Duty Of State Is To Save Lives Of Those Infected With Covid, Non-Availability Of ICU, Ventilators Cannot Be A Reason For Denying Admission: Bombay HC In Suo Motu Case[Read Order]

The Bombay High Court on Thursday took suo motu cognizance of issues faced by the general public due to non-availability of ventilators and oxygenated beds for Coronavirus patients with moderate and severe conditions in order to reduce the death rate in Nagpur.

Division bench of Justice RK Deshpande and Justice PV Ganediwala of the Nagpur bench at the outset observed-

"The main issue which requires our immediate attention is making the ventilators and oxygenated beds available to the patients of moderate and severe conditions so as to reduce the death rate. The people are required to travel from one Hospital to another with serious patients and for want of accommodation, the newspaper report shows that the deaths are occurring. We must note with regret that for want of medical aid, the people are falling prey to Coronavirus. We, therefore, thought that without going into the legal niceties, an immediate arrangement can be worked out to reduce the death rate. Hence, we try to work out the solution."

Court noted that it is not the case of the Municipal Commissioner, Nagpur; the Collector, Nagpur, the Deans of GMCH and IGGMC, Nagpur that the infrastructural facilities namely, ICU, Ventilator beds or oxygenated beds are not available. The bench said-

"Of course, this cannot be the reason for the State and it is the duty of the State to make all such infrastructural and medical facilities available to save the life of people who are affected or likely to be affected by Coronavirus.

The problem of non-availability of the medical and para-medical staff can also not be a problem to deny the admission in the Hospital to the patients. Even private Doctors are under obligation to provide the treatment. The preservation of human life is of paramount importance. Once life is lost, it cannot be restored. Every Doctor whether he is in Government or Semi-Government Hospitals or private professional is under obligation to extend his services with due expertise for protecting life. Even private Doctors cannot refuse to render their services during pandemic in all such Hospitals where they are called or their services are needed."

Dr. Archana Kothari, the President of Indian Medical Association and Dr. Anup Marar, the Director of Orange City Hospital and Convenor of Hospitals Association voluntarily joined the Court in this matter on their own, showing willingness to tackle the problem. However, they expressed the difficulties of the Doctors who are 65 years of age and above or are suffering from co-morbidities to take responsibility for providing treatment by personally attending the patients in various Hospitals or Dedicated Covid Health Centres (DCHCs).

Court noted that there is a classification of patients in different categories – broadly, it is in three categories of mild, moderate and severe. These are further classified as asymptomatic positive patient, symptomatic patient without co-morbidity, symptomatic patient with co-morbidity, symptomatic patient with pneumonia without hypoxia, symptomatic patient with pneumonia with hypoxia and symptomatic patient with pneumonia with hypoxia with sepsis/shock/organ failure.

The affidavit filed by the Dean, Government Medical College, states that there is a set treatment which is provided to different categories of patients of Coronavirus with such variations to be made by the consulting Doctors keeping in view the specific issue relating to the patients.

The bench suggested that Doctors above 65 years may provide guidance through Whatsapp -

"So far as Doctors of 65 years of age and onwards with co-morbidities, it may be possible, keeping in view the experience which they possessed in the profession, to provide guidance in respect of investigation and treatment to be administered to a particular patient through various means of communication like personal contact on cell phone, sending of reports through WhatsApp in pdf or looking the condition of the patient through Video Call and also conducting the conference. We have seen and experienced also that the Doctors who are infected with Covid-19, are managing and administering the patients in the Hospitals while they are in home isolation. It does not seem to be a difficult task to manage the patient by the Doctors."

Court also suggested that the services of the Ayush Doctors or PG students or students in Super Speciality can be utilized and they can work under the guidance and instructions from the senior Doctors through various communication system.

Court was assured by Dr.Archana Kothari, the President, IMA and Dr. Anup Marar, the Convenor of Private Hospital Association, that within a day they shall provide a list of private Doctors in different age groups, who can provide their services either by personally attending the patients or through various communication systems.

Moreover, the Collector, Nagpur, has in exercise of its statutory powers constituted a Task Force consisting of a team of 12 Doctors. Thus the Court said that upon receipt of a list from the IMA and Hospitals Association, the Municipal Commissioner shall in consultation with the Task Force assign the duties and responsibilities to the Doctors in various Hospitals and DCHCs to take the responsibility of treating the patients.

"This shall be done within a period of 24 hours upon receipt of the list by the Municipal Commissioner who shall communicate the duties and responsibilities along with the Centres and Hospitals to the concerned Doctors from the list.

We expect all the Doctors and para-medical staff assigned with the duties and the place of work shall discharge their obligation with promptitude and that this Court does not receive any complaint in respect of "no response" from any such member."

Finally, the bench observed-

"We do not want a situation to occur where the patients are required to travel from one Hospital to another to secure the position in ICU, ventilated beds or oxygenated beds or due to non-availability of the services of medical and paramedical staff. If any patient requires medical assistance and approaches any Hospital or DCHC where such facility is not available for any reason whatsoever, such Hospitals or DCHCs should immediately make necessary enquiries and help the patient to reach the proper destination. It shall be the duty of the Municipal Commissioner and the Task Force to see that all the Hospitals and DCHCs should provide the information and contact numbers of the Hospitals where such facilities can be easily made available and the patients are not required to travel from pillar to post.

We make it clear that there should be no prohibition for the patients of COVID-19 to have consultation with the Doctor of their choice who can visit and examine the patient anywhere in any Hospital or DCHC and advice investigation and medication. This will reduce the responsibilities of others."

The matter will now be heard on September 15 at 10:30 am.

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