Hospital, doctors in dock over organ transplantation declaring a man brain dead

Kochi: Based on the primary inquiry into a case involving an organ transplantation of a Kerala man, after him being declared brain dead, a local court in Kochi ruled that there stands a case under the Transplantation of Human Organs Act against Lakeshore Hospital and eight doctors.

The Ernakulam judicial first-class magistrate court said there is enough evidence against the hospital and the doctors involved in the case to put them on trial after hearing expert testimonies that suggested the failure of crucial procedures to determine brain death in Abin's case.

The Apnea test, a mandatory examination to confirm brain death, was reportedly not conducted. Two experts, Dr P Sanjay and Dr Thomas Iype, expressed their opinion that the declaration of brain death was not performed according to the prescribed procedure, rendering it illegal.

Dr Sanjay, who conducted the autopsy, highlighted a major irregularity in the hospital. He observed that there was an accumulation of blood in Abin's cranial cavity due to a haemorrhage, which was not surgically drained.

Additionally, he noted that Abin was not given the necessary neurosurgery, and the ventilator settings were downgraded despite signs of spontaneous respiration. Dr Sanjay concluded that prompt evacuation of the collected blood could have the saved Abin's life, as his brain injury was not significant.

Further scrutiny revealed that the transplantation team was granted access to Abin even before the declaration of death, which contravened the legal provisions. Dr Philip Augustine, the founder of Lakeshore Hospital, signed the brain stem death certificate without any evidence of examining Abin. Other doctors who signed the certificate also lacked proper authorization, raising questions about the validity of the document.

The court, through Magistrate Eldos Mathew, has ordered the commencement of a trial against all accused parties under sections 18, 20, and 21 of the Transplantation of Human Organs Act, 1994. The accused include Dr Philip Augustine, Dr S. Mahesh, Dr Sai Sudarsan, Dr Thomas Thachil, Dr Murali Krishna Menon, Dr Sujith Vasudevan, and Dr Sajeev S.

The case gained attention when Dr S. Ganapathy, conducting research on illegal transplantation, came across a newspaper report on the incident. Suspecting discrepancies, he initiated an inquiry and discovered inconsistencies in the treatment process. Dr Ganapathy found it alarming that Abin was referred to Lakeshore Hospital despite Mar Baselios Hospital having a neurosurgeon. He noted that the referral seemed to be an adjustment, as the doctor involved had previously worked at Lakeshore.

Following the court's intervention, the hospital in a statement said that the authorities have ordered an investigation to determine the validity of the complaint made by a private individual in the incident that happened around 13 years ago.

In 2009, when the incident occurred, the only registered body in Kerala promoting cadaver organ donation was the Society for Organ Retrieval & Transplantation (SORT).

The hospital pledged its wholehearted cooperation with the investigation and stated that all that it did then was in compliance with the Transplantation of Human Organs Act (THO).

"All investigations were conducted in the presence of two witnesses, and written consent for organ retrieval was obtained from the patient's mother. The hospital authorities sought assistance from SORT, Kochi, and acted under their written advice in retrieving cadaveric organs," reads the statement.

The hospital asserted that during the incident, they strictly followed medical procedures, organ donation laws, and human rights laws. It regretted the circulation of false information about the hospital which has been providing exemplary emergency care services for over 20 years, and its ultimate goal is to ensure that all patients receive the best possible treatment.