Health minister Veena George and the medical community in Kerala spar over who should be held accountable for the alleged failure in adhering to established organ transplant protocols in Thiruvananthapuram Medical College.
The minister says that the responsibility vests with doctors. The medical community, on the other hand, feels the health minister and the health secretary should at least take "vicarious liability" for what happened at the Medical College.
"The government cannot shy away from its responsibility of putting in place allied mechanisms like a team of nurses, attendants and a public relations officer, as they have in private hospitals, to aid the expert doctors involved in organ transplant," said Dr Samuel Koshy, the president of Indian Medical Association, Kerala Chapter. "Has the government bothered to create such a team in the medical college," he asked.
The big charge against the medical college was that there was none present to receive the organ when the ambulance arrived from Kochi. It was some outsiders who took the ice container and rushed inside the hospital.
After the health minister said doctors should take responsibility for the failure early on Tuesday, the IMA issued a statement lampooning the minister for abdicating her responsibility. "Instead of finding solutions for systemic failures at the government level, this approach of making scapegoats of doctors is unacceptable," the IMA statement said. "It is highly condemnable to suspend doctors as a remedy for any complaint," the statement said.
The IMA even termed the suspension "absurd". One of the suspended doctors, Nephrology head Dr Jacob George, was not even in Kerala when the incident took place. "He was in Delhi, conducting the Diplomate of National Board (DNB) examinations," Dr Koshy said.
The IMA said that penalising doctors had become the norm. "When a patient with criminal antecedents broke out of the Kuthiravattom Mental Health Centre (Kozhikode), the hospital superintendent was suspended. At Kuthiravattom, there are just two security personnel for 450 patients," Dr Koshy said. "Recently, the head of the Department of Orthopedics at Thrissur Medical College was suspended for having done the right thing," Dr Koshy said. The doctor had called back a dead body that was released by a junior doctor without conducting an autopsy.
The IMA questioned certain charges that were raised as part of the organ transplant in Thiruvananthapuram Medical College.. "It is not clear why it was said there was a delay in conducting the operation when the harvested kidney would remain preserved for up to 24 hours," the IMA statement said.
The IMA said the controversy surrounding the issue was devoid of any basic understanding of organ transplants. "First of all, it is not possible to find the right recipient beforehand. Tests will be done on possible candidates to establish the match only after receiving information of the brain-dead donor," the IMA said. Once the right recipient is found, the patient will be taken for haemodialysis, which usually takes four hours. "When the donor kidney arrived, the dialysis was not yet over," the IMA said. This was a point the minister had also stressed.
In the case of Suresh Kumar, the 62-year-old end-stage renal patient who received the kidney, he had suffered respiratory issues after the dialysis. "This necessitated extra care. And once in the operation theatre, certain tests have to be done before the patient is sedated. The donor kidney, too, has to be subjected to some tests," the IMA said, hinting that if at all there was a delay, it was normal.
Considering Suresh Kumar's grave condition, his relatives were informed of the high possibility of failure. Suresh Kumar eventually died of cardiac arrest.