The Justice Arumughaswamy commission has recommended an investigation against VK Sasikala – late Tamil Nadu Chief Minister Jayalilathaa’s confidante, former TN Health Minister C Vijayabaskar, former Health Secretary J Radhakrishanan, and Dr Sivakumar, a relative of Sasikala who Jayalalithaa was consulting. The report also recommends an investigation against Prathap Reddy, chairman of Apollo Hospitals and two other doctors in Apollo Hospitals, where Jayalalithaa was admitted for 75 days starting September 22, 2016 until her death in December of that year. The commission report was tabled in the Tamil Nadu Assembly on Tuesday, October 18.
The report recommends action against the ICU consultant of Apollo Hospitals, Dr Babu Abraham, saying that he neglected to go ahead with an angiogram procedure and an early valve surgery. The report adds that this decision was deliberate, despite the recommendations of Dr Richard Beale and two other doctors namely Samin Sharma from Mount Sinai Hospital and Stuart Russell from The Johns Hopkins Hospital, both in the USA. The report adds that Babu Abraham “played a trick to postpone the angio treatment of late CM, under the pretext of Dr Richard Beale, but, which is not found anywhere in the Medical Records, and because of this, late CM, was deprived of this critical treatment and at a later stage her clinical condition deteriorated which later led to her unfortunate demise.” (sic)
The report goes on to ask why, despite the recommendations, the procedure was not carried out. According to the report, Samin Sharma had convinced Jayalalithaa to go ahead with the surgery.
In scans of hospital notes reportedly made by Dr Babu Abraham, Dr Samin, who had been invited as a consultant, had been briefed about Jayalalithaa’s condition and the sequence of events since her hospital admission on September 22. The notes say that the briefing which happened in the Apollo Hospital chairman’s office and was attended by the chairman Prathap Reddy, and Apollo doctors Sathyabama, YVC Reddy and Babu himself. It further reads, “After the discussion Dr [Samin] Sharma felt that these episodes of pulmonary oedema were due to diastolic cardiac failure and that she [Jayalalithaa] would benefit from a coronary angiography (CAG) at some point.” The notes also add that Dr Samin assessed the late CM and discussed the need for a CAG with her. Dr Samin had further proposed that the procedure be done the same evening (November 25, 2016). “This discussion was discussed with Prof Richard Beale, in London, over the phone,” the scanned notes also say.
According to the same notes, due to Jayalalithaa’s multiple conditions, a consensus including with Richard Beale, was reached to postpone the “CAG procedure to a later date once her general condition improves.” It was also agreed upon that CAG was “not an emergency procedure for her and that it can be done in a planned fashion at an appropriate time later.”
The commission report also says, “It is a point to be pondered upon, why Apollo Hospital was very cautious in ensuring that no thoracic surgeon of the hospital entered the treating room.”
The commission says that two experts, Dr Samin Sharma and Dr Stuart Russell, recommended an angio for Jayalalithaa. Though cardiologists like Dr MR Girinath and Dr KM Cherian had said there was no need for an angio or a surgery, the commission has rejected these statements saying that the doctors in question did not meet Jayalalithaa personally. It is to be noted that Dr Stuart also did not visit Jayalalithaa in person. The Commission also noted that another expert Dr Mathew Samuel said there was no need for angio. Dt Nitish Naik who was part of the AIIMS Medical Board had also suggested that there was no need for a surgery, however Justice Arumughaswamy has largely gone by Dr Samin Sharma’s recommendation.
Another question the report asks is why despite Richard Beale saying he was prepared to take Jayalalithaa abroad for treatment, that had not materialised. It is to be noted that in a press conference, Beale himself on February 6, 2017 said that it was Jayalalithaa who did not want to go abroad for treatment. He said, “The issue of transferring to London was discussed at great length and kept under review. The issue of transferring a critically ill patient is always a balanced one, because there clearly are risks to transfer. Particularly a transfer of that distance. Having said that, you can move nearly anybody if you put enough resources and effort into it. The question is that is there some particular treatment that can be provided in the place you’re going to that cannot be provided in the place you’re coming from. The facilities at Apollo are first rate, the team was highly expert and it was being reinforced with extra opinions as you’ve heard. So while we discussed this at considerable length, our shared view in that early phase when she was on the ventilator and unconscious, the things we were doing were going in the right direction. That risk-benefit balance did not justify the journey of that length with the risk associated with it. However, we kept it under review."
Importantly, he said, "Later, of course she was awake, and by them it was very clear that she herself did not wish to move. Once she’d woken up and was interacting as we’ve described, it was obvious to me, and I'm sure you all know, that there was no way that we could tell the honourable Chief Minister what she should or shouldn’t do in this regard. So it became a matter of her choice, not ours. But that’s how it worked.”
According to the report, there is also no clarity regarding the date of Jayalalithaa’s death. Her death was announced on December 5 at 11.30 pm, but eyewitness accounts say that she passed away on the previous day at 3.30 pm, the report says.
The report says after Jayalalithaa was admitted in the hospital, all other details regarding her health became a secret.
The Arumughaswamy Commission of Inquiry, constituted by the previous All India Anna Dravida Munnetra Kazhagam (AIADMK) government in Tamil Nadu commenced its hearing on November 22, 2017. The panel head is a retired judge of the Madras High Court. On August 27 this year, the report was submitted to the Tamil Nadu government and it was placed before the state Cabinet in its August 29 meeting. Justice A Arumughaswamy, who led the probe, heard over 150 witnesses before submitting the report. The commission was formed after former Chief Minister O Panneerselvam, who was believed to be close to Jayalalithaa, raised questions about the circumstances surrounding her death.
Watch: Did Arumughaswamy report on Jayalalithaa draw conclusions based on evidence?