AMIT ARORA vs DIRECTORATE OF ENFORCEMENT
$~
* IN THE HIGH COURT OF DELHI AT NEW DELHI
% Reserved on: 30.04.2024
Pronounced on: 06.05.2024
+ BAIL APPLN. 2727/2023
AMIT ARORA ….. Petitioner
Through: Mr. Vikas Pahwa, Senior Advocate with Mr. Prabhav Ralli, Ms. Nimisha Jain, Mr. Aditya Shukla and Mr. Kushal Gupta, Advocates.
versus
DIRECTORATE OF ENFORCEMENT ….. Respondent
Through: Mr. Zoheb Hossain, Special Counsel for ED with Mr. Vivek Gurnani, Advocate.
CORAM:
HON’BLE MS. JUSTICE SWARANA KANTA SHARMA
JUDGMENT
SWARANA KANTA SHARMA, J.
CRL.M.A. 9533/2024
1. The instant application under Section 482 of the Code of Criminal Procedure, 1973 (Cr.P.C.) has been filed on behalf of petitioner seeking appropriate directions in view of his deteriorating medical health conditions, thereby praying that he may be shifted to Arihant Hospital, Sector-52, Gurugram, Haryana, from RML Hospital, Delhi for a period of six weeks.
2. The case set out by the petitioner is that he is suffering from serious and life threatening medical conditions including but not limited to Compensated Chronic Liver Disease (CLD) (Cirrhosis), Diabetic Kidney Disease (DKD), Chronic Stable Angina (CAD), Diabetic Peripheral Neuropathy, Grade 3 Fatty Liver, Advanced Metabolic Syndrome, Very Severe Obstructive Sleep Apnea, PIVD, CIVD (Cervical Spondylitis), Grade 3 Hypertension, Complicated 4 Diabetes. It is stated that the petitioner was admitted to Medharbour Hospital, Gurugram, Haryana, on 30.05.2023, on account of his severe deteriorating health condition during his time in custody, as the Medical facility in Tihar Jail was unable to adequately manage his severe condition. The petitioner had undergone several medical examinations during the time he was admitted at Medharbour Hospital. He was advised to undergo bariatric surgery to be performed as Life Saving Surgery on account of his morbid obesity which was performed on an urgent basis on 18.08.2023. Following his surgery, the petitioner had remained admitted in Fortis Hospital for post-operative care until 31.08.2023. Thereafter, vide order dated 31.08.2023, the learned Trial Court had ordered his immediate discharge from the Hospital, and he was thus, sent back to judicial custody. Thereafter, the petitioner had preferred interim bail application before this Court and vide order dated 06.09.2023, this Court had allowed him to be hospitalized in RML Hospital, Delhi where he remains admitted till date.
3. Learned Senior Counsel appearing on behalf of the petitioner submits that the petitioner is constrained to approach this Court in view of his worsened medical condition despite him remaining continuously admitted in RML Hospital. It is stated on behalf of petitioner that he needs urgent medical attention due to recurrent vomiting, abdominal pain, nausea, and altered urine output, the petitioner’s condition has not shown any improvement even after more than 200 days of hospitalization. In fact, there has been a serious deterioration in the petitioner’s condition and continuous vomiting episodes have now increased to a range of 10-12 times a day as on date, as can be seen from the nursing record of the Hospital. It is submitted that the petitioner is currently receiving constant intravenous (IV) injectables, administered thrice daily to control recurrent vomiting episodes, despite which there are about 10-12 vomiting episodes per day. It is further stated that the petitioner had experienced two seizure episodes/psychogenic nonepileptic seizures (PNES) at RML Hospital on 22.11.2023 and 18.02.2024. It is also pointed out that petitioner is a diagnosed case of Grade 3 Hypertension, characterized by refractory and resistant hypertension and further has a history of multiple abnormal ECG results. It is further submitted by learned Senior Counsel that MRI of the petitioners brain had revealed the presence of small vessel ischemic disease. Further, it is submitted that in addition to elevated blood sugar levels, the petitioner has experienced 5-6 episodes of low blood sugar/hypoglycaemia attacks also. It is further argued that since undergoing bariatric surgery on 18.08.2023, the petitioner has been confined to a liquid diet regimen i.e. milk, soup and tea, but the continuous requirement of a liquid diet for more than 200 days raises questions about the progression of his recovery. It is further argued on behalf of petitioner that he was advised by his treating doctors, prior to his hospitalization in RML Hospital, to undergo several medical examinations/treatment, however, the same have either not been done at all or not been done effectively and properly at RML Hospital even after more than 200 days of hospitalization. It is argued that the RML Hospital handles an extensive patient load and faces significant challenges in providing individualized and specialized care to each patient and the medical examination facilities at the hospital are consistently pre-booked way in advance, often leading to delays in accessing necessary and urgent diagnostic tests. Learned Senior Counsel also argued that the other co-accused persons in the same ECIR, with similar or less serious medical issues, have been permitted by this Court and the learned Trial Court to seek medical examination and treatment at hospitals, with the doctors of their choice. Therefore, it is prayed that the petitioner be admitted at Arihant Hospital, Sector 52, Gurugram, a specialized palliative care facility which focuses on post-surgery rehabilitation.
4. Learned Special Counsel appearing on behalf of the Directorate of Enforcement, on the other hand, argues that the present application is bereft of any merit since the medical condition of the petitioner is stable and he has been given proper and adequate medical treatment in RML Hospital over a period of several months. It is argued that as per the report of Medical Board constituted at RML Hospital, Delhi, the medical condition of the petitioner is clinically stable, and he can be discharged from the hospital and managed in judicial custody in Tihar Jail, and in case of any complaint, he can be referred to bariatric surgery department, AIIMS, Delhi. It is further submitted that the petitioner has been out of jail for more than 300 days now, and there is no further requirement of his hospitalization even in custody. Therefore, it is prayed that the present application be dismissed.
5. This Court has heard arguments addressed by learned Senior Counsel for the petitioner and learned Special Counsel for the Directorate of Enforcement, and has perused the material placed on record.
6. In the present case, a perusal of record reveals that the petitioner has remained in the remand of ED and in jail due to his judicial custody for a period of about 115 days, on interim bail for a period of about 72 days, remained admitted in a private hospital in judicial custody for a period of 93 days, and has been admitted in the RML Hospital, New Delhi where he remains under judicial custody for a period of about 240 days approximately i.e. since 07.09.2023.
7. Vide order dated 24.01.2024, this Court had called for a specific medical status report regarding the medical condition of the petitioner, since it was contended on behalf of the petitioner that the petitioner had been continuously vomiting 7-8 times a day. The relevant portion of the order reads as under:
1. This Court is in receipt of medical Status Report dated 15.01.2024
2. Learned Senior Counsel for the applicant vehemently argues that though the medical report states that the medical condition of the applicant is satisfactory, it is far from being so. He states that the applicant is continuously vomiting 7-8 times a day and a report in this regard may be called from the hospital.
3. In view of the submissions made before this Court, let a specific medical Status Report be submitted to this Court regarding the present medical status of the applicant.
8. The report, as called for, has been received from RML Hospital, which reflects that a board of four doctors from department of endocrinology, nephrology, gastroenterology and medicine, has reviewed the medical condition of the petitioner on 18.04.2024, and thereafter, has opined as under:
The patient diagnosed as a case of T2DM, HTN, CLD and PIVD with history of bariatric surgery (Laparoscopic Sleeve Gastrectomy on 18.08.2023).
He is clinically stable. He is having occasional vomiting, managed with oral medications. He is undergoing physiotherapy treatment for cervical and knee joint pain.
He can be discharged from our side and managed in judicial custody in Tihar Jail. In case of any complaint he can be referred to bariatric surgery unit, department of Surgery, AIIMS, New Delhi.
9. Learned counsel appearing on behalf of the respondent, while relying upon this report, has prayed that the petitioner be sent back to Tihar Jail, where he can be provided with the necessary treatment. Conversely, the learned Senior Counsel for the petitioner has argued that he has not been receiving adequate treatment in RML Hospital and therefore, he be shifted to a private hospital, even if in custody, for proper treatment.
10. As per opinion of the Medical Board at RML Hospital which has been extracted above, the petitioner is clinically stable. Though he is having incidents of vomiting occasionally, the same is being managed with oral medications. Further, he is being provided physiotherapy for cervical and knee joint pain. However, the medical board has clearly opined that the petitioner can be discharged from the Hospital since his medical condition can be managed in judicial custody in Tihar Jail. The Board has further opined that in case there is any complaint by the petitioner, he can be referred to the bariatric surgery unit at AIIMS, New Delhi.
11. At this stage, the opinion of Medical Board at RML Hospital is categorical, that the petitioner can be managed well within the Tihar Jail. Also, there is no surgical intervention of any sort which is required at this stage. During the course of arguments, it had been repeatedly argued on behalf of the petitioner that he had been vomiting continuously; however, the medical status report referred hereinabove mentions that the same can be managed through oral medications.
12. It was also contended on behalf of the petitioner that the reports submitted by the RML Hospital are far from reality and the petitioner in fact has not received proper treatment so far and his condition has worsened. In this Courts opinion, the said argument would primarily mean casting aspersions on the medical examination of the petitioner conducted and the reports prepared by the Medical Board, comprising of senior doctors, at RML Hospital. This Court would only reject such an argument, especially in face of repeated medical reports submitted to this Court by RML Hospital, including reports dated 01.01.2024, 15.01.2024, 29.01.2024, 15.02.2024, 04.03.2024 and 18.04.2024, which mention that the condition of the petitioner is stable and he can be discharged from the Hospital and can be managed well in Tihar Jail. These reports further opine that in case of any need of hospitalization or any other treatment required, he can be taken to AIIMS, New Delhi. RML Hospital has been one of the premier Government Hospitals in Delhi, and this Court would not venture into casting doubt on their reports or suggest they have been manipulated.
13. Moreover, the petitioner herein has remained admitted in private as well as government hospitals, in custody, for about 330 days now. Though the petitioner is deemed to be in custody even while being admitted in hospital, he however has been out of actual judicial custody i.e. prison throughout this time. During this entire period of time, he has also had the benefit of meeting his family members since one of the conditions imposed by this Court while allowing him to be admitted in Hospital, in custody, was that his wife and children could meet him in hospital on a daily basis.
14. Therefore, in these circumstances, and taking into account the medical reports submitted by RML Hospital, this Court directs that the petitioner be sent back to Tihar Jail.
15. Needless to say, the jail authorities shall be obliged to ensure that the petitioner is afforded the required medical support including medications, tests, etc. The Jail authorities shall also resort to the Jail Referral Policy i.e. taking the petitioner on OPD basis to Hospitals, whenever such need arises.
16. However, in the meanwhile, considering the fact that the petitioner has claimed that he is suffering from several serious and life threatening medical conditions which have been mentioned in the present application, which this Court cannot comment upon since this Court is not an expert in the medical field, it is directed that a Medical Board be constituted at AIIMS, New Delhi, which shall examine the petitioner, including but not limited to the medical conditions flagged by the petitioner in the present application, and the Board shall prepare a detailed report inter alia including as to whether the petitioners health and medical conditions can be managed in the jail premises or whether he needs hospitalization. The petitioner shall be examined by such Medical Board at AIIMS within a period of two weeks from today, and the report shall be placed before this Court within a week thereafter by the Hospital. Copy of the report shall also be furnished to the petitioner and his counsel. The petitioner shall be at liberty to move an appropriate application seeking relief, if any qua his medical condition, thereafter.
17. Accordingly, the present application i.e. CRL.M.A. 9533/2024 stands disposed of in above terms.
18. Copy of this order be communicated to the Jail Superintendent concerned forthwith.
19. The judgment be uploaded on the website forthwith.
SWARANA KANTA SHARMA, J
MAY 6, 2024/zp
BAIL APPLN. 2727/2023 Page 1 of 9