Earlier on 24.08.2018, Hon’ble Chief Justice of Delhi High Court had accepted and had converted the representation filed by Dr. KK Aggarwal, Padma Shree Awardee and National President of Heart Care Foundation of India (HCFI) into Public Interest Litigation (PIL) on the issue of Cardiopulmonary Resuscitation (CPR) and automated external defibrillator ((hereinafter “AED”) machine in public places like courts, railways and metro. Notices were issued to Union Government, Government of NCT of Delhi, Supreme Court Registrar, etc. in the said PIL.

On Wednesday i.e. 14.11.2018, the said PIL was listed for hearing and all the respondents have been granted 4 weeks’ time to file their counter affidavits / replies.

HCFI has been working on the subject of heart care since its inception and regularly conducts program to train people in essential life saving techniques like hands-only CPR for revival of patients after sudden cardiac arrest.

HCFI has been working for the benefit of public at large and to save the lives of thousands of people who die because of sudden cardiac arrest in absence of cardiac first aid including CPR and also in absence of non-availability of AED.  The said persons who are dying because of sudden cardiac arrest are sometimes even not aware that their lives can be saved by cardiac first aid or by taking the assistance of AED.

According to World Health Organization (WHO), nearly 5.8 lakh people are dying due to heart stroke in the world in a year. Nearly 1.15 lakh people die due to cardiac arrest every day in the world.

Sudden Cardiac Arrest (SCA) is the number one killer in India, killing approximately 25 lakhs people every year. As per the data revealed by Delhi Economic Survey about 150 to 250 deaths happen in the city of Delhi every single day and out of these deaths, 25 to 45 deaths occurred due to SCA.

50% of the patients can be saved if proper CPR is given on time. However, about 98% of the country’s population is not trained in CPR. 

Many valuable lives can be saved by giving training to the people in Cardiac First Aid (CFA) including CPR and also by installing of AED at public places and with further training given to the staff / employees stationed at such public places / offices to conduct the CPR and use the facility of Defibrillator in case of any person suffering from SCA.

An AED is a simple to use unit based on computer technology, which is designed to analyze the heart rhythm itself in deciding if electric shock is required to be given to the patient.  They are designed to be used by persons who require little training to operate them correctly. 

An ambulance reaches the patient in much delayed time who suffered a SCA in a public place. There is even an acute shortage of cardiac ambulances, which are to be mandatorily equipped with Defibrillator and because of that several deaths take place.  In the above scenario if public at large is trained in Cardiac First Aid including CPR and AEDs are installed at public places large number of invaluable and precious human lives can be saved.

HCFI had identified 3 main public places, which are being visited by thousands and lakhs of people every day i.e. all courts, metro and railways.

HCFI had noticed that the people who are visiting such places are under great stress and they are prone to cardiac arrest and in such places no AED machine is being installed and in fact the staff of such places are also not well trained in CPR technique.

In this regard, HCFI had sent representations dated 6.9.2016 to the office of Hon’ble Prime Minister of India, Hon’ble Minister for Health & Family Welfare, Hon’ble Lt. Governor of Delhi, Hon’ble Chief Minister of Delhi and also Hon’ble Health Minster of Govt. of NCT of Delhi.  However no concrete steps have been taken till date and the representations submitted by HCFI remained unanswered.

Earlier in the year 2016 and later in 2018, HCFI had filed various applications under Right to Information Act to the various courts including Hon’ble Supreme Court of India, this Honble Court and all the Distt. Courts situated in Delhi and also to the National Consumer Disputes Redressal commission and State Consumer Disputes Redressal Commission. 

HCFI was shocked to learn that no Defibrillator has been installed in any court of law and moreover the staff of the respective Honble Courts has also not been trained in Cardiac First Aid including CPR except the staff of Hon’ble Supreme court of India, which has been trained in the Cardiac First Aid including CPR.

Also, in the month of February, 2018, HCFI had sent one RTI application dated 12.02.2018 to Delhi Metro Rail Corporation (DMRC) and one application to Ministry of Railways.  

DMRC replied that there is no dispensary at any metro station, AED machine is not being installed neither in any metro station nor in any metro train. Only in some metro stations the pharmacy / chemist shop is available.

In response to the RTI application sent to Ministry of Railways, HCFI received various replies from almost all Railway Zones across the country and was shocked to know that 45,160 people have died in last 5 years in 14 zones and 10685 people have died inside the train.

The fourth-largest railway network in the world by size, with 121,407 kilometres (75,439 mi) of total track over a 67,368-kilometre (41,861 mi) route and which runs more than 13,000 passenger trains daily, on both long-distance and suburban routes, from 7,349 stations across India does not even have dispensary and First Aid Medicines. Even trains do not have First Aid medicines.

As almost 8.26 billion passengers travel by Indian Railways across the country, so it is imperative for the Indian Railways to have a proper and updated medical and First Aid facility both inside the trains and also at the railways stations.

On receiving such shocking data and replies from various courts, railways, metro, HCFI submitted one representation before the Hon’ble Chief Justice of Delhi High Court requesting the Hon’ble Court to treat the said representation as Public Interest Litigation as the same concerns the health and life of the public at large and to issue relevant directions thereby directing all courts in the state including Hon’ble Supreme Court, Hon’ble Delhi High Court and all district courts in Delhi and National Consumer Disputes Redressal Commission and Delhi State Consumer Disputes Redressal Commission, Delhi Metro Rail Corporation Limited and Ministry of Railways to:

1. To open a dispensary in all courts, metro stations and all railway stations and said dispensaries should function properly.

2. To train all their staff / employees / security personnel in Cardiac First Aid including Cardiopulmonary Resuscitation (CPR)

3. To install “Automated External Defibrillator” (AED) machines at all relevant and conspicuous places like all courts, all metro stations, all railway stations, in all metro trains and in all railway trains.

4. First Aid medicines for Sudden Cardiac Arrest (SCA) should be available in all courts, metro stations, all railway stations, in all metro trains and in all railway trains.

5. All Courts, Metro stations and all railway stations should have a tie-up with ambulance services for the purposes of emergencies.

6. Doctor should be available in the working hours at all places.

7. At least one pharmacy / chemist shop should be available at all courts, all metro stations and at all railway stations

8. All courts, metro stations and all railway stations should maintain a data w.r.t deaths taking place due to Sudden Cardiac Arrest.

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA