MDT 1 year ago

Thanks to all who have expressed their views here. However, we are finding that many people are using pseudonym or fake identity to abuse someone or post nasty comments. In addition we are also finding there are too many ‘vested interests’, which are using this space. Therefore we have decided to close comments on this article. In case you still want to express your views kindly write to the Editor (mail@moneylife.in).
Regards,
Moneylife Digital Team

Maj Pankaj Rai 1 year ago

There is a credibility issue about the qualifications of the doctors - Dr Rajanna Sreedhara and Dr Ramcharan Thiagarajan. Firstly, Dr Rajanna Sreedhara: Dr Sreedhara claims to be a professor at Institute of Nephro Urology. However, he has not been there since more than two years (or maybe more). The reason is simple, he does not have the qualifications considered appropriate to hold and sustain a medical teaching job recognised in India. Is Dr Sreedhara still at Fortis Hospital or has his CV not updated?

Dr Thiagarajan: Dr Thiagarajan still claims to be the Medical Coordinator at ZCCK which he is not. Again, his CV does not show any specific expertise in pancreatic transplant surgery nor does his CV on the website at Fortis. Again, since Fortis did not have license to do pancreatic transplant surgery how could he have been registered to do pancreatic transplant?

Ramesh S Arunachalam 1 year ago

I sum up the key issues from the article and please Dr Shroff, I would like your views on these. Thanks in Advance:

A) I would like to point out that Mr E V RAMANA REDDY, a person no less than Appellate Authority & Secretary to Government, Health and Family Welfare Department while passing his judgment on an appeal - made UNDER SECTION 17 OF THE TRANSPLANTATION OF HUMAN ORGANS ACT, 1994 – has noted (and I quote him):

“3.5 I am of the opinion that the APPELLANT HOSPITAL (FORTIS) DOES NOT HAVE LICENCE for transplantation of “Pancreas”. There is no basis for argument of the Appellant that Liver includes Pancreas and other abdominal organs. Not only the Office of the Appropriate Authority in Karnataka but also the Director General of Health Services, Government of India, have categorically stated that licence granted for liver does not include “Pancreas”. If it was not specifically rejected under Section 15(2) of the Act, it was not specifically granted also. I agree with the contention of the Respondent-1 (Maj Pankaj Rai Retd) that there is no clause for “deemed approval” if something is not specifically rejected under the Act. Contention of the Appellant that Dr. Ramesh, the then Joint Director (Medical) categorically stated that Liver includes all other abdominal organs cannot be agreed to. There is no written proof for this and EVEN IF THE THEN JOINT DIRECTOR (MEDICAL) WERE TO GIVE IT IN WRITING, IT IS IN VIOLATION OF THE ACT.”

B) Likewise, the report of the Karnataka Lokayukta (THEN UNDER THE HELM OF MR SANTOSH HEGDE) (No.Compt/LOK/BCD/621/2010/ARE-1, Bangalore), Dated: 20th May, 2011, notes that:


“The Appropriate authority has given permission to Fortis hospital to do transplantation of kidney, liver and homograft usage only (Page # 4)

Thus the Fortis hospital has registered with the Appropriate Authority to undertake only for kidney, homograft and liver transplantation surgeries only and NOT FOR PANCREAS (Page # 5)

Section 13 of Human Transplantation Act is violated by the Appropriate Authority as the Appropriate Authority has not conducted periodic inspections of the Fortis Hospital and has failed to look at the WEBSITE of the Hospital.(Page # 6)

The Hospital authorities have violated Sec. 9 of the Human Transplantation Act as they have allowed Dr. Ramacharan Thaigarajan to perform pancreatic transplantation in spite of not having the permission to undertake pancreatic transplantation surgery in their Hospital. (Page # 6)”

C) I have also seen the inspection reports of the appropriate authority of Karnataka prior to granting of the transplant licenses. The one for FORTIS does not list pancreas (in terms of infrastructure clearance) where as the one for BGS explicitly lists Pancreas (in terms of infrastructure clearance). This is just one example and there are others that can be shared

D) Also, the certificate of registration (Form 12) provided by the appropriate authority to BGS clearly lists Pancreas where the one for FORTIS does not. This is just one example and there are others that can be shared

E) According to Maj Pankaj Rai (Retd), Late Seema Rai had not registered for a pancreas transplant. Despite this, it was transplanted on her on 2 May 2010 at Fortis Hospital, Bannerghatta Road, Bangalore.


Interestingly, the ZCCK (Zonal Coordination Committee of Karnataka for Transplantation) in a letter (page 1, point 2 and page 2, last point) to Major Pankaj Rai claims that it was not aware of the fact that Fortis did not have a valid transplant license (to undertake PANCREAS transplantation).

The ZCCK also notes (Page 2, point 3) that "There are no rules laid down wherein a patient can be allocated organs even if he/she has not registered for the same". The letter is enclosed as Exhibit # 4 in the article above.

This clearly means that when a patient has not registered for transplant of a specific organ, there are no rules under the act to allocate the specific organ to the said patient. Yet the ZCCK allotted the organ to Late Seema Rai. Now, why and on what basis was this done is an aspect that needs to be probed!

It is also very strange and ironical that ZCCK says that it was not aware that Fortis did not have a valid pancreas transplant license. This is because the Dr Ramcharan T, who is listed as the medical coordinator on ZCCK's letter head, also happened to be the transplant surgeon at Fortis (at that point in time). Besides, the very fact that Dr Ramcharan T was part of the ZCCK (authorization committee), does show that there was a significant conflict of interest and in fact, his presence in the authorization committee appears to be a violation of the The Transplantation of Human Organs Act (THOA)

Specifically, The Transplantation of Human Organ Rules, 1995, Rule 4A talks about the authorisation committee- (1) The medical practitioner who will be part of the organ transplantation team for carrying out transplantation operation shall NOT be a member of the authorisation committee constituted under the provisions of clauses (a) and (b) of sub-section (4) of section 9 of the Act.

Doctor, given the above, I would be grateful if you can let me know what your views are with regard to these violations

Thanks and I look forward to your response and it is important that as one of the leading practitioners you set the record straight as far as legal violations (by Doctors) are concerned

Sunil Shroff 1 year ago

I have never said exonerate the doctor. I said first establish his intentions or was it done in 'good faith' as the law states. If this cannot be established - I am not sure why the law has this clause.

Was the surgeon competent or not - look at his credentials, his previous records. Get references from others. You can’t judge him by one case. If he was not competent, punish him but don't go on hearsay.

Some of you have taken the whole medical profession to task. No we are not perfect. Yes we do have bad apples among us. Yes our ethics has eroded as has the ethics of our society at large. Yes this is most unfortunate. But in a civilized society you cannot sweep everyone in medical profession or any other profession be it law or education with the same broom. It reflects the immaturity of persons making such statements. It is a more in line with medieval thought process.

Some of you have gone personal with me. It doesn’t bother me, because I walk the straight line in my profession and my work or anything else I do. But let me put the records straight I am not the one who allocates organs in Tamil Nadu when a cadaver organs are available In the case that was mentioned the health dept. of Govt. of Tamil Nadu has taken action. You can read this on their website and on the following link.
http://articles.timesofindia.indiatimes....

‘Hospital rapped for transplant violation

CHENNAI: The government has issued an order "severely reprimanding" Apollo Hospitals for violation of cadaver organ transplant norms.

Yes I am involved with MOHAN Foundation and I am proud to say so. If it was not for this foundation - over 2600 patients would not have got a second chance in life. These patients didn’t have a donor they got a cadaver organ. India need to promote the cadaver programme in a big way otherwise millions will die in the coming years. We are sitting on an epidemic of organ failure, thanks to our lifestyle and our genetic propensity towards diabetes and to some extent to hypertension .
MOHAN Found commitment to the cause is total. Their trustees and members have donated organs of their loved ones – what more commitment does one requires to prove credentials of an organization working in such a difficult and sometimes hostile area.

No I am not an agent of any hospital. I can sue you for making such defamatory statements. If you have the guts send me your address and be ready for a lawyers notice for defamation.

All this heat has not lead us anywhere. The family is traumatized, the medical doctors have been traumatized. Some rationale thinking is required to come to any decision. It can’t be done on such platforms. But let at least the discussions can be more rationale – this much we owe as a society to the medical profession.

Sashi 1 year ago

Dr Shroff seems to be jumping too quickly to the rescue of "villains".
Dr Shroff is another "Merchant of Death" involved in MOHAN Foundation which is a cadaveric transplantation in Chennai.

They seem to be involved in this MURDER case where an Indian patient was denied Transplantation over a Mauritius tourist patient.

Any comments, Dr Shroff? Are you hands also bloodied with the Blood money of patients?

Link here:
http://articles.timesofindia.indiatimes....