Health Minister Veena George ordered the suspension of two doctors heading the Nephrology and Urology departments at Government Medical College, Thiruvananthapuram, pending enquiry, following the death of a chronic kidney disease patient at the medical college hospital (MCH), post renal transplant, on Monday.
The incident had triggered wild speculation that it was the lack of coordination between these departments and the delay in performing surgery after receiving the organ that contributed to the patient’s death.
The decision to pin the responsibility on department heads and conduct a detailed enquiry to ascertain the cause of death and if any external factors could have contributed to it was taken following a preliminary report by Additional Chief Secretary (Health) Asha Thomas. There seemed to have been some miscommunication and lack of coordination at various levels in the run-up to the surgery, Ms. George told the media.
Sureshkumar, a 62-year-old patient with end-stage renal disease from Karakonam and who had been on the waiting list for renal transplant under Mrithasanjeevani, had been admitted to the MCH early morning on Sunday after the family had been intimated about the possibility of an organ from a deceased donor being made available for him.
A team from the MCH that went to Rajagiri hospital, Kochi, on Sunday morning rushed the organ to the MCH by 5.30 p.m. with the help of the green channel passage arranged by the police. Though the transplant surgery was carried out on Sunday night itself, the patient died following complications on Monday morning.
The allegation that there was a delay by over three hours in performing the transplant after bringing the organ to the MCH and that it was due to the lack of coordination and preparedness of Nephrology and Urology departments was raised later and snowballed into an issue by afternoon.
Sources at the MCH said there might have been a lack of coordination at some levels, in that there were none from either departments to receive the organ. The ice box containing the organ was rushed inside the MCH by two “outsiders” who had no clue where they were supposed to take it to.
“The acceptable cold ischemia time for kidneys (the time that an organ surgically removed for transplantation can remain in a chilled perfusion solution before transplantation) is 18-24 hours. Hence, the supposed delay in performing the transplant could not have affected the surgical outcome,” said experts in transplant medicine.
It also means that in the first place, there was no need to rush the kidney in three hours to the MCH, especially when it was known to all concerned that the patient had been taken in for haemodialysis at 4 p.m. (which lasts up to four hours). However, the manner in which the organ was rushed in and the subsequent confusion gave the impression that there was a lack of preparedness.
MCH sources said the patient had been considered as high-risk, with multiple comorbidities. Even though a kidney transplant is considered to be relatively easier than a liver transplant, many unexpected complications can happen.
According to sources, in this case, there were surgical complications requiring surgeons to do anastamosis (surgical connection between blood vessels) twice, apart from other technical issues. The patient died of cardiac arrest.
Ms. George said a post-mortem examination would be done to ascertain the cause of death.
Meanwhile, the State Human Rights Commission has taken a suo motu case and directed the Director of Medical Education to submit a detailed report within four weeks.
The local police have also now registered a case of unnatural death, following a complaint by the patient’s brother.
