Delhi High Court
Akash Sharma vs Union Of India & Ors. on 16 February, 2022
$~2
* IN THE HIGH COURT OF DELHI AT NEW DELHI
Date of Decision: 16.02.2022
+ W.P.(C) 11212/2021
AKASH SHARMA ..... Petitioner
Through Mr.Ajit Kakkar, Adv.
versus
UNION OF INDIA & ORS. ..... Respondents
Through Mr.Farman Ali, Adv.
Wing Commander (Dr)
Prashant Rudra, Air Hq (RKP).
CORAM:
HON'BLE MR. JUSTICE MANMOHAN
HON'BLE MR. JUSTICE NAVIN CHAWLA
NAVIN CHAWLA, J. (Oral)
The petition has been heard by way of video conferencing.
1. The present petition has been filed praying for bringing on
record and setting aside the impugned medical certificates dated
13.05.2021 and 13.08.2021. The petitioner further prays for a direction
to the respondents to conduct the medical re-examination of the
petitioner at a hospital of their choice or appoint the petitioner on the
basis of the medical certificates issued by various civil hospitals.
2. It is the case of the petitioner that pursuant to the notification
issued by the respondents, the petitioner applied in the Indian Air
Force through the Armed Force Common Admission Test (hereinafter
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referred to as „AFCAT‟). On and after clearing the AFCAT, the
petitioner was directed to appear for the SSB at Dehradun wherein the
petitioner cleared all tests with respect to the prescribed criteria of
physical efficiency. The petitioner was then recommended to join the
training academy and was AIR 1 holder in his branch in the merit list.
3. The petitioner thereafter appeared for his Detailed Medical
Examination (in short, „DME‟) and on 13.05.2021, was declared to be
medically unfit on the ground of „retinal periphlebitis both eyes‟.
Aggrieved by the same, the petitioner applied for his Appeal Medical
Examination (in short, „AME‟) and appeared for the same at Base
Hospital, Delhi Cantonment. The petitioner, at the stage of the AME,
was again declared to be medically unfit on the ground of „retinal
periphlebitis both eyes.‟
4. The petitioner made a representation on 13.08.2021 itself
seeking the constitution of a Review Medical Board (in short, „RMB‟),
however, the same was rejected vide impugned communication dated
13.09.2021 and he was declared to be unfit for AFCAT on the ground
of „retinal periphlebitis both eyes.‟
5. The learned counsel for the petitioner submits that the petitioner
was not examined properly for retinal periphlebitis at both stages of
the medical examination. He submits that at the DME stage, the
petitioner was solely examined with the help of an ophthalmoscope.
He further submits that at the AME stage, the petitioner was not made
to undergo a fluorescein angiography, which is a more intrinsic test as
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compared to the ophthalmoscopy, which was conducted on the
petitioner.
6. The learned counsel for the petitioner finally places reliance on
the reports of Nutema Hospital, Meerut; Dr. Ram Manohar Lohiya
Hospital, New Delhi (hereinafter referred to as „Dr. RML Hospital‟)
and All India Institute of Medical Sciences, New Delhi (hereinafter
referred to as „AIIMS‟) to submit that the petitioner was found to have
healed from retinal periphlebitis and is thus medically fit to be
inducted in the Indian Air Force.
7. Vide order dated 01.10.2021, this Court had directed the
respondents to produce the medical record of the petitioner. This
Court had further directed a doctor from the respondents‟ side to be
present and explain as to how the petitioner was medically examined
during the DME as well as the AME stages.
8. In pursuance to the same, the respondents produced the medical
record of the petitioner before the Court. Perusal of the same shows
that vide report of the DME dated 13.05.2021, the petitioner was
declared to be medically unfit on the ground of „gynecomastia
bilaterally‟ by a Classified Specialist (Surgery) and „retinal
periphlebitis both eyes‟ by a Graded Specialist (Opthal). Upon the
petitioner‟s request for an AME, the petitioner was referred to Base
Hospital, Delhi Cantt. for a specialist opinion. Based on the opinion of
the concerned specialist, the petitioner, vide report dated 18.08.2021,
was declared „Unfit‟ for „retinal periphlebitis both eyes.‟
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9. Wing Commander (Dr) Prashant Rudra, who joined the
proceedings today by way of online video link, submitted that the
petitioner was examined by Graded Specialist (Ophthalmology) at
AFCME during the DME and by Senior Advisor (Ophthalmology) at
Base Hospital, Delhi Cantt, during his AME and was declared to be
medically unfit on account of „retinal periphlebitis both eyes‟ based
on the clinical examination (fundoscopy) using ophthalmoscopy as per
the provision of para 3.12.9 of IAP 4303 (4th Edition). He submits that
both the specialists at AFCME and Base Hospital are experts in their
area and have diagnosed the case based on the observation and years
of experience gained. He submits that any retinal changes may be
systemic disease and entails rejection as per Para 2.11.38 and Para
3.12.9 of IAP 4303 (4th Edition). He submits that retinal periphlebitis
is an inflammation on the retina which may be associated with
tuberculosis, for which he refers to some medical literature. He
submits that the diagnosis is made by clinical examination/fundoscopy
and therein fluorescein angiography is not warranted in this case. He
further submits that even the reports at Dr. RML Hospital and AIIMS
have found the petitioner to be case of „Healed Vasculis‟, which
would render the petitioner „Unfit‟ for appointment. He placed
reliance on articles in medical journals to explain that retinal
periphlebitis is a sight-threatening inflammatory condition affecting
the retinal vessels. He submits that the same can be caused as a result
of tuberculosis, syphilis, CMV, HIV and multiple sclerosis; among
other diseases.
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10. We have considered the submissions made by the learned
counsels for both the parties.
11. Para 3.12.9 of the IAP 4303 (4th Edition), which is the
repository for medical examination in the Indian Air Force, states that
any clinical findings in the media (cornea, lens, vitreous) or fundus,
which is of pathological nature and likely to progress will be a cause
for rejection. It further states that the examination will be done by slit
lamp and ophthalmoscopy. Clause 2.11.38 of IAP 4303 (4th Edition)
further mandates that in the examination, the normality of the disc and
the vascular pattern in the disc and its edges, AV ratio, papillary
oedema or colour change in and around the disc and pigmentary
changes elsewhere provide valuable clues to various systemic disease
and must be carefully noted. The two Paragraphs are reproduced
hereinbelow:
"3.12.9 Any clinical findings in the media (cornea, lens,
vitreous) or fundus, which is of pathological nature and likely to
progress will be a cause for rejection. This examination will be
done by slit lamp and ophthalmoscopy under mydriasis."
"2.11.38. Ophthalmoscopic Examination. Ophthalmoscopic
examination is carried out to exclude any abnormality in the fundi
and media. Examination must be carried out in a systematic
manner starting from the cornea, anterior chamber, pupil, iris,
lens, posterior chamber and retina. Note will be taken of reaction
of the pupil to the light, abnormality of the papillary edge, any
evidence of inflammation of the iris and lenticular opacity.
Vitreous floaters are usually of no significance. Any abnormal
vascular pattern, macular scarring, hemorrhages or exudates in
the fundi will be noted. The normality of the disc and the vascular
pattern in the disc and its edges, AV ratio, papillary oedema or
colour change in and around the disc and pigmentary changes
elsewhere provide valuable clues to various systemic disease and
must be carefully noted."
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12. The IAP therefore, places emphasis on the eye fitness. In the
present case, both at the stage of the DME as also AME, the petitioner
has been examined by the specialist doctors. Their findings are
unanimous that the petitioner is suffering from „retinal periphlebitis
both eyes‟. Wing Commander (Dr) Prashant Rudra has stated that
retinal vasculitis is a sight-threatening inflammatory condition
affecting the retinal vessels; occlusive periphlebitis can cause retinal
edema, intraretinal haemorrhages, and hemorrhagic retinal infarctions.
It is caused by tuberculous hypersensitivity, syphilis, CMV etc. and
therefore, is a definite cause of disqualification of the candidate.
13. The report from Nutema Hospital, relied upon by the petitioner,
also states that the petitioner has an „old healed vasculitis‟. The report
from Dr. RML Hospital opines the petitioner as a case of „healed
vasculitis‟ and „peripheral vascular & sheathing‟. The report of
AIIMS also opines the petitioner as a case of „healed vasculitis‟ and
advices „wait & watch‟. These reports also therefore, do not support
the petitioner‟s case.
14. Be that as it may, this Court is of the opinion that in selection to
the Armed Forces, the candidate must be fully fit and no benefit of
doubt in this regard can be given to a candidate. In Abhigyan Singh vs
Union of India, W.P.(C) 5083 of 2021, this Court held that the
doctors of the Forces are the best judge to ascertain whether a
candidate ought to be enrolled in the services or not, owing to the
strenuous and hostile terrain and environment where personnel would
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have to serve. Any error in judgment, particularly with respect to
medical ailments as serious as the one in the present case, would not
only endanger the life of the petitioner but also of those other officers
involved in possible operations.
15. This Court, in its judgment dated 21.12.2020 in Km. Priyanka
vs. Union of India & Ors., W.P.(C) 10783 of 2020, has also held that
the standard of physical fitness for the Armed Forces and the Police
Forces is more stringent than for the civilian employment. It was held
that it is the doctors of the Forces who are aware of the demands of
duties and the physical standards required to discharge the same. It
was further held as under:
"8. We have on several occasions observed that the
standard of physical fitness for the Armed Forces and the
Police Forces is more stringent than for civilian
employment. We have, in Priti Yadav Vs. Union of India
2020 SCC OnLine Del 951; Jonu Tiwari Vs. Union of India
2020 SCC OnLine Del 855; Nishant Kumar Vs. Union of
India 2020 SCC OnLine Del 808 and Sharvan Kumar Rai
Vs. Union of India 2020 SCC OnLine Del 924, held that
once no mala fides are attributed and the doctors of the
Forces who are well aware of the demands of duties of the
Forces in the terrain in which the recruited personnel are
required to work, have formed an opinion that a candidate
is not medically fit for recruitment, opinion of private or
other government doctors to the contrary cannot be
accepted inasmuch as the recruited personnel are required
to work for the Forces and not for the private doctors or the
government hospitals and which medical professionals are
unaware of the demands of the duties in the Forces."
16. This Court, in its judgment dated 15.07.2020 in Priti Yadav vs.
Union of India, W.P.(C) 3930 of 2020, has held that once the Rules
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for judging medical fitness of a candidate provide for finality and are
found to have provided for a review to eliminate the possibility of
human error, the finality has to be accepted, unless a case for
interference is made out.
17. In the present case, we find that no case is made out by the
petitioner warranting any interference with the report of the DME and
the AME. Consequently, we find no merit in the present petition. The
same is dismissed. There shall be no order as to cost.
NAVIN CHAWLA, J
MANMOHAN, J
FEBRUARY 16, 2022/AB
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