Will The Three Mystery Doctors Please Stand Up

The Arumughaswamy Commission’s allegations against the Tamil Nadu Health Secretary is based on testimonies by three doctors – but who on earth are they?

By Sandhya Ravishankar

On 27 December 2018, Standing Counsel for the Arumughaswamy Commission filed an application demanding that the Tamil Health Secretary J Radhakrishnan and former Chief Secretary P Rama Mohana Rao be included as Respondents in the probe into late Chief Minister J Jayalalithaa’s hospitalisation and death on 05 December 2016.

“The medical evidence adduced so far against the Respondent No. 2 namely Apollo Hospital clearly established the fact that the Apollo Hospital failed to provide Angio treatment inspite of the fact that three senior doctors hailing from various hospitals have suggested such a course.”

The application states that Radhakrishnan “colluded” and “conspired” with the hospital to hide this “fact”.

Strangely though, the three doctors alluded to in the application appear to be non-existent.

The only doctor who the Commission could possibly be referring to, albeit in a distant manner, is Dr Samin K Sharma, cardiologist with Mount Sinai Hospital in the US, who was brought by VK Sasikala, Jayalalithaa’s close aide, for an opinion on the late Chief Minister’s health.

Dr Sharma has not testified before the Commission so far. But from testimonies of other witnesses, it may be gathered that he had volunteered to conduct the angiogram and any surgery needed since he was in Chennai for one day.

Take for example the deposition of Dr N Ramakrishnan, Director of Critical Care Services in Apollo Hospital recorded by the Commission on 19 November 2018 – “Dr Shamir (sic) Sharma, US doctor, held discussions with the Apollo medical team. At that time, Dr Shamir (sic) Sharma said that at some point, an angiogram had to be done and that he was ready to do the same that day itself.”

Dr Sharma had to return to the US the next day, according to various doctors involved in the discussions with him on 25 September 2016.

The Lede looked keenly through the depositions of the main treating doctors from Apollo Hospital as well as the testimonies by the medical team from AIIMS that visited five times. This was in the hope of finding those three doctors who have allegedly recommended angio and/or surgery for the late Chief Minister.

To our surprise, none of the doctors have even remotely recommended an angio or heart surgery to fix the vegetation on Jayalalithaa’s mitral valve or the perforation. Here are excerpts from the depositions of the key doctors on the subject of angio and/or heart surgery.

In fact, reports by the AIIMS team handed over to the Tamil Nadu State government just after each of their five visits in 2016, have the clear facts of the case for not doing an angio or surgery on the heart.”

The Lede also looked through the reports handed over by the AIIMS medical team to the Tamil Nadu government after each of their five visits between October and December 2016, when Jayalalithaa was hospitalised.

Key doctors with Apollo Hospital too have stressed on the fact that there was no need for an angio to be done.

When In Despair, Blame Health Secretary

The Standing Counsel for Commission also said in his application that Tamil Nadu Health Secretary J Radhakrishan had stated in his testimony that “he was against the airlifting the former chief minister as he felt that it is a disgrace for doctors of the entire India. He fails to appreciate the fact that the welfare of the patient is the paramount consideration.”

On 14 December 2018 was held the first examination of Radhakrishnan. He was asked –

Commission: In case you had given a report to a senior minister of the cabinet then probably she would have taken abroad for treatment just like it was done with former Chief Minister MG Ramachandran.

Radhakrishnan: Since there were all facilities available in the hospital where Amma was being treated and the treating doctors did not tell us that they cannot treat her here and please take her abroad and since AIIMS doctors also stated that the treatment being given to her was satisfactory, such a situation did not arise.”

Radhakrishnan, according to multiple sources present during the hearing, also attempted to explain to the retired judge that there was a qualitative difference during the time MGR was sent abroad as compared to the advanced medical treatment available to Jayalalithaa. He explained that not only had medical science, equipment and labs become sophisticated and on par with the Western world since MGR’s time in the 1980s but also that today there was no need for a special retro-fitted flight for transportation of a critically ill patient as had happened with MGR. Today, he had told the Commission, air ambulances with all the requisite equipment are available on demand.

But the retired judge, perhaps in an attempt to provoke the “truth” out of the Health Secretary, stated as his last question for the day – that Jayalalithaa’s death was due to the “carelessness” on the part of the Health Secretary for not having been taken abroad and for angio not having been performed.

Radhakrishnan: I completely deny it. In fact the way you are saying it is as if you are humiliating the doctors here (in India).”

Goaded and emotional, the Health Secretary appears to have lost his cool over a question already asked and answered, allowing a streak of sarcasm to creep into his response. The Commission’s Counsel, instead of taking the statement with the context it was stated in – that medicine in India is on par with treatments abroad and that there was no need for a patient in Jayalalithaa’s stage to be airlifted abroad, was taken out of context and made into a standalone comment for which Radhakrishnan has received much flak.

When Radhakrishnan continued his testimony on 04 January 2018, he insisted that the retired judge note down the point made in his primary answer yet again.

The IAS Officers’ Association of Tamil Nadu submitted a letter to the Chief Minister on 04 January expressing “serious concern” over comments made by Law Minister C Ve Shanmugam and Fisheries Minister D Jayakumar against the Health Secretary. Pointing out that an IAS officer is not supposed to respond publicly as per Conduct Rules, the Association stated that the Health Secretary had been dragged unnecessarily into a controversy “when the matter is sub judice.” The Association also sought the intervention of the Chief Minister to “ensure that such statements are not made against serving civil servants and that decorum is maintained.”

Funnily enough, none of the four applications made to the Commission since the last week of December 2018 have been taken up by the retired judge.

  • The first is the application made by counsel for Apollo Hospital demanding that a medical board be constituted.
  • The second is by the Commission’s own counsel demanding the addition of the Health Secretary and former Chief Secretary as repondents.
  • The third is that of Dr Madan Kumar of Apollo Hospital who has pointed out that the changes he had made in his testimony had not been carried out and instead erased.
  • The fourth is that of VK Sasikala’s counsel who has asked for full disclosure of all correspondence between the Commission and the current Chief Secretary Girija Vaidyanathan.

Tamil Nadu could well go down in Indian history as having been the State to have thrown public money into an unreliable Commission whose records are incorrect, whose accusations and allegations are without basis or evidence, whose enquiry is wide-ranging and outside the scope of terms of reference and whose refusal to constitute a medical board has led it to make bloopers of the most embarrassing sort.