More than a decade after ‘illegal’ organ transplant, Kerala court issues summons to Kochi hospital and doctors

The complaint alleged illegal organ transplantation connected to the organ donation of a young person who was declared brain dead after a motorcycle accident in November 2009.

BySumit Jha

Published Jun 15, 2023 | 12:10 PM Updated Jun 15, 2023 | 12:10 PM

More than a decade after ‘illegal’ organ transplant, Kerala court issues summons to Kochi hospital and doctors

A Kerala court has issued a summons to VPS Lakeshore Hospital in Kochi and a few doctors, who allegedly transplanted the liver of a 21-year-old accident victim to a Malaysian national in violation of the existing laws, almost 14 years ago.

Ernakulam Judicial First Class Magistrate VIII Eldos Mathew issued the summons after prima facie finding substance in the petition filed by a Kollam-based modern medical practitioner, Dr S Ganapathy. He contended that the liver transplant violated the Transplantation of Human Organs Act (THOA), 1994.

Summons were issued to the Lakeshore Hospital and Research Centre (now VPS Lakeshore Hospital), its doctors Philip Augustine, S Mahesh, George Jacob Eraly, Sai Sudarsan, Thomas Thachil, Murali Krishna Menon, and Sujith Vasudevan, and Dr Sajeev S of the Mar Baselios Hospital at Kothamangalam in the Ernakulam district.

The case pertains to November 2009. On the 29th of that month, 21-year-old Abin VJ was admitted to Baselios Hospital with a head injury sustained in a two-wheeler accident. The next day, he was shifted to Lakeshore Hospital, where he was declared brain dead on 1 December.

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The court’s findings

Dr Ganapathy, the petitioner, came to know of the liver transplant through a news report in January 2010. On enquiring, he found that the transplantation was carried out in violation of the laws, and the consent of the victim’s parents was obtained under misrepresentation.

He alleged that there was a conspiracy involving improper treatment and the hasty declaration of brain death. The complainant alleged that the doctors who declared the brain death were not authorised to do so and that crucial procedures mandated under THOA were ignored.

After examining the records and consulting experts, the court found that an apnoea test, which confirms brain death, was not conducted. Blood was not drained from the cranial cavity, and actions that could have potentially saved the victim’s life were not initiated.

Additionally, the declaration of brain death was not made according to proper procedures.

The court also noted that Abin underwent an HIV test before doctors declared him brain dead. The test was conducted despite there being no plan for neurosurgery.

Additionally, the transplantation team visited the patient and performed a liver function test even before brain death was officially declared.

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Abin’s life could have been saved

The court’s examination of records, along with inputs from police surgeons and neurologists, revealed significant blood accumulation in the cranial cavity when Abin was admitted to the hospital. The court viewed the failure to perform an evacuation procedure to save his life as a major lapse by both hospitals.

The liver was transplanted to a Malaysian national without obtaining the necessary authorisation from the internal committee. The recipient’s wife was falsely listed as the organ donor on the Malaysian Embassy certificate, whereas the organ was transplanted from Abin.

During the organ harvesting process, the thoracic chamber was opened (sternotomy), and the heart was mutilated.

Considering these findings, the court took into account the various grounds raised by the complainant. The court concluded that the victim’s life could have been saved through the evacuation procedure, but neither of the hospitals made any effort to drain the blood.

Based on the findings, summons was issued to all the accused, acknowledging the complainant’s compliance with all requirements under the Act.

“I find that there is a prima facie case and sufficient grounds for proceeding in respect of offences under Sections 18, 20, and 21 of the Transplantation of Human Organs Act, 1994 (pre-amended), against all accused,” the court said.

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Lakeshore explains

VPS Lakeshore Hospital said its Managing Director SK Abdullah has assured to fully cooperate with the investigation. The hospital believed that there was no lapse on its part. Necessary legal actions have been initiated to prove its innocence.

Hospital authorities stated that the allegations regarding the wrongful issuance of a brain-death certificate and serious accusations against the doctors were false.

On 30 November, 2009, Mr. Abin VJ, a 21-year-old from Thodupuzha, was admitted to Lakeshore Hospital with severe head injuries after a road accident. The patient’s condition was critical upon arrival at the hospital, Lakeshore said.

“When the patient was brought to the emergency department, he was already intubated at the previous hospital, and subsequent CT scans, performed while he was unconscious with dilated pupils, revealed a severe head injury,” an official told South First.

“A neurosurgeon’s examination confirmed the severity of the brain damage, and the patient’s condition was explained to his family members,” he said.

The Kerala government introduced a special law for organ transplantation in 1998, but there was no active organisation working towards promoting cadaver organ donation. The Society for Organ Retrieval & Transplantation (SORT), which coordinates organ donation, was formed only in 2012.

“To comply with the regulations of the Transplantation of Human Organs Act, all necessary tests were conducted after obtaining written consent from the deceased’s mother and in the presence of two witnesses,” the official stated.

The official asserted that all medical procedures, organ donation laws, and human rights laws were fully adhered to in the incident, and there was no negligence on the part of the hospital.