Commission names Sasikala, says investigation into Jayalalithaa's death must be ordered

Jayalalithaa, who was wheeled into the Apollo Hospitals on September 22, 2016, passed away on December 5 following a cardiac arrest the previous day

Finding fault with V K Sasikala and three others for not acting on advice of doctors, including the suggestion to perform an angiogram and a cardiac surgery on former Chief Minister J Jayalalithaa, the Justice A Arumughaswamy Commission constituted to go into her hospitalisation and subsequent death has suggested an inquiry against the four persons.

However, the Commission said there was no suspicion in Jayalalithaa’s hospitalisation as shifting her to a medical facility was warranted after her condition – she was running fever for two days -- worsened at her Poes Garden residence on September 22, 2016. The Commission’s conclusion busts several conspiracy theories around the circumstances that led to her hospitalisation including the one that she was pushed by “someone” at her home.

Another significant aspect of the report is the Commission’s claim that Jayalalithaa could have died at 3.50 pm on December 4, 2016 after suffering a cardiac arrest though her death was officially declared the next day at 11.30 pm.

Besides Sasikala, the Commission named K S Sivakumar, the former CM’s personal physician, the then Health Minister C Vijayabaskar, and Health Secretary J Radhakrishnan in its report. It also recommended a probe against the then Chief Secretary P Rama Mohana Rao for not addressing a letter and intimating to the Government regarding his signature in 21 forms on various dates for procedural aspects.

‘Not acting on medical advice’

The Commission blamed Sasikala and the three others mentioned for not acting on medical advice rendered by doctors, including Richard Beale who flew from London, and Stuart Russell from the US, to shift Jayalalithaa abroad for treatment and to perform an angiogram and a “life-saving” cardiac surgery on her.

It also suggested that the treatment and entire hospitalisation period of Jayalalithaa was shrouded in secrecy and rejected the contention of a board of doctors from AIIMS which agreed with the treatment protocol.

“The Commission, considering the above aspects, is constrained to come to no other conclusion, but to indict R-1 (Sasikala). From all these aspects, the Commission concludes that Sasikala, Sivakumar, Radhakrishnan, and Vijayabaskar have to be found at fault and investigation is to be ordered,” Justice Arumughaswamy wrote in his nearly 600-page report.

Jayalalithaa’s hospitalisation and politicisation of her death

Jayalalithaa, who was wheeled into the Apollo Hospitals on September 22, 2016, was declared dead on December 5, 2016 after 75 days of hospitalisation. Her death was one of the most politicised events in Tamil Nadu recent history with her party, AIADMK, leading the pack -- the DMK, then in Opposition, also jumped to take political advantage of questions raised over her death by people from her own party.

The Commission’s report, which included politically loaded statements against Sasikala and others, did not surprise many as its constitution was more political than to dispel any doubts as this was the key demand of Panneerselvam to merge his faction led by EPS.

After dodging the commission for years, Panneerselvam finally appeared before justice Arumughaswamy in March this year and said he had no suspicion “personally” over the death of the AIADMK supremo and that he was only “reflecting” public sentiments.

‘Apollo Reddy’s statements condemnable’

The Commission, which was instituted by the then AIADMK Government in 2017 as part of a compromise formula to unite the factions led by Edappadi K Palaniswami and O Panneerselvam, has also come down heavily on Pratap C Reddy, Chairman of Apollo Hospitals, for making statements “beyond the truth” regarding Jayalalithaa’s 75-day hospitalisation.

The report said Reddy’s statement that Jayalalithaa was “ready to discharged” from the hospital in November 2016 was false and sought to know whether there was “any pressure” upon him to make such a false statement. “This conduct of Dr Pratap C Reddy is highly condemnable, which may require thorough investigation,” the Commission said.

On the timing of Jayalalithaa’s death, the Commission relied on a statement by the late leader’s nephew, Deepak, who performed the last rites, to come to the conclusion that she died on December 4 and not on December 5. Deepak told the Commission that he conducted the first year anniversary rites considering the time of death to be between 3:00 and 3:30 pm on December 4, 2016.

“This would, in the view of this Commission, ultimately prove that late Chief Minister passed away on 04.12.2016 at 3:50 PM itself and the CPR and sternotomy exercises were futile and these have been used as a ploy to explain away the delay in the official declaration of her death,” the retired judge wrote.

Report politically motivated: Sasikala

In her response, Sasikala said it was unfortunate that Jayalalithaa’s death continues to be politicised. The appointment of the Commission itself is a “political move” and the report goes to make unsubstantiated lies and claims about Jayalalithaa’s treatment.

“I never interfered in the treatment of Amma (Jayalalithaa). I don’t have medical knowledge to advice about treatment and related issues,” Sasikala said, adding that she was “not bothered” about the blame on her as “this is not the first time I have been blamed.”

Doubts raised over the treatment

Depending on statements from several witnesses who appeared before it, the Commission said Sasikala and Jayalalithaa never enjoyed the “same relationship” after the former was expelled from AIADMK and her Poes Garden residence in December 2011 only to be taken back three months later.

Though there was no delay in hospitalisation, an Echo test conducted in 2015 on Jayalalithaa had diagnosed LV dysfunction, the Commission said, adding that the personal physician did not respond to questions why he did not examine Jayalalithaa on the morning of September 22.

“Being the personal doctor, he ought to have examined her to treat and diagnose and to suggest the future course of treatment. This in the view of the Commission may be termed as sheer indifference on his part. Proper diagnosis after consultation was needed and the possibility of her having been taken to the hospital earlier for treatment could not be ruled out. In such an event, the episode at 9.45 P.M. could have been avoided,” he said.

Though Jayalalithaa fell unconscious after fainting at her home, she “regained” her consciousness while she was brought out of the emergency room after half an hour, after which she was shifted to CCU, the Commission said.

It also added that since doctors had concentrated only on Sepsis infection and diagnosed it as Enterococcus bacteria for which they gave treatment till September 27, they have failed to attend to the cardiac problems, which led to the sudden setback.

‘Advice from foreign doctors ignored’

Dr Beale suggested that he could take Jayalalithaa abroad for treatment and that he himself would accompany her in the air-ambulance, while another doctor, Stuart Russell of John Hopkins Institute, US advised coronary angiogram.

“However, during the remaining days of her stay in the hospital, she appeared to have also been treated for Cardiac and Pulmonary oedema ailments. It is baffling to know as to why the factum of late CM having been treated for these critical and complicated multiple health disorders had not been disclosed to anyone,” the Commission asked.

Though it is true that some of the doctors attached to Apollo who are essentially physicians opined that no surgery need be done, the Commission said, the fact remains that at no point of time during the course of treatment any cardio thoracic surgeon was asked to attend on Jayalalithaa.

Significantly, the entire treatment protocol was within the special knowledge of the then Health Secretary, Health Minister, the Chief Secretary, and few doctors, besides of course Sasikala who was “on the vanguard.”

‘Health Secretary was evasive in response’

The Commission also came down heavily on Radhakrishnan for being evasive and irresponsible, smacking of a doubt that all was not well in the prevalent dispensation.

“Astoundingly, the then Health Secretary persisted in the course of conduct and when questioned as to why she was not taken abroad for better and more efficacious treatment, he rhetorically came out with an answer that such a course of action would amount to an insult to our Indian doctors,” the retired judge noted.

‘Why was cardiac surgery not performed?’

Justice Arumughaswamy raised questions as to why a “life-saving” Cardiac surgery was not performed on Jayalalithaa as per advice from renowned Cardio Thoracic Surgeon, Dr Samin Sharma, who examined Jayalalithaa in the hospital on November 25.

“He analysed the case records and discussed with the late CM herself, when she was conscious and she gave consent to the course of treatment proposed. The said US doctor’s considered opinion was that she had to necessarily undergo a life-saving cardiac surgery in view of the vegetation that had developed in her heart and other attendant health parameters,” he wrote.

While Dr Sharma was confident of doing an angiography, why did Dr Babu Abraham, a pulmonologist, called Dr Beale, he asked. “Therefore, the Commission concludes that Dr Babu Abraham played a trick to get over doing of Angio, to convince some power centre,” he said.

OPS and his deposition

Making political comments, the Commission termed OPS a “silent spectator” saying he fully knew what transpired in the hospital, especially the treatment episode, and he resorted to protest and demanded a CBI Inquiry, “after losing his position.”

In his deposition, Panneerselvam also said neither V K Sasikala nor her family members plotted against the former multi-term Chief Minister of Tamil Nadu. Sasikala, in her voluminous written response, narrated her side of the story and how Jayalalithaa’s conviction by a Bengaluru court in 2014 triggered a host of health issues for the former chief minister.

The Commission, over five years, examined 154 persons including politicians, bureaucrats, doctors, and others. It couldn’t function for over two years due to a case filed by Apollo Hospitals against its jurisdiction.