Delhi

StateCommission

CC/08/191

K.C. MALHOTRA - Complainant(s)

Versus

ESCORTS HEART INSTITUTE AND RESEARCH CENTER LIMITED - Opp.Party(s)

22 Apr 2016

ORDER

IN THE STATE COMMISSION: DELHI

(Constituted under Section 9 of the Consumer Protection Act, 1986)

                                                             Date of Decision: 22.04.2016

Complaint Case No. 191/2008

In the matter of:

Shri. K.C.Malhotra

S/o Late Sh. R.L.Malhotra

R/o Flat No. D-210, New Arohi Apartments

Plot No. 13, Sector 12, Dwarka, Phase I

New Delhi-110075                                       .........Complainant

 

Versus

 

1. Chairman

Escorts Heart Institute & Research Centre Ltd.

 

2. Director

Escorts Heart Institute & Research Centre Ltd.

Okhla Road, New Delhi-110025     .......Opposite Parties

                                                                  

CORAM

 

N P KAUSHIK                         -                  Member (Judicial)

 

1.       Whether reporters of local newspaper be allowed to see the judgment?           Yes

2.       To be referred to the reporter or not?                                                       Yes

 

N P KAUSHIK – MEMBER (JUDICIAL)

 

Judgment

1.         Smt. Krishna Malhotra, wife of the complainant Sh. K.C.Malhotra had been suffering from attacks of tachycardia in the year 1970. She underwent treatment from different hospitals uptil 1999. She then went to Escorts Heart Institute and Research Centre Delhi (in short the ‘OP’) where Dr. T S Kler performed the procedure of elecro physiological study and ablation. She then used to get herself checked up once a year from the said doctor. In the year 2000, Smt. Krishna Malhotra suffered from diabetes. It could not be specifically controlled. In September 2006, complainant took his wife to OP hospital where Dr. T S Kler advised her to undergo angiography. After performing the angiography, Dr. T S Kler declared that there was a huge blockage in the artery of the heart and her kidney also suffered from malfunctioning. Complainant thereafter went to one Dr. Amarpal Singh Suri for the problem of diabetic foot. After examination, Dr. Amarpal Singh Suri found that the blood circulation in the portion above the left foot had stopped. Due to this reason, she had acute pain in the left foot.
2.         On 15.08.2006 complainant took his wife to an Imaging and Research Centre in Green Park New Delhi. C.T.Angiography of both the lower limbs was done. She was referred to Dr. Ashok Gupta, a vascular surgeon of the OP-1 hospital. Complainant accordingly went to Dr. Ashok Gupta who after examination advised that insertion of a jet in the affected lower portion of the leg would restore normal blood circulation. She was informed that the cost of entire procedure would be Rs. 1,20,000/-. Complainant contends that the said vascular surgeon Dr. Ashok Gupta lacked in confidence to perform the procedure. Dr. Ashok Gupta consulted the Director of the OP-1 hospital Dr. Naresh Trehan and Dr. T S Kler. Both these doctors were of the opinion that a bye-pass surgery would restore the blood supply to the affected portion of the left leg. Dr. Naresh Trehan with his team of doctors performed a bye-pass surgery on the patient on 06.10.2006. Patient paid an amount of Rs. 2,50,000/- for this. Contention of the complainant is that despite the aforesaid treatment and assurances given by Dr. Naresh Trehan, Dr. T S Kler and Dr. Ashok Gupta, the blood circulation to the lower portion of the left leg could not be restored. The doctors however discharged the patient on 16.10.2016. Patient could not put her left foot on the ground. She was crying in excruciating pain. After a horrible period of ten days, Smt. Krishna Malhotra was taken to the emergency ward of OP-1 hospital in an unconscious condition at about 4:00 am. She was admitted and Dr. Ashok Gupta, the vascular surgeon was informed by the staff of the emergency ward. At about 7:00 am on 25.10.2006, Dr. Ashok Gupta visited the emergency ward. Complainant was informed by the OP-1 hospital that the vascular surgery would be conducted in the operation theatre with 96% chances of success. He was informed that the cost of operation would be Rs. 1,60,000/-. Dr. Ashok Gupta being in doubt consulted Dr. Naresh Trehan and Dr. T S Kler. The patient remained in the emergency ward uptil midnight. A team of junior doctors under the guidance of Dr. Ashok Gupta gave some injections and tubes from the thigh of the patient unsuccessfully. The patient was shifted to ICU ward of OP-1 hospital in the night. Dr. Ashok Gupta asked the complainant if the amount of Rs. 1,60,000/- had been deposited. Complainant had deposited Rs. 1,00,000/-. Dr. Ashok Gupta before admitting the patient to ICCU ward took her to operation theatre situated in front of the room of Dr. Naresh Trehan. Complainant was again asked about the balance charges. He assured Dr. Ashok Gupta that the balance of Rs. 60,000/- would be deposited immediately after the operation.
3.         Next grievance of the complainant is that after shifting the patient to ICCU ward, the patient kept on rotting for a period of 22 days from 25.10.2006 to 16.11.2006. The only treatment given to the patient was dressing with some medicines and injections aimed at thinning of the blood. Strongest antibiotics were given. Patient used to regain consciousness intermittently.  She used to ask the hospital staff to give her injections for mercy killing. On enquiry by the complainant, an assurance used to be given. Complainant approached Dr. Naresh Trehan who deputed other doctors and visited the patient casually. Now Dr. Ashok Gupta started visiting the patient in ICCU ward on alternate days. Finding himself helpless, Dr. Ashok Gupta referred the patient to a homeopath named Dr. Rachna Khanna Singh in OP-1 hospital itself. She prescribed costliest medicines but no relief was forthcoming. One fine morning, Dr. Ashok Gupta declared that the patient had developed gangrene and the same was spreading fast in the whole of the body. There was a risk to her life. A choice of life or limb was given. Complainant obviously chose for life. Complainant was informed that amputation of the left leg upto thigh would be done by the Surgeon Dr. Colonel Harsharan Singh of OP-1 hospital. Complainant met Dr. Naresh Trehan who informed him that there was no alternative except to amputate the left leg upto thigh. Dr. Colonel Hasharan Singh amputated the left leg below thigh on 06.11.2006 in the operation theatre. Dr. Colonel Harsharan Singh used to bandage and dress the patient. He also assured that the patient would lead a normal life wearing normal clothes even after amputation.
4.         Complainant visited Dr. Colonel Hasharan Singh for one year. He used to charge exhorbitantly besides the fee being paid to OP-1 hospital. Even after a lapse of two years, she suffered from phantom sensation.
5.         Complainant submitted that his wife Smt. Krishna Malhotra became completely handicapped even with the artificial limb as the veins from the right leg had been removed for bye-pass surgery. Even the right leg became non-functional for bearing the load of the whole body. On the basis of these facts, the complainant claimed compensation to the tune of Rs. 75,00,000/- alongwith interest @ 18% p.a. Legal expenses to the tune of Rs. 50,000/- were also prayed for. Complaint was filed on 21.08.2008. During the pendency of the complaint, Smt. Krishna Malhotra died on 20.09.2010.
6.         In their written version OP-1 hospital and its Director (OP-2) raised an objection that after the death of Smt. Krishna Malhotra, the complaint was not maintainable. A claim for unliquidated damages for any tortious liability is a mere right to sue which cannot be transferred. The legal objection shall be dealt with later.
7.         OPs admitted that Smt. Krishna Malhotra was first admitted to their hospital on 11.10.1999. She was hypertensive, non-diabetic with no family history of Ischemic heart disease. She was a case of PSVT (Paroxysmal Supraventrical Tachycardia). Patient was admitted with c/o chest discomfort during episodes of palpitation for last 6 months. She was admitted for CART (Coronary Arteriography) and EP (Electrophysiological) study. CART was done on 12^th October 1999 which revealed: Right Coronary Artery-100%, Proximal Stenosis, Left Anterior descending-70% proximal stenosis, Left Circumflex-70% proximal stenosis 40% Mid Stenosis 30% Osteal stenosis. 1^st obtuse-60% proximal stenosis. She was diagnosed as a case of Triple Vessel Disease and was recommended Myocardial Revascularisation.
8.         The OP further submitted that the patient underwent EP study and RF ablation (Radiofrequency ablation) on 14^th October 1999 done by Dr. T S Kler. She was discharged on 14.10.1999 in a stable condition.
9.         OPs submitted that the patient was again admitted on 11.09.2006. She was hypertensive, diabetic and had peripheral vascular disease and c/o pain in the left foot which had increased since the last one month. She was advised admission for Coronary Angiography. Coronary Angiography was conducted on 11.09.2006 which revealed RCA-100% proximal segment stenosis, LAD-60% proximal segment stenosis, 70% mid segment stenosis, LCX-90% proximal segment stenosis. She was diagnosed as a case of Triple Vessel Diseases and Peripheral Vascular Disease.
10.  Contention of the OPs is that the patient was advised CABG+Peripheral Vascular Surgery & Renal Angiography. She was discharged on 12.09.2006. She was re-admitted on 27.09.2006. She presented with c/o pain in left lower limb with numbness, tingling for last 4 months. In between the patient had been admitted at Fortis, Vasant Kunj on 20^th September 2006 for UTI. She was stabilised on medical treatment. CT Angiography of both lower limbs carried out on 15^th September 2006 at Focus Imaging & Research Centre Ltd, revealed diffuse atherosclerotic vascular disease. She was admitted to OP hospital for further management. She was diagnosed as a case of Triple Vessel Disease and peripheral vascular disease & diabetes.
11.  OPs further submitted that the patient was evaluated & investigated. Diabetologist was consulted for her diabetic state and she was put on treatment as advised. Dr. Ashok Gupta, Vascular Surgeon, was consulted for peripheral vascular disease who advised CABG followed by Left Limb Vascularisation for her Peripheral Vascular Disease.
12.  Next contention of the OPs is that the patient thereafter was referred to Dr. Naresh Trehan a Cardiac Surgeon who carried out CABG on 06.10.2006. She was discharged on 16.10.2006 in a stable condition. OPs admitted that the patient was readmitted to their emergency ward on 25.10.2006 with c/o pain and discoloration of left foot. CT Angio Thorax (Aorta) and peripheral was carried out which revealed generalized atherosclerosis. She was seen by Dr. Ashok Gupta who discussed the case with Dr. Naresh Trehan. Risk involved in left femoral popliteal artery bye-pass was explained to the relatives.
13. Next submission of the OPs is that after informed consent, left femoral and popliteal artery exploration was carried out on 26^th October 2006. An attempt was made to revascularise the left lower limb but the vessel was found to be severely diseased, calcified, and totally unsuitable for bye-pass grafting and thus the procedure was abandoned and wound closed.
14. OPs further submitted that the findings of the surgery and the unsuitability of the vessels for bye-pass was fully explained to the relatives by  Dr. Ashok Gupta and also the risk of developing gangrene was informed.
15. Contention of the OPs is that a definitive amputation of the left lower limb was done to prevent the spread of infection and the risk to the life of the patient. All efforts were made to psychologically support the patient and rehabilitate the patient with active physiotherapy.
16. In their defence OPs have also relied upon the opinion of the expert committee who opined that the patient was treated as per standard protocol.
17.  We have heard the arguments addressed by the Ld. Counsel for the complainant Sh. R.L.Nanda Advocate and Ld.  Counsel for the OP Sh. Sajad Sultan Advocate.
18. Before proceeding further, it may be mentioned here that the parties have not referred to the treatment given to the patient in October 1999 which related to the EP Study and RF ablation. It is not the case of the parties that the said treatment had any relationship with the treatment given to the patient on 11.09.2006 and thereafter. I, therefore, do not dwell further on the said treatment given in October 1999.
19. On an application moved by the OPs, this Commission invited experts opinion from Maulana Azad Medical College and Hospital New Delhi. The said opinion is reproduced below:

“Expert opinion regarding complaint case No. C-08/191 Titled K.C.Malhotra Vs Escort Heart Institute.

After scrutinizing the record, please find our point wise reply to points of reference

1. In a 69 years old female, diabetic, hypertensive patient with significant coronary artery disease in a patient with peripheral vascular disease, a preoperative Coronary revascularization with Coronary artery bypass grafting (CABG) or percutaneous coronary intervention is class I indication (.ACC/AHA2004 guidelines update for CABG).
2. Conservative management of a patient with peripheral vascular disease while the patient is waiting for revascularisation include treatment of risk factors like, diabetics, hypertension, high cholesterol and medical therapy with drugs like Cilastazol, Pentoxifylline etc.
3. The outcome of revascularization procedure is affected by anatomic and clinical factors. The quality of the distal vessels, length of the treated segment/bypass, and number of levels of disease treated (aortoiliac femoral, tibial) influence outcomes. Patient specific factors such as persistent smoking, diabetes mellitus, renal dysfunction and cardiac dysfunction negatively affect outcomes.
4. The complications associated with peripheral vascular disease include, limb loss (due to disease and due to amputation), associated coronary artery disease and its related morbidity and mortality, Renal artery disease with its related renal dysfunction and cerebrovascular disease.
5. Medical therapy has an ancillary role in patients undergoing amputation for PVD with gangrene and unsuitable anatomy for revascularization. This includes treatment of risk factors like diabetes mellitus, hypertension, high cholesterol levels as well as treatment of co-existing coronary artery disease.
6. Optional medical therapy for PVD with gangrene includes treatment of risk factors like diabetes mellitus, hypertension, high cholesterol levels as well as treatment of co-existing coronary artery disease. Medical therapy also include medications like cilastazol and pentoxylline.
7. As per document the document available the patient was treated and as per the standard protocol.

 

20. Despite relying upon the expert’s opinion, the OPs have relied upon the article written by a few doctors of Cleveland Clinic Foundation, Department of Vascular Surgery and Department of Peripheral Vascular Disease, Cleveland, Ohio. The article was given for publication for 03.06.1983. This relates to a coronary angiography performed on 1000 patients (mean age, 64 years). They were under consideration for elective peripheral vascular reconstruction. Patients found to have severe surgically correctable coronary artery disease were advised to undergo myocardial revascularisation (CABG). 381 patients in the sample of 1000 patients were suffering from lower extremity ischemia. Article runs into more than ten pages. ‘Discussion’ given at the end of the article is relevant in the present context. The same is reproduced below:
    •  

Since preliminary results of this study were presented in 1979,²² the use of routine coronary angiography in the evaluation of patients under consideration for peripheral vascular reconstruction has generated considerable controversy. The issue of whether it is reasonable to investigate and correct associated CAD which may adversely influence late survival as well as postoperative mortality has been addressed in previous publications and discussions,^1,22 The authors are convinced that it is. The present report of 1000 patients is an attempt to classify the incidence of severe CAD so that coronary angiography may be employed selectively in the future.

The results of this investigation indicate that approximately 30% of all patients scheduled for aortic aneurysm resection, lower extremity revascularization, or extracranial reconstruction have severe CAD which warrants myocardial revascularization or already is inoperable. Severe CAD is concentrated among patients with conventional criteria for ischemic heart disease that may be detected without sophisticated equipment at any hospital.”
 

21.  Now question arises whether the OP hospital treated the patient Smt. Krishna Malhotra as per standard protocol. Patient Smt. Krishna Malhotra was first admitted to OP hospital on 11.09.2006 for the purpose of coronary angiography. She was discharged on 12.09.2006. The discharge summary prepared on 12.09.2006 under the consultant incharge Dr. T S Kler is exhibit PW1/4 which shows that the patient was diagnosed for following diseases:
22. 1. Hypertension
    2. Type 2 Diabetes Mellitus
    3. Coronary Artery Disease
    4. Peripheral Vascular Disease

Advice

1. CABG + Peripheral Vascular Surgery & Renal Angioplasty”.

22. Admittedly the patient had presented with complaint of pain in the left lower limb with numbness and tingling on 11.09.2006. After coronary angiography was done on 12.09.2006, she was diagnosed as a case of Triple Vessel Disease and Peripheral Vascular Disease. Admittedly OPs performed CABG on the patient for removal of any blockage in the heart with a view to avoid any risk of heart attack during the procedure on the lower limbs. For this purpose, OPs have relied upon the above referred medical literature exhibited as exhibit RW1/3.
23. Patient was again admitted to the OP hospital on 27.09.2006. Heart bye-pass surgery (CABG) was performed on her on 06.10.2006. She was discharged on 16.10.2006. Discharge summary, exhibit RW1/4 shows the procedure done as under:

 “Procedure:

Coronary Angiography: Done on 12.09.2006 – Report to be collected from RC Building, (Room No) – 37.”

24.  Admittedly no procedure relating to peripheral vascular surgery or renal angioplasty was done before discharging the patient on 16.10.2006. Perusal of the discharge summary dated 16.10.2006 which runs into seven pages shows that the patient has nowhere been advised to report for the treatment of peripheral vascular surgery or renal angioplasty, thereafter. The patient was advised rest for three months. It contradicts the stand of the OP hospital that the CABG was done only to avoid the risk of heart attack during the procedure of revascularisation of the lower limbs. Peripheral vascular surgery was neither performed nor advised while discharging the patient on 16.10.2006. The patient remained in excruciating pain at her home from 16.10.2006 to 25.10.2006. She was brought to the OP hospital at 04:00 a.m. on 25.10.2006 when she was admitted. Contention of the complainant is that on 25.10.2006 at about 07:00 a.m., vascular surgeon Sh. Ashok Gupta visited the emergency ward and informed that there were 96% chances of success in vascular surgery of lower limb. Vascular surgery of the lower limb was attempted on 26.10.2006 itself. Finding the blood vessels severely diseased, calcified and totally unsuitable for bye-pass, grafting of the blood vessels of the left leg was abandoned. Contention of the OP hospital is that the risk of developing gangrene was explained to the relatives. Be that as it may, the patient was referred to the surgeon on 03.11.2006. On the contrary, the case of the complainant is that the patient was referred to a homeopath Dr. Rachna Singh sitting in another building in the same OP hospital who prescribed medicines as per documents exhibited as exhibit PW1/7. Exhibit PW1/7 is dated 30.10.2006. In a diagram it shows a portion of the leg near the ankle as gangrenous. There was a discoloration of the said portion. The prescription slip exhibited as exhibit PW1/7 shows her examination by the homeopath on 03.11.2006, 06.11.2006, 10.11.2006, 13.11.2006 and 15.11.2006. Admittedly the amputation of the left leg of the patient upto thigh was done on 06.11.2006 by Dr. Colonel Harsharan Singh General Surgeon of OP hospital.
25.  Before proceeding further, let us have a look at the health condition of the heart of the patient at the time of her discharge on 16.10.2006 and also at the time of her discharge on 16.11.2006. Discharge summary exhibited as exhibit RW1/4 relating to the discharge on 16.10.2006 shows the ejection fraction as ‘0.60’ under the heading ‘investigation’. The relevant portion reads as under:
26.  

2D Echo Doppler Colour : 28/09/2006. RWMA. EF 0.60. Normal cardiac chamber dimension. No significant MR/TR. DRA (A>E). No clot/vegetation/PE.

On the contrary, same investigation conducted on 25.10.2006 shows Akinetic basal mid inferior wall. Ejection fraction is now reduced to 0.40. The relevant part of the report is reproduced below:

“2D ECHO DOPPLER COLOUR : 25/10/2006 Akinetic basal inferior wall. Mid IVS. LVEF 0.40. Normal Cardiac Chamber Dimension. DRA E<A. Trace TR PASP 30 mmHg. No MR. No. I/C clot/veg/PE.

 

After the bye-pass surgery of the heart, there should have been a better blood supply to the heart resulting into a better health condition. Shockingly, basal mid inferior wall is almost dead. In other words, the muscles at the said place of the heart have become non functional. Ejection fraction has dropped from 0.60 to 0.40. What has happened to the heart in a span of one month and that too after heart bye-pass surgery? Claim of the OP hospital is that the bye-pass surgery would improve vascularisation of the heart and avoid any heart attack. The heart has now become weaker than before.

26. The basic question as referred to above is whether bye-pass surgery itself was a treatment for symptoms of numbness and pain in the lower portion of the left leg. OP hospital itself has taken a stand that the bye-pass surgery was conducted only to avoid the risk of heart attack during peripheral vascular surgery. Did the OP hospital conduct any procedure relating to peripheral vascular surgery before discharging the patient on 16.10.2006? The answer is in the negative. Did it advise the patient to report back after certain time so as to undergo procedure for vascularisation of the leg? Answer is again in the negative. In other words, OP hospital did not treat the patient for the actual disease of peripheral vascular surgery till 25.10.2006 when she came back in excruciating pain. No attempt was made for peripheral vascular surgery during the period of her admission till 16.10.2006. Patient had approached the hospital without any symptoms relating to the heart disease. Assuming that there was a blockage in the artery of the heart, tests like stress thalium, stress echo were not conducted to rule out the possibility of normal or near normal blood supply to the muscles of the heart.
27. Now coming to the research paper relied upon by the OP hospital, it may be mentioned here that the same relates to the year 1983. It was simply submitted for publication on 30.06.1983. This paper is a research conducted on 1000 samples. Author of the paper is of the view that in certain cases of peripheral vascular disease CABG is beneficial when it precedes the peripheral vascularisation. In any case it is not a conclusive finding and accepted in medical jurisprudence worldwide. It has also not found any place in the medical text books. A lot of water has flown down the Ganges since 1983. Innumerable researches might have been conducted on this subject in this span of 42 years. No material has been placed on record in respect of the said principle if adopted by the medical world.
28. OP hospital in its pleadings or the affidavit, has remained silent on the allegations of referring the patient to the homeopath Dr. Rachna Singh. It has also not challenged the document exhibit PW1/7, a prescription slip in the handwriting of Dr. Rachna Singh relied upon by the complainant. Document has remained uncontroverted. It leads to an inference that the patient was treated by the homeopath Dr. Rachna Singh as well. Dr. Rachna Singh on the first date observed gangrene in the lower portion of the leg. Dr. Ashok Gupta did not record any observation relating to said gangrene. Was he oblivious of the fact or deliberately concealed the disease? Why did Dr. Ashok Gupta after consultation with OP-2 Dr. Naresh Trehan notcontinue with treatment on the basis of their knowledge and skill gained in the allopathy system of medicine? The patient never wanted the OP hospital to treat her by way of homeopathic system of medicine. Factum of concealment of the treatment by homeopath Dr. Rachna Singh itself casts doubts on the bonafides of the OP hospital.
29. Exhibit RW1/8 are the ‘progress notes’ filed by the OP hospital. These pertain to only two dates i.e. 26.10.2006 and 06.11.2006. The date 26.10.2006 is re-written as 27.10.2006. Be that as it may, it shows no investigation or procedure conducted on the patient between 27.10.2006 and 06.11.2006. Why the OP hospital kept the patient in its hospital without specific treatment? Peripheral vascularisation having failed, the OP hospital could have planned amputation immediately after it noticed the onset of gangrene. It was first noticed on the lower part of the leg. Amputation upto that level could have avoided amputation of the leg upto the level of thigh.
30. Objection raised by the OP that on the death of Smt. Krishna Malhotra, the complaint was not maintainable (referred to above), is devoid of merits. Consumer Protection Act 1986 in its section 2(1)(b) provides the definition of the ‘complainant’ as under:

“     “Complainant” means-

1. a consumer; or
2. any voluntary consumer association registered under the Companies Act, 1956 (1 of 1956) or under any other law for the time being in force; or
3. the Central Government or any State Government; or

          ¹[(iv)       one or more consumers, where there are numerous

   consumers having the same interest;]

          ²[(v)       in case of death of a consumer, his legal heir or 

            representative;] who or which makes a complaint.   ”

 

Clause (V) above shows that in case of death of a consumer, his LRs are competent to file the complaint. Present complaint is filed by the husband of the deceased Smt. Krishna Malhotra. Clearly, the same is maintainable in the eyes of law.

 

31. In view of the discussion above, I am of the considered opinion that the OP hospital is guilty of ‘unfair trade practice’ in not treating the patient for the actual disease of peripheral vascular uptil 16.10.2006. Even on subsequent admission on 25.10.2006, the doctors have shown a great laxity when procedure of peripheral vascularisation failed. A prolonged period of non treatment led to spread of gangrene and consequent amputation of the leg upto thigh. It is, therefore, also a clear case of medical negligence and explained by the principle of ‘res ipsa loquitor’. I, therefore, direct the OP hospital to pay to the complainant as under:
    1. an amount of Rs. 20,00,000/- towards compensation alongwith interest @ 12% p.a. w.e.f. the date of filing of the complaint i.e. 22.08.2008.
    2. to deposit an amount of Rs. 75,00,000/- in the Consumer Welfare Fund of the State maintained by this Commission within a period of sixty days from today for doing unwanted treatment on the patients who are not easily identifiable by this Commission.
    3. to pay an amount of Rs. 50,000/- as litigation charges.

 

Complaint is disposed of accordingly.

 

32. Copy of the orders be made available to the parties free of costs as per rules and thereafter the file be consigned to Record Room.

 

(N P KAUSHIK)
MEMBER (JUDICIAL