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2025 DIGILAW 2122 (GAU)

Thejangulie v. Christian Institute of Health Sciences And Research(Cihsr)

2025-12-19

DEVASHIS BARUAH

body2025
JUDGMENT AND ORDER : DEVASHIS BARUAH, J. Heard Ms. Barbara Nunes as well as Mr. Thejangulie, the present Petitioners, who are present in person during the course of the hearing. I have also heard Mr. K.N. Balgopal, the learned Advocate General, Nagaland assisted by Ms. V. Suokhrie, the learned Additional Advocate General, Nagaland appearing on behalf of the State of Nagaland and Mr. S. Abraham, the learned counsel appearing on behalf of the Respondent No. 1. 2. The Petitioner No. 1 is a citizen of India whereas the Petitioner No. 2 is a citizen of Portugal. Both the Petitioners claim that they are married to each other. The Respondent No. 1 claims it to be a Hospital which was set up for the benefit of needy. The Respondent No. 1’s Hospital is set up in a plot of land leased out by the State of Nagaland. 3. Shorn of unnecessarily details, it is an admitted stand of the Petitioners in the writ petition that the Petitioner No. 2 had complication when she was pregnant. Resultantly, a premature baby was born on 13.10.2020. Various allegations have been made in the writ petition against the doctors and staff of the Respondent No. 1 that the treatment meted out to the child of the Petitioners was a case of negligence which led to the instable medical condition of the child. It is also alleged in the writ petition that exorbitant charges were levied upon the Petitioners which the Petitioners were compelled to pay. Be that as it may, on 21.12.2021 a bill amounting to Rs. 18,85,890/- was served upon the Petitioners and it is the allegation of the Petitioners that an ultimation was given to the Petitioners to make payment else the treatment would be stopped. It is under such circumstances, the present writ petition was filed arraying various parties which included the doctors and staff of the Respondent No. 1. It is relevant to take note of that when the writ petition was filed the Petitioner No. 1 was the sole Petitioner. At this stage, this Court finds it relevant to take note of the reliefs claimed when the writ petition was filed. The reliefs sought are reproduced herein under: “(a) Admit this petition. (b) Issue direction to the Respondent Nos. At this stage, this Court finds it relevant to take note of the reliefs claimed when the writ petition was filed. The reliefs sought are reproduced herein under: “(a) Admit this petition. (b) Issue direction to the Respondent Nos. 1 and 2 to provide the complete set of medical records associated with the treatment of the Petitioner’s daughter ever since her birth, till date. (c) Issue direction to conduct an independent inquiry into the negligence committed by the Respondent Nos. 1, 2, 3, 4, 5 and 6 at various occasions through the three admissions that the Petitioner’s daughter has been through ever since her birth and due to which she is looking a life of complete disablement and thereafter prepare a detail report and place it before this Hon’ble Court for further action and direction. Issue direction to the Respondents to provide adequate compensation that would be required by the Petitioner and his family to take care of the baby after she is discharged as she would be completely dependent on her family, as well as to compensate the emotional, mental and physical trauma that the Petitioner and his family have had to go through because of the gross negligence committed by the Respondents. (d) Issue direction to the Respondent Nos. 7 and 8 to take appropriate legal action against the Respondent No. 1,. 2, 3, 4, 5 and 6 for the gross medical negligence committed by them against the Petitioners daughter who is now completely disabled, and for the mental and emotional agony suffered by the Petitioner and his wife during the one year that their daughter has been admitted in the Respondent No. 1 Hospital. (e) Issue direction upon the Respondent Nos. 1 and 2 to reimburse the medical expenses paid by the Petitioner to the hospital for the treatment of his daughter. (f) Waive the pending bills of the Petitioner’s daughter incurred in Respondent Nos.1’s Hospital. (g) Any other Orders/Directives as deem fit and proper. -AND- In the interim pending disposal of the case, may be pleased to direct the Respondents: i. To continue the treatment of the Petitioner’s daughter without any interruption. ii. Pass a direction prohibiting the Respondents from causing further mental agony and harassment upon the Petitioner and his wife.” 4. The writ petition was moved before this Court on 18.02.2022. -AND- In the interim pending disposal of the case, may be pleased to direct the Respondents: i. To continue the treatment of the Petitioner’s daughter without any interruption. ii. Pass a direction prohibiting the Respondents from causing further mental agony and harassment upon the Petitioner and his wife.” 4. The writ petition was moved before this Court on 18.02.2022. The order passed on 18.02.2022 is relevant for the purpose of deciding the present proceedings. The order dated 18.02.2022 is reproduced herein below: “ 18.02.2022 Heard Ms. D. Ghosh, learned counsel appearing for the Petitioner, assisted by Ms. H. Betala, learned counsel and Mr. E. Thiba Phom, learned Government Advocate on behalf of Respondent No. 7. A perusal of the writ petition shows that the State of Nagaland is not made a party. Taking into consideration the matter in the entirety, this Court deems it proper that the State of Nagaland should be made a party and accordingly, this Court impleads the State of Nagaland, represented by the Chief Secretary, Government of Nagaland as Respondent No. 4 to the instant writ petition. This Court, also, is of the opinion that the Respondent Nos. 2, 3, 4, 5 and 6 are not necessary or proper parties to the instant writ petition in so far as the issues involved herein and accordingly, their names are struck off. The Registry is accordingly directed to rearrange the numbers of the Respondents in terms of the instant order. Issue notice, returnable on 07.03.2022 Mr. E. Thiba Phom, learned Government Advocate accepts notice on behalf of Respondent Nos. 2 and 4. Notice in respect of the Respondent Nos. 1 to 3 be served by registered post with A/D alongwith usual process. The Petitioner is also permitted to take steps by way of dasti. The instant writ petition has been filed by the Petitioner, who is the father of a baby, aged about 1 year and 3 months. The grievance of the Petitioner is that on account of certain unpaid dues, the Respondent No. 1, which is an institute of Health Sciences & Research set up on the basis of tripartite partnership between Christian Medical College, Vellore, Emmanuel Hospital Association, New Delhi and the Government of Nagaland as a charitable society and organization. The grievance of the Petitioner is that on account of certain unpaid dues, the Respondent No. 1, which is an institute of Health Sciences & Research set up on the basis of tripartite partnership between Christian Medical College, Vellore, Emmanuel Hospital Association, New Delhi and the Government of Nagaland as a charitable society and organization. Though there has been various allegations made in the writ petition pertaining to the negligence of the Respondent No. 1 and the doctors therein, the learned counsel for the Petitioner submits that she is not pressing for reliefs sought for in the instant writ petition and would file appropriate application for deletion of the same, however, the only grievance of the Petitioner in the instant petition is that the baby, who is presently suffering from Global Cortical Atrophy, requires treatment and sans the treatment presently meted out to her by the Respondent No. 1, she would not survive. The learned counsel further submits that at present, there is no other hospital in the State of Nagaland which provides such treatment. I have heard the learned counsel for the parties and also perused the writ petition. Right to life and personal liberty under Article 21 of the Constitution also includes the right of patients to be treated with dignity. Similarly right to health, i.e. right to live in clean, hygienic and safe environment is a right covered under Article 21 of the Constitution. The Hon'ble Supreme Court, in the case of Union of India vs Moolchand Khairati Ram Trust , reported in (2018) 8 SCC 321 had discussed in detail as regards entitlement of have-nots to medical treatment. In paragraphs 66, 67 and 68, the Hon'ble Supreme Court had observed that every doctor whether at Government Hospital or otherwise has the professional obligation to extend his services with due expertise for protecting life and the said obligation is total, absolute and paramount, and laws of procedure, whether in statutes or otherwise which would interfere with the discharge of this obligation cannot be sustained and must, therefore, give way and there is an obligation upon the doctor to treat the injured victims on his appearance before him either by himself or being carried out by others. It has also been taken note of that in a welfare State, the primary duty of the Government is to secure the welfare of the people and to provide adequate medical treatment is an essential obligation to be undertaken by the Government in a welfare State. Government discharges this obligation by running hospitals and health centers which provides medical care to the person seeking to avail of those facilities. Preservation of human life is thus, of paramount importance and it is a duty imposed upon the Government to provide timely care to serious persons. Paragraphs 66 to 68 being relevant are quoted herein below:- "66. In Parmanand Katara this Court has observed that every doctor whether at a government hospital or otherwise has the professional obligation to extend his services with due expertise for protecting life. The obligation being total, absolute and paramount, laws of procedure whether in statures or otherwise, which would interfere with the discharge of this obligation cannot be sustained and must, therefore, give way, and there is an obligation upon the doctor to treat the injured victim on his appearance before him either by himself or being carried by others. It has also been observed by this court that the effort to save the person should be the top priority not only of the medical processional but even of the police or any other person who happens to be connected with the matter or who happens to notice such an incident or a situation. Apprehensions that the doctor will have to face police interrogation and stand as a witness in court and face all the harassments, should not prevent them from discharging their duty as medical professionals to save a human life and to do all that is necessary. 67. In Paschim Banga Khet Mazdoor Samity, this Court has observed that the Constitution envisages the establishment of a welfare State. In a welfare State, the primary duty of the Government is to secure the welfare of the people. Providing adequate medical facilities for the people is an essential part of the obligations undertaken by the Government in a welfare State. The Government discharges this obligation by running hospitals and health centers which provide medical care to the person seeking to avail of those facilities. Preservation of human life is thus of paramount importance. Government is duty-bound to provide timely care to persons in serious conditions. The Government discharges this obligation by running hospitals and health centers which provide medical care to the person seeking to avail of those facilities. Preservation of human life is thus of paramount importance. Government is duty-bound to provide timely care to persons in serious conditions. Medical facilities cannot be denied by the Government on the ground of the non- availability of bed. Denial of medical assistance on unjust ground was held to be in violation of right to life under Article 21 and the State was directed to pay the compensation of Rs, 25,000 to the Petitioner and requisite directions were issued by this Court. The State cannot avoid its constitutional obligation in that regard on account of financial constraints and was directed to allocate funds for providing adequate medical infrastructure. 68. In our opinion, the State can also impose such obligation when the government land is held by such hospitals and it is the constitutional obligation imposed upon such hospitals. Under Article 47, State has to make constant endeavour to raise the level of nutrition and the standard of living and to improve public health. It is also one of the fundamental duties enshrined in Article 51-A(h) to develop the scientific temper, humanism and the spirit of inquiry and reform. It would be inhuman to deny a person who is not having sufficient means or no means, the life- saving treatment, simply on the ground that he is not having enough money. Due to financial reasons, if treatment is refused, it would be against the very basic tenets of the medical profession and the concept of charity in whatever form we envisage the same, besides being unconstitutional would be violative of basic human rights. In our opinion, when the State largesse is being enjoyed by these hospitals in the form of land beside it is their obligation by the very nature of the medical services to extend the reciprocal obligation to the public by providing free treatment as envisaged in the impugned order. In our opinion, when the State largesse is being enjoyed by these hospitals in the form of land beside it is their obligation by the very nature of the medical services to extend the reciprocal obligation to the public by providing free treatment as envisaged in the impugned order. In case they want to wiggle out of it and not to comply with it, they have to surrender the land and orge out the benefit which they have received by virtue of holding the government land in an aforesaid manner." On the basis of the law as laid down by the Hon'ble Supreme Court in the above mentioned judgment and taking into consideration the present need that the child in question requires continuous treatment, this Court is of the opinion that till the next returnable date, the Respondent No. 1 shall continue to provide the present treatment being meted out to the said child. The entitlement of the Respondent No. 1 to the amount as claimed in the legal notice as well as the treatment meted out to the child of the Petitioner, shall be considered on the returnable date. List accordingly.” 5. On 07.03.2022, the writ petition could not be taken up for which the writ petition was directed to be listed on the next day i.e. on 08.03.2022. On 08.03.2022, when the writ petition was taken up, another counsel appeared on behalf of the Petitioner No. 1, namely Ms. Neiteo Koza. It was submitted before this Court that the Respondent No. 1 had issued a communication dated 03.03.2022, wherein it is mentioned that due to lack of Neurology and Pulmonology services in the State of Nagaland, the parents have agreed for a referral to a centre which offers both services and accordingly, had recommended that the Petitioners’ child gets further treatment at AIIMS, Delhi or any other Government Hospital which provides the said services. It was further submitted by the learned counsel appearing on behalf of the Petitioner No. 1 that the Petitioner No. 1 did not have the documents relating to his child's medical treatment and as such, it was difficult for the Petitioner No. 1 to obtain any consultation, as to which, Government Hospital would be offering such services and therefore sought for appropriate directions upon the Respondent No. 1 to provide the documents which the Head of the Department of Pediatrics and Pulmonology of the Respondent No. 1 considers would be sufficient for the purpose of formation of an opinion and/or consultation as regards the future treatment of the Petitioners’ child in a Government Hospital or any other Hospitals. 6. Taking into account the above, this Court directed the Department of Pediatrics as well as the Department of Pulmonology of the Respondent No. 1 to look into the medical records of the Petitioners’ child and thereupon provide the Petitioners with necessary documents on the basis of which the Petitioners can obtain necessary consultation and/or opinion where the treatment of the Petitioners’ child can be meted out. This Court further directed that the Respondent No. 1 shall continue to provide the treatment meted out to the Petitioners’ child, taking into consideration the best interest of the child. The said order dated 08.03.2022 being relevant, is reproduced herein under: “ 08.03.2022 Heard Ms. Neiteo Koza, learned counsel for the Petitioner and Mr. Pfosekho Pfotte, learned counsel appearing on behalf of the Respondent No. 1 as well as Mr. T. B. Jamir, learned Sr. Addl. A.G. appearing on behalf of the State of Nagaland. Ms. Neiteo Koza, learned counsel appearing on behalf of the Petitioner has drawn the attention of this Court to a letter dated 03.03.2022, issued by the Respondent No. 1, wherein it has been mentioned that due to lack of neurology and pulmonology service in Nagaland, the parents had agreed for a referral to a centre which offers both services and accordingly, had recommended that the child gets further treatment at AIIMS, Delhi or any other Government hospital which provides aforesaid services. Ms. Ms. Neiteo Koza, learned counsel for the Petitioner submits that the Petitioner, at present have certain documents pertaining to the child's medical treatments but the Petitioners are not aware as to whether those documents pertaining to the child's medical treatment would be sufficient for formation of opinion for consultation as to which Government Hospital would be offering such services and as such, submits that a direction may be issued to the Respondent No. 1 to provide the documents which the Head of the Department of Pediatrics and Pulmonology of the Respondent No. 1 considers would be sufficient for the purpose of the formation of the opinion and/or consultation as regards the treatment of the child in a Government Hospital or any other hospitals. She further submits that though this court had passed an order on 18.02.2022, that the Respondent No. 1 shall continue to provide the present treatment to the child, the order passed by this Court has not been followed. On the other hand, the learned counsel appearing on behalf of the Respondent No. 1 submits that the Respondent No. 1 is carrying on the same treatment and the protocols since April, 2021, for giving the best of the treatment to the child. The learned counsel for Respondent No. 1 further submits that though the Respondent No. 1 is giving best of the services, the Petitioners have been harassing the nurses and the doctors. I have heard the learned counsel for the parties. A perusal of the said referral letter dated 03.03.2022 stipulates that the child, namely, Adrianna is currently undergoing treatment in the Pediatric Ward of the Respondent No. 1 Hospital and she has Global Cerebral Atrophy and has severe neurological (GMFCS level 5) impairment with refractory seizures and recurrent pneumonia. It further appears that the Pediatric Neurology and Pulmonology services are lacking in the State of Nagaland and as such, a referral has been made to AIIMS, Delhi or any other Government Hospital which provides the aforesaid services. For the Petitioner to find out as to which Government Hospital would be providing such services, it would be necessary for the Petitioner to get the necessary medical records of the child, Adrianna so that the Petitioner can take necessary consultation and/or opinion as to where the treatment of the said child can be carried out. For the Petitioner to find out as to which Government Hospital would be providing such services, it would be necessary for the Petitioner to get the necessary medical records of the child, Adrianna so that the Petitioner can take necessary consultation and/or opinion as to where the treatment of the said child can be carried out. Accordingly, this Court, therefore, directs the Department of Pediatrics as well as the Department of Pulmonology of the Respondent No. 1 to look into the medical records of the child, Adrianna and thereupon, provide the Petitioner with such necessary documents on the basis of which the Petitioner can obtain necessary consultation and/or opinion as to which hospital the further treatment of the child, Adrianna can be meted out. Accordingly, the Respondent No. 1 is directed to provide the said medical records as stated herein above during the course of the day. Further to that, it is observed that vide order dated 18.02.2022, this Court had directed the Respondent No. 1 to continue to provide the present treatment meted out to the child, Adrianna. The said Respondent No. 1 shall continue to do so, taking into consideration the best interest of the child. Let the matter be further taken up on 10.03.2022 , for further consideration.” 7. At this stage, it is also pertinent to take note of that the Petitioner No. 1 filed an application on 07.03.2022 which was registered and numbered as I.A.(Civil) No. 16/2022 whereby the Petitioner No. 1 sought for deletion of prayer No. (c) in the original writ petition and inclusion of an interim prayer to the effect that a direction be issued to the State of Nagaland through the Respondent Nos. 2, 4 and 5 to shift the Petitioners’ child to a Government Hospital, outside the State which has the capacity to provide specialized care required by the Petitioners’ child and to bear all expenses associated there with for her treatment as well as transportation. 8. On 08.03.2022, when the aforesaid application was taken up, the application was withdrawn and this Court granted liberty to the Petitioner No. 1 to file an appropriate Interlocutory Application for deletion of the relief No. (c) sought inasmuch as orally it was submitted during the course of hearing on 18.02.2022, that the Petitioner No. 1 would not insist on the said prayer. 9. 9. Another application, being I.A.(Civil) No. 15/2022 was filed on 07.03.2022, whereby the Petitioners sought for impleading the Union of India through its Secretary, Ministry of Health and Family Welfare as a Respondent in the present writ petition. The said application was allowed vide the order dated 08.03.2022 thereby impleading the Union of India represented by the Secretary to the Government of India, Ministry of Health and Family Welfare, Room No. 348, ‘A’ Wing, Nirman Bhavan, New Delhi-110001 as the Respondent No. 5. 10. The record reveals that on 09.03.2022, 2 (two) more Interlocutory Applications were filed by the Petitioner No. 1 which were registered and numbered as I.A.(Civil) No. 17/2022 and I.A.(Civil) No. 18/2022. 11. I.A. (Civil) No. 17/2022, was an application whereby the Petitioner No. 1 sought for directions upon the State of Nagaland to bear all expenses of the Petitioners’ child to be transferred to AIIMS, Delhi via Air Ambulance and direct AIIMS, Delhi to admit the Petitioners’ child and provide her the required medical care. 12. I.A.(Civil) No. 18/2022, was an application filed by the Petitioner No. 1 whereby modification were sought to the reliefs in the writ petition thereby seeking substitution of the prayer No. (c) in the Writ Petition with another relief whereby directions be issued upon the State of Nagaland through the Respondent Nos. 2, 4 and 5 to shift the Petitioners’ child to a Government Hospital, outside the State which has the capacity to provide specialized care required by the Petitioners’ child and to bear all expenses associated therewith for her treatment as well as the transportation and further sought for deletion of prayer Nos. (d), (e) and (f) in the writ petition. 13. The application being I.A.(Civil)/18/2022 was allowed vide an order dated 10.03.2022. 14. In I.A.(Civil) No. 17/2022, this Court passed an order on 10.03.2022 thereby directing the Respondent No. 1 to submit a report by 14.03.2022 as regards the medical condition of the Petitioners’ child and what treatment is required, which is not available in the Respondent No. 1’s Hospital. This Court further directed the learned Senior Additional Advocate General, Nagaland to obtain instruction(s) as to how the State of Nagaland would be able to aid in the treatment of the Petitioners’ child and accordingly directed the matter to be listed again on 14.03.2022 for further consideration. 15. This Court further directed the learned Senior Additional Advocate General, Nagaland to obtain instruction(s) as to how the State of Nagaland would be able to aid in the treatment of the Petitioners’ child and accordingly directed the matter to be listed again on 14.03.2022 for further consideration. 15. In the meantime, the Petitioners filed another application on 10.03.2022 which was registered and numbered as I.A.(Civil) No. 20/2022 whereby the Petitioners sought to implead All India Institute of Medical Sciences, Delhi represented by its Director and the Government of Delhi represented by its Chief Secretary as Respondent Nos. 6 and 7 to the writ petition. 16. On 15.03.2022, this Court disposed of the Interlocutory Application being I.A.(Civil) No. 20/2022 thereby impleading the All India Institute of Medical Sciences, New Delhi as the Respondent No. 6 to the writ petition. However, this Court declined to implead the Government of Delhi as the Respondent No. 7. 17. Taking into account the various additions and deletions of the parties, this Court finds it relevant to reproduce the rearranged Respondents in the present proceedings as it would aid in issuing directions. 1. Christian Institute of Health Sciences and Research (CISHR) 4 th Mile, Dimapur, P.B. No. 31 P.O. ARTC, Nagaland, 797115 2. Principal Secretary Department of Health & Family Welfare Representing the Sate of Nagaland Government of Nagaland Kohima, Nagaland, 797001 3. Nagaland Medical Council PMTI Complex, Merhulitsa Colony Kohima-797001, Nagaland 4. State of Nagaland Represented by the Chief Secretary, Government of Nagaland, Kohima, Nagaland, 797001 5. The Union of India Represented by the Secretary to the Government of India, Ministry of Health & Family Welfare, Room No. 348, ‘A’ Wing, Nirman Bhavan, New Delhi-110001 6. All India Institute of Medical Sciences (AIIMS), Delhi Represented by its Director, Ansari Nagar, New Delhi-110029 18. On 15.03.2022, this Court disposed of the Interlocutory Application being I.A.(Civil) No. 17/2022 by passing certain directions. Paragraph Nos. 17 and 18 of the said order being relevant are reproduced herein under: “17. In view of the aforesaid reasons, discussions and decisions, as an interim measure, this Court is inclined to pass the following orders. On 15.03.2022, this Court disposed of the Interlocutory Application being I.A.(Civil) No. 17/2022 by passing certain directions. Paragraph Nos. 17 and 18 of the said order being relevant are reproduced herein under: “17. In view of the aforesaid reasons, discussions and decisions, as an interim measure, this Court is inclined to pass the following orders. i. The Principal Secretary, Department of Health and Family Welfare, State of Nagaland, the Secretary to the Government of India, Ministry of Health and Family Welfare and the Deputy Commissioner, Dimapur, shall cooperate with each other and do the needful for Airlifting baby Adriana by Air Ambulance to AIIMS, New Delhi forthwith. Such action need to be taken in consultation with the Doctor treating baby Adriana in Respondent No. 1 Hospital and subject to baby Adriana's health condition allowing such transport. ii. The expenditure of such transfer and treatment of baby Adriana shall be borne by the Union of India in the Ministry of Health and Family Welfare Department and Department of Health and Family Welfare, State of Nagaland. ii. The aforesaid authorities i.e. Union of India, Ministry of Health and Family Welfare Department, the Principal Secretary, Department Health and Family Welfare, Nagaland and the Deputy Commissioner, Dimapur shall also approach GOC, Eastern Command through the Indian Army station Head Quarter, Dimapur for availing the Army's Air Ambulance service. This Court requests GOC Eastern Command to do the needful, if possible for Airlifting baby Adriana to the AIIMS, New Delhi, cost of which shall be borne by Union of India in the Ministry of Health and Family Welfare & the State of Nagaland jointly. 18. Copy of this order be furnished to the learned Senior Additional Advocate General, State of Nagaland, to the learned ASG, for forwarding the same to the concerned authorities including GOC, Eastern Command, Indian Army through the Station Headquarter, Dimapur for doing the needful.” 19. Pursuant to the aforementioned directions, the Respondent No. 5 vide a letter dated 18.03.2022, forwarded the order of this Court dated 15.03.2022 to the Nodal Officer, AIIMS, New Delhi, i.e. the Respondent No. 6 for taking further necessary action in coordination with the Principal Secretary, Department of Health and Family Welfare, Government of Nagaland. Pursuant to the aforementioned directions, the Respondent No. 5 vide a letter dated 18.03.2022, forwarded the order of this Court dated 15.03.2022 to the Nodal Officer, AIIMS, New Delhi, i.e. the Respondent No. 6 for taking further necessary action in coordination with the Principal Secretary, Department of Health and Family Welfare, Government of Nagaland. On the basis of the said letter and the directions so passed by this Court on 15.03.2022, the specialist of the Respondent No. 6 discussed the medical issues faced by the Petitioners’ child with the specialist of the Respondent No. 1 in a Zoom meeting held on 13.04.2022. The Minutes of the Zoom Meeting held on 13.04.2022 was duly recorded. The contents of the said Meeting being self explanatory, the said contents of the Minutes of the Zoom Meeting held on 13.04.2022 is reproduced herein under: “ Minutes of zoom meeting held on 13.04.2022 A zoom meeting regarding baby Adriana was held by Pediatric consultants from CIHSR hospital, Dimapur, and doctors from AIIMS, Delhi on 13/04/2022. The meeting was attended by the following doctors: From AIIMS: 1. Dr. Madhulika Kabra, MD Professor and Incharge, Division of Genetics, Department of Pediatries. 2. Dr. Neerja Gupta, MD, DM Additional Professor, Division of Genetics, Department of Pediatrics. 3. Dr Rakesh Lodha, MD Professor, Division of Pediatric Pulmonology and Intensive Care, Departmient of Pediatrics. 4. Dr. Sheffali Golati, MD, FRCPCH, FAMS, FIAP, FIMSA Professor and Faculty-in-charge, Child Neurology Division, Department of Pediatrics. From CIHSR Hospital: 1. Dr. Sulanthung Kikon, MD Consultant and Head of Department, Pediatrics. 2. Dr. R. Wonashi Tsanglao, MD, MRCPCH Consultant Pediatric Critical Care. The meeting was organised by Dr. Neerja Gupta, and chaired by Dr. Madhulika Kabra. The team from AIIMS mentioned that they had received the detailed clinical summary of Adriana and have gone through it and further took a brief update on Adriana and her current status. Following were the inputs and conclusion from the meeting: 1. The team from AIIMS commented that Adriana's condition is very likely as a result of perinatal events. 2. From the neurology point of view, seizure management has been appropriate and her current medications are optimal. They mentioned that she may not get any additional benefit with transfer to AIIMS. 3. Following were the inputs and conclusion from the meeting: 1. The team from AIIMS commented that Adriana's condition is very likely as a result of perinatal events. 2. From the neurology point of view, seizure management has been appropriate and her current medications are optimal. They mentioned that she may not get any additional benefit with transfer to AIIMS. 3. Regarding transfer to AIIMS, it would have been considered appropriate had there been a gap in management or facility, but from whatever records they have seen and from our discussion, they felt overall management has been appropriate and that they may not be able to offer any additional specific treatment that could be beneficial for Adriana. And therefore taking the risk of air-transfer; staying far away from homeland for no additional specific treatment may not be ideal. 4. Managing in any health facility exposes a child to infection. And given Adriana’s condition, the team from AIIMS suggested that she may finally need to be managed at a home setting including home ventilation (provided parents agree, and they have the necessary support). 5. The Team from AIIMS mentioned that based on the combined detailed discussion, they will give their recommendations to the Ministry of Health regarding the decision related to transferring Adriana to AIIMS. Minuted by: Dr. Sulanthung Kikon Dr. R. Wonashi Tsanglao” 20. Pursuant thereto, the Respondent No. 6 issued a communication on 18.04.2022 to the Ministry of Health and Family Welfare Department, Government of India making certain recommendations. The content of the said communication is self explanatory and being relevant is reproduced herein under: “To, Dated:18.04.2022 Union of India Ministry of Health and family Welfare New Delhi Sub: Regarding the writ petition filed for seeking treatment at AIIMS, New Delhi (file no. W 11037/26/2022-Grant (RD) Ref: 1. I.A.(C) No. 15 of 2022;parties:Mr. Thejagulie Vs CIHSR & 3 Ors 2. I.A.(C) No. 17 of 2022 in W.P.C no. 6 of 2022; parties: Mr. Thejagulie vs CIHSR & 4 Ors. Sir, This is in response to your communication dated 18-03-2022 regarding the above-mentioned subject. W 11037/26/2022-Grant (RD) Ref: 1. I.A.(C) No. 15 of 2022;parties:Mr. Thejagulie Vs CIHSR & 3 Ors 2. I.A.(C) No. 17 of 2022 in W.P.C no. 6 of 2022; parties: Mr. Thejagulie vs CIHSR & 4 Ors. Sir, This is in response to your communication dated 18-03-2022 regarding the above-mentioned subject. A videoconferencing between the treating physicians (Dr R Wonashi Tsanglao, MD Pediatrics, MRCPCH Pediatric critical care, CIHSR Hospital, and his team member) and the team from AIIMS, New Delhi (Dr M Kabra- Geneticist and Chairperson COE Rare Diseases AIIMS, New Delhi, Dr S. Gulati- Pediatric neurologist, Dr R Lodha - Pediatric Intensivist), Dr Neerja Gupta (Geneticist and nodal officer COE Rare Diseases AIIMS, New Delhi) was conducted on Wednesday 13 th April 2022. Patient's clinical status update was briefed by the treating physician. Child was born premature baby 30 weeks 2 days with a very Low Birth Weight (1.125 kg). He has sequele of prematurity and adverse perinatal events in the form of global developmental delay, recurrent pneumonia poor oropharyngeal coordination, GERD, bilateral profound hearing loss, bilateral optic neuropathy, chronic lung disease and refractory epilepsy. He has been admitted in the NICU for about a year in the hospital. Presently, seizures are controlled. Parents have been counseled by the treating team about the prognosis and over all unfavorable outcomes. Based on the details provided regarding the present clinical status, the treatment being offered seems appropriate and transferring the baby to AIIMS New Delhi will not change the overall outcome. As he primarily needs supportive care shifting may not be a sustainable option. Financially also it might be challenging for the parents to shift to Delhi for the similar management that is being provided locally. Members unanimously agreed that shifting the baby to AIIMS Delhi shall not offer any additional benefit though the team shall be available and happy to provide inputs for supportive care. Kindly also note that the application for management of this baby was submitted to the rare disease committee but the case does not fall in the purview of rare diseases. Rakesh Lodha Pediatric Intensivist AIIMS, New Delhi” 21. It is very important to note some of the observation in the above quoted communication. It was opined that the treatment being offered by the Respondent No. 1’s Hospital appeared to be appropriate and transferring the Petitioners’ child to AIIMS, New Delhi would not change the overall outcome. Rakesh Lodha Pediatric Intensivist AIIMS, New Delhi” 21. It is very important to note some of the observation in the above quoted communication. It was opined that the treatment being offered by the Respondent No. 1’s Hospital appeared to be appropriate and transferring the Petitioners’ child to AIIMS, New Delhi would not change the overall outcome. It was further opined that the Petitioners’ child primarily needs supportive care and shifting may not be a sustainable option. Financially also, it might be challenging for the parents to shift to Delhi for similar management that is being provided locally. It was also opined that the case of the Petitioners child do not fall within the purview of rare diseases. 22. The aforesaid aspect was brought to the notice of this Court by the learned Central Government Counsel by placing a communication dated 27.04.2022 issued by the Director (RD) of the Government of India, Ministry of Health and Family Welfare (Rare Diseases Cell), wherein the communication issued by the Respondent No. 6 to the Government of India dated 18.04.2022, which have been already quoted herein above, was enclosed. The communication dated 27.04.2022 is also of importance and as such, the contents thereof is reproduced herein under: “ F.No. W-11037/26/2022-Grants(RD) Government of India Ministry of Health and Family Welfare (Rare Diseases Cell) Nirman Bhawan, New Delhi Dated 27.04.2022 To Shri Yanger Wati, Central Government Counsel, Gauhati High Court, Kohima Bench, Kohima, Nagaland. Email: yangerwati@gmail.com Subject: I.A.(C) No. 17/2022 in W.P.C. No. 6/2022-Mr. Thejagulie Vs. CIHSR & 4 Ors. In High Court of Assam, Nagaland, Mizoram and Arunachal Pradesh, Kohima Bench- reg. Sir, I am directed to refer to this Ministry letter of even number dated 04.04.2022 on the subject mentioned above and to say that the order of the Hon’ble High Court dated 15.03.2022 was forwarded to the Nodal Officer, AIIMS, New Delhi for taking further necessary action in coordination with the Principal secretary, Department of Helath & Family Welfare, Government of Nagaland. AIIMS, New Delhi vide letter dated 18.04.2022 (copy enclosed) intimated that they have conducted a video conferencing between the treating physicians, CIHSR Hospital, Dimapur and the team from AIIMS, New Delhi on 13 th April, 2022. AIIMS, New Delhi vide letter dated 18.04.2022 (copy enclosed) intimated that they have conducted a video conferencing between the treating physicians, CIHSR Hospital, Dimapur and the team from AIIMS, New Delhi on 13 th April, 2022. Based on the details provided regarding the present clinical status, the team from AIIMS, New Delhi opined that the treatment being offered seems appropriate and transferring the baby to AIIMS, New Delhi will not change the overall outcome. As the patient needs supportive care, shifting may not be a sustainable option. Financially also, it might be challenging for the parents to shift to Delhi for the similar management that is being provided locally. 2. Members of Rare Diseases Committee, AIIMS, New Delhi unanimously agreed that shifting the baby to AIIMS, Delhi shall not offer any additional benefit though the team shall be available and happy to provide inputs for supportive care. 3. In view of the above, it is requested to apprise the Hon’ble Court accordingly. This issues with approval of the Competent Authority. Yours faithfully, (Rabindra Prasad) Director (RD) 011-23062434” 23. The above aspect was brought to the notice of this Court on 28.06.2022. At this stage it is relevant to observe from the records that the earlier counsels who were representing the Petitioner No. 1 recused themselves on account of indifference for which this Court appointed an Amicus to assist the Petitioner No. 1. The learned Amicus Curiae submitted that the Petitioner No. 1 had no intention to go against the advice given in the letter dated 27.04.2022. This Court on the said date passed an order thereby directing the learned counsel for the Respondent No. 1 to provide details as regards the status of the Respondent No. 1 and whether any Memorandum of Understanding was executed between the Respondent No. 1 and the State or any other parties and as to the contribution of the State or any other parties for managing the Hospital and the circumstances as to how the Respondent No. 1 has been managed, including the salaries paid to the doctors of the Respondent No. 1. 24. 24. At this stage it is also relevant to take note of that on 21.11.2023, the Petitioner No. 1 filed an application which was registered and numbered as I.A. (Civil) No. 141/2023 for impleading the Petitioner No. 2 who is his wife and further allowing her to contest the present proceedings on behalf of the Petitioners. The reason for filing the application was that even the Amicus so appointed to assist the Petitioner No. 1 sought recusal. This Court vide the order dated 23.11.2023 allowed the said application thereby impleading the Petitioner No. 2 in the instant proceedings. 25. The records further reveal that while the sole issue involved in the writ proceedings was as regards the treatment to be meted out to the Petitioners’ child, but on account of various allegations being made by the Petitioners in person against the Advocates, various Interlocutory Applications were filed. These Interlocutory Applications were primarily related to initiation of action against the counsels who represented the Petitioners earlier. In view of these applications filed, the core issue involved in the instant proceedings was digressed from. The resultant effect was that this Court was kept busy on the question as to whether actions were required to be taken against the counsels who represented the Petitioner No. 1. Meanwhile, the treatment of the child by the Respondent No. 1 continued on the basis of the interim orders passed by this Court without any further orders. 26. More than 3 (three) years post the interim orders were passed, on 29.08.2025, when the present writ petition was listed before this Court, the Petitioners in person along with their newly engaged counsel sought for time to rethink on the applications which have been filed making allegations against the earlier counsels. Accordingly, this Court fixed the matter on 01.09.2025. On the said date, the learned counsel who was also engaged by the Petitioners also recused himself on account of the indifference with the Petitioners in person and the Petitioners in person submitted that they would represent themselves. This Court fixed the matter on 04.09.2025. 27. At this stage it is relevant to take note of the allegations made by the Petitioners against their earlier set of counsels and more particularly Ms. N. Koza. The allegations primarily revolved around the withdrawal of prayer No. (c) in the writ petition without the consent of the Petitioners. This Court fixed the matter on 04.09.2025. 27. At this stage it is relevant to take note of the allegations made by the Petitioners against their earlier set of counsels and more particularly Ms. N. Koza. The allegations primarily revolved around the withdrawal of prayer No. (c) in the writ petition without the consent of the Petitioners. In the foregoing part of the instant judgment this Court had reproduced the various orders dated 18.02.2022 and 08.03.2022 and the relevant part of the order dated 15.03.2022. It is noteworthy to mention that on 18.02.2022, another counsel, Ms. D. Ghosh had verbally submitted that the Petitioner No. 1 would withdraw the relief No. (c) It is also pertinent to observe that in consequence thereto the application was filed for withdrawal of relief No. (c) and adding various reliefs which were necessary for the purpose of deciding the core issue i.e. the best interest of the child. It is disheartening to note that this very counsel against whom allegations were made was successful in convincing this Court to pass the order dated 15.03.2022. Rather putting on the back of the learned counsel, the Petitioners resorted to make serious allegations against the said counsel. 28. Taking into consideration the above, this Court irrespective of the withdrawal of relief No. (c) directed the Respondent No. 2 to provide the names of 2 (two) doctors who would be in a position to carry out an enquiry, as to whether, there is any medical negligence on the part of the Respondent No. 1 in providing the treatment to the Petitioners’ child and what steps are required to be taken so that the child can have a good prognosis. 29. On 04.09.2025, Mr. K.N. Balgopal, the learned Advocate General, Nagaland appeared at the request of this Court. Ms. V. Suokhrie, the learned Additional Advocate General, Nagaland placed before this Court a communication dated 04.09.2025 containing a list of subject specialists who can be permitted to carry out an enquiry on the aspect pertaining to whether there was any medical negligence on the part of the Respondent No. 1 in providing treatment to the Petitioners’ child and what steps are required to be taken so that the Petitioners’ child can have a good prognosis. The contents of the said letter dated 04.09.2025 being relevant, is reproduced here in under: “ GOVERNMENT OF NAGALAND DIRECTORATE OF HEALTH & FAMILY WELFARE NAGALAND:KOHIMA No. DHFW-17/Legal/09/2022/ Dated: Kohima the th Sept, 2025. To, Ms. Vihelie-u Suokhrie Addl. Advocate General Gauhati High Court, Kohima Bench Kohima:Nagaland Ref: Letter No. AG/ESTT-76/2025/966 dated 01.09.2025 W.P(C) No. 6/2025, Shri Thejangulie-vs- CIHSR & Ors. Sub: Information sought for as per the Hon’ble High Court’s Order dated 01.09.2025 Sir, In inviting a reference to the above referred subject, I an to inform your Office that there is no pediatric Neurologist and Pediatric Pulmonologist among the service members in the Department as reflected in the Hon’ble High Court’s order dated 01.09.2025. However, there are service members related to the subject specialist, 1. Dr. Manwen Konyak, Neurologist, Junior Specialist, District Hospital, Dimapur 2. Dr. Kezholenu Sakhrie, Respiratory Medicine, Senior Specialist, TB Hospital, Jhuzama, Kohima 3. Dr. R. Wapang Imchen, Pediatrics, Chief Medical Officer, Kiphire. In view of the above, your Office may kindly inform the Hon’ble High Court about the 3 Subject Specialists who are related to the query of the Court. This is for your kind information and necessary action. Yours faithfully, (DR. Mereninla Senlem) Principal Director Health & Family Welfare Nagaland:Kohima No. DHFW-17/Legal/09/2022/1914-16/ Dated:Kohima the 4 th Sept, 2025” 30. It is also relevant to take note of that on 04.09.2025, 2 (two) other documents were placed before this Court pursuant to the order passed on 01.09.2025. One document mentioned the present treatment provided to the Petitioners’ child and the other the present status of the Petitioners’ child. These documents were kept on record and marked with the letters “X” & “X1”. 31. During the course of the hearing on 04.09.2025, the Petitioners in person, who were present were provided the 3 (three) names of the subject specialists who can carry out the enquiry. The petitioners in person however submitted that the names of the specialists so provided are not Pediatric Specialists, but rather they are specialists in respect to adults and as such they cannot be experts to determine the aspect of negligence of the respondent No. 1. The Petitioners in person rather submitted that instead of going for an enquiry, they would instead obtain medical evidence from the experts and if the opinion is in their favour they would approach before the Redressal Forum under the Consumer Protection Act, 2019. 32. The Petitioners in person rather submitted that instead of going for an enquiry, they would instead obtain medical evidence from the experts and if the opinion is in their favour they would approach before the Redressal Forum under the Consumer Protection Act, 2019. 32. At this stage, it is also pertinent to take note of that the relief sought for at prayer No. (c) was to conduct an investigation as regards the Negligence of the respondent No. 1, its doctors and staff. Considering that the Petitioners in person do not wish to have an enquiry with the specialists provided rather would approach the Consumer Forum, nothing further remains to be decided in respect to the prayer No. (c). 33. It is also pertinent to take note of that prayer No. (d) is consequential upon the decision in respect to prayer No. (c), and since prayer No. (c) is not being insisted upon by the Petitioners in person, prayer No. (d) also cannot be decided upon. 34. It is further pertinent to take note of that prayer No. (b) relates to providing medical records of the Petitioners’ child. During the course of the hearing, this Court enquired into, as to whether, the Petitioners have been afforded all the medical documents of their child, and it was submitted that till April, 2025 they have been duly provided all medical documents of the Petitioners’ child. Therefore, prayer No. (b) during the passage of time had also become infructuous. 35. The question, therefore, arose as to whether the Petitioners herein are entitled to prayer Nos. (e) and (f) which pertains to the bills of the Petitioners and also reimbursing the medical expenses paid by the Petitioners for the treatment of their child. This Court finds it relevant at this stage to reproduce paragraph Nos. 5 to 14 of the order dated 04.09.2025 which has relevance in respect to the present dispute. “ 5 . Pursuant to the order passed by this Court dated 01.09.2025 in the Writ Petition, instructions issued to the Additional Advocate General by the Principal Director, Health & Family Welfare Department dated 04.09.2025 has been placed. The said communication is kept on record and marked with the letter-Y. From a perusal of the said communication it reveals that the names of 3 Specialists who can carry out an inquiry in respect to the details as observed in paragraph no. The said communication is kept on record and marked with the letter-Y. From a perusal of the said communication it reveals that the names of 3 Specialists who can carry out an inquiry in respect to the details as observed in paragraph no. 6 of the order dated 01.09.2025 are mentioned. 6 . The Petitioners in person have also been provided with the communication dated 04.09.2025. The Petitioners in person submitted that the names of the specialists which are provided are not pediatric specialists but rather they are specialists in respect to adults. The Petitioners in person further submit that instead of going for an inquiry they would instead obtain medical evidence from the concerned specialist and if the opinion is in their favour they would approach before the Redressal Forum under the Consumer Protection Act, 2019. The Petitioners in person, therefore, submitted that they would, therefore, not insist on prayer no. (c), and submitted that the welfare of the child is the prime consideration. 7 . Taking into account the above, the prayer no. (c) stands withdrawn. The consequential effect of the prayer no. (c) being withdrawn is that there cannot be any directions passed in respect to the prayer no. (d), for which the prayer no. (d) stands closed. 8 . This Court has also perused the prayer nos. (e) and (f). This Court would request the learned Advocate General, State of Nagaland to take a call on what can be done in respect to the prayer nos. (e) and (f). 9 . Mr. Samuel Abraham, the learned counsel who appears on behalf of the Respondent no. 1 submitted that the Respondent no. 1 is not averse to discussing with the State as regards to prayer nos. (e) and (f). 10 . A copy of the document which has been kept on record and marked with the letter-X was furnished to Ms. V. Suokhrie, the learned Additional Advocate General, Nagaland. This Court would implore upon the learned Advocate General to explore as to whether the treatment plan so provided can be provided by the State of Nagaland in their hospitals to the child of the Petitioners taking into account that the treatment plan so provided does not appear too complicated as submitted by Mr. Samuel Abraham. 11 . This Court would implore upon the learned Advocate General to explore as to whether the treatment plan so provided can be provided by the State of Nagaland in their hospitals to the child of the Petitioners taking into account that the treatment plan so provided does not appear too complicated as submitted by Mr. Samuel Abraham. 11 . This Court further inquired with the Petitioners in person as to whether they have the medical records in respect to the child in question. They submitted that they have the medical records of the child up till April 2025. In that view of the matter the relief as sought for at prayer no. (b) appears to have already been redressed up till April 2025, 12 . In view of the above, therefore, the only thing that remains before this Court in the present proceedings is to how treatment can be given to the child of the Petitioners. The Petitioners in person, the learned Advocate General as well as the counsels appearing on behalf of the Respondents had submitted that as the instant matter has been heard in detail by this Court the instant matter be kept as part-heard, as more particularly there would be a requirement of a regular monitoring. Taking into account the above, the instant proceedings may be shown as part-heard. 13 . The Petitioners in person submitted that they are facing difficulties in visiting their child in the hospital. Mr. Samuel Abraham, the learned counsel appearing on behalf of the Respondent no. 1 submits that taking into account that various cases have been filed against the Respondent no. 1, they are maintaining strict protocols as per applicable to all concerned. He also submitted that as the child of the Petitioners is in the ICU and the visitation hours being from 9.00 to 9.30 AM and 3.00 to 3.30 PM and the same being applicable for all concerned, the Respondents have adopted the same practice for the Petitioners. This Court would request Mr. Samuel Abraham, the learned counsel appearing on behalf of the Respondent no. 1 to inform the authorities of the Respondent no. 1 to provide assistance to the Petitioners, if for reasons beyond the control of the Petitioners, they are not in a position to visit within the time specified. However, the said should be done keeping the interest of the other patients also. 1 to inform the authorities of the Respondent no. 1 to provide assistance to the Petitioners, if for reasons beyond the control of the Petitioners, they are not in a position to visit within the time specified. However, the said should be done keeping the interest of the other patients also. This Court would also urge upon the Petitioners to maintain cordial relation with the staff and doctors of the Respondent no. 1 as this Court is presently dealing with the dispute. 14 . This Court would also direct the Respondent no. 1 to provide the medical records of the child of the Petitioners to Ms. V. Suokhrie, the learned Additional Advocate General so that the same can be forwarded to the Health & Family Welfare Department of the Government of Nagaland. The said records be provided in a week's time.” 36. The matter was listed before this Court on 06.11.2025 for further consideration which included the issue, as to whether, this Court should issue any directions upon the Respondent No. 1 to waive the expenses incurred by the Respondent No. 1 in the treatment of the Petitioners’ child and further direct that the Respondent No. 1 to reimburse the Petitioners the amounts they paid for the treatment of their child. 37. The materials on record as well as the Minutes of the Zoom Meeting dated 13.04.2022 and the communication dated 18.04.2022 which has already been reproduced herein above would prima facie show that the treatment which was provided to the Petitioners’ child appears to be the proper treatment. The petitioners’ child’s condition unfortunately is likely as a result of perinatal events as is opined. 38. This Court wanted to have an enquiry from amongst the list of specialists provided by the State, as to whether, there was negligence on the part of the Respondent No. 1. The Petitioners in person, however, submitted as is recorded in the order dated 04.09.2025 that these specialists are not Pediatric Specialists, but rather specialists for adult persons. The Petitioners have also stated that they would carry out independent consultation with experts and if there is any negligence on the part of the Respondent No. 1, they would take appropriate steps in terms with the Consumer Protection Act, 2019. 39. Therefore, in the present proceedings, there are no materials which would prove medical negligence except allegations of medical negligence by the Petitioners. 39. Therefore, in the present proceedings, there are no materials which would prove medical negligence except allegations of medical negligence by the Petitioners. The opinion of the specialists of the Respondent No. 6 also prima facie shows that the condition of the Petitioners’ child is due to perinatal events. It also mentions that the treatment provided by the Respondent No. 1 is appropriate. At this stage this Court finds it relevant to refer to a judgment of the Supreme Court rendered in the case of Dr. Harish Kumar Khurana Vs. Joginder Singh & Others reported in (2021) 10 SCC 291 wherein the Supreme Court after analyzing the various judgments observed the medical evidence has to be placed to adjudicate medical negligence. Paragraph Nos. 11, 14 & 16 being relevant are reproduced herein under: “ 11. In the background of the rival contentions, the fact that a second operation was performed on 16-12-1996 and the patient had suffered a cardiac arrest after she was administered anaesthesia appears to be the undisputed position from the medical records as well as the statement of the parties. Every death of a patient cannot on the face of it be considered as death due to medical negligence unless there is material on record to suggest to that effect. It is necessary that the hospital and the doctors are required to exercise sufficient care in treating the patient in all circumstances. However, in unfortunate cases, though death may occur and if it is alleged to be due to medical negligence and a claim in that regard is made, it is necessary that sufficient material or medical evidence should be available before the adjudicating authority to arrive at a conclusion. 14. The learned counsel for the respondents, on the other hand, referred to the decision in V. Kishan Rao v. Nikhil Super Speciality Hospital to contend that the decision in Martin F. D’Souza wherein general directions are given to secure medical report at preliminary stage is held to be not treated as a binding precedent and those directions must be confined to the particular facts of that case. It is held that in a case where negligence is evident, the principles of res ipsa loquitur operates and the complainant does not have to prove anything and in the said case it is held that in such event it is for the respondent to prove that he has taken care and done his duties, to repel the charge of negligence. Though such conclusion has been reached on the general direction, we take note that in V. Kishan Rao the fact situation indicated that RW 1 had admitted in his evidence that the patient was not treated for malaria. In that background, it was taken into consideration that the patient had been treated for typhoid though the test in that regard was found negative and the test for malaria was positive. The said fact situation, therefore, indicated that the principle of res ipsa loquitur would apply. It would be apposite to note that in the very decision this Court has expressed the view that before forming an opinion that expert evidence is necessary, the Fora under the Act must come to a conclusion that a case is complicated enough to require the opinion of an expert or the facts of the case are such that it cannot be resolved by members of the Fora without the assistance of the expert opinion. It is held that no mechanical approach can be followed and each case has to be judged on its own facts. 16. Having noted the decisions relied upon by the learned counsel for the parties, it is clear that in every case where the treatment is not successful or the patient dies during surgery, it cannot be automatically assumed that the medical professional was negligent. To indicate negligence there should be material available on record or else appropriate medical evidence should be tendered. The negligence alleged should be so glaring, in which event the principle of res ipsa loquitur could be made applicable and not based on perception. In the instant case, apart from the allegations made by the claimants before NCDRC both in the complaint and in the affidavit filed in the proceedings, there is no other medical evidence tendered by the complainant to indicate negligence on the part of the doctors who, on their own behalf had explained their position relating to the medical process in their affidavit to explain there was no negligence. The reference made is to the answers given by Dr Khurana to the interrogatories raised by the complainant. In respect of the first operation, it was clarified that the patient did not have any side effects/complications during the first operation which was described as uneventful. On leaving the operation theatre, the patient was in the custody of surgeon. After the operation he had not been called for any complication related to anaesthesia. Since he had written the anaesthesia notes in the register during the first operation, he did not see reason to see the hospital record after the first operation. With regard to the comment of the surgeon after the first operation in the treatment sheet regarding the patient being “poorly tolerant to anaesthesia”, he has replied that the said observation had no meaning since the first operation was uneventful and was successful. There was no anaesthesia related complication of any kind. With regard to the emergency which occurred during the second operation and the manner in which he had alerted the hospital and requisitioned the help of cardiologist, he has answered that the full operation theatre team was already there and the cardiologist was summoned by one of the members of the team and the specific details could not be answered by him since the entire team was busy in attempting to save the patient.” 40. The materials on record, are bereft of medical evidence to show that the Respondent No. 1 or its doctors or staff have been negligent or there was deficiency in service. Under such circumstances, the question for holding the Respondent No. 1 or its doctor or staff to be negligent or there was deficiency in service does not arise. The resultant effect of the above observation is that the reliefs sought for at prayer Nos. (e) and (f) of the writ petition cannot be granted i.e. this Court cannot direct the Respondent No. 1 to waive its medical bills qua the Petitioners as well as also cannot direct reimbursement of any amount paid by the Petitioners to the Respondent No. 1. The above observations however shall only be construed as findings for the present proceedings but would not apply if the Petitioners approaches the Forum under the Consumer Protection Act, 2019 which if initiated be decided on its own merits without being influenced by the aforesaid findings. 41. The above observations however shall only be construed as findings for the present proceedings but would not apply if the Petitioners approaches the Forum under the Consumer Protection Act, 2019 which if initiated be decided on its own merits without being influenced by the aforesaid findings. 41. The next and most pertinent question is, what steps can be taken in the best interest of the Petitioners’ child in question? 42. In this regard, this Court finds it relevant to again refer to the order dated 04.09.2025 and the directions passed therein. In the said order, this Court directed the Respondent No. 1 to provide the medical records of the Petitioners’ child to the learned Additional Advocate General of the State of Nagaland so that the same can be provided to the Health & Family Welfare Department of the Government of Nagaland to explore, as to whether, the treatment plan so provided can be provided by the State of Nagaland in their Hospitals to the Petitioners’ child. 43. This Court further also finds it relevant to take note of the Minutes of the Zoom Meeting held on 13.04.2022, the contents of which have been already reproduced herein above, wherein it was opined that the Petitioners child may finally need to be managed at home setting, including home ventilation. On this aspect, this Court heard the learned Advocate General of the State of Nagaland and he duly submitted that some financial assistance can be given to the Petitioners in terms with the schemes of Ayushman Bharat Scheme and the Chief Minister's Health Insurance Scheme (General Category) in case of patients treated at the Government Hospitals. The learned Advocate General also submitted that he would also ascertain from the State Government if anything can be done for the Petitioners’ child. 44. This Court also finds it relevant again to refer to the order dated 18.02.2022 wherein this Court had reproduced some of the observations of the Supreme Court in the case of Moolchand Khairati Ram Trust (supra) and, more particularly, to paragraph Nos. 66 to 68 observing that in a welfare State, the primary duty of the Government is to secure the welfare of the people and to provide adequate medical treatment which is an essential obligation to be undertaken by the Government. 66 to 68 observing that in a welfare State, the primary duty of the Government is to secure the welfare of the people and to provide adequate medical treatment which is an essential obligation to be undertaken by the Government. This Court also cannot turn a blind eye to the aspect that the Central Government as well as the State Government from their side have provided various schemes like the Ayushman Bharat Scheme as well as the Chief Minister's Health Insurance Scheme. The Petitioner No. 1 can avail such benefits if permissible as per the terms and conditions of those Schemes. 45. Considering the above, this Court, therefore, disposes of the instant writ petition with the following observations and directions: (i) The relief so sought for at prayer No. (b) of the instant writ petition having already been redressed by providing the Petitioners the medical record of their child till April, 2025, no further directions are required, save and except, that when the Petitioners’ child is discharged from the Respondent No. 1’s Hospital, all up to date medical documents of the Petitioners’ child be provided to the Petitioners by the Respondent No. 1. (ii) Insofar as the relief as sought for at prayer No. (c) of the writ petition, nothing further survives taking into account that the Petitioners in person have duly submitted that they would not insist upon prayer No. (c) and, if necessary, approach the appropriate forum under the Consumer Protection Act, 2019, if so advised. Taking into account the same, the Petitioners herein are granted the liberty to approach the appropriate forum under the Consumer Protection Act, 2019, if so advised and the observations made in the instant judgment shall not influence such proceedings. (iii) As the prayer No. (c) is not insisted in the present writ petition, the prayer No. (d) cannot further be acted upon. Further to that, the Petitioners in person have duly submitted during the course of the hearing on 04.09.2025, that they are not satisfied with the specialist offered by the State of Nagaland to carry out an enquiry and they would like to take due opinion on medical negligence from specialists. Under such circumstances, no relief can be passed in respect to prayer No. (d). Under such circumstances, no relief can be passed in respect to prayer No. (d). (iv) As there is no medical evidences produced which would show that there is any medical negligence on the part of the Respondent No. 1’s Hospital, its Doctors and staff, the question of granting the reliefs at prayer Nos. (e) and (f) does not arise. (v) This Court further taking into account the order dated 18.02.2022 and 08.03.2022 wherein it was categorically observed as to the entitlement of the Respondent No. 1 would be decided at the later stages of the instant proceedings, grants liberty to the Respondent No. 1 to take action for recovery, if so advised by following the due procedure of law. However, this Court finds it pertinent to observe that the Respondent No. 1 being a charitable non- profit organization and aim to afford good medical care to the needy people as stated in their affidavit may keep in mind the said aspect before initiating any recovery proceedings. (vi) This Court further grants liberty to the Respondent No. 1 before initiating any recovery proceedings to approach the State of Nagaland. The State of Nagaland and, more particularly, the Respondent Nos. 2 and 4 are directed to consider the request made by the Respondent No. 1 as apparently the Respondent No. 1 has continued the treatment of the Petitioners’ child for the entire period since her birth without any payment. Any amount paid by the State of Nagaland towards the dues of the Respondent No. 1 be set off as regards any claim of the Respondent No. 1 against the Petitioners. (vii) This Court further is of the opinion that the Respondent No. 1 cannot be further burdened to continue with the treatment of the Petitioners’ child without any payment inasmuch as since the birth of the Petitioners’ child till date the Respondent No. 1 have been providing treatment. (viii) It is also the opinion of this Court that some cushion time be granted to the Petitioners to make alternative arrangements. Accordingly, this Court grants the Petitioners a period of 30 (thirty) days from today to make necessary alternative arrangements to continue with the treatment of their child either at the Respondent No. 1’s Hospital or any other Hospitals. (viii) It is also the opinion of this Court that some cushion time be granted to the Petitioners to make alternative arrangements. Accordingly, this Court grants the Petitioners a period of 30 (thirty) days from today to make necessary alternative arrangements to continue with the treatment of their child either at the Respondent No. 1’s Hospital or any other Hospitals. The Respondent No. 1 shall continue to provide the treatment presently administered to the Petitioners’ child for a period of 30 (thirty) days from today and thereupon if the Petitioners wish to continue with the treatment of their child at the Respondent No. 1’s Hospital, the same shall be subject to payment of the dues as per the terms and conditions of the Respondent No. 1’s Hospital. (ix) Liberty is granted to the Respondent No. 1 to recover the dues from the Petitioners after complying with Clause (vi) herein above and the period of limitation for recovery of the dues would start to run 45 (forty five) days from today. (x) This Court further directs the State of Nagaland to carry out necessary negotiations with the Respondent No. 1 so that the amount so claimed by the Respondent No. 1 from the Petitioners can be reduced. (xi) This Court further observes and directs that in the circumstance the Petitioners are not capable of taking care of their child, the Petitioners’ child would come within the meaning of “child in need of care and protection” as defined in Section 2(14) of the Juvenile Justice (Care and Protection of Children) Act, 2015 and the Department of Social Welfare, Government of Nagaland which is the Department implementing the said Act of 2015 would be required to step in and do the needful. (xii) A copy of the instant judgment be provided to Ms. V. Suokhrie, the learned Additional Advocate General, Nagaland to inform the concerned Department of the State of Nagaland for due compliance.