The Hindu - Liver Donor Dies

Family members allege negligence; hospital official denies charge

# Woman donates part of her liver for husband's liver transplantation
# But her husband dies just two weeks after the surgery due to sepsis

HYDERABAD: A. Prameela, a 60-year-old woman, who donated a part of her liver for liver transplantation of her husband four years ago, died on Tuesday at Global Hospitals, amidst accusations of negligence by family members.

Her husband A. Jagannatham, who underwent the transplantation in April 2003, died two weeks after the surgery due to sepsis, said to be a common cause of death in such cases.

He was among the first few patients in the State to have undergone the transplant. His family members had lodged a complaint then with the police alleging gross negligence on the part of the hospital.

Team of specialists

Managing Director of the Hospitals K. Ravindranath denied any laxity and said the best possible care was provided to Prameela. He maintained that the liver transplantation was done by a team of specialists led by Dr. Nigel Heaton of King's College Hospital, London that had followed all the standard protocols.

He said that Prameela suffered cardiac arrest two days after the surgery and the heart was immediately revived. Since the brain did not get proper blood supply, she had slipped into an almost "coma-like" condition and the hospital had taken care of her since then.

He said that complications normally arise in 10 per cent of live donor cases in liver transplants and one death occurs in every 100 live donors.

He said that the Global Hospitals had so far carried out eight `live donor' liver transplants, but Prameela was the first donor to have died.

Source - The Hindu.

Times of India. Coma Victim Gets 44 Lakh Bill

HYDERABAD: It is a story of sacrifice, the kind you read in books of the yore. A Jagannatham, a middle-class resident of Malakpet in his mid-50s was admitted to Global Hospitals with his liver all but damaged in April 2003. The docs said that they could try and save him by experimenting with a liver transplant. But somebody had to donate the liver. His wife, A Prameela volunteered. The operation was conducted with the larger right half of the liver taken away from Prameela and transplanted in the body of Jagannatham.

But a tragedy was in the making. Two days later donor Prameela suffered a heart attack and went into coma. And 15 days later, the husband died of sepsis (infection). Prameela never came out of coma to see him die. She died on Tuesday after lying comatose for 44 months. That's not the end of the story. The family sometime after the death of their father filed a police complaint charging the hospital with negligence and filed a compensation claim with the consumer court. A ruling is still awaited. Meanwhile, the hospital slapped a Rs 44 lakh claim on the family as charges for the failed operation and other services. The family has coughed up Rs 10 lakhs already to the hospital.

Because of the police case, when Prameela died on Tuesday her body was not handed over to her two sons, but was taken for post-mortem. Kin of the deceased assert that although Jagannatham was too weak for the surgery, that they were cajoled and reassured by the doctors that donor and recipient would recover completely. Uday Bhaskar, donor's younger son, said: "We were not clearly informed of the risks of the surgery.

The doctors were confident and wanted to go into surgery immediately. Of the five such surgeries in consecutive years in Global, only two have been successful." His elder brother A Srinivas says: "They said my mother would be normal in five weeks and that my father would recover in six weeks. The doctors have to date not told us exactly why my mother suffered a heart attack".

Doctors at Global Hospitals said they spared no effort to give Prameela the best care. Dr K Ravindranath, MD of the hospital, said: "We are not gods. We did everything we could. The surgery was successful, his liver was functioning well enough. Sepsis affects 20 per cent of transplant patients. The drugs we gave also numb the immune system further". He added: "If not for our efforts, Prameela would not have lived so long."

Source - Times of India.

Mr Prafulla Chandra Pal, BSc, MBBS, DTM&H and FRCS " This is the worst case of human experimentation I have seen. Mr Heaton should be struck off"

The Late Mr Prafulla Chandra Pal Consultant Surgeon [Left]

The Late Mr Prafulla Chandra Pal, Retired Consultant Surgeon was consulted regarding this case. He supported the case until his death in 2005. In his view, Informed Consent had not been obtained. Mr Heaton had been reckless to carry out such a risky Live Liver Transplantation at Global Hospitals. He stated that Global Hospitals did not have the facilities or equipment required and should never have undertaken to do this operation. The surgeon responsible for the conduct of the operation is Mr Nigel Heaton. While he will remain unaccountable in the British Medical System - because they protect their own, Mr Pal was of the view that no Indian or Foreign nationals should ever agree to be operated by Heaton or his team.

Mr Pal was a extremely experienced consultant surgeon, winning the gold medal in surgery at Nilratan Sarcar Medical College,Calcutta. He went onto pass his FRCS in the UK and subsequently worked abroad in Africa as a Consultant Surgeon. It was his view that human experimentation in vulnerable people should be legislated against. He was aware of a number of British surgeons who had gone abroad to practice new untested techniques to avoid legal liability. This remains unacceptable. He felt that the needless loss of life in two vulnerable people should never have happened. Heaton took advantage of two desperate people. This will always be unethical and he felt that every surgeon should ensure Mr Heaton never works in India, in the UK or abroad again.

Nigel Heaton in Egypt. Pharoah is Unimpressed

Egypt Unimpressed by Heaton

Nigel Heaton is apparently in Egypt. A message was left by an anonymous poster. They stated

"I attended a lecture for Dr Nigel Heaton today in Cairo University teaching Hospital.Egypt...and I searched for his name and found this article...which unfortunately did not shock me as I've already heard of foreigner surgeons coming to Egypt and operating liver transplants in new untested techniques thus avoiding legal consequences"

Of course, Nigel Heaton's last transplant patient appeared to be a little too wrapped up to make any further comment. The question we have of course is how many transplants has Heaton done in Egypt?