Healthcare report

How allegedly negligent doctors allowed the kidney transplant racket in Mumbai to occur

An inquiry committee of Maharashtra's health department is investigating the case at LH Hiranandani Hospital.

A senior urologist alleged to be involved in a kidney transplant racket exposed by the Mumbai police last month has claimed that he never met the potential donor and recipient before the scheduled surgery. This claim has baffled the three-member inquiry committee instituted by Maharashtra’s health department to investigate the role played by doctors and the hospital in the alleged racket.

On July 15, Mumbai police busted a kidney racket at LH Hiranandani Hospital in Powai after receiving a tip off. The end-stage kidney failure patient, Surat resident Brijkishore Jaiswal, was to receive a kidney from Shobha Thakur, showing Thakur as his wife, Rekha Devi. But Thakur, a resident of Gujarat, was to sell her kidney in exchange for money.

The sale of organs contravenes the Transplantation of Human Organs Act, the law governing organ transplants in India.

The urologist, Dr Mukesh Shah, in his statement to the committee, claimed that he had never met the donor and recipient. Shah's declaration, perhaps to evade responsibility, made matters worse. A committee member said that not meeting the donor and recipient before the surgery is in itself a violation and indicates the “casual approach” of the doctors towards the transplant.

The doctor reiterate his statement to “I had never met them before the admission. I am a technical person,” he said, refusing to comment further.

Committee instituted

According to Mumbai police, the mastermind of the racket is Bhijendra Bisen alias Sandeep who is said to lure poor residents of Gujarat to sell their kidneys. Thakur was allegedly promised Rs 3 lakh for the organ, according to the investigators.

The hospital’s social worker, Nilesh Kamble, was arrested by the Powai police station in Mumbai on July 16. During a search, the police found Rs 8 lakh in Kamble’s home. LH Hiranandani Hospital’s CEO, Dr Sujit Chatterjee, said that the hospital has already terminated Kamble’s services. “We have also written to the police to take the strictest action possible,” he said.

Following the police action, the state health department instituted a three-member committee to inquire into the role of the hospital and doctors involved in the transplant of Jaiswal. Shah and his colleague, nephrologist Dr Mukesh Shete, also attached to LH Hiranandani Hospital are under the scanner of the committee.

Negligent doctors

The committee has found both Shah and Shete negligent in performing their duties as prescribed under the law. As far as Shete is concerned, Jaiswal who is also an accused in the case has told the committee that Shete was present when he was discussing about the exchange of money with the alleged mastermind of the racket, Bisen.

Shete refuted the allegations. “Our primary role is to evaluate the patient medically,” he said. “It’s not just the treating doctors, several others are involved in giving the final green signal for the transplant which includes a member from the government.” Shete said that he has been involved with over 300 transplants.

But Dr Gauri Rathod, a member of the committee and also the implementing authority of the Transplantation of Human Organs Act in Maharashtra, said that it was clear that "some doctor" was involved in the illegal network. The doctors "were working on a casual mode and so was the hospital" she said. "We are gathering proof.”

Following the findings of the committee, the Powai Police station is also investigating the role of the two doctors. “We are still inquiring,” said an officer from the police station. “It is too preliminary to say anything.”

Poor scrutiny

According to Dr Rathod, the law expects the treating doctor, the hospital and the authorisation committee to scrutinise the donor and recipient. “They [the hospital and the doctors] just relied on copies of documents," she said. "They are expected to interview and establish whether the relationship that the donor and recipient claim, actually exists.”

To be assured that the donor and the recipient are not claiming a relationship where none exists, the doctors are expected to interview them to establish their relationship. For instance, the husband is asked details about his wife’s maternal family. In case of sisters or brother inquiries are made about the size of their homes or ask them about their neighbours. “The interview is done to make sure that the donor and recipient are not faking the relationship,” said Dr Rathod.

The committee said that if the hospital had conducted a thorough interview of Thakur (donor) and Jaiswal (recipient), it would have suspected something amiss. The committee also pointed out that the doctors are expected to show extra precaution when the potential donor is a woman. “There is always a possibility of intimidation which needs to be ruled out by the doctors before granting permission in cases of women donors,” said Rathod.

A senior doctor privy to the inquiry said other checks such as interviewing of the donor and recipient are essential because documents can be forged. Both the doctors Shah and Shete have signed on several forms pertaining to the transplant that is indicative of their negligence.

Dr Sujit Chatterjee, CEO of LH Hiranandani Hospital, said the establishment has not initiated any action against the doctors. “We have not received any formal communication from the government pertaining to this," he said. "How can doctors distinguish between forged and original documents, it is the work of the police.”

When asked about the non-adherence to the interview protocols, Chatterjee said that hospital has video-recorded the entire procedure. “We are following every procedure,” he insisted.

Not for the first time

The three-member inquiry committee is also looking at two other transplant cases performed at the hospital. During the inquiry, Bisen confessed to have allegedly facilitated two more transplants using forged documents. “We have learnt that two unrelated individuals were show as siblings to get the permission of the transplant,” said a committee member. “We are going to call them for the inquiry.”

In June, a similar kidney racket was busted at Indraprastha Apollo Hospital, Delhi. The mastermind, Rajkumar Rao, was arrested in Kolkatta. The personal staff of the hospital doctors were alleged to be involved in the racket.

In march, residents of Gujarat’s Pandoli village complained of being lured by a gang operating in Delhi and Tamil Nadu in selling their kidneys. The Gujarat police is investigating the complaint and has made several arrests.

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