A medical board of the All India Institute of Medical Sciences (AIIMS) in its report has concluded that the treatment given to former Tamil Nadu chief minister J. Jayalalithaa by the Apollo Hospitals was “factually correct” and there were “no errors in the care provided”.
“The AIIMS medical panel reviewed the sequence of events and found it to be factually correct. The treatment to the former CM was as per the correct medical practice and no errors have been found in the care provided,” the report, accessed by THE WEEK, says. The report was submitted on August 4.
Following a Supreme Court order on November 30, 2021 based on a petition filed by the Apollo Hospitals, the AIIMS had constituted a medical board to look into the treatment given to Jayalalithaa from September to December in 2016. The seven-member panel was led by Dr Sandeep Seth, Professor at Department of Cardiology, AIIMS.
Other members of the panel are: Dr Anant Mohan, Head of the Department of Pulmonary Medicine; Dr Vimi Rewari, Professor at Department of Anaesthesiology; Dr Milind Hotte, Professor at Department of CTVS; Dr Rajesh Khadgawat, Department of Endocrinology; Dr Abhishek Yadav, Professor at Department of Forensic Medicine and Dr Ananth Naveen K. Reddy, Department of Hospital Administration.
The panel submitted its report after hearing all the statements of witnesses called by various parties after a detailed review. It had also taken into account the “recordings of radiological investigations, echo-cardiograms and all other available medical records.”
The three-page report gives in detail Jayalalithaa’s health condition before being admitted to Apollo, the treatment given to her by the hospital, the medical investigations carried out and her health condition from December 3 to December 5, the day she was declared dead. The report also gives the “temporal sequence” of events.
As per the report, prior to admission, the former chief minister had been treated for diabetes, vertigo, atopic dermatitis, irritable bowel syndrome, hypo thyroid and chronic bronchitis. “As per Apollo records and statements of doctors who treated her, she received a short course of steroids for her skin problem. There was a pre-admission history of fever with increased bowel movements for five to seven days,” it says.
As per the report, Dr KS Shivakumar, Dr Shantharam, Dr Saritha, Dr Sivagnanasundaram and Dr Sarulatha were the doctors who had been treating her for various ailments since 1998.
Giving details on her medical condition on the day of admission on September 22, 2016, the report says that the chief minister was found in “altered sensorium, saturation 48 percent, pulse 88bpm, BP 140/70”. It also says that after initial treatment, she was shifted to emergency room. The report also gives in detail the treatment given to her in the emergency room. She was “started on NIV and insulin” as her blood sugar level during admission was 560 mg/dl.
The report notes that a temporary pacemaker was inserted on the same day to increase the blood flow and treat “bradycardia and hypotension”. Though her health condition was worse on September 26, the condition was better on September 27. In fact, on September 26, “transthoracic echos” were done and so the antibiotics were changed accordingly. On day 4 (September 27), though there was “initial worsening, improvement took pace after sometime”. However on September 28 (day 5), there was “sudden worsening” in her condition and she was into “ventilation/intubation”, says the report.
Slowly, post intubation, her “lung infiltrates worsened” and additional doctors including Dr Richard Beale were consulted and various drugs were given. The AIIMS team of doctors also came to administer treatment for the former chief minister. On October 7, tracheostomy was done. In Tracheostomy, an opening is created in the neck through which a tube is inserted into the windpipe to help breathing. On October 14, she developed “interstitial edema”and following this Dr Jayan Parameswar from the UK was consulted. It was decided not to perform an angiogram.
From November 2, “some attempts for speech” were made. Later a cardiac evaluation was done and on December 3, the AIIMS doctors checked her again. They also “agreed with the treatment”. However, on December 3, “increased secretions occurred”. On December 4 “there was increased breathlessness and the ventilation was restarted”. On December 4, CPR, followed by ECMO insertion was done. “ECMO was maintained for 24 hours”.
The report finally concludes that the final diagnosis was made of “bacteremia and septic shock with respiratory infection”. “There was also evidence of heart failure. There was uncontrolled diabetes at the time of admission, which was treated. There was also history of hypertension, hypo thyroid, asthmatic bronchitis, irritable bowel syndrome and atopic dermatitis.”
The report says the AIIMS medical panel agreed with the final diagnosis.
Former chief minister O. Panneerselvam and other AIADMK seniors had in 2017 demanded a probe, alleging mystery behind the death of Jayalalithaa. Following this, then AIADMK government under Edappadi K. Palaniswami set up the Arumughasamy commission which is all set to submit its report on August 23.
THE WEEK in its cover story in 2019 “How did Jayalalithaa die?”had said that Jayalalithaa’s was a natural death, with evidences of the depositions of the doctors, who treated the former chief minister, at the Arumughasamy commission.
