پرویزمشرف کی میڈیکل رپورٹ پر اعتراضات
پرویزمشرف کےخلاف سنگین غداری کامقدمہ چلانے کےلیے بنائی گئی خصوصی عدالت نے پرویزمشرف کےقابل ضمانت وارنٹ گرفتاری کرتےہوئےانہیں سات فروری کوپیش ہونے کاحکم دیاہے ۔سابق صدر کی میڈیکل رپورٹ عدالت میں پیش کی گئی تواس پر پراسیکیوٹرنےتیرہ اعتراضات داخل کیے جن کی بناپر مشرف کی رپورٹ پربددیانتی پرمبنی قراردیاگیا یہ اعتراضات کیا تھے اس کی تفصیل آپ نیچے پڑھ سکتے ہیں
Before
the Hon’ble Special Court, Islamabad
Established
under the Criminal Law Amendment
(Special
Court) Act 1976
Misc.
Application No. ___________ / 2014
In
Complaint
No. 01 / 2013
Federal
Government of Pakistan
Versus
General
(R) Pervez Musharraf
OBJECTION
TO MEDICAL REPORT DATED 24.01.2014 IN
RESPECT OF ACCUSED, ON BEHALF OF PROSECUTION
Respectfully
Stated:
PRELIMINARY
SUBMISSION:
1. That
this Honourable Special Court vide its order dated 16th of January, 2014,
directed the constitution of a Medical Board comprising of senior doctors of
Armed Forces Institute of Cardiology (AFIC). It is pertinent to note here that
the purpose of constituting this Medical Board was to verify the state of health of the Accused
in light of his continuous non-appearance before this Special Court.
2. That
this Honourable Special Court further, framed following specific questions for
the Medical Board which are reproduced as under:
i)
How
precarious is the health condition of the accused which restricts his movement
so as to prevent him from attending the Court?
ii)
Has
the accused undergone any surgery or other medical procedure during his stay in
the hospital or any surgery or medical procedure is planned to be undertaken
during his hospitalization?
iii)
For
how long the accused has been advised for further hospitalization?
3. That
pursuant to order dated 16th of January, 2014, the Medical Board so
constituted has submitted a self-styled report to which the Prosecution takes
the following Objections as under:
OBJECTIONS:
a) That
the instant medical report, with respect to any outcomes, is virtually a duplication
of the previous medical report dated 7th of January, 2014, which had
concluded in its paragraph 7 as under:
“Coronary Angiography is required to
optimize the management and to ascertain the possibility of further
interventions, like coronary artery bypass surgery”.
The findings on 7th of
January, 2014, were that a diagnostic test (Coronary angiography) is required
to conclusively ascertain the condition of the Accused and the finding in
current medical report dated 24th of January, 2014, in its paragraph
3 (a) are as under:
“A coronary angiogram is required urgently to
ascertain the need for further interventions like coronary artery bypass graft
surgery, to optimize the management”
b) That the medical report reveals that no
further tests have been carried out on the Accused, since the submission of the
last medical report. That the previous report revealed that a multislice CT
coronary angiography was done which revealed:
“5
(a). densely calcific triple vessel
coronary artery disease including left main stem disease”.
In the present report which has been
submitted after a gap of sixteen days the same diagnosis is reiterated in
paragraph 2 (d), that:
“his
multi-slice CT coronary angiogram has revealed densely calcific triple vessel
coronary disease including left main stem disease.
The presence of disease in the left main stem is of grave concern due to its very
location, as detailed in Annex A.”
That in the instant report the Board has
come to an entirely new conclusion on the same data as before that this disease
is of “grave concern”. That if such a
grave concern was present as is alleged, then the question arises as to why
this concern was not either shown in the first report or why no further
diagnostic testing been carried out.
The report also has not suggested any
aggressive management of the disease, which shockingly suggests absence of any cardiac
ailment.
c) That
the findings of the medical report are inconclusive and deliberately vague. The
report discloses no reasons as to why a patient of such a disease needs
constant hospitalization since 2nd of January, 2014, especially
without any progress in his clinical evaluation or management. There are non
invasive procedures like E.T.T and thalium scan which are biblically performed
before considering the invasive test of Angiogram.
d) The
medical report is unsatisfactory and does not even come close to addressing any
of the questions, which the Board was bound to answer in terms of order dated
16th of January, 2014. It is neither a rational nor a befitting
reply to the queries of this Honourable Special Court. As such this Honourable
Special Court does not gain anything from this second medical report, rather
the time of the learned Special Court has recklessly been wasted at the cost of
reputation of our premier institution of cardiac disease. The report does not
proceed on any basis suggesting of existence or occurring of the disease during
all this time of hospitalization.
e) The
instant medical report has come to an erroneous conclusion regarding the state
of health of the Accused. Dr. Ismail Bokhari, MD, an
internationally known cardiologist from U.S has, on the basis of the two
medical reports, opined as under:
“I
reviewed the report on General Pervaiz Musharraf very carefully. He was
presented with chest discomfort with prior history of left shoulder disease and
cervical spine disease. No history of hypertension, diabetes and no prior
history of precipitating or relieving factors for chest pain. His cardiac
examination was perfectly normal, heart rate was described at 56 beats/min,
which is normal (it was described as sinus bradycardia). The
electrocardiogram and cardiac enzymes were normal. Echocardiogram is
normal, has good ejection fraction, which is most important predictor for good
prognosis. Cardiac CT angiography shows calcifications, no impressive lumen
narrowing, especially in the left mainstem. CT angiogram narrowing is
usually less severe on actual coronary angiography. With this
information, on routine practice, patient needs stress test before recommending
coronary angiography. High calcium score without lumen narrowing is not
an indication for coronary angiography. This patient is in the hospital
since January 2nd, 2014, and continues to have normal electrocardiograms and
cardiac biomarkers. Chance for serious cardiac disease is very low. His
chest discomfort mostly likely is from cervical spine and shoulder disease.
In my opinion, he is low risk for any serious cardiac event at this time.”
f) That
the medical report refers to the previous report dated 7 January 2014 as being
a “detailed medical report on his health status” which is precisely what that report
was not. In fact, it was due to the previous report having serious gaps, that
this Honourable Special Court sought it appropriate to give the Medical Board
precise questions or terms of reference, which have despite these explicit
queries remained un-heeded even now.
g) That
such a long hospitalization when no diagnostic process has to be carried out is
against the established norms of medical rules. That even in serious
cardiovascular interventions, subject to appropriate treatment, the patients
are not hospitalized for such an extended period of time.
h) That
it appears that AFIC’s management has housed an unwilling patient who does not
even trust the esteemed cardiac center’s expertise in carrying out a relatively
common and a routine investigative test performed on millions of patients by
the ‘State of the Art facility’.
i) That
the report by a Medical Board comprising of four senior doctors should have
contained a factual analysis of the Accused’s disease. Instead the report contains
conjectures and hypothetical situations, which are inapplicable to the accused and
as such does not deserve a serious consideration.
j) That there is no place in a medical report of
reproducing statements or opinion of the Accused. (see Paragraph 3 (b)).
k) That
the report is inconclusive and makes attempts to thwart the judicial process by
urging the Special Court to come to a decision regarding further
procedures/interventions without expressing as to whether the pre-requisite
tests prior to angiogram have been performed, indicating the necessarily for
the same.
l) That
without prejudice to the other objections, even if the Accused needs medical
supervision that does not render him unable to make attendance before this
Special Court.
m) That
it is now manifest that the Accused is prolonging stay in hospital in order to
evade the judicial process. That as per orders of this Special Court dated 16
January 2014, the Special Court was faced with two options, either to presume
that the Accused is avoiding to appear before this Court or to verify the state
of his health. That the second option was exercised and exhausted, hence
resulting in what was a presumption having crystallized into a fact, which is,
that the Accused is avoiding appearance before this Special Court.
That in light of the above objections, including the
reference of global procedures, this Special Court may kindly pass appropriate
orders for the attendance of the Accused as per the mandate of law.
(Mohammad Akram Sheikh)
Prosecutor - Sr. Advocate Supreme Court
On Behalf of the Federal Government
