VPS Lakeshore Hospital in Kochi and nine doctors, including Dr Philip Augustine, the founder of the Lakeshore Hospital and Research Centre, have received notice from the Judicial First Class Magistrate-8, Ernakulam.
The notice was issued in response to a complaint regarding crimes under the Transplantation of Human Organs Act, 1994, wherein Dr Philip Augustine and 8 others were accused of harvesting the kidney and liver of an 18-year-old youth Abin V J, a youth brain dead without following due procedure.
The accused in the case are Lakeshore Hospital and Research Centre presently known as VPS Lakeshore Hospital, doctors with the hospital- Dr Philip Augustine, Dr S Mahesh, Dr George Jacob Eraly, Dr Sai Sudarsan, Dr Thomas Thachil, Dr Murali Krishna Menon, and Dr Sujith Vasudevan, and Dr Sajeev S of Mar Beselios Hospital.
Dr Philip Augustine conferred with Padma Shri by the UPA-Govt in 2010
Dr Philip Augustine is a gastroenterologist. He is a specialist in gastrointestinal endoscopy and a hospital administrator from Ernakulam, Kerala. He founded the Lakeshore Hospital and Research Centre in 2003. In 2010, Dr Philip Augustine was conferred with Padma Shri Award, for his services to the fields of medicine by the then-UPA Government.
Dr Philip and his associate doctors were summoned based on a complaint filed by Dr S Ganapathy, of Maruthadi, Kollam. Dr S Ganapathy alleged that VJ Abin’s kidneys and liver were removed illegally in violation of the Transplantation of Human Organs Act of 1994 after the hospital declared him brain-dead following a motorcycling accident.
Dr S Ganapathy also asserted in his complaint that the Apnea test, which is mandatory to confirm brain death was not conducted in the case of Abin.
The court found that there was a prima facie case and enough evidence against each and every accused party in the case. It, therefore, decided to pursue the death and organ transplantation performed on Abin V J declaring it a case fit to be probed.
“I find that there is a prima facie case and sufficient grounds for proceeding in respect of offences u/s. 18, 20 and 21 of the Transplantation of Human Organs Act, 1994 (pre-amended), against all accused”, read Magistrate Eldos Mathew’s order on May 29.
The case
The case date back to the year 2009, when a young boy from Kerala named VJ Abin, who was 18-year-old then, met with a two-wheeler accident and was rushed to Mar Baselios Hospital Kothamangalam on November 29, 2009, and later to Lakeshore on November 30, 2009.
Abin’s family accused both hospitals of medical negligence but the complaint against the two hospitals and their doctors was eventually filed by Dr S Ganapathy after he came to know the details about the organ transplantation through a media report in 2019.
UPA-era Padma Shri awardee Dr Philip Augustine and his team hurriedly declared patient brain dead
Dr Ganapathy was doing research on illegal transplantation when he learnt about the goof-ups on the part of the hospital and doctors. He alleged that the hospital and the doctors engaged in a criminal conspiracy by denying the victim proper medical care and hurriedly declared Abin brain dead only to transplant his organs on a foreign national in violation of the prescribed laws. He accused the hospital of amassing a huge sum of money in the process.
“I saw a report saying there is nothing illegal in the case. I enquired about the report and one of the doctors who was mentioned in the report said she did not attend any meetings regarding it. Then I realized there was something. He was not treated at Mar Baselios hospital though they had a neurosurgeon and they referred him to Lakeshore. It was an adjustment as the doctor had earlier worked in Lakeshore,” Dr S Ganapathy had then told the media.
Medical negligence, violation of prescribed laws, Dr Philip Augustine signing the death certificate without examining the patient: What all did the court observe in the organ transplant case
Dr P Sanjay, Assistant Professor, Department of Forensic Medicine, Government Medical College, Manjeri who had performed Abin’s autopsy, identified an irregularity by the hospital that led to a blood clot in the brain cavity from a haemorrhage. Even though Abin was rushed to the hospital right away after the accident, the hospital’s medical staff did not perform a surgical blood drain, he told the court, adding that this was a major lapse from the part of the two hospitals where he was treated.
Dr Sanjay, also noted that at Lakeshore Hospital, Abin was not subjected to neurosurgery. “Though the patient started respiring himself, the authorities downgraded the ventilator settings,” Dr Sanjay further told the court.
He concluded that Abin did not have a significant brain injury and that evacuation of the collected blood could have saved his life.
Both Dr Sanjay and Dr Thomas Iype, Head of Neurology at Medical College Hospital in Thiruvananthapuram, who had been asked by the court to provide an expert opinion, claimed that the declaration of brain death had not been made legally and in accordance with procedure. The transplantation team had access to the patient even before his death was officially declared and his liver was transplanted to a Malaysian citizen, which they said was in violation of the rules.
The patient’s brain stem death certificate was signed by Dr Philip Augustine. The court, however, observed that there is no evidence to prove that Philip Augustine had examined Abin before signing the death certificate. The court also noted that some other doctors who signed the death certificate also had no authorisation.
The court also found that the due processes outlined in the TOHO Act were not followed in Abin’s case. It said that Abin’s liver was transplanted to a Malaysian national without obtaining sanction from the internal authorisation committee. The court also observed that the recipient’s wife was listed as the organ donor on the Malaysian Embassy document, even though Abin’s organ had actually been transplanted.
The court also learnt that the thoracic chamber was opened (sternotomy) during the organ harvesting process and the heart was subsequently damaged. Based on these observations, the court said that it found sufficient grounds for proceeding with the case and accordingly summoned all the accused to hear them as part of the probe.
Hospital clarifies
According to VPS Lakeshore Hospital, the court has mandated an investigation to ascertain the veracity of the complaint made by a private individual regarding brain death. The hospital will fully cooperate with the investigation, said managing director S K Abdullah. Regarding the incident in question, he claimed that there was no lapse on the part of the hospital, adding that they are taking necessary legal actions to prove the hospital’s innocence before the court.
