The medical board of All India Institute of Medical Sciences (AIIMS) doctors appointed by the Supreme Court to look into the treatment provided to former Tamil Nadu Chief Minister J Jayalalithaa, in its report, has concluded that there were no errors in the medical care provided to her and that the treatment was given as per correct medical practice. The three-page report accessed by TNM includes the sequence of events and details pertaining to the health history of the former CM. The Supreme Court, on November 30 last year, had directed the AIIMS to constitute a board of doctors to look into the course of treatment given by Apollo Hospitals in Chennai.
The move came after the Apollo Hospitals had submitted a plea with the apex court to constitute a medical board to help the Arumugasamy Commission, which was inquiring into the death of the late Tamil Nadu Chief Minister. The medical panel was led by Dr Sandeep Seth and had seven members. The panel had experts from the field of Pulmonary Medicine, Anaesthesiology, Endocrinology, Forensic Medicine, Hospital Administration and Cardiovascular and Thoracic Surgery (CVTS). With the panel’s report, the Justice Arumugasamy Commission is expected to submit the final report to the government on August 23.
The report documents that on the day before her death, on December 4, 2016, there was “increased breathlessness and the ventilation was restarted”. It also states that the same day, she suffered from cardiac arrest on CPR (Cardiopulmonary Resuscitation) followed by ECMO (Extracorporeal membrane oxygenation) insertion. “On 5th December 2016, death was declared by the treating team as per correct medical protocol with the Apollo team and doctors from AIIMS examining and finding no brain or heart activity. Death declared at 11:30 pm, 5/12/2016,” the report adds.
“The above is the temporal sequence of events reviewed by the AIIMS medical panel and found to be factually correct. The treatment of the former CM was as per correct medical practice and no errors have been found in the care provided,” the report concludes.
The doctors, in the report, have also noted down the list of diseases/disorders that Jayalalithaa and a list of doctors treating her. The report also draws a timeline of the events starting from the admission of Jayalalithaa to Apollo hospital on September 22, 2016. As per the report, at 10 pm, an ambulance was called to the late CM’s house and that she had “altered sensorium [inability to think clearly/concentrate], saturation 48%, pulse 88 bpm, BP 140/70”. She was treated initially and then transferred to the emergency room, where the CM was in “altered sensorium”, with blood sugar level at 560 mg/dl.
On the same day, a temporary pacemaker was inserted by doctors to increase blood flow and to treat bradycardia (slow heartbeat) and hypotension (low blood pressure).
While there was initial worsening of Jayalalaithaa’s condition on September 26 (day 4), she is said to have been better the next day on September 27. However, it was on September 28 that a ventilation/intubation was done on the former CM due to sudden worsening of symptoms and additional doctors, including Dr Richard Beale, were consulted.
Following this, a tracheostomy (an opening created at the front of the neck through which a tube is inserted into the windpipe to help breathe) was performed on October 7. The report also states that the doctors had decided not to perform an angiogram or any intervention on October 14, and that “some attempts at speech were possible” on November 2.
The report also notes that a final diagnosis was made of “Bacteremia and Septic shock with respiratory infection”, based on the documents. “There was also evidence of heart failure. There was uncontrolled Diabetes at admission which was treated. There was also a history of hypertension, hypothyroid, asthamatic bronchitis, irritable bowel syndrome and atopic dermatitis. The medical panel at AIIMS agrees with the above final diagnosis,” the report concluded.
The Arumugasamy Commission was constituted on September 22, 2017 after several AIADMK leaders raised questions about the sequence of events leading to Jayalalithaa’s death on December 5, 2016. The Commission, which was scheduled to finish its enquiry by August 3, had earlier submitted to the court that the report will be finalised by the first week of August.
The Supreme Court had stayed the proceedings of the commission on April 26, 2019, after the Apollo Hospitals, where the late Chief Minister spent her last days, had filed a petition challenging the scope of the inquiry. After the stay was vacated, the commission resumed its inquiry on March 7, 2022, when a panel of doctors from AIIMS joined the inquiry to assist the commission in the probe.