Sternotomy not available at GH, says Dean

The Dean of the Madras Medical College and the Rajiv Gandhi Government General Hospital on Friday testified before the Commission of Inquiry looking into the former Chief Minister Jayalalithaa’s death.

Counsel for V. K. Sasikala, Aravindan Arulselvam, appearing before the Justice (Retd.) A, Arumughaswamy Commission said Dr. R. Jayanthi had submitted a list of equipment that her hospital had in 2016, the year of the former CM’s hospitalisation and death.

A source said the Commission had tried to find out why Jayalalithaa had to be hospitalised at Apollo Hospitals, instead of a government facility.

Dr. Jayanthi also submitted that her hospital does not have an extracorporeal membrane oxygenation device. She said that at her facility, cardiopulmonary resuscitation was performed on cardiac arrest patients: sternotomy and subsequent ECMO were not options available to doctors at the General Hospital.

Mr. Arulselvam said that the Commission also quizzed Dr. Jayanthi on various details of sternotomy. She said that she had never performed or witnessed a sternotomy, but spoke from an academic standpoint. She testified that sternotomy and chest massage could be done intermittently in order to ensure the continued supply of blood and to avoid brain death.

Focus on discrepancies

On Friday, a source said the Commission had decided to focus on reported discrepancies in the statements made by five doctors who appeared as witnesses: Ramesh Venkataraman, R. Narasimhan, T. Sunder, Minal Vora and K. Madan Kumar. According to the source, the Commission has also focused on how sternotomy was done and how long it took to complete the procedure.

It also wanted to know if the sternotomy was done intermittently with cardiopulmonary resuscitation. The source said that doctors Venkataraman, Narasimhan and Sunder reportedly told the Commission that it was not possible to perform CPR during sternotomy and that sternotomy took anywhere between 10-20 minutes.

The source said that the Commission believes that if CPR was not performed on Jayalalithaa during sternotomy, it would have affected the circulation of blood. Various witnesses have testified that brain death occurs if circulation is stopped for more than three minutes.

However, doctors, Vora and Kumar, distinguished between CPR and a part of it, chest compressions. They said that other components of CPR were administered while the sternotomy was on: the doctors said that compressions were done intermittently with incisions that are part of the sternotomy. This ensured the continued supply of blood, preventing brain death. Both doctor said that the procedure took 30 minutes.

A source said that Dr. Madan, who had had objected to the way the Commission had recorded a part of his testimony on Thursday, continued to do so on Friday. The cardiothoracic surgeon has refused to sign on a page of the testimony prepared by the Commission: he does not believe that the Commission recorded the time frame of performing the sternotomy as he testified.

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