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IN THE COURT OF JAGDEEP JAIN,SPECIAL Jude, CBI COURT, CHANDIGARH.
CORRUPTION CASE NO:26COMPUTER I.D. NO:36014R0034262006DATE OF INSTITUTION:02.03.2006DATE OF DECISION:02.03.2009
Central Bureau of Investigation
Versus
1. Dr. R.S.Dhaliwal, son of Joginder Singh Dhaliwal, resident of House No.58, Sector 24-A, Chandigarh.
2. Sat Pal Singla, son of Hari Ram, resident of House No.15, Sector 11-A, Chandigarh.
.....Accused
FIR No.RC No. 18 (A) 03 dated 29.5.2003, (Chargesheet No.II) Under Sections 120-B, 420, 467, 468 and 471 of the Indian Penal Code and under Section 13 (1) (d) of the Prevention of Corruption Act,1988. P.S. CBI,SPE, Chandigarh.
Present:Shri R.L. Negi,Senior Public Prosecutor for C.B.I.Accused R.S.Dhaliwal on bail being assisted by Shri Matwinder Singh, Advocate.
Accused Sat Pal Singla on bail being assisted by Shri Vinod Arya, Advocate
1
J U D G M E N T:
Post Graduate Institute of Medical
Educational Research, Chandigarh (for short the
P.G.I.) is a premier institute. It has a
department of Cardio Vascular & Thoracic Surgery
(for short CVTS) which deals with open heart,
closed heart, lung and related surgeries. Open
Heart Surgery can be performed only by a doctor
of the rank Associated Professor or above. He is
assisted by Senior Resident doctor along with
Anesthesia and Nursing Staff.
2. Dr. R.S.Dhaliwal the accused named above
joined the CVTS department in 1976. He became
head of the department in 1998.
3. In the year 2001, the CBI registered a
preliminary inquiry on receiving information that
Dr.R.S.Dhaliwal in criminal conspiracy with a
private person Surinder Singh Uppal had been
dishonestly referring a number of patients
requiring open heart surgery to the latter for
the purchase of artificial heart valves and the
latter had been supplying valves at exorbitant
rates and sharing profits with Dr.R.S.Dhaliwal in
2
the ratio of around 70:30. It was also suspected
that M/s. Paul Medical Hall, Chandigarh and M/s.
Northern Remedies, Chandigarh had also been
supplying artificial heart valves and other
material in the like manner. Preliminary inquiry
was converted into regular case.
4. During investigations it was found that
Dr. R.S.Dhaliwal had conducted 324 open heart
operation as open heart surgeon during the period
January 1994 to July 2001. Out of them 38 cases
were shortlisted and investigated in detail. It
was found that in 24 cases Surinder Singh Uppal
was involved with Dr. R.S.Dhaliwal while in 14
cases it was M/s. Paul Medical Hall and Dr.
R.S.Dhaliwal. It was found that all the 14
patients were private grant/sponsored patients in
the sense that for their treatment money had been
deposited in the PGI by the respective funding
Agencies in advance. Dr. R.S.Dhaliwal would send
requisition to M/s Paul Medical Hall through the
Medical Superintendent, PGI specifying the items
to be supplied for the treated patients. He would
requisition the artificial heart valves by brand
name St. Jude which was costing Rs.45,000/- per
3
piece. M/s. Paul Medical Hall would issue cash
memos/invoices showing the sale of St. Jude heart
valves whereas actually the valves supplied were
Omni Science or Starr Edwards which were cheaper.
It was also established that in some cases two
valves were requisitioned for a patient. Payment
was received for two valves but only one was
implanted. In some cases two St. Jude heart
valves were requisitioned but only one St. Jude
valve was implanted while the other valves would
be cheaper viz. Omni Science or Starr Edwards or
Machhi or Edward Mira. In some cases, Dr.
R.S.Dhaliwal made interpolations in the record to
justify the bills raised by M/s. Paul Medical
Hall.
5. Following are the 14 instances in which
Dr. R.S.Dhaliwal and M/s. Paul Medical Hall were
involved:-
1. Pt. Dwarka Prasad CR No.398793 operated on 30.5.2000.
The patient was member of ESI. A
sum of Rs.1,40,000/- was deposited in PGI
for his treatment vide receipt No.99289.
4
Vide letter dated 24.4.2000 issued
through Medical Superintendent, PGI. Dr.
R.S.Dhaliwal requested M/s. Paul Medical
Hall to supply the items including one
Mitral (St. Jude heart valve-Bileaflet).
M/s. Paul Medical Hall issued cash memo
dated 24.5.2000 for Rs.45,000/- as cost
of valve. The amount was released by the
office of Medical Superintendent by way
of cheque. However, instead of St. Jude
heart valve, Dr. R.S.Dhaliwal implanted
Omni Science valve Serial Number 676371.
This valve had been purchased by M/s.
Paul Medical Hall from M/s. B.L.
Marketing Services Limited. The result
was that M/s. Paul Medical Hall received
payment for St. Jude Valve against the
supply of Omni Science valve.
2. Pt. Baldev CR No.395456 operated on 18.6.1999.
The Govt. of Punjab had deposited
Rs.1,50,000/- with PGI for the treatment
of Baldev. Vide letter dated 11.5.1999
5
issued through Medical Superintendent,
PGI. Dr. R.S.Dhaliwal requested M/s. Paul
Medical Hall to supply the items
including two heart valves Mitral/Aortic
(St. Jude heart valve Bileaflet) for
Rs.45,000/- each as cost of valve. The
amount of Rs. 1,12,543-75 was released by
the office of Medical Superintendent, PGI
in favour of M/s. Paul Medical Hall. This
included costs of two valves. However,
only Mitral valve replacement was done in
the patient on 18.06.1999. However,
neither the unused valve was returned nor
the amount of Rs.45,000/- towards costs
for unused valve was refunded.
3. Pt. Jigri Singh CR No.194769 operated on 02.09.99.
The Employer of the patient had
deposited Rs.95,000/- with PGI for the
treatment of Baldev vide letter dated
03.08.1999 issued through Medical
Superintendent, PGI. Dr. R.S.Dhaliwal
requested M/s. Paul Medical Hall to
6
supply the items including two heart
valves Mitral/Aortic Starr Edwards for
Rs.24,500/- each as cost of valve. The
amount was released by the office of
Medical Superintendent, PGI in favour of
M/s. Paul Medical Hall. This included
costs of two valves. The patient was
operated on 2.2.1999. One Omni Science
and one Starr Edwards valves were
implanted. However, the patient died on
3.9.1999 in the PGI itself. Vide letter
dated 6.9.1999 Dr. R.S.Dhaliwal requested
the office of Medical Superintendent, PGI
to make additional payment of Rs.20,500/-
to M/s. Paul Medical Hall for the price
of difference between St. Jude Valve
which was implanted and Starr Edwards
Valve which was requisitioned. The office
of Medical Superintendent called for
clarification in response to which Dr.
R.S.Dhaliwal gave a note dated 16.10.1999
justifying the implantation of St. Jude
valve instead of Starr Edwards. Whereas
no Starr Edwards valve had been
7
implanted. Since the balance left in the
account of the patient was Rs.15,033/-
this much was released through cheque in
favour of M/s. Paul Medical Hall. The
latter issued bill dated 2.9.1999 showing
the supply of St. Jude heart valve
whereas no such valve had been supplied.
4. Pt. Suresh Kumar CR No.399748 operated on 08.10.99.
Dr. R.S.Dhaliwal issued letter
dated 15.9.1999 through Medical
Superintendent, PGI requesting M/s. Paul
Medical Hall to supply items including
one Mitric (St. Jude bileaf let) heart
valve for Rs.45,000/-. M/s. Paul Medical
Hall raised bill. The amount was released
by the office of Medical Superintendent,
PGI. However, when the patient was
operated on 8.10.1999 Omni Science heart
valve bearing No.670399 was implanted in
his heart. Therefore against supply of
Omni Science the payment received for
Mitric (St. Jude bileaflet) heart valve.
8
5. Pt. Sheela Devi CR No.447298 operated on 04.05.2000.
Dr. R.S.Dhaliwal issued letter
dated 10.4.2000 through Medical
Superintendent, PGI requesting M/s. Paul
Medical Hall to supply items including
one Mitric (St. Jude bileaf let) heart
valve for Rs.45,000/-. M/s. Paul Medical
Hall raised bill. The amount was released
by the office of Medical Superintendent,
PGI. However, when the patient was
operated on 4.5.2000 Omni Science heart
valve was implanted in her heart.
Therefore against supply of Omni Science
the payment received for Mitric (St. Jude
bileaf let) heart valve.
6. Pt. Narinder Kumar CR No.401753- operated on 14.10.99.
Dr. R.S.Dhaliwal issued letter
dated 3.8.1999 through Medical
Superintendent, PGI requesting M/s. Paul
Medical Hall to supply items including
one Mitric (St. Jude bileaf let) heart
9
valve for Rs.45,000/-. M/s. Paul Medical
Hall raised bill. The amount was released
by the office of Medical Superintendent,
PGI. However, when the patient was
operated on 14.10.1999 Omni Science heart
valve bearing No.663106 was implanted in
his heart. Therefore, against supply of
Omni Science the payment received for
Mitric (St. Jude bileaf let) heart valve.
7. Pt. Rajesh Kumar CR No.437812 operated on 23.5.2000.
Dr. R.S.Dhaliwal issued letter
dated 24.4.2000 through Medical
Superintendent, PGI requesting M/s. Paul
Medical Hall to supply items including
one Mitric (St. Jude bileaf let) heart
valve for Rs.45,000/-. M/s. Paul Medical
Hall raised bill. The amount was released
by the office of Medical Superintendent,
PGI. However, when the patient was
operated on 23.5.2000 Omni Science heart
valve bearing No.676103 was implanted in
his heart. Therefore, against supply of
10
Omni Science the payment received for
Mitric (St. Jude bileaf let) heart valve.
8. Pt. Raj Kumar CR No.444411 operated on 11.04.2000.
Dr. R.S.Dhaliwal issued letter
dated 15.3.2000 through Medical
Superintendent, PGI requesting M/s. Paul
Medical Hall to supply items including
one Mitric (St. Jude bileaf let) heart
valve for Rs.45,000/-. M/s. Paul Medical
Hall raised bill. The amount was released
by the office of Medical Superintendent,
PGI. However, when the patient was
operated on 11.4.2000 Starr Edwards heart
valve was implanted in his heart.
Therefore, against supply of Starr
Edwards the payment received for Mitric
(St. Jude bileaf let) heart valve.
9. Pt. Shiv Shankar CR No.356543- operated on 06.04.2000.
Dr. R.S.Dhaliwal issued letter
dated 6.3.2000 through Medical
Superintendent, PGI requesting M/s. Paul
11
Medical Hall to supply items including
one Mitric (St. Jude bileaf let) heart
valve for Rs.45,000/-. M/s. Paul Medical
Hall raised bill. The amount was released
by the office of Medical Superintendent,
PGI. However, when the patient was
operated on 6.4.2000 Starr Edwards heart
valve was implanted in his heart.
Therefore, against supply of Starr
Edwards the payment received for Mitric
(St. Jude bileaf let) heart valve.
10. Pt. Dayal Singh CR No.426450- operated on 15.10.1999.
The Govt. of Himachal Pardesh had
deposited Rs.1,50,000/- with PGI for the
treatment of Dayal Singh. Vide letter
dated 9.9.1999 issued through Medical
Superintendent, PGI, Dr. R.S.Dhaliwal
requested M/s. Paul Medical Hall to
supply the items including two heart
valves Mitral/Aortic (St. Jude heart
valve Bileaf let) for Rs.45,000/- each as
cost of valve. The amount of Rs.
12
1,12,543-75 was released by the office of
Medical Superintendent, PGI in favour of
M/s. Paul Medical Hall. This included
costs of two valves. However, only Mitral
valve replacement was done in the patient
on 15.10.1999. The valve implanted was
Mira Bextor Edward. However, neither the
unused valve was returned nor the amount
of Rs.45,000/- towards costs for unused
valve was refunded. Even the price
difference between St. Jude heart valve
and Mira Bextor Edward was not refunded.
11. Pt. Sneh Lata CR No.239492- operated on 25.10.1999.
The Govt. of Himachal Pradesh had
deposited Rs.1,25,000/- with PGI for the
treatment of Sneh Lata. Vide letter dated
15.9.1999 issued through Medical
Superintendent, PGI, Dr. R.S.Dhaliwal
requested M/s. Paul Medical Hall to
supply the items including two heart
valves Mitral/Aortic (St. Jude heart
valve Bileaf let) for Rs.45,000/- each as
13
cost of valve. The amount of Rs.
1,113,798/- was released by the office of
Medical Superintendent, PGI in favour of
M/s. Paul Medical Hall. This included
costs of two valves. However,only Mitral
valve replacement was done in the patient
on 25.10.1999. The valve implanted was
MVR 29 mm St. Jude. However, neither the
unused valve was returned nor the amount
of Rs.45,000/- towards costs for unused
valve was refunded. Later on Dr.
R.S.Dhaliwal falsified the official
record by making addition in operation
note to show that apart from MVR it was
also a case of AVR. Dr. Sukant who issued
discharge summary confirmed that only MVR
was done. But, Dr. R.S.Dhaliwal had made
the addition in the operation note in his
presence and since he was a junior doctor
he subsequently issued discharge summary
mentioning AVT 21 at the instance of Dr.
R.S.Dhaliwal.
12. Pt. Mani Mari CR No.018187- operated on 18.04.2000.
14
The Poor Help Council had
deposited Rs.1,00,000/- with PGI for the
treatment of Mani Mari. Vide letter dated
2.9.2000 issued through Medical
Superintendent, PGI, Dr. R.S.Dhaliwal
requested M/s. Paul Medical Hall to
supply the items including two heart
valves Mitral and Aortic (St. Jude heart
valve Bileaf let) for Rs.45,000/- each as
cost of valve. The payment was released.
The patient was operated on 18.4.2000.
One Omni Science valve Serial Number
676215 and one SJM Serial Number 60317357
were implanted. Therefore, the payment
received was for two St. Jude heart
valves against supply of one Omni Science
and one SJM.
13. Pt. Ram Sabad CR No.101239- operated on 18.11.1999.
A sum of Rs. 1,76,000/- was
deposited by the Employer of the patient
for his treatment. Vide letter dated
5.10.1999 issued through Medical
Superintendent, PGI, Dr. R.S.Dhaliwal
15
requested M/s. Paul Medical Hall to
supply the items including two heart
valves Mitral and Aortic (St. Jude heart
valve Bileaf let) for Rs.45,000/- each as
cost of valve. The Paul Medical Hall
issued cash memo showing the sale of two
St. Jude Mitral valves for Rs.45,153/-
each. The payment was released by the
Office of Medical Superintendent
accordingly. The patient was operated on
18.11.1999. But instead of two St. Jude
heart valves one Mira Mitral Serial No.
99020066 and one SJ Aortic Serial
No.80537792 were implanted. Therefore,
the payment received was for two St. Jude
heart valves against supply of one Mira
Mitral and one SJ Aortic.
14. Pt. Ishwar Chand CR No.287442- operated on 17.10.1994.
The patient was a member of ESI.
An amount of Rs.1,00,000/- was deposited
in PGI for his treatment. Vide letter
dated 23.09.1994, Dr. R.S.Dhaliwal
16
requested the Medical Superintendent, PGI
to issue a cheque in the sum of
Rs.32,000/- in the name of the patient so
that artificial valve could be purchased
by him. Accordingly Cheque No.021343 for
Rs.32,000/- was released in favour of the
patient on 7.10.1994. He encashed the
cheque on 10.10.1994 and as per direction
of Dr. R.S.Dhaliwal the whole amount was
given to him for purchasing the valve.
Dr. R.S.Dhaliwal paid Rs.26,000/- out of
that amount to Surinder Singh Uppal for
purchase of valve. Surinder Singh Uppal
procured a valve for Rs.15,000/-. Out of
the profit he gave Rs.5,000/- to Dr.
R.S.Dhaliwal. The patient was operated on
17.10.1994 and his Mitral valve was
replaced with Machhi 3MAV. Subsequently
vide letter dated 26.10.1994 Dr.
R.S.Dhaliwal submitted five bills
amounting to Rs.63,000/- issued by M/s.
Paul Medical Hall and requested the
Medical Superintendent to release the
payment in favour of M/s. Paul Medical
17
Hall. Subsequently the said amount was
released vide cheque No.021415, dated
28.10.1994. As per one of the bills which
had been attached with Dr. R.S.Dhaliwal
with his letter one Starr Edwards Valve
worth Rs.30,000/- had been supplied by M/
s. Paul Medical Hall for patient Ishwar
Chand. To justify this Dr. R.S.Dhaliwal
subsequently added the words “& Aortic
valve replacement” in the discharge
summary.
6. The documents in which interpolations/
additions/ alterations were made were sent to the
Govt. Expert of Questioned Documents (for short
GEQD). He gave positive opinion as to the
authorship of Dr. R.S.Dhaliwal.
7. It was found that Dr. R.S.Dhaliwal was
cooperating with Surinder Singh Uppal and M/s.
Paul Medical Hall separately. Therefore, the
cases in which there was involvement of Dr.
R.S.Dhaliwal and Surinder Singh Uppal were
segregated and separate charge sheet was filed in
respect thereof.
18
8. The investigation established that M/s.
Paul Medical Hall is the partnership firm having
three partners namely Sat Pal Singla, Smt. Usha
Rani Singla and Anita Rani Singla. It was
established that Satpal Singla was the active
partner while the remaining two were the sleeping
partners. Hence, Satpal Singla was arrayed as an
accused while the remaining partners were left
out.
9. Sanction for prosecution of Dr.
R.S.Dhaliwal was obtained and on completion of
investigations charge sheet was filed.
10. Copies of charge sheet and documents
were supplied to the accused named above free of
costs in compliance of the provisions contained
in Section 207 of the Code of Criminal Procedure.
11. Finding prima facie case, charges under
Section 120-B, 420, 467,468 and 471 of the
Indian Penal Code were framed against both the
accused while charges under Section 13 (1) (d)
of Prevention of Corruption Act, 1988 were also
framed against accused Dr. R.S.Dhaliwal. The
accused pleaded not guilty and claimed trial.
19
12. To prove its case, the prosecution
examined 49 witnesses. They can be divided into
following categories.
The officials/Doctors from PGI.I. PW1 Dr. V.K. Batra, Professor,
Department of Anesthesia.
II. PW2 Dr. V.K. Grover, Professor, Department of Anesthesia.
III. PW5 Dr. R.K. Sharma, Deputy Medical Officer.
IV. PW6 Smt. Kanchan Ba Jandeja, Chief Perfusionist, department of CVTS.
V. PW7 D.P. Mehta, Joint Medical Superintendent.
VI. PW8 Dr. Anil Kumar Gupta, Medical Superintendent.
VII. PW10 Gauri Shankar Sinha, Senior Medical Record Officer.
VIII. PW13 Sh. Bihari Lal, Principal Private Secretary to the Head of the Department.
IX. PW15 Dr. Deepak Puri, who joined PGI as Junior Resident and worked as Senior Resident and as Assistant Professor in CVTS.
X. PW16 Dr. Rana Sandip Singh, Additional Professor, Department of CVTS.
XI. PW17 Dr. Devinder Mohan, the then Senior Resident, who worked as Senior Resident in the department of
20
CVTS from January 2000 to December 2002.
XII. PW18 Dr. Gangadhar. He did senior residency from department of CVTS from January 2001 to December 2003.
XIII. PW19 Smt. Satnam Kaur. She worked as Stenographer in the department of CVTS from 1991-1992 to 2001.
XIV. PW22 Sh.Jagmohan Singh, Superintendent Purchase.
XV. PW23 Dr. A. Rai Baruah. He pursued his Post Graduate Study MCH in the department of CVTS from July 1994 to June 1996.
XVI. PW-25 K.K. Sharma. He remained posted as Senior Lab. Technician, Technical Assistant and Profusionist from 1971 to 2002.
XVII. PW29 Daya Dhar, Assistant Cashier.
XVIII. PW36 Suman Arora, Senior Assistant, Accounts Branch.
The patients or their wards.I. PW14 Pt. Dawarka Prashad.
II. PW24 Ashok Kumar- Ward of patient Dayal Singh.
III. PW27 Amar Nath- Ward of patient Jigri Singh.
IV. PW31 Pt. Ishwar Chand.
V. PW32 Pt. Rajesh Kumar.
VI. PW33 Pt. Baldev.
VII. PW37 Om Parkash-Ward of Patient Sheela Devi.
21
VIII. PW38 Pushminder Singh- Ward of patient Sneh Lata.
IX. PW40 Pt. Raj Kumar.
The Suppliers/representatives.I. PW20 Kewal Kumar Seth, C&F Agent of
TTK Health care.
II. PW21 Sh. Sunil Aggarwal, Director of M/s. BL Marketing Services Limited.
III. PW28 Sh. Sandeep Ghaisas Distribution Manager, Edwards Life Sciences India Pvt. Ltd.
IV. PW35 Arvind Kumar Aggarwal, Accountant, Paul Distributor, Chandigarh.
V. PW39 Rajiv Kumar Gupta, Assistant Finance Manager, Baxter India Private Limited.
VI. PW47 Surinder Singh Uppal.
Bank Officers.I. PW12 Mandeep Singh, the then Senior
Manager, Bank of Punjab (now in Centurian Bank of Punjab), Chandigarh.
II. PW34 Sh. P. Anant, Manager, Canara Bank,Jalandhar.
III. PW43 Vinod Kapoor, the Chief Officer, SBI, PGI Branch.
IV. PW44 V.K. Narula, the then Officer, Bank of India, Sector 17, Chandigarh.
V. PW45 V.P. Mehta, the Manager Accounts, State Bank of Patiala,
22
Sector 7-C, Chandigarh.
VI. PW46 M.L. Gupta, Special Assistant, State Bank of India, PGI Branch.
Sanctioning Authority.I. PW9 Dr. K.K. Talwar, Director, PGI.
Witnesses as to handwriting.I. PW42 S.K. Sharma, AG-I (M), FCI- in
whose presence specimen signatures and writings of Sat Pal Singla and Ashok Kumar were taken.
II. PW48 Dr. Ravindra Sharma, Assistant Govt. Examiner of Questioned Documents.
Witnesses as to Miscellaneous matters.I. PW3 Dr. Raman Nijawan, SMO,
Radiology, General Hospital, Sector 16, Chandigarh.
II. PW4 Dr. Prem Chand, SMO, Radiology, General Hospital, Sector 16, Chandigarh.
III. PW11 S.S. Parmar, the then Assistant Excise and Taxation Commissioner, Chandigarh.
IV. PW41 Kashi Ram, Senior TOA, Office of GMT, Ferozepur, Punjab.
Investigating Officer.I. PW49 Jai Singh Inspector CBI.
13. In their statements recorded under
Section 313 of Code of Criminal Procedure, when
23
confronted with incriminating circumstances, the
accused pleaded innocence.
14. The following explanation was given by
Dr. R.S.Dhaliwal:-
“I became the HOD of CVTS Department in 1998. There was no proper purchase procedure for procuring disposable items or Artificial Heart Valves (AHVs) for open heart surgery before I became HOD. There was no purchase system as prevalent in AIIMS, Delhi and other prestigious Private Hospitals (like Appolo Hospital, Fortis Hospital etc.). During my tenure also despite my best efforts I could not succeed in introducing efficient system due to various impediments.
At that time there were very few
suppliers of AHVs and disposable items
for open heart surgery e.g.
1. Paul Medical Hall2. Bharat Medicos.
Before I became HOD of CVTS, in cases of
private patients the patients or their
wards were verbally told to go to one of
the supplier and procure disposable items
and AHVs. Set (s) of AHVs however were
24
supplied by supplier to operation theatre
directly. Usually particular suppliers
kept particular brands of valves. The
information regarding the suppliers was
sought by patients/wards from other
patients, wards of other patients, staff
and doctors of CVTS department.
In case of sponsored patients the
requisition was sent to MS office and it
was the prerogative of the MS office to
procure the AHVs and disposables. At the
M.S. Office the system in practice was
either to form Spot Committees or float
short term tenders for procuring these
items. Even in the cases of sponsored
patients the suppliers brought the set of
AHVs (consisting of 5-6 AHVs of different
sizes) to the operation theatre as the
price of only one AHV was paid to the
supplier.
When I joined as HOD in 1998, I
tried to streamline process of purchase
by introducing lists of disposable items
25
and valves for different open heart
operations. Thereafter the lists Started
being given to patients or their
attendants. Similar lists were supplied
to MS office regarding sponsored
patients.
When the patient comes to OPD of
CVTS department, directly or after having
been referred by Cardiology or Pulmonary
Medicine Department, then he is firstly
checked by Junior residents or senior
residents of CVTS department and
thereafter shown to a consultant Surgeon
and after a set of investigations the
decision regarding the replacement of
Heart valve (HV) is taken. Patient and
his attendants are told to arrange blood
and told about approximate expenditure
involved in the operation. The procedure
for fixing the dates and supply of lists
of consumables/ disposables and AHVs to
the patients or their wards is handled
mainly by senior residents.
26
Files of the patients and
operation notes and pre and post
operation progress notes are written by
senior residents as it is their main
duty.
Regarding the allegation that
patients were charged for 2 AHVs but
only one implanted or patients charged
were for expensive AHV but cheaper one
implanted it is explained that ever since
I joined CVTS department, the procedure
followed relating to surgery for
implanting the AHV remained almost the
same. The supplier/ his representative
would bring a set of AHV (consisting of
different sizes) to the operation theatre
just before the AHV was to be implanted.
The set was handed over by the supplier
to one of the Profusionist or a
technician of CVTS operation theatre. The
Profusionist and attending nurse opened
the sealed boxes containing the AHVs and
handed over the same to the Operating
Surgeon in the presence of surgeon
27
/anesthesia team. In case two AHVs were
planned to be implanted then two sets
would be brought.
Each set used to contain the AHVs
of following sizes:
The AHVs of St. Jude, Omni and TTK brands
consisted of following sizes:
Mitral Aortic
21mm 17mm
23mm 19mm
25mm 21mm
27mm 23mm
29mm 25mm
31mm 27mm
The AHVs of Starr Edwards and Machhi
brands consisted of following sizes :
Mitral Aortic
1m 8A
2m 9A
3m 10A
4m 11A
5m 12A
28
Many a times the set/ sets brought
by supplier consisted of AHVs of
different brands. It was because at times
the supplier did not have complete set/
sets of one brand which had been
requisitioned or for which the patient
had been charged by the supplier. In such
circumstances there was no time to
arrange the set of the specific brand of
AHV which was requisitioned as by the
time the set was brought to operation
theatre the patient was connected to
heart lung machine and his heart was
exposed and opened for implantation.
However AHV of whatever brand was
implanted was duly mentioned in the
operation notes in the patient file. The
AHVs were always of reliable and
established brand conforming to
international standards. The remaining
AHVs i.e the ones left after use from the
set/sets, were taken by the supplier/
representative back after the surgery. At
times after the surgery the doctors
29
including myself used to mention the size
of the AHV which had been used for the
information and record of the supplier/
his representative. I mentioned the sizes
of the AHV implanted on few occasions on
my letter head on being requested by
supplier or his representatives.
The patients/wards used to pay
only for one or two AHV(s) to the
supplier directly or through MS/PGI,
whereas the supplier used to bring to the
operation theatre full set/ sets of AHVs
because the size of AHV(s) to be
implanted could be known only after
opening the chamber of the heart of the
patient, where valve had to be implanted.
Due to that reason the AHV was never
handed over to the patient/ward by the
supplier because while the patient paid
for only one or two AH valves the exact
AHV(s) had to be chosen from the full
set/ sets, each set consisting of 5/6
AHVs of different sizes, which was many
more time costly than the single valve.
30
The AHV was also not handed over
to the patients/wards because it is
packed in a highly sterile sealed box and
there was risk of contamination of AHV if
the same was opened before operation by
the patients/ wards out of curiosity.
Some such instances had been noted in the
past.
There were times when the doctors
planned to implant two AHVs during pre
operative work up of patient but at the
operation table, on examination of heart,
it was concluded/ decided that it was
possible to repair one heart valve or not
to treat it in any way as the defect was
too minor, therefore, even if two AHV
sets were requisitioned, only one AHV was
implanted. Similarly if one heart valve
was planned for replacement, but at the
operation table it was found repairable
or was found all right then the whole set
of the AHVs requisitioned or brought by
supplier was returned to supplier without
implantation of AHV.
31
Whether two or one or no AHV was
implanted was duly mentioned in the
operation notes.
The operation notes were always written
by senior resident doctors assisting the
main operating surgeon. In case senior
resident doctors sought any guidance then
operating surgeon used to give/ provide
the same. It was always expected of the
senior resident doctors to write the
operation notes correctly and honestly.
After the surgery it was always expected
of the suppliers that they would refund
the amounts to the patients or the PGI in
case the AHV(s) supplied by them were not
implanted and therefore returned to them
or if they had supplied the AHV of brand
of lesser price after having charged for
AHV of brand of higher price. This
procedural aspect was not within the
control of main operating surgeon.
The disposables and AHVs were
supplied by suppliers after the receipt
of money from patients directly or
32
through MS office of PGI. The disposable
items were handed to the patients/
attendants but AHVs i.e. the set of AHVs
was supplied directly in the operation
theatre at the time of open heart
surgery.
The bills submitted by the
patient/wards for verification for the
purpose of reimbursement at CVTS
department, were verified by senior
residents in OPD. Because of the heavy
work load some discrepancies could have
remained undetected as the bills were
verified by the senior residents in
routine without meticulous comparison
between the bills and operation files of
the patient.
Regarding SS Uppal it is explained that:
The wife of SS Uppal and my wife
were close friends before marriage.
During their school times both were
Punjab State Level and National Level
33
Basketball players. They played together
many tournaments as team mates and
traveled and stayed together during those
times and became good friends. After SS
Uppal’s marriage the social interaction
between the families also continued as
both of them i.e my and SS Uppal’s wife
settled in Chandigarh. His wife was
teacher to both of my sons in their
nursery school i.e. Ankur Nursery School
(Panjab University Campus)
As SS Uppal was not well settled
in any profession, therefore, he
continued to change his professions e.g.
1. Private Tuitions
2. Sold books (Agent)
3. Sold electric meters.
SS Uppal and his wife borrowed
money from us after their marriage
somewhere in middle 80s at various stages
totaling about over Rs.2.00 lacs which SS
Uppal always promised to return whenever
his financial condition became stable.
34
SS Uppal at his own initiative
made inquiries from me and various other
doctors and employees of CVTS department
regarding procedure for the supply of
AHVs and other materials for use in CVTS
department, PGI.
Taking advantage of close social
relations with me he was able to campaign
and persuade the various doctors and
employees of CVTS department to introduce
the names of his concerns to the patients
and their wards regarding supply of AHVs.
There were very few suppliers of
AHV in Chandigarh at the time when he
established himself in this field e.g.
1. Paul medical Hall
2. Bharat Medicos.
I never directly helped him by
specially mentioning the names of his
concerns to the patients or their wards
regarding AHVs.
The patients and their wards
35
decided about the suppliers of AHVs by
asking from other patients/ wards,
employees and doctors of the CVTS
department.
Whenever the patients/ wards
directly asked me then I used to mention
the names of all the established
suppliers including the name of SS
Uppal’s concerns after I found him also
to be a reliable supplier.
I never gave any referral slips to
patients/ wards in favour of SS Uppal’s
concerns or any other supplier. However I
did mention the exact implanted AHVs
brand name and size on my letter head
after the implantation on being asked by
supplier or his representative for their
information or record. Such information
was also given in writing by other
doctors whenever the supplier asked for
the same. Such information on my letter
heads is being projected wrongly as
reference slips in favour of SS Uppal/his
firms.
36
Regarding Diary of SS Uppal it is explained that:
After he Started supplying the
AHVs to CVTS department, it appears that
he Started having stable income and then
he Started repaying the loans he had
taken from us. On few occasions, he made
the repayments by cheques from his
concerns. I told him that since he was
supplying the AHV to CVTS departments
through his concerns/firms therefore the
repayments of loans by cheques from those
concerns could be misconstrued. Therefore
the repayments of loans were
predominantly by cash. This is the reason
why the cheque payments could not be
connected to allegations of profit
sharing between SS Uppal and myself even
in the fabricated diary.
He repaid the loans by 1998. I
never received payments for AHVs or for
any other purpose on behalf of SS Uppal/
37
his concerns or on behalf of any other
supplier. I never shared any profits from
the sale of AHVs with owners of Paul
Medical Hall. From the time I joined in
preliminary inquiry and regular case
investigation by EO/IO the CBI officials
did not even show or mention to me the
diary/ledger allegedly prepared
contemporaneously by SS Uppal.
The diary is a fabrication, a
forged document prepared in connivance
between the CBI officials and SS Uppal
after SS Uppal decided to become an
approver probably when he was confronted
by CBI with evidence of overcharging from
patients for AHVs. The purpose was to
entangle me in a false case as otherwise
the CBI were not in a position to
implicate me.
For making SS Uppal the approver,
the CBI officials apparently subjected
him to persistent physical and mental
torture.
38
The open heart register at CVTS
department was filled by the
Perfusionists. It was taken for reference
by various senior residents, junior
residents, doctors in connection with
their medical research papers and
publications not only of CVTS department
but other departments as well. It never
remained in custody of any one in
particular and never remained in lock and
key of anyone.
All the allegations of
interpolation, erasures, forgeries
against me whether in open heart/
operation register, in patient files, or
bills or any where else are false. All
the allegations that I campaigned for or
referred the patients/wards to SS Uppal’s
concerns are false.
The PWs were tutored by IO Jai
Singh to make allegations against me
while recording their statements and then
in the court with various pressure
39
tactics. He pressurized them by threats
that in case the PW did not make
statements as recorded by him under
section 161 Cr.P.C. then they would be
prosecuted for perjury. He lured them by
mentioning compensation if the PWs
deposed in a particular way regarding
deaths of the relatives.
A few patients died after the open
heart surgery because of various reasons.
Surgery for replacing HV is a major
surgery and there is always a heavy risk
involved.
The patient can die because of
following reasons :-
i. Heart failure due to weak muscle
of the heart or prolonged heart
disease.
ii. Due to bleeding during post
operative period, which could be
because of prolonged Cardio
pulmonary bypass, use of heparin,
damage to components of blood by
40
H/L machine, multiple blood
transfusion and deranged
coagulation profile of the patient
which is common in long standing
heart disease.
iii. Acute renal shut down which can
happen in any patient after open
heart surgery.
iv. Respiratory failure because lungs
are badly damaged in most of heart
patients.
v. Infection
vi. Myocardial infarction
vii. Cerebro vascular accident like
brain hemorrhage or thrombosis.
viii.Due to poverty, negligence or
ignorance, number of patients do
not take anti coagulant tablets/
drugs after implantation of AHV.
This can lead to thrombosis on the
valve leading to its mal-
functioning which can lead to
death.
ix. Due to excessive intake of anti
41
coagulant drugs by patients it can
result in hemorrhage in brain or
in any other vital organ.
But in order to prejudice the PWs
against me the PWs were fed with
misinformation that inferior quality AHVs
were implanted leading to deaths of their
relations.
Jai Singh IO was always present
outside the court and tutored/
pressurized the PWs before they deposed
in the court.
There were times when the MS
office of PGI told the staff of CVTS
department to transmit the cheques of the
suppliers to them i.e. the suppliers. On
receiving the information through
telephone call the cheques were brought
by CVTS staff and passed on to the
suppliers. This task was assigned to CVTS
department especially because of shortage
of staff with MS office and their heavy
load of work.
42
This case is the result of the
influence exerted on the CBI by vested
interests who wanted to harm me
professionally for their own selfish
ends.”
15. Accused Sat Pal Singla gave the following
explanation:-
“I am innocent. I have been falsely
implicated in this case. M/s. Paul
Medical Hall was supplying consumables
/surgical equipments to the PGI as Paul
Medical Hall was on the approved list of
PGI for supplying consumables/surgical
including artificial heart valves. The
goods as requested by the doctors were
deposited in the Central Store of the
Medical Superintendent after due
verification. Since at the time of
surgery the members of the valves and
brand of valves, due to the need of the
patient could not be foreseen, therefore,
numerous valves and brands were sent at
43
the time of planned surgery. In case
requisition came for two valves then two
valves were deposited in the store.
However, the bills were prepared before
the deposit of goods in the store,
subsequently excess or less amount
received were subject to reconciliation
and finalization of accounts and at that
time actual goods were also compared.
Since there was acute shortage of the
staff in Medical Superintendent Office,
reconciliation of the accounts could not
take place despite sending numerous
officials of the Chemists number of times
to the Medical Superintendent's Office.
In many cases excess amount received has
been returned to the PGI and in many
other cases amount received was less.
Thus, there were ongoing transactions
between the PGI and Paul Medical Hall.
The Investigating Officer in this case
has taken into account the wholesale
price at which valve was received by the
Chemist. However, valves were supplied at
44
the rate taking into account expenses for
promotion of brand, literature, holding
of conferences, seminars, sale tax and
interest cost for maintaining huge
inventory and the capital employed as it
could not be foreseen which number, size
and brand of the valve will be consumed.
The artificial heart valves being very
delicate and fragile also could be
rendered useless. Since the technology
was rapidly changing, valves light in
weight and durable were replacing
conventionally used brands of valves.
Omni Science being a better product
technologically and clinically same was
insisted for users by the Medical
fraternity”.
16. In defence the following witnesses were
examined:-
DW-1 Jarnail Singh, whose son Jagtar
Singh was operated by accused
R.S.Dhaliwal.
45
DW-2 Mandhir Mohan, whose wife was
treated by Dr. R.S.Dhaliwal.
DW-3 Dr. Rama Krishana who did
senior residency in the department of
CVTS from 2000 to 2003.
DW-4 Subhash Gupta, whose wife Indu
Gupta was treated by Dr. R.S.Dhaliwal.
DW-5 Dr. Lakhbir Dhaliwal. She is the wife of Dr. R.S.Dhaliwal and Head of
Department of OB Gynecology.
DW-6 Dr. Kuldeep Singh Sidhu who did
senior residency CVTS from 1985 to
1987.
DW-7 Dr. Rajan Mehra, who did senior residency CVTS from 1991 to 1993.
DW-8 Ms. Jassy Anand, Documents
Expert.
17. Dr. R.S.Dhaliwal himself appeared in the
witness box as DW9 after getting due permission
within the meaning of Section 315 of the Code of
46
Criminal Procedure.
18. I have heard the learned Public
Prosecutor and learned counsel for the accused.
19. Following points arise for
determination:-
(i) Whether cognizance has been taken
on the basis of valid sanction for
prosecution of accused Dr. R.S.Dhaliwal?
(ii) Whether there was criminal
conspiracy between R.S.Dhaliwal and Sat
Pal Singla to cheat the patients, the
funding agencies and the PGI?
(iii) Whether in pursuance of conspiracy
accused Sat Pal Singla of M/s. Paul
Medical Hall used to charge the price for
a particular valve but Dr. R.S.Dhaliwal
used to implant a different heart valve
of lesser price in the patients?
(iv) Whether in pursuance of the
conspiracy the accused Sat Pal Singla
used to charge for two artificial heart
47
valves but only one used to be supplied
and implanted?
(v) Whether in pursuance of conspiracy
accused Sat Pal Singla prepared and
issued false bills/invoices?
(vi) Whether in pursuance of conspiracy
accused Dr. R.S.Dhaliwal tampered with
record?
20. In so far as the sanction of prosecution
is concerned PW-9 Dr. K.K. Talwar has made clear
that Governing Body of the PGI was competent
authority and as such the relevant papers
supplied by CBI were placed before the Governing
Body and vide agenda item No.17, dated 9.1.2006
(ExD2) it accorded sanction and simultaneously
authorized him, being Member Secretary, to sign
and convey the sanction on behalf of Governing
Body.
21. Learned counsel for accused would argue
that the sanction is bad for the following
reasons:-
48
I. As admitted by PW9, vide Agenda
Item No.17 he was only authorized to sign
and convey the sanction whereas the
discussion regarding the matter had taken
place on earlier dates i.e. 31.8.2005 and
20.12.2005.
II. Neither the Agenda Item No.17 nor
the minutes of 31.8.2005 and 20.12.2005
were supplied to the Investigating
Officer.
III. There is no reference to the
meetings dated 31.8.2005 and 20.12.2005 in
the Agenda Item No.17.
IV. Admittedly the sanction order was
prepared only after the meeting dated
9.1.2006 in which Agenda Item No.17 was
taken up but the same was never placed
before the Governing Body for its approval
before being signed by PW9.
V. The Sanction order was prepared by
the Vigilance Section attached with the
office of PW9. This means that there was
49
no application of mind by the
competent authority i.e. Governing Body.
VI. PW9 does not remember which
documents were gone through or perused by
him before he signed the order prepared by
the Vigilance Section. He even could not
remember what documents were circulated to
the Governing Body and how the documents
were circulated.
22. To my mind the reasons cited by the
defence are not convincing. There is no doubt
that Governing Body of the PGI is the competent
authority to remove Dr. R.S.Dhaliwal from
service. It cannot be disputed that the
Governing Body can authorize any person to sign
the orders on its behalf. Whether the decision
to accord sanction for prosecution of Dr.
R.S.Dhaliwal was taken on 20.12.2005 the fact
remains that agenda came to be signed by the
Chairman of the Governing Body on 9.1.2006.
Therefore, what is relevant is the Agenda Item
vide which the decision to accord sanction was
taken. A bare perusal of Agenda Item No.17 ExD2
50
would make it clear that Governing Body had
taken the decision to accord sanction. Since
the minutes were signed on 9.1.2006 technically
it can be said that the decision was taken on
9.1.2006 irrespective of the fact that
practically the decision was taken on
20.12.2005.
23. When PW9 says that the decision to accord
sanction had been taken on 20.12.2005 but he was
authorized to convey and sign the sanction on
9th January 2006, he does not mean to say that
these were two different meetings. He never said
that Agenda Item No.17 was meant to only
authorize him to sign the sanction order. As
discussed above, the Agenda Item No.17 is self
explanatory that decision to accord sanction and
to authorize PW9 to sign and convey the sanction
on behalf of the Governing Body was taken in one
meeting. Since the minutes of meeting were
signed by the Chairman of the Governing Body on
9.1.2006 PW9 said that the decision to accord
sanction was taken on 20.12.2005 but, he was
authorized to convey and sign the sanction
order on 9.1.2006. There was the technical
51
reasons for him to say so. Because authorization
could be possible only after signing of the
minutes by the Chairman of the Body.
24. Agenda Item No.17 itself makes it clear
that the decision to accord sanction was being
taken after due deliberations and after
considering all aspects of the case. The
documents which were gone through by the
Governing Body are mentioned in the Agenda Item.
The report of S.P. includes the statements of
witnesses. It is therefore, evident that
Governing Body had gone through the entire
record and only thereafter it was satisfied
about the necessity to accord sanction. Merely
because at this stage PW9 could not recall as to
which particular documents were circulated among
the members of the Governing Body it does not
mean that the decision was taken without
application of mind. Agenda Item No.17 is self
explanatory. Moreover, the sanction order itself
mentions that the material examined included the
statements of the witnesses and other relevant
documents.
52
25. In so far as placing of the sanction
order before the Governing Body again for its
approval is concerned the same was not required
because, there was no such direction by the
Governing Body that PW9 would sign the order
only after getting the draft approved. Once the
decision to accord sanction had been taken and
PW9 had been authorized to sign and convey the
same, there was no need of placing the draft of
sanction order before the Governing Body before
signing and conveying it. There is presumption
that all officials acts were duly performed.
26. There is nothing wrong if help from the
Vigilance Section was taken because PW9 makes it
clear that he signed the order only after
finding it to be in order. Therefore, it cannot
be said that it was the Vigilance Section and
not the Governing Body of the PGI which accorded
sanction. Even otherwise, the defence has not
been able to show any defect which could be a
pointer to non application of mind by the
members of the Governing Body. Merely because
PW9 does not know what does Section 467 of
Indian Penal Code mean, it does not mean non
53
application of mind, the provisions of law
alleged to have been violated by the accused
were mentioned in the FIR as well as the report
of SP. If the Vigilance Section found them to be
attracted and assisted PW9, there is nothing
wrong.
27. All said and done, the defence has not
been able to prove that the sanction for
prosecution of Dr. R.S.Dhaliwal is invalid.
Hence, point No.1 is answered in favour of the
prosecution.
28. Coming to the allegations, since all the
14 cases discussed above were those of sponsored/
private grant patients, before proceeding
further, it would be fruitful to have a bird's
eye view of the procedure for procurement of
disposables /valves and for payment. As stated by
PW-8 Dr. Anil Kumar Gupta, there were three
phases during which different procedures were
prevailing. Those are as under:
i. Till 1996 The treating doctor would send a
54
requisition enlisting the items required
along with the names of the
manufacturers and the cost. The amount
would be sent to him in the shape of
cheque to be forwarded to the supplier
as per his request. If there was no such
request, the cheque would be sent
directly to the supplier.
ii.From 1996 to 2000 With the assistance of the Heads of
Departments, specifications of the items
required were collected and through
tenders rate contracts were arrived at
which were supplied to the respective
departments to be adhered to. The
treating doctor used to send the order
directly to the supplier whose rate
contract had been approved by the
competent authority. The copy of the
order used to be endorsed to the Office
of Medical Superintendent.
iii. From 2000The system of constituting spot
55
committees comprising representatives of
treating surgeon, representative of
financial Advisor and an Officer from
the Office of Medical superintendent was
introduced. Spot committees would
collect the quotations for the items
required and after evaluating the
quotations they would recommend
purchases from the supplier quoting
lowest rates. Supplier would supply the
items to the Central store of the
hospital. The treating doctor/his
representative would come to the store;
verify the items and indent them for
surgery.
29. From the perusal of record and statements
of the witnesses, the following facts stand
established beyond doubt:
(1)On the basis of preliminary
investigations/diagnosis, the treating
surgeon would determine how many valves
need to be replaced.
56
(2)The treating surgeon would furnish an
estimate of expenses.
(3)On the basis of the estimate, the
funding agency will deposit the amount
in PGI.
(4)After admitting the patient in the ward,
the treating surgeon would issue a
requisition/supply order to the supplier
/chemist through the Medical
Superintendent mentioning the items with
specifications and the price (In the
instant case all but one instance
pertain to the period when rate contract
was in prevalence. The rate contracts of
Paul Medical Hall had been approved vide
Ex.PW-22/1 to Ex.PW-22/3. The price, in
the supply order was being mentioned as
per the rate contract.
(5)The Office of Medical superintendent
would issue cheque in the sum mentioned
in the supply order to the supplier
/chemist. Normally, the cheque would be
issued before the date fixed for
57
surgery.
(6)Depending on the diagnosis, the treating
doctor would have an idea as to which
brand of valve was required.
Accordingly, he will requisition that
particular brand. However, since the
size of valve required to be implanted
would be known only after opening the
chest, the valve will not be supplied in
advance. The supplier/chemist or his
representative will bring a set
consisting 5-6 valves of different sizes
directly to the operation theater in the
morning when the operation was to be
performed. Sometimes a set/sets brought
by the supplier/chemist would consist of
valves of different brands because at
that particular time he will not have
the complete set/sets of one brand which
had been requisitioned or for which the
price has been received.
(7)In cases where the double valve
replacement had been planned, there
58
could be a possibility that only one
would be replaced and the other
repaired. Similarly, in cases where
single valve replacement had been
planned there could be a chance of the
valve being repaired and, hence, no
replacement.
(8)The number of valve/valves actually
implanted and the brand/brands used to
be mentioned in the operation notes as
well as in the open heart register.
(9)Operation notes used to be written by
the Senior Residents assisting the
operating surgeon. The entries in open
heart register used to be made by the
Profusionist.
30. The gist of offence of conspiracy lies
in the forming of agreement of conspiracy. Such
an agreement need not be formal or express. It
may be inherited in and inferred from the
circumstances, especially declaration, act and
conduct of the conspirator. In State of
59
Tamilnadu Versus S. Nalini and others, 1999 Crl.Law Journal, page 3124 the Hon'ble Supreme Court has observed that Conspiracy is hatched in
private or in secrecy. It is nearly impossible
to establish a conspiracy by direct evidence.
Usually, both the existence of the conspiracy
and its objects have to be inferred from the
circumstances and the act and conduct of the
accused.
31. To prove conspiracy Section 10 of the
Evidence Act also comes handy. Once a prima
facie evidence is found affording a reasonable
ground for the Court to believe that two or more
persons anything said, done or written by any
one of them in reference to their common
intention will be evidence not only for the
purpose of proving the existence of the
conspiracy but, also for the purpose of showing
that the said persons were party to it.
Needless to say that once a conspiracy to commit
an illegal act is prima facie proved, any act
done by one conspirator in pursuant to the
agreement becomes the act of other. As observed
in State of Tamilnadu Versus S. Nalini and
60
others (Supra), this joint responsibility
extends not only to what is done by any of the
conspirators pursuant to the original agreement
but also to collateral acts incidental to and
growing out of the original purpose.
32. Having discussed the law on the point let
us take up the instances separately to find out
whether there was criminal conspiracy between
Dr. R.S.Dhaliwal and Sat Pal Singla.
PATIENT: ISHWAR CHAND
As per patient file Ex.PW-10/1, Ishwar
Chand was operated on 17.10.1994. On the
admission form Ex.PW-16/1. Originally, the
following surgical procedure was mentioned:
On 17/X/94
CPB Mitral Valve replacement done using
SE No.3 valve by Dr. R.S.Dhaliwal.
By cutting the words 'SE' the words
'Machi No.3' were written so as to give the
61
impression that the valve implanted was Machi
No.3. In open heart register Ex.PW-6/1 Page No.9,
Serial No.81 (Ex.PW-25/1) also, there is a
erasure in the encircled portion Q-7. After
erasure the words written are “3 Machhi”.
This was a case of private
grant/sponsored patient. Rupees One lac were
deposited in advance for the treatment vide
receipt Ex.PW-7/2.
On 23.09.1994, Dr. R.S.Dhaliwal wrote
letter Mark PB/1, whereby he requested the
Medical Superintendent for issuance of a cheque
of Rs.32,000/- in the name of the patient so that
he could get the valves from the company. The
words 'in the name of patient' were written after
striking off the words 'Alfa Surgicals'.
Learned counsel for the accused would
argue that this document cannot be read in
evidence, as the original is not on record and no
permission to lead secondary evidence has been
sought or granted.
To my mind, there is no merit in the
62
contention. PW-7, the then Deputy Medical
Superintendent has categorically stated that
letter Mark PB/1 was received in the Office of
Medical Superintendent and after processing the
same, cheque for Rs.32,000/- duly signed by the
then Medical Superintendent was handed over to
Ishwar Chand on 07.10.1994. In the requisition
Ex.PW-7/7 vide which the cheque was sought to be
issued by Medical Superintendent, there is a
column as to for what purpose the amount is
required. Against this column, it is clearly
mentioned that it is for the purchase of double
valve for open heart surgery. Since the amount
could not have been released without
recommendation by the treating surgeon, there can
be no doubt about the authenticity of the letter
Mark PB/1. Even if, for a pause, it is admitted
that this letter cannot be read in evidence for
substantive purpose, it can still be read for
collateral purpose of corroborating the statement
of PW-7. To that extent, this letter is
admissible. On the basis of this letter, the
cheque Ex.PW-29/24 dated 05.10.1994 was released
by the Office of Medical Superintendent in favour
63
of the patient Ishwar Chand. The said Ishwar
Chand appeared in the witness box as PW-31 and
deposed that after encashing the cheque he had
given Rs.32,000/- to Dr. R.S.Dhaliwal who had
represented that the second valve was with him.
As per diary Ex.PW-47/1, Page No.27,
Surinder Singh Uppal received Rs.26,000/- from
Dr. R.S.Dhaliwal on 10.10.1994 for patient Ishwar
Chand. He supplied valve worth Rs.15,000/- and
out of profits gave Rs.5,000/- to Dr.
R.S.Dhaliwal.
As to why the words 'Alfa Surgicals' were
struck off from the letter Mark PB/1 and in their
place the words 'in the name of patient' were
written would be clear from the fact that by the
time the letter was issued Alfa Surgical had not
yet opened its account in the bank. Ex.PW-33/18
proves that the account in the name of Alfa
Surgicals was opened only on 21.11.1994.
Accused R.S.Dhaliwal did not stop at
this. The patient was discharged on 26.10.1994 as
is evident from the discharge summary Ex.PW-19/1.
In this summary, the final diagnosis was
64
mentioned as chronic RHD with MR, MS + Gr. II AR.
In the column of operation, the following was
mentioned:
“Mitral valve replacement under CPB on
17.10.1994”
However, the words 'and Aortic valve replacement'
were added in hand to show that it was a case of
double valve replacement.
While going through the record to
ascertain as to whether these words are in the
hand of Dr. R.S.Dhaliwal, I have come across
many documents on which there is no doubt about
the writing of Dr. R.S.Dhaliwal. Out of those
documents, the following are being referred to
specifically:
(1)The noting Ex.PW-8/35 in the patient
file of Jigri Singh.
(2)The certificate Ex.PW-13/10 filled in by
Dr. R.S.Dhaliwal.
(3)The application dated 07.05.1987 written
by Dr. R.S.Dhaliwal to the Head of
65
Department of CTV Surgery.
(4)The application dated 26.06.1985
Ex.PW-13/14 written by Dr. R.S.Dhaliwal
to Director, PGI, Chandigarh.
In the noting Ex.PW-8/3, the accused has
used the word 'Aortic'. This writing matches the
writing of the word 'Aortic in the portion Q-40
on the discharge summary Ex.PW-19/1in all its
details and particulars except for the fact that
on Ex.PW-8/35, the word has been started with
small 'a' while on Ex.PW-19/1 this word starts
with capital 'A'. The manner of joining the
letters 'o', 'r', 't' and 'i'; the manner of
writing the letter 'i'; with dot not on the top
but on the right side and the manner of writing
the letter 'c' in the end at some distance from
the letter 'i' is identical. There is striking
similarity in the execution of the word 'valve'
in Ex.PW-8/35 and on Ex.PW-19/1. The manner in
which the letter 't' has been executed whenever
it comes in the end is identical in the words
'patient', 'cost' and 'root' etc., as appearing
in Ex.PW-8/35 and the word 'replacement'
appearing in Ex.PW-19/1. The manner and style of
66
joining the letters 'r' and 'e' whenever the
word starts with small 'r' is identical in the
words 'recommendation' and 'rest', as appearing
in Ex.PW-13/14 and Ex.PW-13/12 respectively and
the word 'replacement' in portion Q-40 on
Ex.PW-19/1. Similarly, the manner of writing the
letters 'm', 'e' and 'n' and joining them is
identical in the word 'recommendation' as
appearing in Ex.PW-13/14 and the word
'replacement' as appearing in portion Q-40
Having looked at the record with as much
care as it could, this court has also gone
through the opinion evidence. While the
prosecution has examined the Government Expert as
PW-48, the defence has examined a private expert
Ms. Jassy Anand as DW-8. Naturally, the opinion
of Government Expert is in favour of the
prosecution while that of private expert is in
favour of the defence. However the Court has
considered the opinion of both the experts with
one eye without any bias or prejudice keeping in
mind the settled principle that the evidentiary
value of defence witnesses is the same as that of
prosecution witnesses.
67
It is worth mention that while standard
writings/signatures of Dr. R.S.Dhaliwal were
forwarded to the Government Expert along with
the disputed writings/signatures, the private
expert opted to obtain the specimen writings in
her laboratory and compared them with the
disputed writings. Dr. R.S.Dhaliwal had moved an
application seeking permission from the court to
the expert Jassy Anand to take photographs of
his disputed handwritings and admitted
signatures/handwritings from the court file and
to take his specimen signatures and handwriting
in the court. Vide order dated 23.04.2008,
permission was granted to the expert to take
photographs from the court file. At the same
time, it was made clear that no indulgence of the
Court was required insofar as the taking of the
specimen signatures/handwritings of Dr.
R.S.Dhaliwal by the expert was concerned, as this
could be done by the expert at her own level.
This, however, did not mean that accused could
select the mode of proof. Had the accused Dr.
R.S.Dhaliwal been serious, he would have asked
for the summoning of the record having his
68
handwriting from the PGI so as to be compared
with the questioned writing. Instead he opted to
lend his specimen writing in the laboratory of
the expert engaged by him. The possibility of his
having changed his writing under the expert
supervision cannot, thus, be ruled out. The
disputed writings were available when the
specimen writings were taken by expert Jassy
Anand. Changing the speed, wrist movement,the
size and spacing between the letters, the
alignment and, the slant while having the
disputed writings in front would not have been a
difficult task particularly, when there was an
expert to guide.
While drawing this inference, the Court
has exercised utmost caution in not getting
swayed by surmises and conjectures. The Court is
alive and conscious that an inference is to be
drawn not from another inference but from facts.
The manner in which the facts are presented is
also a relevant consideration. Therefore, the
Court has to be at its intuitive best to separate
grain from the chaff.
69
It is quite interesting to note that
while taking specimen handwriting of Dr.
R.S.Dhaliwal, the expert DW-8 has, inter alia,
taken the following specimen:
“Please make payment from the balance
left. Rest will be paid by patient's
attendant”.
While comparing the above portion which
has been marked SH by DW-8 with the disputed
writing Q-68 (Ex.PW-13/8), she has come to the
conclusion that this writing (Q-68) along with
the other disputed writings is a result of copied
forgery. By opining this, DW-8 has made the job
of the court easy. In fact, Dr. R.S.Dhaliwal
never denied the noting Q-68 despite having got
an opportunity when he stepped in the witness
box. Therefore, denial by DW-8 is virtually
meaningless. It is worth mention that in the
specimen SH, Dr. R.S.Dhaliwal had lent his
writing as well as signatures. DW-8, while making
comparison, ignored the signatures and just
concentrated on the writing as would be evident
from the photograph Ex.DW-8/25. It is evident
that the segregation of writing from the
70
signatures was done deliberately as no opinion as
to the forgery of the signatures would have been
possible. The portion Q-68 (Ex.PW-13/8) is the
noting given by Dr. R.S.Dhaliwal on the back of
his letter Ex.PW-8/33 in response to the
information given by the Office of Medical
Superintendent. Although, this noting was in
context of patient Jigri Singh yet, the same is
being considered here for the sole purpose of
testing the genuineness of the opinion rendered
by DW-8. Dr. R.S.Dhaliwal does not say that his
signatures in the portion Q-68 (Ex.PW-13/8) are
genuine but the writing is not that of him. Even
otherwise, it is not understandable as to why Dr.
R.S.Dhaliwal would affix his signatures with date
on the back of the letter in blank portion and
why would somebody else copy his writing by
giving a note above the signatures. It is evident
to naked eye that the entire note with signatures
has been executed in one go with same pen. The
note is not out of the context as would be
evident from the letter Ex.PW-8/33 and the
notings Ex.PW-8/34, Ex.PW-8/35 and the subsequent
notings given on the face of the letter
71
Ex.PW-8/33. In fact, nobody stood to gain by
forging this noting Ex.PW-13/8. So long as there
is no dispute about the noting Ex.PW-8/35, no
question mark can be raised against the noting
Ex.PW-13/8. But, in their wisdom the accused
R.S.Dhaliwal and DW-8 have ventured to prove that
the noting Ex.PW-13/8 is a result of copied
forgery. This sole instance shows the worth of
the opinion rendered by DW-8. To say that she has
gone out of the way in supporting Dr.
R.S.Dhaliwal, who had engaged her, would not be
exaggregation. Even regarding the remaining
questioned writings, DW-8 has termed natural
variations as inherent dis-similarities. If there
could be dissimilarities between the specimen SH
and the portion Q-68 (Ex.PW-13/8), the fact that
there are dis-similarities between the remaining
questioned writings and the specimen writings is
meaningless. Even if, it is assumed that while
lending specimen, Dr. R.S.Dhaliwal was not
tutored by DW-8 or that he did not try to change
his writing deliberately, the mere fact that
according to DW-8 herself there are
dissimilarities between specimen SH and disputed
72
writing Q-68, the dissimilarities as highlighted
by her between the other specimen and questioned
writings, have to be ignored being natural
variations. While expressing so, the Court has
taken the noting portion Q-68 (Ex.PW-13/8) as
duly proved to be in the hand of Dr. R.S.Dhaliwal
and none else.
No gain saying that proof of authorship
of a document/signature is proof of a fact like
any other fact and as held in Mubarak Ali Ahmad Versus State of Bombay AIR 1957 SC 657, the evidence relating thereto may be direct or
circumstantial. It may consist of direct evidence
of a person who saw the document being
written/signed it may be the proof of the
handwriting of the contents or the signatures by
one of the modes provided in Sections 45 and 47
of Indian Evidence Act. It may also be proved by
internal evidence afforded by the contents of
the documents and other external evidence.
In coming to the conclusion that the
noting portion Q-68 (Ex.PW-13/8) is duly proved
to be in the hand of Dr. R.S.Dhaliwal the Court
has taken into account the statement of PW-13 who
73
had been working under Dr. R.S.Dhaliwal as his
Private Secretary. The Court has also looked at the internal evidence afforded by the contents of
the document and other external evidence. Hence,
the overzealous but partisan opinion rendered by
DW-8 has to be ignored. Instead of assisting, she
has tried to mislead the court in order to serve
the interests of Dr. R.S.Dhaliwal, who engaged
her. As against this, the Court finds the opinion
rendered by PW-48 to be truthful, unbiased and
convincing.
In Murari Lal Vs. State of M.P. AIR 1980 (SC) 531,
the Hon'ble Supreme Court after considering a
catena of precedents held that where the reasons
for the opinion of handwriting expert are
convincing and there is no reliable evidence
showing a doubt, the uncorroborated testimony of
the expert may be accepted. The Hon'ble Apex
Court observed:-
“An expert deposes and not decides. His duty is to furnish the Jude with the necessary scientific criteria for testing the accuracy of his conclusion so as to enable the Jude to form his own independent judgment by the application of these criteria to the facts proved in evidence ------------. By comparing the writing itself the Court would not assume to itself, the
74
role of an expert. Section 73 of the Evidence Act expressly enables the Court to compare disputed writings with admitted or proved writings to ascertain whether a writing is that of a person by whom it purports to have been written. Where there are expert opinions, they will aid the Court. Where there is none, the Court will have to seek guidance from some authoritative text book and the Court's own experience and knowledge. But discharge it must, its plain duty with or without expert with or without other evidence.”
Murari Lal's case (supra) acts as a beacon
light to guide the Courts as to how the opinion
evidence of handwriting expert is to be
appreciated. No doubt, the science of
identification of handwriting is not as perfect
as the science of identification of finger prints
is. However, in cases where the Court comes to
the conclusion about the identity of the
handwriting in dispute with or without expert
opinion, no further corroboration is required and
the accused can be convicted accordingly.
Learned counsel for the accused has
argued that as per prosecution version, the
accused had added the words 'and Aortic valve
replacement' in the discharge summary Ex.PW-19/1.
However, in response to a specific question,
75
PW-59 Dr. Ravinder Sharma, the handwriting expert
has stated that he had only expressed his opinion
on the writing 'MVR Mitral'. Therefore, according
to the counsel, there is no opinion on the
writing 'and Aortic valve replacement' on
Ex.PW-19/1.
To my mind, the contention is misplaced.
The question, to which reference is being made,
was regarding the portion Q-41, whereas the
portion in question on the discharge summary
Ex.PW-19/1 is marked Q-40. The portion Q-41 is in
the progress sheet in the file Ex.PW-10/1 in
which the words 'MVR Mitral' appear. Therefore,
the expert was right when he stated that with
regard to Q-41, he has expressed his opinion only
with regard to the writing MVR Mitral. Otherwise
as discussed above, there is least doubt that the
writing of the portion 'and Aortic valve
replacement' in the portion Q-40 on Ex.PW-19/1 is
in the hand of Dr. R.S.Dhaliwal. From the X-rays
Ex.PW-3/5 and Ex.PW-3/6 and report Ex.PW-3/7, it
is evident that only one valve was implanted in
the heart of Baldev Singh.
Dr. A.Rai Baruah, who prepared the
76
discharge summary Ex.PW-19/1, appeared in the
witness box and categorically stated that the
words 'and Aortic valve replacement' were not
there when the discharge summary was issued. It
is, thus, proved beyond doubt that accused
R.S.Dhaliwal added these words in the discharge
summary.
Having done this, Dr. R.S.Dhaliwal wrote
letter Ex.PW-7/8 to the Medical Superintendent on
the same day enclosing duly verified bills
amounting to Rs.63,000/- towards the cost of
Oxygenator disposables and other medicines etc.
purchased from Paul Medical Hall. He requested
that a cheque for Rs.63,000/- may be prepared and
sent to him so that the same could be forwarded
to the chemist. On the strength of this letter,
Cheque No.68678 for Rs.63,000/- was issued. This
was credited to the account of Paul Medical Hall
on 04.11.1994, as is evident from the statement
of account Ex.PW-35/26. This fact stands
acknowledged by accused Sat Pal Singla of Paul
Medical Hall vide his letter Ex.PW-35/25.
Along with the letter Ex.PW-7/8, the
bills with following details were attached:
77
Sr.No. Bill No. Date Amount1. 4718 16.10.94 Rs.4302.002. 4719 16.10.94 Rs.22525.003. 4720 16.10.94 Rs. 2027.00 4. 4721 16.10.94 Rs.33394.405. 4745 16.10.94 Rs. 751.60
It is quite strange that out of the five bills,
one bill Mark PB/2 is Photostat. The remaining
four bills are original. It is the Photostat bill
in which mischief was committed. It is evident to
naked eye that Item No. I Starr Edwards valve for
Rs.30,000/- was added subsequently in the bill
Mark PB/2. Therefore, the bill, which was for
Rs.3,394.40 Ps., was inflated to Rs.33,394.40 Ps.
It appears that original bill was removed from
the file Ex.PW-7/1 with the purpose of concealing
the commission of forgery therein. It is evident
that the writing of the words 'Starr Edwards
Valve' as appearing in the bill Mark PB/2 is
different from remaining writing in the bill.
This is even different from the writing in the
bills Ex.PW-13/47 to Ex.PW-13/50. There is strong
possibility that the original bill was removed
subsequently and photo copy was placed in the
file.
78
Learned counsel for accused Dr.
R.S.Dhaliwal argued that he had nothing to do
with the verification of the bills and payment to
the suppliers, as verification used to be done by
the Senior Residents and payment used to be made
by the Office of Medical Superintendent. Drawing
attention of the Court to the statement of PW-17
made in cross-examination, learned counsel argued
that due to heavy work load the Senior Residents
had no time to cross-check the bills with the
operation files before verification and,
therefore, there could be some discrepancies
which, by no means, can be attributed to the
accused Dr. R.S.Dhaliwal. He further argued that
if the supplier committed some mischief by adding
a particular item in a particular bill either
before or after submission thereof and that
mischief went un-noticed, it is the supplier and
not Dr. R.S.Dhaliwal who is liable.
To my mind, there is no substance in the
above contentions. If Dr. R.S.Dhaliwal had
nothing to do with the verification and if this
was the job to be performed by the Senior
Residents, question arises as to why did he
79
verify the particular bills submitted by Paul
Medical Hall. Heavy work load cannot be an excuse
for mischief. If Dr. R.S.Dhaliwal was not to come
in picture for the payment of the bills and the
supplier had to send the bills directly to the
Medical Superintendent Office, question arises as
to why did Dr. R.S.Dhaliwal receive the bills;
verified and then send them to the Medical
Superintendent Office vide recommendation
Ex.PW-7/8. Another particular question would be
as to why he requested Medical Superintendent to
send the cheque to him so as to be forwarded to
the supplier? It is evident that Dr. R.S.Dhaliwal
and Paul Medical Hall were in league.
Quite interestingly, Dr. R.S.Dhaliwal has
deposed that he had planned replacement of two
valves and accordingly two artificial heart
valves were procured from two different
suppliers. He has stopped short of telling the
names of the suppliers but from the statement of
Surinder Singh Uppal and the entry in the diary
Ex.PW-47/1, it is proved that the second supplier
was Alfa Surgicals owned by Surinder Singh Uppal.
Dr. R.S.Dhaliwal has not made clear as to which
80
particular valve was procured from which
supplier. At the same time, he has cleverly
concealed as to out of two suppliers, to whom the
valve was returned. Therefore, the statement of
Dr. R.S.Dhaliwal conceals vital information and
reveals little.
It is pertinent to mention that this was
a case of private grant/sponsored patient.
Requisition to the supplier for disposables,
medicines, valves etc. had to be made by the
treating surgeon through the Office of Medical
Superintendent as was being done in case of other
such patients. However, in this case, no such
requisition was made. Rather, an amount of
Rs.32,000/- was cleverly got released in favour
of the patient and then taken from the patient to
be paid to Surinder Singh Uppal. When there was
no other requisition, how can the accused claim
that two valves were procured from different
suppliers? In fact, only one valve was procured
and that was through Surinder Singh Uppal.
Another interesting fact to be noticed is
that while writing the letter Ex.PW-7/8, accused
81
R.S.Dhaliwal concealed that the bills included
the bill for artificial heart valve. He simply
mentioned that the bills were towards the cost
of Oxygenator disposables for open heart surgery
and other medicines etc. There was no reference
to artificial heart valve. This was a clever ploy
to keep the Medical Superintendent Office in dark
because for procuring artificial heart valve, a
sum of Rs.32,000/- had already been got released
and subsequently there was no intimation to the
Medical Superintendent Office that one more valve
was to be procured. Although, the Office of the
Medical Superintendent, on its part, was lax in
releasing the payment on the strength of the
bills annexed by Dr. R.S.Dhaliwal with the letter
Ex.PW-7/8 without properly checking the record
yet, the fact remains that it was a clever
manoeuvre by Dr. R.S.Dhaliwal in association with
Paul Medical Hall to hoodwink the Medical
Superintendent Office into complacency.
Taking the court through the statement of
Dr. R.S.Dhaliwal made by him while deposing as a
defence witness, learned counsel pointed out that
out of the two valves that had been procured, one
82
was implanted and the other was returned to the
supplier. However, the bill had already been
raised by the supplier before surgery but, it
came to him after surgery and as he had returned
the valve, he presumed that the supplier must
have refunded the requisite money to the Medical
Superintendent Office and, therefore, he cleared
the bill in routine. This, according to the
counsel, cannot be termed as fraudulent act.
The statement of Dr. R.S.Dhaliwal itself
exposes him. As observed above, there is no
requisition to Paul Medical Hall to supply the
valve, disposables etc. Therefore, no payment had
been made to Paul Medical Hall by the Medical
Superintendent Office in advance as was being
done in case of other patients. No doubt that the
bills were raised by the Paul Medical Hall on
16.10.1994 and the same were verified by Dr.
R.S.Dhaliwal after the surgery on 26.10.1994.
The cheque was released in favour of Paul Medical
Hall on 28.10.1994 on the basis of those very
bills. When no payment to Paul Medical Hall had
been made before 28.10.1994, question arises as
to how Dr. R.S.Dhaliwal could presume on
83
26.10.1994 that Paul Medical Hall must have
refunded the price of the returned valve? It is
evident that Dr. R.S.Dhaliwal has come up with
the explanation as an afterthought. If the valve
had been procured from Paul Medical Hall a day in
advance but the same had been returned on the
date of operation; if the bill had been raised on
the date of supply of the valve but, the same
came up for verification after the surgery, there
was no point in verifying the same without first
asking Paul Medical Hall to delete the item at
Serial No.1 in the bill Mark PB/2. Dr.
R.S.Dhaliwal was himself requesting the Office of
Medical Superintendent vide letter Ex.PW-7/8 to
release the amount of the bills in favour of Paul
Medical Hall but, now he says that he thought
that Paul Medical Hall must have refunded the
amount of the returned valve. This is, indeed, a
strange explanation.
By taking the plea that one valve was
returned, Dr. R.S.Dhaliwal admits that it was a
case of single valve replacement. This amounts to
implied admission that even on 26.10.1994 he knew
that only one valve had been replaced while the
84
other had been returned. Therefore, the
interpolation made by him in the discharge
summary in the portion Q-40 is not
understandable. This interpolation amounts to
forgery. Needless to say that despite the denial
by Dr. R.S.Dhaliwal, it has been proved on record
that the interpolation was made by him.
Therefore, this was not a case, where the
chemist/supplier committed mischief on its own.
This was a case of meeting of minds between Paul
Medical Hall and Dr. R.S.Dhaliwal for agreeing to
do or causing to be done an illegal act and in
pursuance of that conspiracy Paul Medical Hall
submitted false bill. Dr. R.S.Dhaliwal verified
the bill and asked the Medical Superintendent
Office to release payment. To justify this, even
forgery was made in the discharge summary
Ex.PW-19/1. The plea of innocence raised by Dr.
R.S.Dhaliwal, therefore, fails to convince the
Court.
PATIENT: JIGRI SINGH
As per file Ex.PW-15/1 and Operation Note
Ex.PW-15/2, Jigri Singh was operated on
85
02.09.1999. The surgical procedure was 'Repair of
RSOV (RSOV stands for Raptured Sinus of Valsalva)
+ AVR (19 MM Omni Science) and TVR (32 MM SE)
(AVR stands for Aortic Valve Replacement and TVR
stands for Tricuspid Valve Replacement). As per
open heart register Ex.PW-6/1 Page No.115 Entry
No.109/1 Ex.PW-25/3, the serial numbers of the
valves were Omni Science 673893 and Starr Edwards
Jude FJ0184.
This was a case of private grant
/sponsored patient. Rupees One lac were deposited
by the employer of the patient vide receipt
Ex.PW-8/28.
Vide Ex.PW-8/30 addressed to Paul Medical
Hall through Medical Superintendent, the
disposables and valves were requisitioned by Dr.
R.S.Dhaliwal. This included two Starr Edwards
ball cage valves for Rs.24,500/- each. On the
basis of this requisition, Cheque No.196329
(Ex.PW-29/17) was issued on 11.08.1999. As per
the statement of account Ex.PW-44/1, the amount
was credited to the account of Paul Medical Hall
on 04.09.1999.
86
Jigri Singh died on 03.09.1999.
On 06.09.1999, Dr. R.S.Dhaliwal wrote
letter Ex.PW-8/33 to the Medical Superintendent.
The text follows as under:
“The above said patient was taken up
for double valve replacement on
2.9.1999 and two Starr Edward Valves
were procured from M/s Paul Medical
Hall for replacement in Mitral and
Aortic position. However, on table it
was found that the aortic root was very
narrow and hence a St. Jude Heart Valve
was procured from M/s Paul Medical Hall
and inserted in aortic position instead
of Starr Edward Valve. The cost of St.
Jude Heart Valve is Rs.45,000/- while
the cost of Starr Edward is Rs.24,500/-
so that the balance amount of
Rs.20,500/- may please be forwarded to
M/s Paul Medical Hall”.
The letter Ex.PW-8/33 was taken up in the
Office of Medical Superintendent. Vide noting
Ex.PW-8/34 in the file Ex.PW-8/27, Medical
87
Superintendent asked for the reasonableness of
the cost of the material (This amounts to asking
for the reasons why St. Jude heart valve worth
Rs.45,000/- was implanted, whereas the cost of
Starr Edwards was Rs.24,500/-.
On 16.10.1999, Dr. R.S.Dhaliwal gave the
following reason vide his noting Ex.PW-8/35:
“I have written in my letter, why St.
Jude valve was required.
Technically in a small Aortic
root Starr Edwards valve is contra-
indicated and St. Jude's valve has to
be implanted which was done in this
patient.
His balance money is lying in
PGI, it should be paid, rest patient
(Or his family) will pay.
The price (cost) is
reasonable).”
As a sum of Rs.15,033/- only was lying in
balance with PGI in the account of Jigri Singh,
88
Cheque No.197005 dated 27.10.1999 (Ex.PW-29/9)
for this much was sent to Paul Medical Hall. As
per the statement of account Ex.PW-44/1, this
amount was credited to the account of Paul
Medical Hall on 28.10.1999.
On the face of it, the letter Ex.PW-8/33
reflects dishonest intention because as per
record the valves implanted were Omni Science and
Starr Edwards. These brands were not only
mentioned in the operation note Ex.PW-15/2 and
open heart register Ex.PW-6/1 but, also mentioned
on the admission form Ex.PW-10/2. In fact, on the
back of the admission form, the sticker of Starr
Edwards stands pasted while the slip of Omni
Science stands stappled. Although, the slip does
not specifically mention the name of the brand
i.e. Omni Science yet, the simple fact that the
details mentioned in the columns are identical
with the details mentioned in the open heart
register, it is proved that the slip is that of
Omni Science valve. Even otherwise from invoice
Ex.PW-21/2 issued by B.L. Marketing Services
Limited, it is evident that Omni Science heart
valve Serial No.673893 was supplied to Paul
89
Medical Hall a for which payment was made by Paul
Medical Hall vide cheque No.1318205 dated
25.10.1999 (Ex.PW-44/17).
It is worth mention that Dr. R.S.Dhaliwal
appeared in the witness box as DW-9. In cross-
examination, he admitted that no St. Jude valve
was implanted in the heart of Jigri Singh and
that as per operation note Ex.PW-15/2, one Starr
Edwards and one Omni Science valve were
implanted.
Dr. R.S.Dhaliwal tried to explain his
position in the following manner:
“In case of Jigri Singh, the bill raised
for St. Jude heart valves was passed by
me. On clarification from MS office I
had informed that in place of Starr
Edwards, St. Jude valves had been used
due to some technical reasons. When the
bill came to me, it was not accompanied
by any file of the patient. Even
discharge slip was not there because the
patient died after surgery. Therefore in
routine, I passed the bill. Even when
90
clarification was given, I recalled from
my memory and thought that there were
technical reasons to implant Saint Jude
valve and informed the office of MS
accordingly. Even at that time I had no
file or discharge slip of the patient”.
The above explanation clarifies little.
It is more of a confusing statement. Not that
there was confusion in the mind of Dr.
R.S.Dhaliwal. He rather tried to confuse the
Court. Instead of offering explanation as to the
letter Ex.PW-8/33, he tried to project as if
everything happened because he had passed the
bill raised for St. Jude heart valve without
going through the patient file and when
clarification was sought by the Medical
Superintendent Office he thought that there must
have been some technical reasons to implant St.
Jude valve. As a matter of fact, there was no
stage for Dr. Dhaliwal to pass the bills. In case
of sponsored patients, the bills used to be sent
by the supplier/chemist to the Office of Medical
Superintendent directly. No witness has stated
that the bills had to be routed through the
91
surgeon or that the amount could be released only
after the bills had been passed by the surgeon.
Therefore, it is clear that Dr. R.S.Dhaliwal has
concocted the story that since he had already
passed the bill raised for St. Jude heart valve,
while giving clarification to the Medical
Superintendent Office, he was under the
impression that due to technical reason St. Jude
valve must have been implanted. He cleverly
tried to evade the issue of the letter
Ex.PW-8/33. In other words, he had no explanation
to offer as to under what circumstances, this
letter was written by him. In fact, the Medical
Superintendent Office sought clarification only
after receipt of the letter Ex.PW-8/33 and not
just because there was some doubt about the bill.
A perusal of the letter Ex.PW-8/33 would make it
clear that it was categorical assertion by Dr.
R.S.Dhaliwal that although, two Starr Edwards
valves were procured yet, on table it was found
that the Aortic root was very narrow and, hence,m
St. Jude heart valve was procured and inserted
instead of Starr Edwards valve. such a
categorical assertion cannot be due to oversight
92
or inadvertence as has been tried to be projected
by accused R.S.Dhaliwal.
In fact, by coming up with the
explanation as above, accused R.S.Dhaliwal has
tried to put the entire blame on Paul Medical
Hall. He has tried to depict that because the
bill Ex.DW-9/2 was raised, it created a false
impression in his mind which, he thought was
genuine impression and due to that he wrote the
letter Ex.PW-8/33. As observed above, Dr.
R.S.Dhaliwal has admitted that no St. Jude valve
was implanted in the heart of Jigri Singh. This
indirectly means that the bill Ex.DW-9/2 raised
by Paul Medical Hall was false. On the other
hand, Paul Medical Hall too has also not made a
clean breast of it. In his statement under
Section 313 of the Code of Criminal Procedure,
Satpal Singla was put the following question:
“Q.14 That on 6.9.99 after the death
of the patient your co-accused RS
Dhaliwal vide letter Ex.PW-8/33 asked
the Medical Superintendent to release
Rs.20,500/- on the ground that St. Jude
93
Heart Valve had been implanted in the
heart of patient in aortic postilion
instead of Starr Edwards valve?
In reply he simply stated “I do not
know”.
He even denied having received Cheque
No.197005 dated 27.10.1999 which is otherwise
proved to have been credited to his account on
29.10.1999. The fact remains that the bill
Ex.DW-9/2 was raised for one Starr Edwards Mitral
valve and one St. Jude valve Aortic. When the
valves requisitioned were Starr Edwards, the bill
should have been for Starr Edwards valves. If St.
Jude valve had not been implanted in the heart of
Jigri Singh, there was no question of supply
thereof by Paul Medical Hall for that patient. It
is, thus, evident that the bill Ex.DW-9/2 was
raised by accused Sat Pal Singla in criminal
conspiracy with accused R.S.Dhaliwal and to
facilitate the smooth passage of the bill,
R.S.Dhaliwal wrote letter Ex.PW-8/33 and gave
clarification vide noting Ex.PW-8/35. All this
was done to draw excess of Rs.20,500/- from the
94
account of Jigri Singh who, by that time, was no
more. Ultimately, the accused succeeded in
getting Rs.15,033/-. This was the fruit of
illegal means adopted by the accused persons in
furtherance of the object of the conspiracy.
Assuming that Accused Satpal Singla was
not aware of the letter Ex.PW-8/33 and the noting
Ex.PW-8/35, it will not affect his culpability.
The simple fact that he raised the bill for St.
Jude valve, whereas the valve supplied was Starr
Edwards proves that he was associated with the
object of the conspiracy. It is not necessary
that all the conspirators must know each and
ev3ery detail of the conspiracy as long as they
are the co-participators in the main object.
Different techniques are adopted by the
conspirators to achieve the common goal of
conspiracy and for that purpose there may be
division of performances in the chain of actions
with one object. In other words, there must be
unity of object or performance but there could be
cruelty of means. The only relevant fact is that
all means adopted and illegal acts done must be
and purported to be in the furtherance of the
95
object of the conspiracy.
PATIENT: BALDEV
As per file Ex.PW-10/4, Operation Note
Ex.PW-15/6 Baldev was operated on 18.06.1999 and
his Mitral valve was replaced with 31 MM st. Jude
artificial valve. As per the open heart register
Ex.PW-6/1 Page No.109 Entry No.73/9 (Ex.PW-25/2)
the serial number of St. Jude valve implanted was
80615242.
Baldev was a private grant/sponsored
patient. Vide requisition Ex.PW-13/89,
disposables and two St. Jude heart valves (M & A)
worth Rs.45,000/- each were requisitioned by Dr.
R.S.Dhaliwal from Paul Medical Hall through
Medical Superintendent, PGI. Bill No.326 of Bill
Book Ex.PW-35/32 was raised for two St. Jude
heart valves costing Rs.90,000/- in total.
Cheque dated 05.06.1999 Ex.PW-29/23 was issued by
the Office of Medical Superintendent in favour of
Paul Medical Hall. This was for Rs.1,12,549/-.
The amount included the cost of disposables and
medicines. As per the statement of account
Ex.PW-44/1, the cheque was credited to the
96
account of Paul Medical Hall on 09.06.1999.
Baldev appeared in the witness box as
PW-33 and stated that at the time of discharge
Dr. R.S.Dhaliwal had told him that his two valves
had been changed.
PW-15 Dr. Deepak Puri, who assisted Dr.
R.S.Dhaliwal in the surgery, has stated that
Mitral valve of Baldev was replaced with
artificial valve while Tricuspid was repaired.
It is, therefore, evident that against
supply of one valve, Paul Medical Hall received
payment for two valves.
PATIENT: SNEH LATA
As per file Ex.PW-10/7, Operation Note
Ex.PW-15/10 Sneh Lata was operated on 25.10.1999
and her Mitral valve was replaced with 29 MM St.
Jude artificial valve. In the open heart register
Ex.PW-6/1 Page No.119 Entry No.12/135
(Ex.PW-25/7), it is mentioned that St. Jude MVR
serial No.80655807 was implanted. Sticker of only
one St. Jude valve bearing this serial number
stands affixed. As per the discharge summary
97
Ex.PW-19/2 also, the operative procedure was 'MVR
29 MM St. Jude valve'. However, on the operation
note Ex.PW-15/10, the words 'AVR 21 MM' were
added in the portion Q-49 by way of
interpolation. On the admission form Ex.PW-15/9
in the column of surgical procedures initially
the words 'MVR 29 MM St. Jude valve were written
but by cutting the letter 'M' it was changed into
'D' to give the impression that it was DVR
(meaning double valve replacement). In between
the words 'MVR' and numerals '29' the numerals 21
were subsequently added to give the impression
that the valves were 21 MM and 29 MM St. Jude. It
is, therefore, clear that the record was fudged
purposely by way of cuttings and interpolations,
it was projected through the operation note and
admission form that two St. Jude heart valves had
been implanted. No such interpolations/cuttings
were, however, made in the open heart register
and discharge summary.
Vide requisition Ex.PW-13/9, disposables
and two St. Jude heart valves (M & A) worth
Rs.45,000/- each were requisitioned by Dr.
R.S.Dhaliwal from Paul Medical Hall through
98
Medical Superintendent, PGI. Bill No.396 dated
24.10.1999 of Bill Book Ex.PW-35/32 was raised
for two St. Jude heart valves costing Rs.90,000/-
in total. Cheque No.196717 dated 24.09.1999
Ex.PW-29/18 was issued by the Office of Medical
Superintendent in favour of Paul Medical Hall.
This was for Rs.1,13,799/-. The amount included
the cost of disposables and medicines. As per the
statement of account Ex.PW-44/1, the cheque was
credited to the account of Paul Medical Hall on
26.10.1999.
Question would be as to when there are
additions and cuttings in two documents but in
other two documents there are no such
cuttings/interpolations, which document is to be
taken to be containing authentic information? It
could be argued that in fact both Mitral and
Aortic valves of Sneh Lata were replaced with St.
Jude artificial valves but in the open heart
register and discharge summary this fact could
not be mentioned. However there would be no
substance in such a contention because it is
evident to that it was a case of Mitral valve
replacement. There was no question of Aortic
99
valve being replaced inasmuch as the diagnosis
was RHD, severe MR with mild AR.
PW-15 Dr. Deepak Puri, who assisted Dr.
R.S.Dhaliwal has categorically stated that Mitral
valve replacement was done with 29 MM St. Jude
valve. No suggestion was given to him that it
was a case of DVR i.e. double valve replacement.
Learned counsel for Dr. R.S.Dhaliwal
would argue that since Paul Medical Hall had
issued bill for two St. Jude heart valves and had
received payment for two valves but, only one
valve was replaced, interpolations/cuttings were
made in the operation note and admission form at
its behest to justify the receipt of money for
two valves. Learned counsel would question what
benefit Dr. R.S.Dhaliwal was going to get by
getting the record fudged? He would contend that
it was not the duty of R.S.Dhaliwal to prepare
and maintain the record, therefore, if there is
forgery, the same cannot be linked to him.
It is interesting to note that despite
having diagnosed that the patient was having
severe MR and mild AR, Dr. R.S.Dhaliwal had, vide
100
requisition Ex.PW-13/9, asked for two St. Jude
heart valves.
Although in ordinary course, the Court
should not question the wisdom of the doctor who
is an expert in his own right yet, in the
circumstances of this case, the court has tried
to find out as to whether there was justification
in requisitioning two valves. As per acc. org
practice Guidelines mentioned in the Journal of
American College of Cardiology (JACC) 2008, 52:
1-142 the patients with mild AR are not
candidates for AVR.
Despite this, if Dr. R.S.Dhaliwal asked
for two artificial heart valves, it can be safely
inferred that his intention was dishonest right
in the beginning. Otherwise, as per diagnosis,
there was no need to call for two valves. Hence,
there is no substance in the contention of Dr.
R.S.Dhaliwal that if there is forgery the same
cannot be linked to him. Notwithstanding the fact
that the expert has not been able to point out
whether the disputed writing in the disputed
portions is that of Dr. R.S.Dhaliwal,
101
circumstances indicate that the forgery was done
either by Dr. R.S.Dhaliwal himself or by another
person at his behest.
PATIENT: RAJ KUMAR
As per file Ex.PW-10/9, Operation Note
Ex.PW-15/17, Raj Kumar was operated on 11.04.2000
and his Mitral valve was replaced with 3 M SE
(Starr Edwards). On the admission form
Ex.PW-15/16, sticker of Starr Edwards Serial
No.FJ1784 stands pasted. In the open heart
register Ex.PW-6/1 Page No.131 Entry No.54/7
(Ex.PW-25/10) also sticker of Starr Edwards
serial No.FJ1784 stands pasted showing that it
was a case of Mitral valve replacement.
Vide requisition Ex.PW-13/80, disposables
and one St. Jude heart valves worth Rs.45,000/-
was requisitioned by Dr. R.S.Dhaliwal from Paul
Medical Hall through Medical Superintendent, PGI.
Bill No.207 of Bill Book Ex.PW-35/30 was raised
for one St. Jude heart valve costing Rs.45,000/-.
Cheque No.19456 dated 05.04.2000 Ex.PW-29/21 was
issued by the Office of Medical Superintendent in
favour of Paul Medical Hall. The amount included
102
the cost of disposables and medicines. As per the
statement of account Ex.PW-44/1, the cheque was
credited to the account of Paul Medical Hall on
11.04.2000.
From Bill Ex.PW-35/16, it is proved that
the valve serial No. FJ-1784, Starr Edwards, was
supplied to Paul Medical Hall. It is, thus, clear
that accused Satpal Singla supplied Starr Edwards
valve but he received and retained the price of
St. Jude valve. From letter Ex.PW-8/33 written by
Dr. R.S.Dhaliwal itself, it is clear that the
price of St. Jude was Rs.45,000/- while that of
Starr Edwards was Rs.24,500/-. Therefore, the
accused took pecuniary advantage to the extent of
Rs.20,500/-.
PATIENT: DWARKA PRASAD
As per file Ex.PW-10/12, Dwarka Prasad
was operated on 30.05.2000 and his Mitral valve
was replaced with 27 MM Omni Science artificial
heart valve. As per open heart register Ex.PW-6/1
Page No.135 Entry No.77/17, the valve replaced
was Omni Science Serial No.676371
103
Vide requisition Ex.PW-8/16, disposables
and one St. Jude heart valve worth Rs.45,000/-
was requisitioned by Dr. R.S.Dhaliwal from Paul
Medical Hall through Medical Superintendent, PGI.
Bill dated 24.05.2000 of Bill Book Ex.PW-18/7
was raised for one St. Jude heart valve costing
Rs.45,000/-. Cheque dated 16.05.2000 Ex.PW-29/11
was issued by the Office of Medical
Superintendent in favour of Paul Medical Hall.
The amount included the cost of disposables and
medicines. As per the statement of account
Ex.PW-44/1, the cheque was credited to the
account of Paul Medical Hall on 20.05.2000.
As per Ex.PW-21/5, the invoice of B.L.
Marketing an Omni Science valve with the same
serial number was supplied to Paul Medical Hall
for Rs.33,000/-. However against supply of Omni
Science valve for patient Dwarka Prasad, Paul
Medical Hall received payment of St. Jude valve.
When the matter came up before the Office of
Medical Superintendent for refund of the balance
to the funding agency, vide noting Ex.PW-18/9 the
file was sent to Dr. R.S.Dhaliwal for
verification of the bills. Dr. Dhaliwal gave
104
noting “needful has been done”. After this
verification, the balance amount was refunded.
At no point of time did Dr. R.S.Dhaliwal point
out the discrepancy that the valve requisitioned
was St. Jude, the one implanted was Omni Science
but, the bill had been raised for St. Jude. This
shows that Dr. R.S.Dhaliwal and Paul Medical Hall
were in league. Dr. R.S.Dhaliwal cannot escape
the liability by simply claiming that due to rush
of work, he had verified without referring to the
file/record.
PATIENT:MANI MARI
As per file Ex.PW-10/10, Operation Note
Ex.PW-15/19, Mani Mari was operated on 18.04.2000
and her Mitral and Aortic valves were replaced
with 27 MM Omni Science and 17 MM St. Jude
valves. In open heart register Ex.PW-6/1 Page
No.132 Entry No.56/9 (Ex.PW-25/11), the serial
numbers of the valves are mentioned as under:
“Omni Science- Sr. No.676215
St.Jude- Sr. No.60317357
105
Vide requisition Ex.PW-13/69, two St.
Jude heart valves (M & A) worth Rs.45,000/- each
were requisitioned by Dr. R.S.Dhaliwal from Paul
Medical Hall through Medical Superintendent, PGI.
Bill No.214 dated 18.04.2000 of Bill Book
Ex.PW-35/30 was raised for two St. Jude heart
valves costing Rs.90,000/-. Cheque No.194217
dated 17.02.2000 Ex.PW-29/13 was issued by the
Office of Medical Superintendent in favour of
Paul Medical Hall. The amount included the cost
of disposables and medicines. As per the
statement of account Ex.PW-44/1, the cheque was
credited to the account of Paul Medical Hall on
20.04.2000.
As per Ex.PW-21/4, the invoice of BL
Marketing an Omni Science valve with the same
serial number i.e. No.676215 was supplied to Paul
Medical Hall for Rs.33,000/-. It is, therefore,
clear that Paul Medical Hall supplied Omni
Science valve for patient Mani Mari, whereas the
valve requisitioned was St. Jude. Needless to say
that against the supply of Omni Science valve
Paul Medical Hall received payment for St. Jude
valve.
106
PATIENT: RAM SHABAD
As per file Ex.PW-10/3 Operation Note
Ex.PW-15/4, Ram Shabad was operated on 18.11.1999
and his Mitral and Aortic valves were replaced
with St. Jude valve and Edward Mira. As per the
stickers pasted in open heart register Ex.PW-6/1
Page No.120 Entry No.7/144 (Ex.PW-15/8), the
serial numbers of the valves are as under:
Edward Mira Serial No.99020066
St. Jude- Serial No.80537792
Vide requisition Ex.PW-13/54, two St.
Jude heart valves (M & A) worth Rs.45,000/- each
were requisitioned by Dr. R.S.Dhaliwal from Paul
Medical Hall through Medical Superintendent, PGI.
Bill No.399 dated 31.10.1999 of Bill Book
Ex.PW-35/32 was raised for two St. Jude heart
valves costing Rs.90,000/-. Cheque No.196873
dated 09.10.1999 Ex.PW-29/14 was issued by the
Office of Medical Superintendent in favour of
Paul Medical Hall. The amount included the cost
of disposables and medicines. As per the
107
statement of account Ex.PW-44/1, the cheque was
credited to the account of Paul Medical Hall on
02.11.1999.
As per Mark D-1, the invoice of Baxter
India Limited Edward Mira valve with the same
serial number i.e. No.99020066 was supplied to
Paul Medical Hall for Rs.38,000/-. It is,
therefore, clear that Paul Medical Hall supplied
Edward Mira valve for patient Ram Shabad, whereas
the valve requisitioned was St. Jude. Needless to
say that against the supply of Edward Mira valve,
Paul Medical Hall received payment for St. Jude
valve.
PATIENT: DAYAL SINGH
As per file Ex.PW-10/6, Dayal Singh was
operated on 15.10.1999 and as per Operation Note
at Page No.14 of the said file, his Mitral valve
was replaced with 29 MM Edward Mira valve. As
per the open heart register Ex.PW-6/1 Page No.118
Entry No.8/131 (Ex.PW-25/6) serial number of
Edwards Mira valve implanted was 98040674.
Vide requisition Ex.PW-13/52, disposables
108
and two St. Jude heart valves (M&A) worth
Rs.45,000/- each were requisitioned by Dr.
R.S.Dhaliwal from Paul Medical Hall through
Medical Superintendent, PGI. Bill No.392 dated
14.10.1999 of Bill Book Ex.PW-35/32 was raised
for two St. Jude heart valves costing Rs.90,000/-
in total. Cheque No.196643 dated 15.09.1999
Ex.PW-29/16 was issued by the Office of Medical
Superintendent in favour of Paul Medical Hall.
This was for Rs.1,12,080/-. The amount included
the cost of disposables and medicines. As per the
statement of account Ex.PW-44/1, the cheque was
credited to the account of Paul Medical Hall on
16.10.1999.
Shri Ashok Kumar, PW-24, the father-in-
law of Dayal Singh stated that before surgery Dr.
R.S.Dhaliwal had told them that each valve will
cost Rs.45,000/-. As per invoice Ex.PW-39/2, the
Edward Mira valve implanted in the heart of
patient was purchased by Paul Medical Hall from
Baxter India Limited. It is, thus, evident that
against supply of Edward Mira Mitral valve, Paul
Medical Hall received payment for two St. Jude
valves.
109
This was a case, where the patient had
been diagnosed with severe MR and mild AR.
Despite this, Dr. R.S.Dhaliwal, vide requisition
Ex.PW-13/52 called for two St. Jude artificial
heart valves.
Although in ordinary course, the Court
should not question the wisdom of the doctor who
is an expert in his own right yet, in the
circumstances of this case, the court has tried
to find out as to whether there was justification
in requisitioning two valves. As per acc. org
practice Guidelines mentioned in the Journal of
American College of Cardiology (JACC) 2008, 52:
1-142 the patients with mild AR are not
candidates for AVR.
Despite this, if Dr. R.S.Dhaliwal asked
for two artificial heart valves, it can be safely
inferred that his intention was dishonest right
in the beginning. Otherwise, as per diagnosis,
there was no need to call for two valves. Hence,
there would be no merit in the contention of Dr.
R.S.Dhaliwal that if Paul Medical Hall received
payment for two valves did not refund the price
110
of one valve to the PGI, he is not at fault. As
discussed above, conspiracy is a clandestine
activity. People generally do not form illegal
covenants openly, therefore, the factum of
conspiracy is to be inferred from the
circumstances, the act and conduct of the
accused. Here the act of Dr. R.S.Dhaliwal in
requisitioning two artificial valves despite the
diagnosis as stated above indicates that he set
the ball rolling. Thereafter, in view of the
procedure flaws, it was a cake-walk for Paul
Medical Hall. Needless to say that the technique
was adopted to achieve the common goal although
there was division of performances in the chain
of actions.
PATIENT: SHIV SHANKAR
As per file Ex.PW-10/8, Operation Note
Ex.PW-15/15 Shiv Shankar was operated on
06.04.2000 and his Mitral valve was replaced with
3 M SE (Starr Edwards). On the admission form
Ex.PW-15/14, sticker of Starr Edwards Serial
No.FJ1778 stands pasted. In the open heart
register Ex.PW-6/1 Page No.131 Entry No.50/3
111
(Ex.PW-25/9) also sticker of Starr Edwards serial
No.FJ1778 stands pasted showing that it was a
case of Mitral valve replacement.
Vide requisition Ex.PW-13/75, disposables
and one St. Jude heart valve worth Rs.45,000/-
was requisitioned by Dr. R.S.Dhaliwal from Paul
Medical Hall through Medical Superintendent, PGI.
Bill No.202 of Bill Book Ex.PW-35/30 was raised
for one St. Jude heart valve costing Rs.45,000/-.
Cheque No.194709 dated 23.03.2000 Ex.PW-29/20 was
issued by the Office of Medical Superintendent in
favour of Paul Medical Hall. The amount included
the cost of disposables and medicines. As per the
statement of account Ex.PW-44/1, the cheque was
credited to the account of Paul Medical Hall on
06.04.2000.
From Bill dated 29.03.2000 (Ex.PW-35/16),
it is proved that valve serial No. FJ-1778 Starr
Edwards was supplied to Paul Medical Hall by
Baxter India Limited. It is, thus, clear that
accused Satpal Singla supplied Starr Edwards
valve but he received and retained the price of
St. Jude valve.
112
PATIENT: SHEELA DEVI
As per file Ex.PW-10/13, Operation Note
Ex.PW-2/2, Sheela Devi was operated on 04.05.2000
and her Mitral valve was replaced with 29 MM Omni
Science artificial heart valve. On the admission
form Ex.PW-15/13, Sticker of Omni Science
No.676257 stands pasted. As per open heart
register Ex.PW-6/1 Page No.133 Entry No.63/3
(Ex.PW-25/12), the valve replaced was Omni
Science Serial No.676257.
Vide requisition Ex.PW-8/12, disposables
and one St. Jude heart valve worth Rs.45,000/-
was requisitioned by Dr. R.S.Dhaliwal from Paul
Medical Hall through Medical Superintendent, PGI.
Bill No.239 Ex.PW-18/2 of Bill Book Ex.PW-35/30
was raised for one St. Jude heart valve costing
Rs.45,000/-. Cheque No.195045 dated 24.04.2000
Ex.PW-29/10 was issued by the Office of Medical
Superintendent in favour of Paul Medical Hall.
The amount included the cost of disposables and
medicines. As per the statement of account
Ex.PW-44/1, the cheque was credited to the
account of Paul Medical Hall on 05.05.2000.
113
As per Ex.PW-21/7, the invoice of B.L.
Marketing, an Omni Science valve with the same
serial number was supplied to Paul Medical Hall
for Rs.33,000/-. However against supply of Omni
Science valve for patient Sheela Devi, Paul
Medical Hall received payment of Rs.45,000/- for
St. Jude valve.
When the matter came up before the
Office of Medical Superintendent for issuing
utilization certificate to the funding agency,
vide noting Ex.PW-18/5 the file was sent to Dr.
R.S.Dhaliwal for verification of the bills. Dr.
Dhaliwal gave noting “needful has been done”.
After this verification, the balance amount was
returned to the funding agency. At no point of
time did Dr. R.S.Dhaliwal point out the
discrepancy that though the valve requisitioned
was St. Jude, the one implanted was Omni Science
but, the bill had been raised for St. Jude. This
shows that Dr. R.S.Dhaliwal and Paul Medical Hall
were in league. Dr. R.S.Dhaliwal cannot escape
the liability by simply claiming that due to rush
of work, he had verified without referring to the
file/record.
114
PATIENT: NARINDER KUMAR
As per file Ex.PW-10/14, Operation Note
Ex.PW-2/3, Narinder Kumar was operated on
14.10.1999 and his Mitral valve was replaced with
29 MM Omni Science artificial heart valve. As per
open heart register Ex.PW-6/1 Page No.118 Entry
No.7/130 (Ex.PW-25/5), the valve replaced was
Omni Science Serial No.663106.
Vide requisition Ex.PW-8/25, disposables
and one St. Jude heart valve worth Rs.45,000/-
was requisitioned by Dr. R.S.Dhaliwal from Paul
Medical Hall through Medical Superintendent, PGI.
Q-78 is written in the hand of R.S.Dhaliwal. Bill
No.391 dated 14.10.1999 Ex.PW-13/37 was raised
for one St. Jude heart valve costing Rs.45,000/-.
Cheque No.196605 dated 09.09.1999 Ex.PW-29/19 for
Rs.67,019/- was issued by the Office of Medical
Superintendent in favour of Paul Medical Hall.
The amount included the cost of disposables and
medicines. As per the statement of account
Ex.PW-44/1, the cheque was credited to the
account of Paul Medical Hall on 15.10.1999.
The Omni Science valve No.663106 was
115
supplied by Paul Medical Hall after purchasing
the same from BL Marketing. As per invoice
Ex.PW-21/1, BL Marketing supplied the said valve
to Paul Medical Hall on 04.11.1999 for
Rs.33,000/-.
It is, therefore, established that
against supply of Omni Science valve, Paul
Medical Hall received payment for St. Jude valve.
PATIENT: RAJESH KUMAR
As per file Ex.PW-10/11, Operation Note
Ex.PW-13/13, Rajesh Kumar was operated on
23.05.2000 and his Aortic valve was replaced with
21 MM Omni Science artificial heart valve. As per
open heart register Ex.PW-6/1 Page No.134 Entry
No.73/13 (Ex.PW-25/13), the valve replaced was 21
MM Omni Science Serial No.676103.
Vide requisition Ex.PW-13/12, disposables
and one St. Jude heart valve worth Rs.45,000/-
was requisitioned by Dr. R.S.Dhaliwal from Paul
Medical Hall through Medical Superintendent, PGI.
Bill No.254 of Bill Book Ex.PW-35/30 was raised
for one St. Jude heart valve costing Rs.45,000/-.
116
Cheque No.195254 dated 11.05.2000 Ex.PW-29/12 for
Rs.60,321/- was issued by the Office of Medical
Superintendent in favour of Paul Medical Hall.
The amount included the cost of disposables and
medicines. As per the statement of account
Ex.PW-44/1, the cheque was credited to the
account of Paul Medical Hall on 20.05.2000.
The Omni Science valve implanted in the
heart of patient Rajesh Kumar was supplied by
Paul Medical Hall, as the same valve had been
purchased by Paul Medical Hall from BL Marketing
vide invoice Ex.PW-21/4.
It is, therefore, established that
against the supply of Omni Science valve, Paul
Medical Hall received payment for St. Jude valve.
PATIENT: SURESH KUMAR
As per file Ex.PW-10/5, Operation Note
Ex.PW-15/8, Suresh Kumar was operated on
08.10.1999 and his Mitral valve was replaced with
31 MM Omni Science artificial heart valve. On the
admission form Ex.PW-15/7, Sticker of Omni
117
Science No.670399 stands pasted. As per open
heart register Ex.PW-6/1 Page No.118 Entry
No.5/128 (Ex.PW-25/4), the valve replaced was
Omni Science Serial No.670399.
Vide requisition Ex.PW-13/92, disposables
and one St. Jude heart valve worth Rs.45,000/-
was requisitioned by Dr. R.S.Dhaliwal from Paul
Medical Hall through Medical Superintendent, PGI.
Bill No.387 of Bill Book Ex.PW-35/32 was raised
for one St. Jude heart valve costing Rs.45,000/-.
Cheque No.196705 dated 22.09.1999 Ex.PW-29/22 for
Rs.67,019/- was issued by the Office of Medical
Superintendent in favour of Paul Medical Hall.
The amount included the cost of disposables and
medicines. As per the statement of account
Ex.PW-44/1, the cheque was credited to the
account of Paul Medical Hall on 09.10.1999.
The Omni Science valve implanted in the
heart of patient Suresh Kumar was supplied by
Paul Medical Hall, as the same valve had been
purchased by Paul Medical Hall from BL Marketing
vide invoice Ex.PW-21/3.
It is, therefore, established that
118
against supply of Omni Science valve, Paul
Medical Hall received payment for St. Jude valve.
33. A perusal of the above would reveal a
pattern. Leaving aside the case of Ishwar Chand,
in all but one case the valves requisitioned were
St. Jude. However, only in the cases of Baldev,
Sneh Lata, Ram Shabad and Mani Mari, the valves
actually implanted were St. Jude albeit, in the
cases of Baldev and Sneh Lata one valve each was
implanted against the requisition of two while in
case of Mani Mari and Ram Shabad against
requisition of two St. Jude, the valves actually
implanted were one St. Jude and one Omni science
(Mani Mari) and one Edward Mira and a St. Jude
(Ram Shabad). In the cases of Raj Kumar and Shiv
Shankar, the valves actually implanted were Starr
Edwards. In the case of Dayal, the valve actually
implanted was Edward Mira while in the case of
Dwarka Parshad, Sheela Devi, Narinder Kumar,
Rajesh Kumar and Suresh Kumar, the brand of the
valve actually implanted was Omni Science. In
case of Jigri, the valves requisitioned were two
Starr Edwards. The valves actually implanted were
one Omni Science and one Starr Edwards. However
119
by manipulation, it was shown that the valves
implanted were a Starr Edwards and a St. Jude.
34. While prosecution has asserted that the
price of Edward Mira was Rs.38,000/- and that of
Omni Science was Rs.33,000/- against which the
amount charged was Rs.45,000/- which was the
price of St. Jude, the defence has pointed out
that the prosecution has only established the
price at which the Omni Science and Edward Mira
were being supplied to Paul Medical Hall by the
concerned distributor. According to the defence
counsel, the valves purchased for Rs.33,000/- and
Rs.38,000/- respectively were to be sold by Paul
Medical Hall at profit and since there is nothing
on record to suggest as to what was the MRP, it
cannot be said that Paul Medical Hall cheated or
that against supply of cheaper valves the price
of expensive valves was charged.
35. There appears some force in the
contention of the defence counsel inasmuch as
the prosecution has simply proved the cost of
acquisition and not the retail price of Edward
Mira and Omni Science valves. Therefore, it
120
cannot be said that against supply of cheaper
valve (Edward Mira and Omni Science), Paul
Medical Hall received payment for expensive valve
(St. Jude). However, this will not exonerate the
accused. As pointed out above in cases of Raj
Kumar and Shiv Shankar, the valves actually
implanted were Starr Edwards against the
requisition of St. Jude and it has been
conclusively established on record that the
retail price of St. Jude was Rs.45,000/- and that
of Starr Edwards was Rs.24,500-Rs.25,000/-.
36. A question would arise as to why in all
cases except that of Jigri Singh, St. Jude valve
was being requisitioned but actually some other
valve was being implanted. Related question would
be as to why in case of Jigri Singh, Starr
Edwards valve had been requisitioned but, valves
of other brands were implanted. The defence would
argue that this was because of the availability
of a particular brand of valve of the required
size at the relevant time.
37. On first blush, this contention would
appear attractive but it lacks substance. There
121
was a reason behind requisitioning St. Jude
valves in almost all the cases and Starr Edwards
in case of Jigri Singh. It has already been
noticed above that From 1996 to 2000 the system
of rate contract was in vogue. The rate contracts
of Paul Medical Hall and Bharat Medical Store for
supply of different items were approved. The
valve approved in case of Paul Medical Hall was
St. Jude for which the price fixed was
Rs.45,153/- (vide Ex.PW-22/1). This rate contract
was extended till 30.11.2000 vide Ex.PW-22/2 and
Ex.PW-22/3. The valves approved in case of Bharat
Medical Store were Starr Edwards for which the
price fixed was Rs.25,000/- (Ex.PW-22/4) and St.
Jude for which the price fixed was Rs.45,153/-
(Ex.PW-22/5). It is, therefore, evident that the
brands of artificial heart valves on the approved
list were St. Jude and Starr Edwards only. Omni
Science and Edward Mira were not on the approved
list. This explains why the valves being
requisitioned were St. Jude and Starr Edwards.
This was to satisfy the conditions. The
explanation that sometimes a set of different
sizes of different brands had to be brought to
122
the operation theatre depending upon the
availability of a particular size of a particular
brand does not justify the use of Omni Science
and Edward Mira. If the chemist had quoted the
price of a particular brand and that had been
approved it was expected of him to keep in stock
all sizes. If the treating surgeon had noticed
that all sizes of the approved brand were not
available, he should have brought it to the
notice of the Director/Office of Medical
Superintendent. However, the fact remains that
Dr. R.S.Dhaliwal, at no point of time, pointed
this out. It is not that he simply acquiesced
keeping in mind the interest of the patients. At
the same time, the question is not as to whether
Omni Science and Edward Mira were inferior to St.
Jude. The question is that the brands on the
approved list were St. Jude and Starr Edwards. To
bye-pass the rate contract, Dr. R.S.Dhaliwal used
to requisition St. Jude and Starr Edwards. Paul
Medical Hall used to supply Omni Science in most
of the cases and Edward Mira in some cases. If
the transactions were genuine, Paul Medical Hall
should have issued bill/invoice for the valve
123
actually supplied and not just for the valve
requisitioned. It is evident that there was a
deliberate move by Paul Medical Hall in
connivance with Dr. R.S.Dhaliwal to push other
brands which were not on the approved list. The
price difference, therefore, between St. Jude,
Omni Science and Edward Mira becomes immaterial
although it may be material in case of St. Jude
vis-a-vis Starr Edwards. It is evident that
nothing was by chance. It is not that the valve
of a particular brand was not in stock of Paul
Medical Hall and, therefore, some other valve was
supplied or brought to the operation theatre.
Everything was deliberate. The Office of the
Medical superintendent was being informed
selectively whenever it suited the accused. In
case of Jigri Singh one of the valves was Omni
Science against the requisition of Starr Edwards.
Since Starr Edwards was less expensive, the
Medical superintendent was informed by Dr.
Dhaliwal. It is another aspect that even then he
misled and asked for price difference between st.
Jude and Starr Edwards by making categorical
assertion that the valve implanted was St. Jude.
124
Had he acted bonafide, he would have informed
that the valve implanted was Omni Science. Two
inferences can be drawn from this. Firstly, that
Omni Science being not on the approved list, Dr.
Dhaliwal deliberately misinformed the Medical
Superintendent; secondly that St. Jude was not
fetching the kind of profits to Paul Medical Hall
as Omni Science and Edward Mira were.
38. No doubt, that implanting a valve of a
brand different from the one requisitioned would
not have, by itself, meant much even if it was
not on the approved list. However, the manner in
which the circumstances were created and
manipulated, as discussed above, reveals the true
picture.
39. The defence of the accused Sat Pal Singla
is that the goods requisitioned by the doctors
used to be deposited in the central store of the
Medical Superintendent after due verification and
in case requisition was for two valves, then two
valves used to be deposited in the store but
since at the time of surgery the number of valves
and the brand of valves, due to the need of the
125
patient could not be foreseen, therefore,
numerous valves and brands used to be sent at the
time of planned surgery but since the bills used
to be prepared before the deposit of the goods in
the store, subsequently excess or less amount
received were subject to reconciliation and
finalization of accounts when the actual goods
used to be compared. According to the accused,
there was acute shortage of staff in Medical
Superintendent Office, therefore reconciliation
of accounts could not take place despite his
representative contacting the Office of Medical
Superintendent a number of times.
40. Much emphasis has been laid by counsel
for Sat Pal Singla on the statement of PW-8 Dr.
Anil Kumar Gupta that Utilization Certificate is
issued after verification of consumables and
reconciliation of accounts and; that due to
paucity of staff, reconciliation of accounts used
to take considerable time and, for that reason,
Utilization Certificates, in most of the cases,
were issued after 2-3 years. Taking the Court
through the statement of PW-8, learned counsel
argued that while doing reconciliation, the
126
supplier could refund the amount or receive more
amount later on once it was verified by the
treating surgeon that more or lesser consumables/
costly/cheaper consumables had been used. It has
been further argued that if, as admitted by PW-8,
there were on going transactions between the PGI
and the supplier and discrepancies, if any, used
to be reconciled, no fault can be found with
accused Sat Pal Singla particularly, when PW-8
admits to the possibility of his (the supplier)
having approached the Office of Medical
Superintendent for reconciliation of accounts.
Learned counsel summed up that if there was a
change of brand of valve in some cases while in
other cases only one valve against the supply of
two had been used, the PGI could always ask for
refund from the accused and if no reconciliation
of accounts took place and due to that the PGI
authorities did not ask for refund/adjustment, it
cannot be inferred that the accused was
dishonest.
41. To my mind, the statement made by PW-8 in
cross-examination by accused Sat Pal Singla has
to be read carefully to draw proper conclusions.
127
The same is reproduced hereunder for facility of
reference:
“-------Utilization certificate is issued after verification of consumables and reconciliation of accounts. It is correct that in case of Dwarka Parshad requisition Ex.PW-8/16 is dated 24.4.2000 and after receipt of consumables cheques were issued to the party Pal Medicals after receipt of consumables in the stores. similarly in case of Sneh Lata requisition Ex.PW-8/21 is dated 15.09.1999 and cheque was issued to Pal Medicals after receipt of consumables in the stores on 24.09.1999. Voltd. as per the record I approved the payment on 20.9.99 and cheque dated 24.9.99 was issued to Sunita Kumari. It is not clear from the record as to when was the cheque issued/handed over to Sunita Kumari. It is correct that consumables are received in the store. It is true that in some cases all the consumables that have been requisitioned are not consumed while in some of them
128
some more consumables are required.Therefore, subsequently reconciliation on the recommendation of the treating doctor does take place. It is correct that during surgery brand of the valve required, size of the valve can be decided by the operating surgeon then and there taking condition of the patient into consideration, and accordingly the brand and the size of the valve can be substituted. In all cases of rate contract the utilization certificate is of 2003. The case of Sneh Lata, Jigri Singh, Dwarka Parshad, Narinder Kumar, Narinder Kumar mentioned in my statement are cases of rate contract. So is the case of Sheela Devi. It is correct that reconciliation of the accounts regarding return of goods or substitution or requisition of more goods used to take place after few days of the operation. It is correct that in case of approved source while doing reconciliation approved firm could refund the amount or receive more amount later on
129
once it was verified by the treating surgeon that more consumables /costly consumables had been used. Hence there were on going transactions between the PGI and the approved supplier. Discrepancies if any used to be reconciled at appropriate stages so far as accounts were concerned. In case of change of brand of valve reconciliation used to take place on the recommendation of the treating doctor. Due to error some mistakes in the accounts could occur but none of those nature came to my notice. There used to be 2/3 major surgeries in a week in the department of CTVS. However, I am not sure. I cannot tell how many minor surgeries used to take place per day or per week. Without going through documents I cannot szay yes or no to the question as to whether 6/7 major surgeries used to be scheduled for a week. But it is quite possible. It is correct that the staff available in my office is not adequate to deal with all the matters, particularly
130
procurement of consumables on rate contract basis; regarding the reconciliation of accounts and dispersal of amount. This is one of the reasons as to why utilization certificates were issued after 2/3 years. The possibility of approved sources approaching my office for reconciliation of accounts during that period cannot be ruled out. Since the staff was inadequate the possibility of delay in reconciliation in spite of the visits of approved firm for reconciliation of accounts cannot be ruled out. During the period when rate contract was on vogue, hundred of operations may have taken place”.
42. The above statement has to be understood
with reference to the context. It is not denied
that all the 14 cases pertained to sponsored
/private grant patients. The amount for treatment
of the patient concerned used to be deposited in
the PGI by the relevant funding agency. In the
file of Sneh Lata (Ex.PW-8/17), I have come
across letter written by the Joint Secretary,
Government of Himachal Pradesh (the funding
131
agency) to the Director, PGI. While sending the
bank draft for the treatment of Sneh Lata, the
funding agency requested the PGI to remit the
unspent balance after treatment to the agency
along with medical bills/necessary documents in
token of the treatment having been obtained and
the funds utilized. Therefore, when PW-8 is
referring to reconciliation of accounts in the
opening lines of his cross-examination, the
context is 'Utilization Certificate'. He means to
say that for issuance of Utilization Certificate
to the funding agency, reconciliation of accounts
has to be done. How this is done, would be
evident from the proceedings conducted in the
Office of Medical Superintendent. For example in
the file Ex.PW-8/13 pertaining to patient Dwarka
Parshad, there are notings under the subject
“Issue of Utilization Certificate”. The Office of
Medical Superintendent pointed out that out of
the grant of Rs.1,40,000/-, an amount of
Rs.86,007/- had been utilized and the balance had
to be refunded along with Utilization
Certificate. On a side of the noting, the
following details are mentioned:
132
Requisition No. & Date
Amount utilized Reference to Page No. of file
1/26.04.2000 Rs.77,972/- P-7Less Rs. 6,663/- P-2Balance Rs.71,309/- Cheque cancelled2/27.04.2000 Rs. 6,663/- P-233/14.06.2000 Rs. 8,035/- P-49Total Rs.86,007/-
43. When the matter was put up before the
Joint Medical Superintendent, he asked the branch
to get all the cash memos verified by the A.M.A.
Since the patient had received treatment in the
department of CTVS and the medicines had been
purchased on the basis of the supply orders
/requisitions of that department, the bills were
sent to that department for verification with
reference to their supply orders/requisitions.
Consequently, Dr. R.S.Dhaliwal made the
verification and thereafter the Utilization
Certificate was issued. Therefore, when PW-8 says
reconciliation of accounts before issuance of
Utilization Certificate he means verification of
the bills with reference to the supply
orders/requisitions.
44. Insofar as reconciliation of accounts
133
between PGI and the supplier is concerned, PW-8
has made clear that the same used to take place
after few days of the operation on the
recommendation of the treating doctor. While
saying that there were on going transactions
between the PGI and the supplier, PW-8 does not
mean to say that there was running account in
strict sense. He means to say that while doing
reconciliation of accounts, the supplier could
receive more amount or refund some amount
depending upon the circumstances. When PW-8 says
that the staff in his office was inadequate to
deal with the matters regarding reconciliation of
accounts, the context is 'Utilization
Certificate' and not the reconciliation of
accounts between the PGI and supplier which,
according to him, used to take place after a few
days of the operation. There was no suggestion to
the witness that even that reconciliation of
accounts also used to take place after 2-3 years.
No doubt, towards the end of the statement, PW-8
admits to the possibility of delay in
reconciliation of accounts in spite of the visits
of the approved firm/supplier but, this was in
134
response to suggestion. With no precise and
particular instance having been cited, naturally
PW-8, who had himself committed that the strength
of staff at his command was inadequate, had no
option but to say that possibility could not be
ruled out. Such a wide suggestion would, however,
not mean that reconciliation of accounts between
the supplier and the PGI used to take so much of
time.
45. Even if, for a pause, it is assumed that
the strength of staff being inadequate,
reconciliation of accounts could have taken 2-3
years, the question arises as to on what basis
reconciliation of accounts between PGI and the
supplier was to be done? Whether it was to be
done on the basis of the requisition and the
bills/invoices? If 'yes', the supplier had no
role to play, as the requisition and the bills
used to be available on file. Whether it was to
be done at the instance of the supplier? If
'yes', there should have been a request by him
along with new/amended bill. Whether it was to be
done on the request/report of the treating
doctor? If 'yes', there had to be a communication
135
by the treating doctor citing the reasons. Apart
from the three eventualities, there was no scope
for reconciliation of accounts, as it was
understood that the bills had been issued against
the supply of the items which had been
requisitioned. Therefore, a bald suggestion that
possibility of delay in reconciliation of
accounts in spite of the visits of the approved
firm would not lead to a definite conclusion that
the supplier/his representative used to ask for
reconciliation but due to paucity of staff in the
Office of Medical Superintendent, his request
would be kept pending.
46. It would be axiomatic to say that a man
may lie but the circumstances do not. It is
equally correct that when a document as to a
particular transaction/circumstance is proved to
have been executed in due course, oral evidence
to the contrary is not admissible. The Court has
tried to look into the record to find out as to
what was being done in case more items than the
requisitioned had been used or in cases where
lesser/cheaper items than the requisitioned had
been used. During the exercise, the Court has
136
come across two files i.e. the file of Daya
Krishan and the file of Jigri Singh.
47. In the file of Daya Krishan, there is a
letter Ex.DW-3/1 which is written by Dr.
R.S.Dhaliwal to Paul Medical Hall with a copy to
Medical Superintendent. The text of the letter is
as under:
“Kindly refer to our supply order No. CTU/2000/166 dated 2.2.2000 vide which two St. Jude Heart Valves were procured for implantation in Mitral and aortic position. However, during surgery an Aortic Valve was not implanted. Therefore, it is being returned to you. A cheque/draft for the cost of this valve i.e. Rs.45,000/- may please be issued in the name of the Director, PGI, Chandigarh and forwarded to the undersigned so that it can be sent to the Medical Superintendent's office.”
48. In the file of Jigri Singh, there is a
letter Ex.PW-8/33 written by Dr. R.S.Dhaliwal to
the Medical Superintendent, the contents of the
letter are as under:
“The above said patient was taken up
137
for double valve replacement on
2.9.1999 and two Starr Edward Valves
were procured from M/s Paul Medical
Hall for replacement in Mitral and
Aortic position. However, on table it
was found that the aortic root was very
narrow and hence a St. Jude Heart Valve
was procured from M/s Paul Medical Hall
and inserted in aortic position instead
of Starr Edward Valve. The cost of St.
Jude Heart Valve is Rs.45,000/- while
the cost of Starr Edward is Rs.24,500/-
so that the balance amount of
Rs.20,500/- may please be forwarded to
M/s Paul Medical Hall”.
49. If the letters Ex.DW-3/1 and Ex.PW-8/33
are placed in juxtaposition, it would be clear
that whether some amount is to be refunded by the
supplier or whether some more amount is to be
paid to the supplier, it is on the recommendation
of the treating surgeon. He is the Pivot. He
knows what has been used and what has been
returned. The Office of Medical Superintendent is
138
to go by his recommendation and if there is no
such recommendation, there is no question of any
reconciliation of accounts between the PGI and
the supplier. Whatever reconciliation of accounts
takes place is the internal procedure whereby the
bills issued by the supplier are verified by the
concerned department with reference to the supply
order/requisition so as to enable the Office of
Medical Superintendent to issue the 'Utilization
Certificate'. Needless to say that PW-8 is not
wrong when he says that Utilization Certificate
is issued after reconciliation of accounts and
that it takes about 2-3 years for Utilization
Certificate to be issued. As pointed out above,
this is in context of Utilization Certificate. At
the same time, PW-8 is not wrong when he says
that in some cases, all the consumables that have
been requisitioned are not consumed while in some
of them some more consumables are required,
therefore, subsequently reconciliation on the
recommendation of the treating doctor does take
place. This is with reference to the settlement
of accounts between PGI and the supplier. PW-8
has made explicit that in case of change of brand
139
of valve, reconciliation used to take place on
the recommendation of the treating doctor. Again
he is correct and is supported by record. But the
sequence and positioning of the questions put to
him in cross-examination is such as would give
the impression that there used to be on going
transactions between PGI and the suppliers and it
used to take 2-3 years for reconciliation of
accounts between them. However, if the entire
statement is read in its entirety without picking
up one sentence from here and there, it would be
evident that reconciliation of accounts between
the supplier and the PGI used to take place on
the recommendation of the treating doctor
/surgeon. It is reiterated albeit, at the cost of
repetition, that in the absence of any such
recommendation by the treating doctor or, in the
alternative, a request by the supplier, duly
verified by the treating doctor there could be no
question of reconciliation of accounts.
50. It is quite interesting though, not
strange, that both the accused adopted different
lines on the point of the manner of supply of the
140
valves. As discussed above, the defence of
accused Sat Pal Singla is that the valves used to
be deposited in the central store after due
verification, the defence taken by Dr.
R.S.Dhaliwal is that there was no such procedure.
According to him, the representative of the
chemist concerned used to bring the whole set to
the operation theatre on the day of surgery and
he used to remain present till the end of the
surgery in order to take back the remaining
valves of the set. From this line, accused Dr.
R.S.Dhaliwal has developed defence that it was
always expected of the chemist/supplier that he
would refund the amount to the patient or PGI in
case the valve supplied by him had not been
implanted or if he had supplied the valve of a
brand of lesser price after having charged for
the brand of higher price.
51. It is basically the statement of PW-8
which has caused much confusion. In cross-
examination, he stated that in case of rate
contract the consumables have to be in the store
before surgery and that the cheque used to be
issued only after the verification of the
141
consumables by the representative of the surgeon.
This statement of his is not in sync with his
statement in examination-in-chief, wherein he
stated that the deposit of items in the central
store was a condition under the system of spot
committees. In examination-in-chief, he no where
stated that even under the system of rate
contracts, such was a condition. Even the record
does not support this point of view that the
consumables had to be in the store before the
operation or that the cheque used to be issued
only after the representative of the treating
surgeon had verified the items after their
receipt in the store.
52. I have gone through all the files. There
is noting to suggest that even under the rate
contract, there was a system of deposit of the
consumables in the central store or their
verification by the representative of treating
surgeon. There is no record to support the
contention that the cheque used to be issued only
after receipt of consumables in the store and
their verification by the representative of the
treating surgeon. Otherwise, it is clear that on
142
receipt of the requisition from the treating
surgeon, cheque in favour of the supplier/chemist
used to be issued. For example, in the case of
Dwarka Parshad, the following proceedings were
conducted:
53. First of all, it was pointed out that a
sum of Rs.1,40,000/- stood deposited with the
cashier for the treatment of Dwarka Parshad.
Then, it was pointed out that the professor and
head of CTVS had intimated that the patient had
been admitted in the ward and a sum of
Rs.77,972/- was required for the purchase of
medicines/surgical items/hospital charges etc.
Then, it was requested that the accounts branch
be directed to issue a cheque in favour of the
chemists/suppliers. Pursuant thereto, requisition
was prepared and the cheques were issued in
favour of the suppliers/chemists including Paul
distributors. There was no noting that the
consumables/items had already been received in
the store before the cheques were issued. There
was no order for the verification of the items by
the representative of Head of Department of CTVS.
There is no document to suggest that the
143
representative of the department had actually
verified the items before the cheques were
issued.
54. It is interesting to note here that one
of the cheques in case of Dwarka Parshad was for
Rs.6,663/- in favour of Kumar Brothers. The
cheque was issued on 16.05.2005. However, Kumar
Brothers returned the cheque. The matter was put
up by the Superintendent before the Medical
Superintendent in the following manner:
“As per Rate Contract with M/s. Kumar
Brothers, Sec-11, Chandigarh Cheque was
issued in favour of M/s. Kumar Brothers
Sector-11 amounting to Rs.6663/- for
the purchase of surgical items
/Medicines for the patient Sh. Dwarka
Parsad which has been received back
with the following remarks:-
“It is observed that lowest rates
of various items have been picked
up from our two different offers.
This does not seem to be a proper
course of action. PGI Authorities
144
are requested that they may kindly
operate any one of our offer for
all items. Only in that case we
shall be able to honour their
orders for supplying various items
on rates quoted above”.
As per order of the Medical
Superintendent patient Shri Dwarka
Parsad was directed to obtain the
materials from M/s. Bharat Medical
stores at the rate contract rate. A
copy of the list was given to the
patient. The material was received by
the patient amounting to Rs.6,663/- and
bill has been received from M/s.
Bharat Medical Stores.
In view of the above, if agreed,
we may sent a requisition to Accounts
Branch for issue of cheque amounting to
Rs.6,663/- in favour of M/s. Bharat
Medical Stores and also cancel the
Cheque No.195362 dated 16.05.2000
amounting to /Rs.6,663/- in favour of
M/s. Kumar Brothers.
145
Requisition is placed below for
signatures please”.
55. After going through the noting, the
Medical Superintendent allowed the cheque in
favour of Kumar Brothers to be cancelled. A fresh
cheque in favour of Bharat Medical Stores was
prepared. This would show that the cheque had
been issued before the supply of consumables
/items. In fact, Kumar Brothers had refused to
supply the medicines/items for the reasons cited
in their letter referred to in the noting and had
returned the cheque which had been issued in its
favour.
56. Even in the case of Jigri Singh, the
cheque in favour of Paul Medical Hall was issued
on 11.08.1999. The amount was credited to his
account on 04.09.1999. As per the bills, the
consumables/items were supplied on 02.09.1999.
Therefore, it is established from the record that
there was no system of deposit of the
consumables/items in the central store of the
Medical Superintendent and issue of cheque only
thereafter. Resultantly, the statement made by
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PW-8 in his cross-examination has to be taken
with a pinch of salt. Such a statement could have
been made by him in an unguarded moment.
57. No doubt, where a witness makes two
inconsistent statements in his evidence either at
one stage or at two stages in view of the law
laid down in Suraj Mal Versus State AIR 1979 SC 1408, the testimony of such witness becomes
unreliable and unworthy of credence but, if the
entire statement of PW-8 is read, it would be
clear that the inconsistency creeped in due to
lack of concentration or for any like reason.
This is definitely not a case, where the witness
deliberately made inconsistent statements. A
witness though wholly truthful is liable to be
over-awed by the court atmosphere and the
piercing cross-examination made by the counsel
and out of nervousness he may mix up facts, get
confused or fill up details from imagination on
the spur of moment. The sub-conscious mind of
the witness sometimes so operates on account of
the fear of looking foolish or being disbelieved
though the witness is giving a truthful and
honest account.
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58. It is worth mention that even PW-13 in
his cross-examination stated that the articles
requisitioned for private grant patients used to
be received in the stores and that the cheque
used to be issued to the supplier after the
consumables were received. However, this
statement does not matter much because he was not
referring to any particular phase. His intention
was never invited by the defence as to whether
this practice was being followed under the system
of rate contract. It was a general suggestion and
he replied in affirmative. Since, the system of
deposit of consumables in the central stores
during the currency of spot committee system was
there, it can be inferred that the witness may
have been referring to that.
59. Even if, for a pause, the statement of
PW-8 were to be taken out of reckoning due to
inconsistency, it is established on record, as
observed above, that the cheques to the
suppliers/chemists used to be issued before
supply of medicines/items and that there was no
system of deposit of the consumables/items in the
central store. It is rather proved that the
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supplier/chemist used to bring a set of different
sizes, sometimes of different brands to the
operation theatre just before the surgery; the
surgeon used to implant the valve of the suitable
size; the remaining valves used to be taken back
by the supplier/chemist. However, this will not
shift the focus from Dr. R.S.Dhaliwal to Paul
Medical Hall as has been tried by Dr.
R.S.Dhaliwal. If the latter had nothing to do
with the matter once the surgery was over and if
the onus was upon Paul Medical Hall to refund the
amount to the patient/PGI, question arises as to
what was the need for Dr. R.S.Dhaliwal to make
interpolations in the record and to write letters
to the Medical Superintendent Office in the
manner discussed in detail above? If there was
to be reconciliation of accounts as canvassed by
Paul Medical Hall, question arises, did he submit
fresh/amended bills at any stage? The case of
Ishwar Chand is a glaring example of how the
things were manipulated by both the accused in
conspiracy. If no valve had been supplied by
Paul Medical Hall, why the bill Mark PB/2 was
issued? If Paul Medical Hall had not made
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interpolations in the bill thereby, including one
Starr Edwards valve for Rs.30,000/- in that bill
and if the interpolation had been made by Dr.
R.S.Dhaliwal or by anybody else, the question
arises as to why Paul Medical Hall accepted the
money. If the interpolation had been made by Dr.
R.S.Dhaliwal or by any other person at his behest
and if Dr. R.S.Dhaliwal wrote the letter
Ex.PW-7/8 without the knowledge of Paul Medical
Hall, the question arises as to what benefit was
Dr. R.S.Dhaliwal going to get. The cheque would
have been issued in favour of Paul Medical Hall.
The fact that Paul Medical Hall got the cheque
and encashed it proves that there was perfect
meeting of minds between the accused.
60. The fact remains that the case is not as
simple as has been tried to be projected by the
defence. The issue is not reconciliation of
accounts. The point is not as to what was
expected of Paul Medical Hall once the valve
other than what had been requisitioned had been
implanted. The issue is manipulation of record.
61. Faced with this situation, learned
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defence counsel fell back upon the statement of
PW-6 and argued that if the operation notes were
to be written by senior residents and entries in
the open heart register were to be made by the
Perfusionist and if the surgeon did not have any
occasion to check the patients' files and, the
open heart register did not use to remain under
the lock and key, the chances of errors cannot be
ruled out and, the interpolations, if any, cannot
be attributed to the accused. Learned counsel
would point out that according to PW-6 the
entries in the open heart register used to be
made in advance and later on corrections used to
be made but, in some cases, there could be
errors.
62. There is no substance in the above
contention. When PW-6 says that the entries in
the open heart register used to be made in
advance, it is evident that the endeavour is to
help the accused in diverting attention of the
court. In examination-in-chief, she stated that
entry in the open heart register is made after
the completion of operation albeit, the name of
patient, diagnosis planning for type of operation
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etc. are entered before the operation. However,
in cross-examination she stated that all the
entries in the register are made at the time of
entry of the patient in the operation theatre
when incision is made. Even in response to court
question, she stated that the entry as to the
size/brand of the valve is made before the
operation commences. Even in re-examination by
learned Public Prosecutor, she stuck to this
false version and categorically denied the
suggestion that the make/brand of the valve is
also entered in the register after the completion
of surgery and not before that. It is another
matter that having said so, she contradicted
herself by saying that the make of the valve is
known in advance as it has been prescribed, but
the serial number and size are entered after
completion of surgery. She went on to state that
if brand/make is also changed, cutting has to be
made in the register. It is, thus, evident that
PW-6 Kanchan Ba Jadeja kept on changing her
statement just to prove one thing that the size
and the brand of valve actually implanted in the
heart of the patient is mentioned in the register
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before hand and only requisite changes are made
after the surgery is over. This version is absurd
on the face of it because the witness has herself
admitted in cross-examination by accused Sat Pal
Singla that it is not possible to know before the
surgery as to which particular valve would be
implanted. If actually, it is not possible to
know before hand as to which particular size and
brand would be implanted, the question arises as
to what is the justification in making the entry
of the valve and size in the open heart register
even before the operation commences. The purpose
as to why PW-6 Kanchan Ba Jadeja lied appears to
be to explain a large number of cuttings made in
the open heart register where the make of the
valve is mentioned. Needless to say that it is
her statement in examination-in-chief which
appears to be correct in that all the entries
except the name of the patient, diagnosis and
planning are made after the completion of the
operation.
63. The fact that PW-6 Kanchan Ba Jadeja has
deliberately lied would also be clear from the
answers given by her in re-examination by the
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public prosecutor. She said that every valve has
a sticker and whatever valve has been implanted,
its sticker is pasted in the open heart register
against the relevant entry after the completion
of surgery and, if there is any difference
between the entry earlier made and the sticker,
then cutting in the entry is made. She further
stated that TTK brand did not use to have a
sticker and that a card containing serial number
used to be there in the sealed box and, after
opening the box when the valve used to be
implanted the serial number used to be written in
the open heart register. When her attention was
drawn to entry at serial No.62/2 C.R.No.226754 at
Page No.113 (actually the page No. is 133 but
inadvertently it has been typed while recording
the evidence as No.113. For all intents and
purposes the page number would be read as 133) of
open heart register. She admitted that sticker of
TTK was pasted there. Again she tried to hoodwink
the court by claiming that since the sticker is
in a language different from English, it is
generally not pasted. Again her attention was
invited to the sticker pasted against the
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relevant entry. She admitted that the language on
the sticker was English. The purpose why the
witness resorted to this tactic is not clear but
the same is even not material at this stage
except for the purpose of proving that PW-6 has
gone out of the way in trying to help the accused
Dr. R.S.Dhaliwal.
64. It is interesting to note here that when
the attention of the witness was drawn to the
entries Ex.PW-6/2 and Ex.PW-6/3 at Page 132 and
135 of the open heart register respectively, she
stated that in the entry Ex.PW-6/2, the words
'TTK F66314' were entered after completion of
surgery meaning thereby that only the words 'MVR'
were mentioned in the relevant column before the
surgery started and that in the entry Ex.PW-6/3,
the words 'MVR small Steronotomi TTK' were
written before the operation started and the
'words 27 S. No.F663713' were written after
completion of surgery. Therefore, she ended up
making clear that only the 'procedure' used to be
mentioned before the surgery would start, for
example: MVR or CABH or DVR or ASD. The brand and
the size and the serial number used to be
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mentioned after the completion of surgery. If
that was so, so many cuttings in the name of the
brand of the valve in the relevant column are not
explainable. On the top of it, almost all the
cuttings are in those entries where the surgery
was performed by Dr. R.S.Dhaliwal. These along
with other manipulations cannot be glorified as
errors.
65. If Dr. Dhaliwal had nothing to do with
the operation notes and had no occasion to check
the patients' files, how can he explain the
interpolations, the cuttings and additions made
in some? The fact that it was he who made these
cuttings, additions and interpolations has been
established to the hilt. He not only tampered
with record but also facilitated the payment of
money to Paul Medical Hall by making firm but
wrong assertions as in the cases of Jigri Singh
and Ishwar Chand. Sat Pal Singla too cannot
escape the liability. His having issued wrong
bills claiming that he had supplied St. Jude
valves, whereas he had actually supplied Omni
Science and Edward Mira valves; his having issued
bills where no valves had been supplied and, his
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having received payment on strength of those
bills cannot be termed as innocent. Needless to
say that without there being a meeting of minds
between Dr. R.S.Dhaliwal and Sat Pal Singla, it
would not have been possible to deceive the PGI.
66. Once it is proved that there was
conspiracy between Dr. R.S.Dhaliwal and Paul
Medical Hall (Sat Pal Singla), all the overt acts
committed by one of them in reference to their
common intention would, by fiction of law created
by Section 10 of the Evidence Act, be construed
as the acts of both.
67. As discussed above while dealing with
each instance separately, both the accused were
complementing each other. The manner in which the
things were manipulated leaves no room for doubt
that the accused were party to the conspiracy in
pursuance of which record was tampered with and
fabricated dishonestly and fraudulently with
intent to cheat the patients/wards and the PGI
and to support claim for money where it was not
due or to support claim for more than what was
due in some cases as highlighted above. The
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forged and fabricated documents were deliberately
used as genuine with the same dishonest
intention. At the same time, it is proved that
accused R.S.Dhaliwal not only abused his official
position but also adopted corrupt and illegal
means for obtaining for himself and Paul Medical
Hall (Sat Pal Singla) pecuniary advantage. The
prosecution has, therefore, been able to bring
home the guilt to the accused beyond doubt. As
such, the accused R.S.Dhaliwal and Sat Pal Singla
are hereby convicted under Sections 120-B, 420,
467, 468 and 471 of Indian Penal Code. In
addition thereto, accused R.S.Dhaliwal is also
convicted under Section 13 (1) (d) read with
Section 13 (2) of the Prevention of Corruption
Act.
Pronounced: Special Judge,02.03.2009 Chandigarh.
This judgment contains 158 pages and all the pages have been signed by me.
` Special Judge,Chandigarh.
158
Question of SentencePresent:Shri R.L. Negi,Senior Public Prosecutor
for C.B.I.
Convict R.S.Dhaliwal on bail being assisted by Shri Matwinder Singh, Advocate.
Convict Sat Pal Singla on bail being assisted by Shri Vinod Arya, Advocate
Heard the convicts on question of
sentence.
2. Convict Sat Pal Singla has placed his
medical record before the Court to show that his
health is in critical stage inasmuch as he has
already undergone tripple vessel bye-pass
surgery in 1997 and second heart surgery in
2008. He is a diabetic with all related
problems and has enlarged prostrate. He suffers
from gastro and eye ailments as well. He is 74
years of age.
3. Citing the position of the health of the
convict, his counsel pleads for lenient view,
arguing that he is first offender with no
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criminal background.
4. Convict Dr. R.S.Dhaliwal claims that his
incarceration may not serve the ends of justice
as he has to serve the society being a surgeon.
His counsel pleads that the time wasted, if the
convict is sent behind bars, would be at the
cost of society. Pleading that the convict
should be given a chance to reform. Learned
counsel has pleaded for leniency.
5. Fridemant in his 'Law in changing
Society' has observed that “the State of
Criminal Law continues to be - as it should be -
a decisive reflection of social consciousness of
Society”. Therefore,in operating the sentencing
system the law should adopt the corrective
machinery or the deterrence based on factual
matrix. The facts and given circumstances in
each case, the nature of the crime, the manner
in which it was planned and committed, the
motive for commission of crime, the conduct of
the accused and all other attending
circumstances are relevant facts which as
observed by the Hon'ble Apex Court in State of M.P. Vs. Santosh Kumar 2006 (3) R.C.R.
160
(Criminal) 554,would enter into the area of consideration.
6. In Sevaka Perumal Vs. State of Tamul Nadu 1991(2) RCR (Criminal) 427, it was observed by Hon'ble Supreme Court that undue sympathy to
impose inadequate sentence would do more harm to
the justice system to undermine the public
confidence in the efficacy of law and Society
could not endure under such serious threats. It
is, therefore, the duty of every court to award
condign punishment.
7. For deciding just and appropriate
sentence to be awarded, the aggravating and
mitigating factors and the circumstances in
which the crime has been committed are to be
delicately balanced in a dispassionate manner.
8. Here, this Court is dealing with an
unscrupulous doctor/public servant who has not
only failed to preserve the purity of his life
which he had promised while taking Hippocratic
oath but has also adopted devious means to earn
money. Such like persons debase and defile the
very system they are expected to protect and
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uphold. The kind of crime committed by him in
common parlance is known as 'corruption in civil
life' which is spreading its tentacles far and
wide. It is getting contagious and threatening
to devour the very vitals out of the bone marrow
of the society. A crime committed in the heat of
passion may call for sympathetic consideration.
But a calculated and organized crime like the
one committed by the convict Dr. R.S.Dhaliwal in
the instant case must be visited with severe and
deterrent punishment.
9. The plea that sending the convict behind
bars will not serve any useful purpose in that
it will deprive the society of the services of
an able surgeon does not find favour with the
Court. A surgeon has to be a human being. If the
element of honesty and sincerity is taken out of
a surgeon, there will be no difference between
him and a robot. A gentleman surgeon with
average capability will do great service to the
society. But a corrupt surgeon with exceedingly
fine and efficient hand will only end up causing
harm to the system.
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10. Needless to say that there are virtually
no mitigating circumstances in favour of convict
Dr. R.S.Dhaliwal. The fact that he is under
suspension and is likely to lose his job is
hardly a reason to sympathize with him. He was
being paid for his services by the Government.
He was being treated like God by the patients
and the wards. Therefore, except for greed there
was no motive with him to commit the crime.
11. The age of the convict; the stage of life
he is at and, the fact that he has shown
inclination to reform himself are though, the
factors to be given due weightage.
12. The Court, after giving thoughtful
consideration to the facts, circumstances, and
nature of the crime; the manner in which it was
planned and committed; and the motive and
conduct of convict Dr. R.S.Dhaliwal sentences
him as under:
i) Section 120-B of Indian Penal Code:
To undergo rigorous imprisonment for 3
(three) years and to pay fine of
Rs.10,000/-. In default of payment of
fine, to undergo further rigorous
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imprisonment for 1 (one) month.
ii) Section 420 of Indian Penal Code:
To undergo rigorous imprisonment for 3
(three) years and to pay fine of
Rs.10,000/-. In default of payment of
fine, to undergo further rigorous
imprisonment for 1 (one) month.
iii. Section 467 of Indian Penal Code:
To undergo rigorous imprisonment for 5
(five) years and to pay fine of
Rs.20,000/-. In default of payment of
fine, to undergo further rigorous
imprisonment for 3 (three) months.
iv. Section 468 of Indian Penal Code:
To undergo rigorous imprisonment for 3
(three) years and to pay fine of
Rs.10,000/-. In default of payment of
fine, to undergo further rigorous
imprisonment for 1 (one) month.
v. Section 471 of Indian Penal Code:
To undergo rigorous imprisonment for 3
164
years and to pay fine of Rs.10,000/-. In
default of payment of fine, to undergo
further rigorous imprisonment for 1 (one)
month.
vi. Section 13(1)(d) read with Section 13 (2)
of Prevention of Corruption Act.
To undergo rigorous imprisonment for 3
(five) years and to pay fine of
Rs.10,000/-. In default of payment of
fine, to undergo further rigorous
imprisonment for 1 (one) month.
13. It is evident that Dr. R.S.Dhaliwal was
the Kingpin. He was the axis around which the
things revolved. Sat Pal Singla was, no doubt,
his ally but it will not be fair to treat him
with the same severity which Dr. R.S.Dhaliwal
deserves. No doubt, Sat Pal Singla was also
driven by greed but he was simply the
beneficiary. The master mind was Dr.
R.S.Dhaliwal. It was he who manipulated
everything. It was Dr. R.S.Dhaliwal who
subverted the system. Sat Pal Singla simply
165
assisted him in achieving the object. Keeping
all this in mind as well as the critical state
of health of the convict Sat Pal Singla, the
Court sentences him as under:
i) Section 120-B of Indian Penal Code:
To undergo rigorous imprisonment for 2
(two) years and to pay fine of
Rs.10,000/-. In default of payment of
fine, to undergo further rigorous
imprisonment for 1 (one) month.
ii) Section 420 of Indian Penal Code:
To undergo rigorous imprisonment for 2
(two) years and to pay fine of
Rs.10,000/-. In default of payment of
fine, to undergo further rigorous
imprisonment for 1 (one) month.
iii. Section 467 of Indian Penal Code:
To undergo rigorous imprisonment for 2
(two) years and to pay fine of
Rs.10,000/-. In default of payment of
fine, to undergo further rigorous
imprisonment for 1 (one) month.
166
iv. Section 468 of Indian Penal Code:
To undergo rigorous imprisonment for 2
(two) years and to pay fine of
Rs.10,000/-. In default of payment of
fine, to undergo further rigorous
imprisonment for 1 (one) month.
v. Section 471 of Indian Penal Code:
To undergo rigorous imprisonment for 2
(two) years and to pay fine of
Rs.10,000/-. In default of payment of
fine, to undergo further rigorous
imprisonment for 1 (one) month.
14. All the sentences shall run concurrently.
The period already undergone by the convicts in
custody shall be set-off against the term
awarded. It is made clear that out of the same
FIR, two separate chargesheets were filed.
Since Dr. R.S.Dhaliwal has been convicted in
Chargesheet No.1 as well, it is directed that
the sentence awarded in this Chargesheet shall
run concurrently with the sentence awarded in
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Chargehseet No.1. Fine paid by both the
convicts. All the un-exhibited documents be
returned to the concerned quarters against
proper receipt. File be consigned to the record
room.
Pronounced: (Jagdeep Jain)03.03.2009 Special Judge,
Chandigarh.
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