golden Hospital, Rohni, Sector-3, Delhi. 3. Dr. Arun Gupta, (Consultant) Jaipur Golden Hospital Sector-3, Rohni, Delhi-85 4. Dr. K. Khanna, (Consultant) Jaipur Golden Hospital, Sector No.3 Rohni, Delhi-85. 5. Dr. Sushil Bahasin, Jaipur Golden Hospital, Sector No.3, Rohni, Delhi-85 .........Opposite Parties BEFORE: HON'BLE MR. JUSTICE R.K.BATTA, PRESIDING MEMBER HONBLE MR. VINAY KUMAR, MEMBER For the Complainant : Mr. B.S. Chauhan, Advocate For the Opposite Parties : Mr. Ram N Sharma, Advocate With Dr. Kuldeep Khanna PRONOUNCED ON: 25-08-2011 ORDER
PER MR.VINAY KUMAR, MEMBER
1. This is a consumer complaint filed in early 2000 by Sri Subhash Chand against the following a.
M D Jaipur Golden Hospital, Delhi (hereinafter referred to as JGHD), b.
Dr V Jaiswal, Neuro Surgeon, JGHD, c.
Dr Arun Gupta, Consultant, JGHD, d.
Dr K Khanna, Consultant, JGHD, e.
Dr Sushil Bhasin, JGHD.
2. Facts of the case, as emerging from the records, are that the 45 days old son of the complainant, Subhash Chandar had fallen ill due abdominal distention for four days and one episode of general convulsion. He was taken to the OP-1/ Jaipur Golden Hospital, Delhi (JGHD) on 14.3.1997 and admitted to the I.C.U. According to the Complainant, lumber puncture was performed on the child, which was very traumatic and the blood stained CSF (cerebro spinal fluid) came out. Three days after the lumber puncture, the child developed paraplegia, which is a condition of paralysis of lower limbs, accompanied by paralysis of bladder and rectum.
3. MRI scan of the child was taken on 19.3.1997. The report of this scan of the spine revealed that An extradural globular collection seen in posterior portion of spinal canal from D10 L2 level. This collection is showing iso and hyper intense signal on T1W1 and is largely hypointense on T2W1with few areas of hyper intensity (suggestive of blood and its breakdown products in subacute stage). This collection is causing marked compression and deformity of dural sac and spinal cord. Cord shows hyper intense signal intensity in T2W1in this region. No evidence of intradural/intramedullary mass lesion seen.
As for the brain, the scan report says Both cerebral hemispheres do not show any evidence of altered signal intensity or mass lesions. Mild prominence of ventricular system seen. No evidence of intra ventricular haemorrhage seen. No evidence of midline shift seen. Major vascular flow voids are well maintained.
4. This was referred to the OPs who suggested an operation. It was performed on 21.3.1997 at the JGHD and the extra dural collection (haematoma) was removed. The patient was discharged on 26.3.1997.
5. The case of the Complainant is that he was assured by the doctors JGHD that the child would become alright within a few days.
But, the child never recovered from paraplegia. The lower portion of his body became passive after the operation. He therefore, took the child to Kalawati Sharan Children Hospital and was advised physiotherapy, which was continued till 1998, but the child did not recover. In the meanwhile, the MRI report of 27.5.1997 showed post-operative changes under the lower dorsal spine. This MRI report has two separate parts, one on the spine and the other of the brain. The one on spine, contains the following opinion MRI findings of the cervicodorsal spine are suggestive of a long segment of myelomalacia D 10 to the conus. Please correlate clinically.
6. The MRI report of the brain says MRI findings of the brain are suggestive of venus angioma left cerebellum.
Please correlate clinically.
(In lay language, it can be called a tumour composed of the blood vessels.) (highlights supplied)
7. Nearly two and a half years later, another MRI was done at Jaipur. This MRI report of 12.11.1999 revealed that the spinal cord had abrupt termination at T9-10 level and the distal portion of the cord and conus region showed evidence of myelomalacia. The complainant has placed heavy reliance on this MRI report of 12.11.1999, from the AY DIAGNOSTIC RESEARCH CENTRE, JAIPUR. This report refers to the surgery for removal of intra spinal posterior extradural haematoma at T 9,10 and 11 levels and states Evidence of laminectomy is seen at T 12 level.
Spinal cord shows abrupt termination at T 9-10 level. The distal portion of cord and conus region show evidence of myelomalacia.
8. Laminectomy is an operation in which the arches of one or more vertebrae in the spinal column are removed so as to expose a portion of the spinal cord for removal of a tumour, relief of pressure due to a fracture or disc protrusion. According to the complainant, the above results of the post operative study clearly show that there has been defect and negligence on the part of the OPs. The complaint petition states that due to negligence and defective service by OPs life of the Master Vishnu is spoiled and the boy will not be able to move his lower portion, move his limbs and due to the passiveness of the lower portion the boy has no control on urinating or defecting etc. besides other complications. He has therefore, claimed a compensation of Rs.41.3 lakhs with interest at 24%.
9. Responding to the complaint petition, an affidavit has been filed by Dr. A.K.Dubey Medical Superintendent of OP Hospital. The complaint petition is called misconceived and frivolous, with attempt to twist and distort the facts with malafide intention to tarnish the image of the OP Hospital and doctors. It is stated that the child was brought after 10 PM in very serious condition, with abdominal distention and convulsion. As per this affidavit Master Vishnu was diagnosed as a case of Hypocalcemic Convulsion and Meningitis and certain tests were performed on him and after the tests it was found that he was a case of Late Hemorrhagic disease of the newborn with extradural compressive dorsal myelopathy. Routine lumber puncture at the level of L4 & L5 vertebra of the spine was done and it was found traumatic as bloodstained CSF came out. After 48 hours, this was repeated when it was found to be again the same findings. CT scan skull showed blood in cerebellopontine cisterns and ceribillar region. It is vehemently denied the Master Vishnu developed paraplegia due to lumber puncture or any other action of the respondents. The patient was sick right from his birth as this type of disease is found only newborn babies but was not treated for the same for 44 days as is apparent from the records and as per the statement of the complainant himself at the time of admission of the baby, for the last one month the baby was facing convulsions and other related problems.
10. It is further stated that the paraplegia came to light after three days of admission when the patient was referred to a neurologist. After a MRI was done the patient was found with extra dura blood collection in posterior portion of the spinal canal D 10 and L2 level(Maximal at D11 level) leading to cord compression and ocdema. The complainant wanted treatment of the patient from Dr Sushil Bhasin Respondent No. 5 and accordingly he was called in. Respondent No. 5 advised surgical decompression of cord.
11. In a subsequent paragraph, the affidavit states that The operation was only for removing the extra dural globular compressive lesion at D10 and D 12 and it had nothing to do with the principal disease which the patient was suffering. It is respectfully submitted that the patient was suffering from Late haemorrhagic of New Born due to transient deficiency of vitamin K probably due to lack of vitamin K in the mother and absence of bacterial intestinal flora normally responsible for synthesis of this vitamin.
12. We have perused the records and heard the two counsels. Learned counsel for the complainant has argued, referring to the record of treatment at OP hospital, that the child was normal when brought to the OP hospital on 14.3.1997. The record mentions generalized tonic convulsion and abdominal distention. But, it also clearly says No significant past history;
GC(general condition) Satisfactory CVS- NAD (no abnormality detected) CNS(central nervous system)-
tone and power #(normal) in all four limbs.
13. The first Lumber Puncture was performed on the date of arrival i.e. on 14.3.1997. It was very traumatic and therefore had to be abandoned. Again, on 16.3.1997 Lumber Puncture was attempted. on 16.3.1997, the record at 11 AM shows LP traumatic. Flaccid paralysis of lower limbs. Overflow incontinence.
14. Thus, Paraplegia was first noticed on 16.3.1997. It was therefore, argued that paraplegia did not exist till 16.3.1997 i.e. till the third day in the OP hospital.
15. As against the above, in the written statement of the OP, as well as the affidavit of the hospital, it is claimed that the child was suffering from what was diagnosed as Late Hemorrahagic of New born, since birth and was not given proper treatment or 44 days till he brought to the OP hospital. But, it needs to be noted that the record of treatment in the OP hospital, relied upon by both parties, does not support this claim. In the written arguments, affidavit of OP-1 as well as the arguments of his counsel, it is claimed that neither the Lumber Puncture performed on the child nor any other action of the respondents was the cause of the paraplegia, which the child developed subsequently.
16. The affidavit of OP-1 also raises the issue of limitation under Section 24 A of the Consumer Protection Act, 1986 as the complaint has not been filed within the prescribed period of two years. The complaint relates to alleged medical negligence in the treatment of the child in March 1997, which was almost three years before the filing of the consumer complaint. Understandably therefore, an objection is raised, on behalf of the respondents, that the complaint is barred by limitation under Section 24-A of the Consumer Protection Act, 1986. It was filed in April and admitted by this Commission on 19.12.2000.
17. For matters coming before the consumer fora after two years from the date on which the cause of action has arisen, the provision in sub-section (2) provides Notwithstanding anything contained in sub-section (1), a complaint may be entertained after the period specified in sub-section (1), If the complainant satisfies the District Forum, the State Commission or the National Commission, as the case may be, that he had sufficient cause for not filing the complaint within such period.
18. During the course of the arguments before us, learned counsel for the OPs pointed out that the complainant has not filed any application to explain this delay. Learned counsel for the complainant explained it during the course of his arguments, pointing out that after discharge of the patient on 26.3.1997, the complainant had been frequently taking the child to the OP Hospital for further reviews and treatment. The last such visit was on 19.9.1997, for which the relevant record has already been produced. In addition, treatment was also taken at various other hospitals. No consumer complaint was filed as complainant was still hoping that the child would come out of paraplegia. It is stated in the complaint petition that at Kalawati Hospital, new Delhi, the child was advised physiotherapy which was done till late 1998, but there was no recovery.
19. Learned counsel also explained that the need for obtaining full records of treatment from the OP Hospital arose only after the MRI report of 12.11.1999, which confirmed the nature of damage caused to the child in the course of laminectomy performed by the opposite party. He further argued that it was this report of 12.11.1999 that made him discover the relationship between the operation performed by the OP and the condition of the child. Thereafter, he obtained the record of treatment from the OP hospital and filed this complaint. In this context, it needs to be noted that para 16 of the affidavit evidence of the complainant, states that That deponent last took the boy to the SMS Hospital, Jaipur and again got the MRI done upon the boy, which shows that spine cord shows abrupt termination at T9-10 level. The distal portion of cord and conus region show evidence of myelomalacia. Photocopy of report attached and marked as Ex. CW-1/9 dated 12.11.1999.
20. Explaining the Rule of Discovery in the context of the provision in Section 24-A, Hble Supreme Court of India has observed in a recently decided Civil Appeal, V. N. Srikhande Vs. Anita Sena Fernandes (2011) 1 SCC 53 that Since the term cause of action has not been defined in the Act, the same has to be interpreted keeping in view the context in which it has been used in Section 24-A(1) and object of the legislation. In case of medical negligence, no straight jacket formula can be applied for determining as to when the cause of action has accrued to the consumer. Each case is to be decided on its own facts. If the effect of negligence on the doctor's part for any person associated with him is patent, the cause of action will be deemed to have arisen on the date when the act of negligence was done. If, on the other hand, the effect of negligence is latent, then the cause of action will arise on the date when the patient or his representative complainant discovers the harm/injury caused due to such act or the date when the patient or his representative complainant could have, by exercise of reasonable diligence discovered the act constituting negligence.
The Discovery Rule to which reference has been made by the learned counsel for the respondent was evolved by the courts in the United States because it was found that the claim that lodged by the complainants in cases involving acts of medical negligence were getting defeated by strict adherence to the statutes of limitation.(para 24).In the case before us, the danger of belated, false or frivolous claim is eliminated. In addition, plaintiffs claim does not raise questions as to credibility nor does it rest on professional diagnostic judgment or discretion. It rests solely on the presence of a foreign object within her abdomen (para 28) In the light of the above, it is to be seen, whether the cause of action had accrued to the respondent on 26.11.1993 i.e. the date on which the appellant performed open cholecystectomy and the piece of gauze is said to have been left in her abdomen or in November 2002 when she received histopathology report from Lilavati hospital. If the respondent had not suffered pain, restlessness or any other discomfort till September 2002, it could reasonably be said that the cause of action accrued to her only on the discovery of the pieces of gauze which were found embedded in the mass taken out for abdominal as a result of surgery performed by Dr P Jagannath on 25.10.2002. In that case, the complaint filed by her 19.10.2004 would have been within the limitation. However, the factual matrix of the case tells a different story. In the complaint filed by her, the respondent categorically averred that after discharge from the appellant's Hospital, she suffered being of a non-and it was during unrest to her at home and at workplace; that her sufferings well unless and she had spent sleepless nights and mental strain for almost 9 years.(para 30)..
The respondent was not an ordinary lay person. She was an experienced nurse and was employed in the government hospital. It was respondent's case before the State Commission and the National Commission that after the surgery in November 1993 she was having pain in the abdomen off and on and, on that account, she was restless at home and also at workplace and had to take leave including sick leave on various occasions. Therefore, it was reasonably expected of her to have contacted the appellant and apprised him about paying and agony and sought his advice. That would have been the natural conduct of any other patient. If the respondent had got in touch with the appellant, he would have definitely suggested measures for relieving from pain and restlessness. If the respondent was not to get relief by medication the appellant has suggested her to go for an x-ray or CT scan. In the event of discovery of gauze in the respondent's abdomen, the appellant would have taken appropriate action for extracting the same without requiring the respondent to pay for it. If the measures suggested by the appellant were not to the satisfaction of the respondent and the pain in her abdomen persisted when she could have consulted with any other doctor for relief.(para32).
However, the fact of the matter is that after the surgery, the respondent never informed the appellant that she was having pain in the abdomen, was restless and having sleepless nights. At no point of time she contacted the appellant and sought his advice in the matter. Not only this, she did not consult any other Dr including those who are working in the government hospital where she was employed with the any person of ordinary prudence, who may have suffered pain and discomfort after surgery would have consulted the surgeon concerned or any other competent doctor and sought his advice by the respondent did nothing except taking some painkillers. If the respondent had been little diligent, and she was contacted the appellant and inform him about her sufferings. In that event, the appellant may have suggested appropriate medicines or advise her to go for x-ray or CT scan. If the piece of gauze was found in the abdomen of the respondent, the appellant would have certainly taken remedial measures.(para33) The respondent has not explained as to why she kept quiet for about nine years despite pain and agony. The long silence on a part militates against the bonafides of the respondents claim for compensation and the Discovery Rule cannot be invoked for recording a finding that the cause of action accrued to her in November 2002.(para34) (emphasis added)
21. As already observed, no application for condonation of the delay is filed. In order to determine the cause of action in a case, the bundle of facts as a whole to be seen. The Apex Court has laid down that cause of action under the Consumer Protection Act, 1986 has to be interpreted keeping in view the context in which it has been used under Section 24-A of the Act and the object of the legislation. Section 24-A (2) of the Act lays down that the consumer fora may entertain the Complaint beyond two years from the date on which the cause of action had arisen, if the fora is satisfied that the Complaint had sufficient cause for not filing the same within the time prescribed. It is now well settled that expression sufficient cause has to be liberally construed and it is particularly so in case of complaint under the Consumer Protection Act in view of the observations of the Apex Court underlined above.
22. Even though, there is no specific application for condonation, yet, if the complainant discloses facts which are sufficient to explain the conduct of the complaint due to which the complaint was not filed in time, technical pleas must give way to substantial justice. It has been laid down by the Apex Court in a catena of judgments that procedural laws are hand made of justice and are meant for advancement of substantial justice.
23. Applying the norms laid down in the above decisions to the facts of the case before us, it is noticed that the complainant remained in touch and consultation with the OP hospital for nearly six months after the surgery and discharge of his child. He cannot be accused of any negligence in pursuing treatment of his child even thereafter. The records of physiotherapy and consultations with other hospitals have been produced in evidence of the same.
24. The complaint in the paras 12 to 16 has explained that the treatment and investigation was done at various places including Kalwati Saran Children Hospital New Delhi, Sir Gangaram Hospital, New Delhi. The MRI report of 19.3.1997 showed nothing abnormal with the brain. But, MRI of 27.5.1997 revealed a venous angioma of left cerebellum (brain tumour) and myelomalacia of the spine. Finally, the MRI of 12.11.1999 brought out the discovery of abrupt termination of the spinal cord at D 9-10 level, very close to the point where laminectomy was performed in OP hospital. In between, as already pointed out above, through the entire period since discharge from OP hospital, the patient was undergoing treatment, at OP hospital till 19.9.1997 (as per medical records) and elsewhere, with no let up in the condition of paraplegia. We are therefore, of the view that, in the facts and circumstances of this case, it clearly comes out as a case in which the cause of action first arose with the Lumber Puncture performed on the child in March 1997 and is a continuing cause of action which culminated with the discovery in November 1999 that due to the laminectomy performed on 21.3.1997, the child had lost a part of his spinal cord itself which is discovery of latent negligence on the part of opposite party. Thereafter, the Complainant promptly obtained the record of treatment from OP-1 and filed this complaint. Hence, the conduct of the complainant gets fully explained in terms of the requirement of Section 24-A of the Consumer Protection Act, 1986.
25. Coming to the allegation of negligence in the treatment, the first question that arises relates to the Lumber Puncture (LP) performed on the child. Admittedly, it was attempted twice and was very traumatic on both occasions as admitted in affidavit of Dr. A.K. Dubey Medical Superintendent of OP Hospital. We therefore, need to know if it was necessary and if yes, was it performed correctly? On behalf of the OPs, medical literature on LUMBER PUNCTURE AND CEREBROSPINAL FLUID EXAMINATION has been submitted to explain the process and implications of LP. It is recommended as a primary diagnostic procedure in children with suspected bacterial meningitis, in the absence of overwhelming sepsis or shock or symptoms and signs of brain herniation. But, the Paper also states that performing Lumber Puncture is contra indicated in certain situations including that of symptoms and signs of pending cerebral herniation in a child with probable meningitis. In this case, a generalized tonic seizure is one such sign or symptom. The Paper recommends, These children must be treated immediately with appropriate intravenous antibiotics and measures to reduce increased ICP and transported to a critical care unit for further stabilization and cranial imaging studies before an LP is contemplated. Thus, as per medical literature presented before us, Lumber Puncture on arrival and before brain imaging, is to be considered as a wrong procedure and therefore a deficiency in service.
26. The next question that arises here is whether the haematoma, which developed in the next few days, was caused by LP? In this behalf, OFFICIAL JOURNAL OF AMERICAN ACADEMY OF PEDIATRICS (Vol. 113 No. 1.1.2004, pp172) has been cited on Traumatic Lumber Punctures. It states that it is a common event in acute pediatric practice, worldwide. Another paper has been cited on Complications of Lumber Puncturehttp://queensu.ca/courses/assets/modules/lumber_puncture/complications.html). (http://queensu.ca/courses/assets/modules/lumber puncture/ complications.html). Spinal hematoma is listed as one of the potential complications of this procedure. The paper shows that it is most common in those who under go lumber puncture while having coagulation abnormalities including thrombocytopenia, anti coagulation and bleeding disorders. Aggressive investigation with CT/MRI and associated laminectomy is recommended, if hematoma is present. Another paper has been cited to show that in new borns deficiency of Vitamin K is associated with deficiency of blood clotting factors. In the case before us, as per the record of treatment, the child was diagnosed with deficiency of Vitamin K. This would indicate coagulation abnormalities in the child and explain why on both occasions, LP resulted in discharge of blood stained CSF. Therefore, it can safely be inferred that Lumber Puncture was the cause of the hematoma that developed in the next few days. No other explanation for development of hematoma has been suggested or indicated by the records of treatment or pleadings of parties.
27. Finally, we come to the most important question viz. was paraplegia caused by the treatment at OP hospital? The case of the complainant, as detailed in an earlier part of this order, is that the child was normal on arrival. Paraplegia was noticed on the third day. He, therefore, holds the OPs directly responsible for it. According to the OPs, the surgery was performed several days after paraplegia was first noticed. While they deny that any part of the treatment was responsible for it, they have also not explained what could have caused it. It must however be observed here that neither party has produced any independent expert opinion in support of its claim.
28. The record of treatment carries the following comments in the dateline of 20.3.1997 Sudden solitary attack of tonic spasm six days back . Subsequently the lumber puncture was carried out after admission which was traumatic-bloodstained CSF..2 days later CT scan head was carried out which showed blood in cisterns(inclusive of cerebello-pontine cistern) and cerebellar region.-3rd day subsequent to LP- Pt. developed paraplegia- A MRI carried out revealed an extradural globular, compressive lesion.. There appears to be the possibility of haemorrhagic disorder along with extradural compressive dorsal myelopathy wh. requires decompression at the earliest prevent paraplegia from becoming permanent feature..In view of progressive paraplegia, decompression may be done under cover of FPP (fresh frozen plasma)and platelet concentrate.
29. The above (section in highlight) would suggest that decompression or removal of the hematoma was expected to reverse/arrest progress of paraplegia. In fact, the record of treatment does contain an entry in the dateline of 22.3.1997 (a day after the surgery) which reads
-child has flicker of movements in lower limbs left side>Rt.
But, all subsequent entries, till discharge on 26.3.1997, show no change in paraplegia. We must therefore, hold that the evidence on record does not allow any clear or specific conclusion on the allegation that paraplegia was the result of treatment at OP hospital. The complainant has failed to establish it with any acceptable evidence.
30. From the details examined above, we arrive at the following conclusions on the allegations of medical negligence and deficiency of service in this case a.
Lumber Puncture was performed on the child of the complainant when it was contra-indicated by the condition in which he was brought to the OP hospital.
b.
The MRI of 19.3.1997, which was five days after the first Lumber Puncture, showed the hematoma that had developed in the spine but it showed nothing abnormal with the brain of the child. Subsequent MRI of 27.5.1997 revealed a venous angioma of left cerebellum i.e. a brain tumour. No attempt has been made to show whether it had any relationship with the eventual condition of the child.
c.
From the evidence on record, medical journals produced before us and in the background of the deficiency of vitamin K which the child was diagnosed to be suffering from, it is clear that Lumber Puncture was the cause for hematoma which developed in the next few days following it. Medically, hematoma is recognized as a potential complication and common outcome of Lumber Puncture.
d.
The decision to perform laminectomy for removal of hematoma was medically correct and in accordance with the normal practice.
e.
The question of relationship between laminectomy performed on the child and his eventual paraplegic condition, has not traveled beyond the stage of allegation. The complainant has failed to establish this relationship with cogent evidence, particularly with reference to his allegation relating to abrupt termination of the spinal cord at D 9-10 level as the result of laminectomy.
31. In view of the above, we conclude that the charge of medical negligence and deficiency of service is established, in so far as the two episodes of Lumber Puncture are concerned. The trauma inflicted by this on the child is admitted by OP-1. It was also the cause for the hematoma which developed in the spine in the next few days. The notings in the record of treatment (20.3.1997) are a clear indication of the gravity and possible implications of this hematoma. Needless to say that eventual laminectomy performed on 21.3.1997, would not have been required at all, if it was not to remove this hematoma. We have therefore, no hesitation in holding the OPs responsible for the Lumber Puncture and the consequences it entailed. However, the complainant has failed to establish his allegation, in so far as it relates to the relationship of laminectomy with the condition of uncured paraplegia, which the child is battling since then.
32. Coming to the question of compensation, we note that the complainant first claimed Rs 40 lakhs, without submitting any details to justify the claim. He later enhanced his claim to Rs 10 Crores, again without any explanation. However, in the background of the suffering undergone by the hapless child, together with the expenditure and mental torture undergone by his father i.e. the complainant, we consider that it will be just and proper to award compensation of Rs.3 lakhs for the needless traumatic Lumber Puncture inflicted on the child, Rs.5 lakhs for the resultant suffering undergone by him and the complainant together with Rs.2 lakhs for the medical expenses and Rs.50,000/- towards cost of litigation.
33. In the result, the complaint is partially allowed. Compensation of Rs.10.5 lakhs is awarded to be paid to the complainant by the OPs, jointly and severally. This amount shall carry interest of 6% from the date of the complaint filed in this Commission and shall be paid within three months. For the period of delay, if any, interest shall be payable at 10%. There are no orders as to costs.
Sd./-.
(R.K.BATTA, J.) PRESIDING MEMBER .. Sd./-
(VINAY KUMAR) MEMBER S./-