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Tarsem Lal filed a consumer case on 07 Jun 2023 against Satyam Hospital in the Ludhiana Consumer Court. The case no is CC/19/159 and the judgment uploaded on 23 Jun 2023.
DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, LUDHIANA.
Complaint No:159 dated 25.03.2019. Date of decision: 07.06.2023.
Tarsem Lal son of Late Sh. Prem Chand, resident of H. No.645, Ward No.5, Daheri Road, Azad Nagar, Near Baba Shaheedan Di Samadh, Khanna, Tehsil and District Ludhiana. .…Complainant
Versus
....Opposite parties
Complaint Under Section 12 of the Consumer Protection Act.
QUORUM:
SH. SANJEEV BATRA, PRESIDENT
SH. JASWINDER SINGH, MEMBER
MS. MONIKA BHAGAT, MEMBER
COUNSEL FOR THE PARTIES:
For complainant : Sh. V.K. Jhanji, Advocate.
For OPs : Sh. Anand Sabherwal, Advocate.
ORDER
PER SANJEEV BATRA, PRESIDENT
1. Shorn of unnecessary details, the facts of the complaint are that on 17.08.2017, Sh. Prem Chand, father of the complainant fell ill and was taken to Civil Hospital Khanna for treatment. Opposite party No.3 Dr. Satpal met at Civil Hospital Khanna who after seeing the patient told the complainant that he is suffering from dengue and treatment of dengue is to be started upon which the complainant started treatment of dengue of his father. Opposite party No.3 Dr. Satpal prescribed medicines and diagnosis on the Government OPD slips of Civil Hospital, Khanna and also signed some of the sips but deliberately did not mention the date on the OPD slips. The complainant stated that he has full faith on the doctor of the Civil Hospital like GOD and never noticed any foul play. The complainant further stated that after two days, Dr. Satpal advised him to get his father admitted for better treatment in private hospital run by him and his wife Mr. Babita Abrol, opposite party No.2 under the name and style of Satyam Hospital opposite party No.1. On request of Dr. Satpal, the complainant admitted his father to the said hospital but opposite party No.1 and 2 did not give any slip or writing of admission of his father in the hospital. Even on asking of the complainant for giving him the admission slip of daily rent received the room by charging Rs.3500/- per day besides heavy expenditure on daily tests and medicines. According to the complainant, the micro clinical laboratory from where the tests were being conducted was also situated inside Satyam Hospital, also did not give any document for conducting tests except one test on 19.08.2017. Father of the complainant remained admitted in the said hospital till 30.08.2017 but his position got deteriorated day by day despite spending Rs.80,000/- as per directions of the opposite parties. On 30.08.2017, when the patient became serious, the opposite parties asked the complainant to get the patient admitted in CMC or DMC and seeing no other alternative, the complainant got his father admitted in CMC Hospital, Ludhiana where the doctors after checking his father told that whatever treatment has been given till date was on wrong diagnosis and no treatment was given for actual problem which resulted in deterioration of the condition of the patient. However, they started treatment till 04.09.2017 and then advised for getting treatment at PGI, Chandigarh as the condition of the patient was already deteriorated. The complainant further stated that he got his father discharged from CMC Hospital, Ludhiana for getting treatment at PGI, Chandigarh. After getting appointment, 08.09.2017, the complainant got his father admitted in PGI, Chandigarh but despite their best efforts his father could not be saved and he died on 09.09.2017.
The complainant further stated that doctors of CMC Hospital, Ludhiana and PGI, Chandigarh confirmed the factum of wrong treatment being given by the opposite parties as his father was suffering from Malaria but he was given treatment for Dengue. This amounts to negligence on the part of the opposite parties as from the date of admission they continued to change medicines as per their choice without diagnosing the actual disease and they also got several tests etc. The opposite parties done all this to get themselves enriched by squeezing money from the complainant. Dr. Satpal is a government medical officer and he is running unlawfully private clinic through his wife Dr. Babita Abrol and they never issued any slips or receipts regarding medicine and admission etc. which has caused treatment mental tension, agony and harassment to the complainant as the complainant spent more than Rs.7 Lac on his father who was the only source of income of family as he was running his own business under the name and style of M/s. Prem Chand Verma Electrician and was earning Rs.40,000/- to Rs.50,000/- for which the complainant is entitled to compensation of Rs.20 lac from the opposite parties. In the end, the complainant prayed for issuing directions to the opposite parties to pay Rs.20,00,000/- as damages for imparting negligent and deficient services.
2. Upon notice, opposite party No.1 and 2 filed joint written statement by taking preliminary objections that the complainant has not come to this Commission with clean hands and has ulterior motive of extracting money from them since he has filed similar complaint against them before Hon’ble Governor Punjab with copy to Health Minister Punjab, Secretary Health and Family Welfare, Punjab, Director Health and Family Welfare Punjab and Civil Surgeon, Ludhiana. The opposite parties further stated that the complaint was enquired in the office of Civil Surgeon, Ludhiana by board of senior doctors. They were summoned to appear in enquiry at Civil Surgeon Office, Ludhiana and appeared before the board of senior doctors where they were cross examined by the board members. The record of Satyam Hospital was also examined by the board members in which there was not any entry pertaining to complainant’s father Sh. Prem Chand and same was filed by Principal Secretary Health, Govt. of Punjab. The complainant has not disclosed this fact and has wasted the time of this Commission. The opposite parties further stated that the complainant filed an undated complaint before the Hon’ble Government of Punjab on 02.02.2018 after about five months of death of his father on 09.09.2017. The opposite parties further stated the complaint is an afterthought.
On merits, opposite party No.1 and 2 stated that she has done MBBS and post graduation in General Surgery (MS) and had taken VRS from govt. services (PCMS). She served the Govt. about 21 years and now she is a pension holder and doing private practice and running the hospital. Opposite parties further stated that the complainant has failed to produce any valid documentary evidence pertaining to visit of his father and treatment at Civil Hospital, Khanna on said dates. During the inquiry at Civil Surgeon office, Ludhiana it was verified from S.M.O. Civil Hospital, Khanna that his father Sh. Prem Chand’s name does not figure in any of the register on said dates mentioned in the Civil Hospital, Khanna. The opposite parties further stated that no person in the name of Dr. Sat Pal has ever worked in Satyam Hospital, Amloh Road, Khanna. Moreover, as per CMC discharge summary, there is no mention of prior admission and treatment for dengue of Sh. Prem Chand in any of the hospital prior to 30.08.2017 in the history of illness. The Micro Laboratory at Amloh Road, Khanna is an independent entity and independently functioning. Father of the complainant was never referred by CMC to PGI Chandigarh and the complainant got his father LAMA (Left against medical advice) from CMC, Ludhiana. According to the opposite parties, emergency at PGI, Chandigarh is working round the clock and version of the complainant that he could got his father admitted at PGI after appointment after gap of 4 days is false. He deliberately kept his father at home in serious condition where he also suffered from Malaria and he himself is negligent for not treating his father in time. The opposite parties further stated that the complainant had said that CMC Ludhiana doctors told him that his father was suffering from Malaria and he has not been treated earlier for the malaria and his father died of Malaria at PGI, Chandigarh but the discharge summary from CMC clearly shows that the patient was admitted in CMC on 30.08.2017 and the tests pertaining to Malarial parasites (P. FALCIPARUM/VIVAX) were done on 30.08.2017 which were negative. Similarly MP card test pertaining to malaria was done on230.08.2017 and it was negative. Moreover, as per the discharge summary of CMC Ludhiana, Sh. Prem Chand was suffering from Acute Bronchitis (? Viral), Pancytopenia and congestive cardiac failure and as per history, Sh. Prem Chand was chronic smoker and alcoholic. Even on the last page of discharge summary of CMC, it is clearly mentioned: “that the patient’s condition was explained to the relatives and they want to take patient home against medical advice.” In fact father of the complainant remained admitted in CMC Ludhiana from 30.08.2017 to 04.09.2017 as per discharge summary. On 04.09.2017, Sh. Prem Chand was not discharged but his relatives got him LAMA as per the discharge summary. In fact, Sh. Prem Chand contacted malaria during the negligence stay at home from 04.09.2017 to 08.09.2017 before his admission to PGI, Chandigarh on 08.09.2017. All other allegations of the complaint have been denied as wrong and in the end, a prayer for dismissal of the complaint has been made.
3. Opposite party No.3 filed separate written statement by taking preliminary objections that the complainant has not come to this Commission with clean hands and has ulterior motive of extracting money from him since he has filed similar complaint against opposite party before Hon’ble Governor Punjab with copy to Health Minister Punjab, Secretary Health and Family Welfare, Punjab, Director Health and Family Welfare Punjab and Civil Surgeon, Ludhiana. The opposite party further stated that the complaint was enquired in the office of Civil Surgeon, Ludhiana by board of senior doctors. and the same was filed by Principal Secretary Health, Govt. of Punjab. The complainant has not disclosed this fact and has wasted the time of this Commission.
On merits, opposite party No.1 and 2 stated that she has done MBBS and post graduation in Internal Medicine (MD Medicine) and had worked as medical specialist (Medical Officer) in Civil Hospital, Khanna for 16 to 17 years and was promoted on 08.11.2016 as Senior Medical Officer and joined ESI Hospital, Mandi Gobindgarh as SMO. The opposite party stated that he did not visit Civil Hospital, Khanna on the said dates as he was not medical officer at Civil Hospital Khanna rather was senior medical officer at E.S.I. Hospital, Khanna. The opposite party further stated that the complainant has failed to produce any valid documentary evidence pertaining to visit of his father and treatment at Civil Hospital, Khanna on said dates. During the inquiry at Civil Surgeon office, Ludhiana it was verified from S.M.O. Civil Hospital, Khanna that his father Sh. Prem Chand’s name does not figure in any of the register on said dates mentioned in the Civil Hospital, Khanna. According to the opposite party the govt. OPD slips attached with the complaint may be belonging to his tenure as medical officer in Civil Hospital, Khanna before his promotion on 08.11.2016 when he used to do evening and night emergency duties and used to prescribed medicines on the unregistered OPD slips in the interest of the patient since by that time OPD registration counter was closed. The opposite party stated that he is not running Satyam Hospital, Amloh Road, Khanna. He never visited Civil Hospital, Khanna on 17.08.2017, 18.08.2017 and 19.08.2017. The father of the complainant was never referred by CMC to PGI Chandigarh and the complainant got his father LAMA (Left against medical advice) from CMC, Ludhiana. According to the opposite party, emergency at PGI, Chandigarh is working round the clock and version of the complainant that he could got his father admitted at PGI after appointment after gap of 4 days is false. He deliberately kept his father at home in serious condition where he also suffered from Malaria and he himself is negligent for not treating his father in time. The opposite party further stated that the complainant had said that CMC Ludhiana doctors told him that his father was suffering from Malaria and he has not been treated earlier for the malaria and his father died of Malaria at PGI, Chandigarh but the discharge summary from CMC clearly shows that the patient was admitted in CMC on 30.08.2017 and the tests pertaining to Malarial parasites (P. FALCIPARUM/VIVAX) were done on 30.08.2017 which were negative. Similarly MP card test pertaining to malaria was done on230.08.2017 and it was negative. Moreover, as per the discharge summary of CMC Ludhiana, Sh. Prem Chand was suffering from Acute Bronchitis (? Viral), Pancytopenia and congestive cardiac failure and as per history, Sh. Prem Chand was chronic smoker and alcoholic. Even on the last page of discharge summary of CMC, it is clearly mentioned :”that the patient’s condition was explained to the relatives and they want to take patient home against medical advice.” In fact father of the complainant remained admitted in CMC Ludhiana from 30.08.2017 to 04.09.2017 as per discharge summary. On 04.09.2017, Sh. Prem Chand was not discharged but his relatives got him LAMA as per the discharge summary. In fact, Sh. Prem Chand contacted malaria during the negligence stay at home from 04.09.2017 to 08.09.2017 before his admission to PGI, Chandigarh on 08.09.2017. All other allegations of the complaint have been denied as wrong and in the end, a prayer for dismissal of the complaint has been made.
4. In support of his claim, the complainant tendered his affidavit Ex. CA in which he reiterated the allegations and the claim of compensation as stated in the complaint. The complainant also tendered documents Ex. C1 to Ex. C6 are the prescription slips of Civil Hospital, Khanna, Ex. C7 is the investigation/test report, Ex. C8 to Ex. C21, Ex. C25 are the bills/receipts of CMC Hospital, Ludhiana, Ex. C22 is the copy of discharge summary of CMC Hospital, Ludhiana, Ex. C23 and Ex. C24 are the copies of colour Doppler echocardiography report, Ex. C26, Ex. C28, Ex. C30, Ex. C32, Ex. C34 are the postal receipts, Ex. C27, Ex. C29, Ex. C31, Ex. C33 and Ex. C35 are the copies of representations to various authorities, Ex. C36 is the copy of medical certificate of cause of death issued by PGI, Chandigarh, Ex. C37 is the copy of passbook of Mr. Prem Chand, Ex. C38 is the copy of ration card of Prem Chand, Ex. C39 is the copy of Aadhar card of Prem Chand. The complainant did not conclude his evidence and as such, his evidence was closed by order vide order dated 24.03.2022.
5. On the other hand, counsel for opposite parties tendered affidavit Ex. RA of Dr. Babita Abrol, Prop of Satyam Hospital and affidavit Ex. RB of Dr. Satpaul, Senior Medical Officer, Civil Hospital, Khanna along with documents Ex. R1 is the copy of complaint before the Hon’ble Governor, Punjab, Ex. R2 is the copy of report of enquiry committee dated 27.07.2018, Ex. R3 is the copy of memo No.2070 dated 02.07.2019 of Punjab Government, Ex. R4 is the copy of order of promotion and transfer of Dr. Satpal, Ex. R5 is the copy of order dated 30.11.2016, Ex. R6 to Ex. R29 are the copies of certificates issued by different organizations in the name of Dr. Sat Paul and closed the evidence.
6. We have heard the arguments of the counsel for the parties and also gone through the complaint, affidavit and annexed documents and written replies along with affidavit and documents produced on record by both the parties.
7. The complainant has raised the grievance of medical negligence by emphasizing that his father namely Sh. Prem Chand now deceased (hereinafter called as patient) was actually suffering from Malaria but the opposite parties diagnosed and treated him as a patient of Dengue which resulted in deterioration of his medical condition. Even his subsequent treatment at renowned hospitals such as CMC, Ludhiana and PGI, Chandigarh could not improve upon his condition and he ultimately expired on 09.09.2017 at PGI, Chandigarh. Opposite party No.1 hospital his being run opposite party No.2, wife of opposite party No.3 who at the relevant time was posted as Senior Medical Officer on promotion at ESI Hospital, Gobindgarh and was having an additional charge as Senior Consultant at Civil Hospital, Khanna.
87. The first and foremost issue needs to be decided whether Prem Chand deceased ever remained under treatment of opposite party No.2 and 3 either at Civil Hospital, Khanna or at opposite party No.1 hospital. As per complainant’s version in para No.2 of the complaint he got his father examined on 17.08.2017 at Civil Hospital, Khanna and two days after i.e. on 19.08.2017 as per advise of opposite party No.3, he got his father admitted at opposite party No.1 hospital but perusal of representations dated 02.02.2018 Ex. C27, Ex. C29, Ex. C31 and Ex. C35 made to various authorities reveal that the complainant got his father examined on 22.08.2017 by opposite party No.3 who persuaded him for admission at Satyam Hospital so there are material contradictions in the version of the complainant with regard to the date of his first medical examination, admission, treatment and discharge of the patient by the opposite parties. Further the complainant could have produced some record pertaining to the expenditure incurred by him on medicines, laboratory tests or logistic support etc. The prescription slips Ex. C19 to Ex. C24 produced by the complainant are undated and cannot be co-related with the ailments and treatment of the patient. Perusal of the admission notes of CMC Hospital, Ludhiana also shows that he was not a referred patient. On the other hand, there is a consistent stand of the opposite parties supported with the transfer and posting order Ex. R4 and Ex. R5 that in November 2016, opposite party No.3 was posted as Senior Medical Officer at E.S.I. Hospital, Mandi Gobindgarh on promotion and later on he was given additional duty to work for one day in a week at Civil Hospital, Khanna. 22.08.2017 was a gazetted holiday so the chances of examination of patient at Civil Hospital, Khanna by opposite party No.3 are bleak. Further on the representation of the complainant, Civil Surgeon, Ludhiana constituted a board of three doctors who conducted in-depth inquiry with regard to allegations of the complainant and perused all the relevant records and tentatively opined that it cannot be said with certainty that Mr. Prem Chand remained admitted at Satyam Hospital from 22.08.2017 to 30.08.2017. Therefore, considering the aforesaid facts and circumstances, the complainant has failed to prove that his father remained under the treatment of opposite party No.2 and 3 either at Civil Hospital, Khanna or opposite party No.1 hospital up till 30.08.2017.
9. Now adverting to the allegations of the complainant with regard to medical negligence on the part of the opposite parties, medical negligence can be understood as a breach of duty of care by an act of omission and commission by a medical professional by ordinary prudence. Action of medical negligence is a neglect in exercising of a reasonable degree of skill and knowledge to the pateient to whom he owns a duty of care which has resulted in injury to such person. In the complaint of medical negligence, initial burden is on the complainant to prove the breach of duty, injury and causation. The injury must be sufficiently proximate to the medical practitioner’s breach of duty. In this regard, a reference can be made to case titled as Jacob Mathew Vs State Of Punjab & Anr. 2005(2) Apex Court Judgments 136 (SC) whereby the Hon’ble Supreme Court of India summed up the law on medical negligence in the following words:-
“48. (1) Negligence is the breach of a duty caused by omission to do something which a reasonable man guided by those considerations which ordinarily regulate the conduct of human affairs would do, or doing something which a prudent and reasonable man would not do. The definition of negligence as given in Law of Torts, Ratanlal & Dhirajlal (edited by Justice G.P. Singh), referred to hereinabove, holds good. Negligence becomes actionable on account of injury resulting from the act or omission amounting to negligence attributable to the person sued. The essential components of negligence are three: 'duty', 'breach' and 'resulting damage'.
(2) Negligence in the context of medical profession necessarily calls for a treatment with a difference. To infer rashness or negligence on the part of a professional, in particular a doctor, additional considerations apply. A case of occupational negligence is different from one of professional negligence. A simple lack of care, an error of judgment or an accident, is not proof of negligence on the part of a medical professional. So long as a doctor follows a practice acceptable to the medical profession of that day, he cannot be held liable for negligence merely because a better alternative course or method of treatment was also available or simply because a more skilled doctor would not have chosen to follow or resort to that practice or procedure which the accused followed. When it comes to the failure of taking precautions what has to be seen is whether those precautions were taken which the ordinary experience of men has found to be sufficient; a failure to use special or extraordinary precautions which might have prevented the particular happening cannot be the standard for judging the alleged negligence. So also, the standard of care, while assessing the practice as adopted, is judged in the light of knowledge available at the time of the incident, and not at the date of trial. Similarly, when the charge of negligence arises out of failure to use some particular equipment, the charge would fail if the equipment was not generally available at that particular time (that is, the time of the incident) at which it is suggested it should have been used.
(3) A professional may be held liable for negligence on one of the two findings: either he was not possessed of the requisite skill which he professed to have possessed, or, he did not exercise, with reasonable competence in the given case, the skill which he did possess. The standard to be applied for judging, whether the person charged has been negligent or not, would be that of an ordinary competent person exercising ordinary skill in that profession. It is not possible for every professional to possess the highest level of expertise or skills in that branch which he practices. A highly skilled professional may be possessed of better qualities, but that cannot be made the basis or the yardstick for judging the performance of the professional proceeded against on indictment of negligence.
(4) The test for determining medical negligence as laid down in Bolam's case [1957] 1 W.L.R. 582, 586 holds good in its applicability in India.
Further reference can be made to Dr. Harish Kumar Khurana Vs Joginder Singh & others in (2021) SCC Online SC 673 whereby the Hon’ble Supreme Court of India has held that hospital and the doctors are required to exercise sufficient care in treating the patient in all circumstances. However, in an unfortunate case, death may occur. It is necessary that sufficient material or medical evidence should be available before the adjudicating authority to arrive at the conclusion that death is due to medical negligence. Every death of a patient cannot on the face of it be considered to be medical negligence.”
Further, reference can also be made to the case title Dr. (Mrs.) Chandarani Akhouri and others Vs Dr. M.A. Methusethupathi & others in II (2022) CPJ 51 (SC) whereby it has been held by the Hon’ble Supreme Court of India in para No.27 of its judgment which is reproduced as under:-
“27. It clearly emerges from the exposition of law that a medical practitioner is not to be held liable simply because things went wrong from mischance or misadventure or through an error of judgment in choosing one reasonable course of treatment in preference to another. In the practice of medicine, there could be varying approaches of treatment. There could be a genuine difference of opinion. However, while adopting a course of treatment, the duty cast upon the medical practitioner is that he must ensure that the medical protocol being followed by him is to the best of his skill and with competence at his command. At the given time, medical practitioner would be liable only where his conduct fell below that of the standards of a reasonably competent practitioner in his field.”
10. It is the admitted fact that the patient remained admitted in CMC Hospital, Ludhiana from 30.08.2017 to 04.09.2019. Discharge summary Ex. C22 shows that the patient was diagnosed with Acute Bronchitis? Viral and he was found to be a known smoker and alcoholic. Even his malaria and dengue tests were also found negative. He further left the hospital against medical advise (LAMA) and the patient was never referred to PGI, Chandigarh by the doctors of CMC, Ludhiana. Instead of immediately shifting the patient to PGI, the complainant kept the patient at undisclosed destination for 4 days i.e. from 04.09.2017 to 08.09.2017.
11. Finally the complainant got the patient admitted in PGI, Chandigarh on 08.09.2017 i.e. after a gap of four days after discharge from CMC Hospital, Ludhiana where he expired on 09.09.2017. The medical certificate with regard to cause of death is Ex. C36, the operative part of which is reproduced as under:-
Cause of death | Interval between onset & death approx.
………..
………..
…………
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………
………
…….
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I. Immediate Cause. State the disease, injury or (a) Type-I Respiratory Failure complication which caused due to (or as a consequences of) death, not the mode of dying such as heart failure, asthma etc. Antecedent Cause Morbid conditions, if any, (b) Acute Respiratory Distress syndrome. giving rise to the above cause, Thrombocytopenia due to (or as a stating underlying condition consequences of) last.
II. Other significant conditions (c) Acute Febrile Illness Malaria. contributing To the death but not related to the disease or conditions causing it.
| ||
Manner of death
Natural |
Perusal of this medical certificate shows that the patient died natural death and malaria was not found related to the disease or condition which caused the death of the patient.
12. It has also been noticed that Prem Chand died on 09.09.2017 and the complainant moved representations with regard to alleged medical negligence to various authorities on 02.02.2018 i.e. after a gap of 5 months. The inquiry conducted by Civil Surgeon was concluded on 27.07.2018 and the present complaint has been filed on 25.03.2019 i.e. after a delay of 6 months. The aforesaid delay remained unexplained and also raises doubt with regard to veracity of the version of the complainant. The complainant presented false facts in his complaint and also concealed the material facts regarding moving of representation to the various authorities and conducting of detailed inquiry by the board of doctors. So the pleadings of the complainant are vague and sketchy and the evidence lead by him does not inspire any confidence to return any finding in his favour. In the given set of facts and circumstances of the case, the complainants have failed to prove medical negligence against the opposite parties conclusively.
13. As a result of above discussion, the complaint fails and the same is hereby dismissed. However, there shall be no order as to costs. Copies of the order be supplied to the parties free of costs as per rules. File be indexed and consigned to record room.
14. Due to huge pendency of cases, the complaint could not be decided within statutory period.
(Monika Bhagat) (Jaswinder Singh) (Sanjeev Batra) Member Member President
Announced in Open Commission.
Dated:07.06.2023.
Gobind Ram.
Tarsem Lal Vs Satyam Hospital CC/19/159
Present: Sh. V.K. Jhanji, Advocate for complainant.
Sh. Anand Sabherwal, Advocate for OPs.
Arguments heard. Vide separate detailed order of today, the complaint fails and the same is hereby dismissed. However, there shall be no order as to costs. Copies of the order be supplied to the parties free of costs as per rules. File be indexed and consigned to record room.
(Monika Bhagat) (Jaswinder Singh) (Sanjeev Batra) Member Member President
Announced in Open Commission.
Dated:07.06.2023.
Gobind Ram.
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