Violation of Transplantation of Human Organs Act: Kerala Court initiates criminal proceedings against Lakeshore Hospital, 8 doctors

Kochi: A Kerala court has decided to initiate criminal proceedings against Lakeshore Hospital and eight doctors for the offence of unauthorised removal of organs of an accident victim back in 2009.

The decision by Judicial First Class Magistrate Eldos Mathew came on a doctor's complaint alleging denial of proper treatment to the accident victim, declaring him brain dead without following due procedure and transplanting his organs into a foreign national in violation of the law regulating the same.

The court said it was of the view that "there is a prima facie case and sufficient grounds for proceeding in respect of offences under the Transplantation of Human Organs Act, 1994, against all the accused".

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"The complainant has complied with all the requirements of the Act. Hence, the case is taken on file. Accordingly, it is directed that summons shall be issued to all the accused," the court said in its order of May 29.

The accused include the private hospital where the victim died, the neurosurgeons who examined him at the two hospitals he was taken to after the accident and the doctors of the transplantation team.

The magistrate said that after going through various court rulings, relevant statutes and considering the materials before him, it has emerged that evacuation of blood from the victim's cranial cavity after the accident could have saved his life.

"But there was no effort to drain out the blood, though the victim was examined by neurosurgeons at the two hospitals where he was treated," the court said.

The court also noted that even before planning to conduct neurosurgery or blood evacuation, HIV tests were conducted by Lakeshore Hospital.

"Even prior to the declaration of brain death, doctors of the transplantation team visited the patient and a liver function test was conducted," the court further noted.

It also said the death certificate was not as per the prescribed norms and some of the doctors who signed it were not authorised to do so under relevant laws.

The court also noted that even the Apnoea test, a mandatory examination for determining brain death, was not conducted.

It also said the liver of the victim was transplanted into a foreign national without the sanction of the internal authorisation committee and in the Malaysian Embassy certificate, wife of the recipient is shown as donor which was "suspicious".

All these grounds were also cited by the complainant, Dr S Ganapathy, who had claimed that the victim's relatives were made to believe he was brain dead and thus induced to donate his vital organs.

The victim, Abin V J, had met with an accident on November 29, 2009, when his motorcycle rammed an electric post and he sustained head injuries. He was initially admitted to Mar Baselious Hospital, Kothamangalam. Thereafter, he was shifted to Lakeshore Hospital, Ernakulam, on November 30, 2009, and declared brain dead on December 1, 2009. 

The complainant, who is a doctor by profession, came to know about the facts of the case through a news report in January 2019. Upon his enquiry, he found that the organ transplantation had been conducted in gross violation of the existing laws and that the consent of the parents of the victim had been obtained under misrepresentation.

The complainant alleged that the respondents doctors had acted in criminal conspiracy and denied proper treatment to the victim and thereafter transplanted his organs to a foreign national in violation of the existing laws. He alleged that the hospital had amassed huge amounts of money through the same.

Dr P. Sanjay of Government Medical Medical College, Manjeri, who performed the Autopsy, had raised a strong submission over the non-evacuation of blood from the cranial cavity, although the victim had been admitted to the hospital soon after the accident and the Neuro Surgeon had also been consulted. He opined that the same could have been life-saving for the victim. He further said that the victim had not been subjected to hematoma evacuation or neuro surgery at Lakeshore.

Additionally, it was stated that the hospital authorities had downgraded the ventilator settings, although the petitioner had started breathing by himself on November 30, 2009. The doctor further stated that the declaration of brain death was not done as per the procedure under the Act and that there was no evidence of the patient having been examined by the concerned doctors, although the certificate had been seen to be signed by them. 

Another anomaly pointed out by the doctor was regarding the transplantation team being given access to the patient and his liver being transplanted even before the declaration of death.

Speaking to a TV channel after the court's order, Dr Ganapathy said there were several attempts to sabotage the case by changing the officers looking into it and a report was also released, purportedly by the district-level enquiry committee of the DMO, stating there was nothing wrong done by the hospitals or the doctors concerned.

"When one of the doctors who had signed the report claimed she never attended the meeting and her signature was forged, I knew something was wrong and I started to hunt for the medical records of the case," he said.

He alleged that right from the time the victim was referred from Mar Baselios to Lakeshore, the preparations had begun to harvest his organs without even considering saving his life.

"All that cannot happen without the knowledge and approval of the hospitals' management," he claimed.

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