CAT Calls for Time-Bound Transplant Approvals, Finding No Suitable Lung—Not Processing Delay—Led to Retiree’s Son’s Death

The applicant, a retired railway employee, sought approval and advance payment for a lung transplant for his critically ill son, whom AIIMS Jodhpur had referred to KIMS Hospital, Hyderabad.

After the applicant’s request for referral received no response, he filed this OA; the Tribunal initially directed the respondents to arrange proper treatment under the applicable rules.

The proposed treatment location later changed to KD Hospital, Ahmedabad. The Railway sanctioned and deposited ₹25 lakh for the transplant, but the hospital returned the amount when no suitable lung became available.

Following a renewed request, the Railway deposited the amount again on 5 March 2026. The patient died on 14 March 2026 before transplantation.

The applicant alleged delay in re-sanctioning the advance and sought measures to prevent procedural delay in future emergency cases.

The Tribunal considered the Office Memorandum dated 1 December 2023, which prescribed guidelines and ceiling rates for lung and heart transplant surgery for CGHS/CS (MA) beneficiaries.

It noted that the memorandum provided no timeframe for granting permission and that the composition of the relevant Standing Committee could delay consideration of applications.

No statute or judicial precedent was cited.

The Tribunal’s stated principle was that transplant approvals require prompt handling and that anticipated administrative delay should not prevent timely treatment; it also observed that hospitals should be informed of the applicable ceiling and given written assurance where sanction is delayed.

The Tribunal considered the absence of a prescribed decision period, the potential difficulty in convening the Standing Committee, and the fact that more than three months elapsed before the renewed advance was deposited.

It observed that, after an earlier advance had been sanctioned, the respondents could have kept that sanction alive or promptly re-transferred the amount on request.

It also considered that private hospitals may be reluctant to proceed without an advance, and that a written assurance could address anticipated delay.

However, on the facts, the Tribunal concluded that the patient died because a suitable lung was unavailable, not because the advance was released late; it also noted the applicant’s appreciation of the respondents’ cooperation.

It called for guidelines to ensure prompt processing of organ-transplant approvals and stated that, where sanction may be delayed, the respondents should give the treating hospital a written assurance that payment would follow, communicate the applicable ceiling, and advise the hospital to proceed according to the patient’s needs.

It did not find that administrative delay caused the patient’s death.

No order as to costs was made.