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Central Information Commission
Shri Umesh Chandra Joshi vs Safdarjung Hospital on 29 January, 2010
                          CENTRAL INFORMATION COMMISSION
                            Appeal No. CIC/AD/A/2009/900945 dated 2.7.2009
                              Right to Information Act 2005 - Section 19


Appellant         -          Shri Umesh Chandra Joshi
Respondent            -      Safdarjung Hospital
                                    Decision announced : 29.1.2010


Facts

:

By an application of 12.6.09 Shri Umesh Chandra Joshi of Sarojini Nagar,
New Delhi applied to the CPIO Dr. R. K. Anand, CMO (NFSG), Office of Medical
Superintendent, Safdarjung Hospital, seeking the following information:

“(i) the case file was closed on 6.6.2009 i.e. after the direction of
CIC and not by the unit Head. The case file was closed at
12.45 hours on 6.6.2009 on behalf of Unit head. The name
and designation of the Dr. who closed the file may be
indicated. The reason for closing the file by Dr. Other than
Unit Head and that to one month after the discharge/ death
of the patient may be intimated. The name of Jr. Resident
and Sr. Resident closing the case may be intimated. (See P-
34 of case file).

(ii) It may also be informed whether it is allowed that case can
be closed by person other than Unit Head. The relevant
provisions of manual may be intimated.

(iii) The name of the Doctors who examine the patient and
prescribed treatment in the emergency may be intimated. (P-
25-26 of case file).

(iv) The patient was transferred to Ward-I while the Unit belongs
to ward- 24 (P-34 of the case file). The name and
designation of the Doctor who advised the transfer of the
patient may be intimated.

(v) No advice from ward-B is available in case file for transfer of
patient. However, a note dated 2.5.2009 for transfer to
ward-I after USG is available in case file (P-27 of case file).
However, the case file does not include the USG dated
2.5.2009 for ward-B. Please also provide me the USG done
on 2.5.2009 before transferring the patient to Ward-I. The
name of the Nursing Staff of who transferred the case may

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be intimated, who ordered for transfer of case may be
intimated. The reply is relevant in terms Hon’ble CIC’s
decision No. 338/ICPB/2006 dated 15.2.2007.

(vi) The USG dated 1.5.2009 (P-21-22 of case file) gives the
impression as choleithiasis. I may be intimated when the
hospital came to know about the disease of the patient as
‘Pancreatitis’ as mentioned in diagnosis at P-34 of case file.
What treatment was provided to the patient after diagnosis of
the patient, the same is not clear from case file?

(vii) The Lab. Report as available in P-12 of case file indicates it
as ‘Duplicate’ and is unsigned and dated 4.5.2009. Who
conducted the test, the name and designation of the Bio-
chemist may be intimated. Who is responsible for loss of
original report? Does this not amount to medical
negligence?

(viii) The case was sent to consultation twice to Medicine
department and ICU. The name and designation of the
Doctor who examined the patient and rendered medical
advice may be intimated. (P-8, 9, 26 and 17 of case file).
The date and time of such advice may be intimated. The
date and time on which such referral was made may be
intimated.

(ix) The patient was allotted floor bed no. 15 (P-3 of case file),
while Hon’ble High Court of Delhi has ordered that no patient
may be allotted floor bed and be transferred to Private
Hospitals who are mandatorily required to provide free
treatment to the patient of BPL. This patient was CGHS
beneficiary, why the patient was not transferred to CGHS
recognized hospital. Whether this does not amount to
contempt of Hon’ble High Court of Delhi. Name of the Dr./
Nurse who allotted floor bedding may be intimated.

(x) From the entire case file it is seen that none of the specialist/
consultant examined the patient all along the patients stay in
hospital. Keeping the patients on the mercy of Contractual
Resident Doctors amounts to Medical negligence or not.
Whether non examination of patient by the Specialist and
Consultant of the Hospital to the patient amount to medical
negligence or not. If no, the reason thereof.

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(xi) What are the duties and responsibilities of specialist and
what are the guidelines for their visit to the ward (both
normal ward and emergency ward).

(xii) Name of the nursing Staff who administered the I. V. Infusion
to the patient all alongwith patients stay in hospital may be
informed (shift wise).

(xiii) In part-II (other significant conditions) of P-34 of case
indicate that ‘Cholilishesis’ is not the disease, whether
conclusion is against the impression of USG dated 1.5.2009
(P-21 of case file) or not.

(xiv) I may be provided medical transcript of death summary at P-

32 of the case file.

(xv) What is the treatment of Pancreatitis and whether the
facilities are available in the hospital for pancritis. ERCP
facilities are available in the ho9spital or not.

(xvi) I may be allowed to inspect all the registers and records
maintained in the hospital relating to the treatment of above
patient. I may also be shown ‘Suggestion/ complaint
register’ which is compulsorily needs to be maintained in the
wards.

As already accepted by you during hearing dated 5.6.2009 that
matter relate to life & liberty and hence may be provided within 48
hrs.”

To this Shri Joshi received no response within 48 hours leading him to
appeal on 17.6.09 before Dr. Sudhir Chandra, Appellate Authority and Addl.
Medical Supdt., SJH pleading as follows:

“The information needs to provide within 48 hours in as held by
Hon’ble CIC indecision No. CIC/AD/A/2009/9000676 dated
5.6.2009 and agreed by the CPIO. However, no reply has been
furnished by the CPIO yet.

Non furnishing of reply amounts to refusal of information within the
meaning of Sub-section 2 of section 7of RTI Act, 2005.”

On still not receiving a response, Shri Joshi has moved a second appeal
before us with the following prayer:

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“As per above direction of your honour, the CPIO provided me
the case file containing 34 pages vide letter No. 14/06-

SJH/CPIO/RTI-2009/151 dated 8.6.2009 at 1430 hrs. However,
the case file has some missing reports/ discrepancies, I
requested them to provide me the same, beside inspection of
other document vide my application dated 12.6.2009. I have
also appealed to Appellate Authority vide my appeal dated
17.6.2009. However no reply has been received yet.’

The appeal was heard on 20.7.2009. The following are present:

Appellant
Sh. Umesh Chandra Joshi
Respondents
Dr. R. K. Anand, CMO (NFSG) & CPIO
Sh. Debasish Sarkar, LDC

Dr. R. K. Anand submitted that such information as is held by the Hospital
in this regard including the file sheet of Mrs. Rekha has been provided to
appellant, who has also inspected the records. Appellant Shri Joshi, however,
submitted that some files pertaining to this case have been deliberately
concealed.

Appellant Shri Umesh Chandra Joshi then submitted his arguments in
writing, a copy of which was handed over to respondents Dr. R. K. Anand, CMO.
Appellant Shri Joshi also submitted a copy of a letter sent on 27.6.09 by Dr. R. K.
Anand to Shri Harish Chandra Pandey, husband of the deceased Ms. Rekha,
which reads as follows:

“Your wife Late Smt. Rekha Age 35 years / female was under
treatment in this hospital vide M.R.D. No. 39993/09 and was
admitted on dated : 01.05.09. She expired on 6.5.2009.

You are hereby directed to explain that :

1. Why Mr. Umesh Chandra Joshi is seeking information
related to your Wife’s treatment ?

2. Why Mr. Umesh Chandra Joshi is taking interest in your
Wife’s Case?

3. Whether Mr. Umesh Chandra Joshi is real brother of your
wife or not?

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4. Were you in Delhi at the time of admission of your wife in
Safdarjung Hospital on 1.5.2009?

5. What was your role in the treatment of your wife?

6. Whether Mr. Umesh Chandra Joshi is seeking information
through RTI Cell Safdarjung Hospital with your consent or
knowledge?

7. Why y our signature is not present in the Case Sheet at the
time of admission of your wife in this hospital?

You are hereby directed to give reply of all the above
questions within 10 days of receipt of this letter.”

Shri Joshi has also submitted a copy of a letter of 9.3.09 from Shri Harish
Chandra Pandey to Dr. R. K. Anand affirming that Shri Umesh Chandra Joshi is
the brother of Smt. Rekha and was supervising her treatment. He has also
submitted other documents with regard to the treatment of Ms. Rekha as well as
a complaint against harassment by the CPIO.

It is noted that u/s 11(1), a public authority , if it intends to disclosure
information, is required to give a written notice to such third party of the request
and to the fact that CPIO intends to disclose the information on record or part
thereof. It is conceded that such information, as is being sought in the present
case by appellant Shri Joshi is information that can be treated as confidential as
being a fiduciary relationship and, therefore, exempt from disclosure u/s 8(1)(e).
However, this cannot warrant a peremptory notice as issued by CPIO Dr. Anand
to Shri Harish Chandra Pandey dated 26.11.08 as quoted above, which is more
interrogatory than simply a request for agreement to disclosure.

Nevertheless to allow respondents to reply exhaustively to the points
raised by Shri Joshi and his complaint on information not having been provided
despite several decisions by this Commission, the last being on 5.6.09, Dr. R. K.
Anand was directed to provide a written response by or before 24.7.2009 on the
basis of which this Commission would proceed to arrive at a decision in this
matter. This response dated 24.7.’09 has been received followed by a rejoinder

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from appellant Shri Joshi dated 12.9.’09. The appeal was, therefore, heard once
more on 29.1.10. The following are present:

Appellant
Shri Umesh Chandra Joshi
Respondents
Dr. R. K. Anand, CMO (NFSG) & CPIO
Dr. S. Laxmi, CPIO-I
Dr. Manoj Kumar, CPIO-II
Dr. Ashwani Gupta, Sr. Surgeon
Dr. A.S.N. Rao, Sr. Surgeon
Mr. Debashish Sarkar, Dealing Asstt. RTI Cell

In his written rejoinder appellant has listed questions asked and responses
received, commenting against several that “the record management is very
poor”. On several punts however, appellant Shri Umesh Chandra Joshi has
contested the information provided. We then examined each of these points in
the hearing. This is with regard to point 2, 9, 11, 12, 15 & 16, which are as
follows:

Point 2: Dr. A. N. S. Rao submitted that the response given to appellant Shri
Joshi is correct in light of the fact that this matter is not covered by any
rule and, therefore, part of any manual but is prescribed practice. In this
case the matter had been closed by Dr. Rao himself in the absence of Sr.
Surgeon Dr. Ashwani Gupta.

Point 4: In this matter respondent Dr. Ashwani Gupta submitted that there is
no record of the name and designation of the Dr. who advised the transfer
of the patient, since this would have been on the basis of verbal orders.

Point 9: In this case, again it was confirmed by Sr. Surgeon Dr. Ashwani
Gupta that information provided was correct. There is no record of any
request by the patient for transfer to another CGHS Hospital. Dr. Gupta
submitted that SJH is a tertiary level hospital that provides that same
treatment for all.

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Point 11: In this matter, as informed by CPIO in his comments, Dr. A. N. S.

Rao in his letter of 24.6.09 to CPIO submitted that a reply is to be provided
by the Administration Section.

Point 12: Respondents submitted that there is no such record maintained
since the Nursing Staff works in six rotating shifts and, therefore, it is not
possible to specify which Member of that staff administered IV infusion.

Point 15: CPIO Dr. S. Laxmi submitted that the information sought had been
provided through a letter of 24.6.09, which appellant Shri Joshi confirmed
having received.

Point 16: It was argued that the information sought was maintained only for
day to day use and once used was not maintained as a part of the record.
The particular information, which appellant had sought may not have been
destroyed but was not traceable.

DECISION NOTICE

From the above, it would appear that other than the information mentioned
at point 11 of appellant’s rejoinder, the remaining information such as exists had
infact been provided to appellant Shri Umesh Chandra Joshi. Now, therefore,
CPIO-1 Dr. S. Laxmi will ensure that the information awaited from the
Administration Section is passed on to Shri Joshi within ten working days
of the date of receipt of this Decision Notice, under intimation to Shri
Pankaj KP Shreyaskar, Jt. Registrar of this Commission.

On the other hand, we notice that this Commission has repeatedly had
occasion to take note of the inadequacies in maintenance of records in the SJH.
In our order in Appeal No. 338/ICPB/2006 (File No.PBA/06/345) -S. K. Verma
vs. SJH, announced on 15.2.09, we have noted as follows:

7

“From the facts of this case, it is apparent that there is a need to
streamline the administration of medical health in the hospital in
general and particularly in the Emergency Wards and Casualty
Wards where temporary doctors viz. Junior Residents and Senior
Residents, work for short periods. To ensure accountability among
these temporary doctors, proper records should be kept regarding
dates, time of duty and period of stay etc of all the doctors and
nurses.”

Again in Complaint No. CIC/WB/C/2007/00320 -Rita vs. SJH, we have
advised on 16.8.2007 as follows:

“From the above we find that there has in fact been a delay of one
week between the date when the information became due i.e.
21.6.07 and 28.6.07. This can be deemed reasonable as a result of
information having to be sought from the Admn.IV(D) Section.
However, although a sympathetic view has been taken in this view
in light of appellant Ms Rita’s application for withdrawal, CPIO
Safdarjung Hospital is cautioned to adhere more closely to time
frames mandated u/s7(1) of the Act ensuring that different Sections
within the same public authority also do the same at risk of being
held liable for penalty.”

In our decision in CIC/AD/A/09/900676, Umesh Chandra Joshi vs. SJH
announced on 5.6.09, we have directed as below:

“The Respondent Public Authority is further directed to set up a
nodal RTI Cell at a central place to receive RTI applications and to
aid and expedite the process of seeking information and alleviate
the agony of the information seekers, more so since the Public
Authority is rendering medical / health services which is aimed at
public welfare. Report of compliance of the order to reach the
Commission within a month of the receipt of this order.”

What in fact is required of the SJH, which is a premier institution for the
public health of Indian citizenry, is full compliance with sec. 4 of the RTI Act,
which implies not only efficient storage of information but ready accessibility to be
able to service such cases, as that of appellant Shri Umesh Chandra Joshi.
Medical records, which will be readily acknowledged by all, are a vital
requirement for every citizen of a country which seeks to guarantee the public

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health. Yet we were concerned to hear from the respondents themselves, as can
be seen included eminent Members of SJH’s medical staff, a sense of frustration
at the facilities extended to them, their consequent inability to modernize their
facilities. Therefore, u/s 19(8) (a) we direct that CPIO Dr. R. K. Anand, CMO
(NFSG), SJH immediately prepare recommendations for Ms. K. Sujata Rao,
Secretary (Health) to take all steps necessary to secure compliance with the
provisions of this Act, specifically sec. 4(1) (a) & (b) to enable ready access to
information whenever requested by any citizen of India, in light of the earlier
decisions of this Commission cited above. This appeal is disposed of with the
above directions.

Reserved in the hearing this decision is announced in the afternoon of this
29th day of January, 2010. Notice of this decision be given free of cost to the
parties including a copy to Ms. K. Sujata Rao, Secretary, Ministry of Health
& Family Welfare. .

(Wajahat Habibullah)
Chief Information Commissioner
29.1.2010

Authenticated true copy. Additional copies of orders shall be supplied against
application and payment of the charges, prescribed under the Act, to the CPIO
of this Commission.

(Pankaj Shreyaskar)
Joint Registrar
29.1.2010

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