in the same vein there was a UK based NRI assamese doc who came to assam, setup a small
transplant clinic and implanted a pigs heart into a human. as an aside just note the state of
medical facility in NE in 1996!!
http://www.issuesinmedicalethics.org/052mi062.html
The first Indian porcine nenotransplant (2)
The Press Guwahati (PTI) transmitted this report on
2 December 1996: In a volte face, controversial heart surgeon Dhani Ram Baruah, who claimed to have transplanted a pig’s heart to a human being on December 15 here, today denied the transplantation saying he only repaired two holes in the patient’s heart.
Official sources, quoting the doctor, said today as the holes were repaired Dr Baruah did not have too use the animal’s heart as planned earlier.
Meanwhile, the inquiry committee appointed by the Assam government to look into the controversy, today visited the Dr Baruah Heart Institute and Research Centre at Sonapur near here.
Though the doctor initially fended off the investigators, he relented when told the team was accompanied by a magistrate.
On December 18, the hospital staff did not allow the inquiry committee into the hospital. Dr Baruah also refused to meet it.
Incidentally, apart from personally telling journalists that he did transplant the pig’s heart, Dr Baruah had claimed the same in a television interview. He has invited the local medical fraternity to challenge him at the world conference of heart surgeons in Barcelona, Spain, in July, according to a local English daily,The North- East Times, today. He told the paper over telephone yesterday he planned to present his patient, Mr Purna Saikia (32), along with his papers in Barcelona if he was fit by then.
Reacting to the doubts over the authenticity of his claim, the doctor said he could keep an isolated heart of an animal beating for hours in his laboratory.
Meanwhile, the patient’s relatives complained to journalists they were not being allowed to either see him nor enter the hospital premises.
Amidst a raging controversy in medical and lay circles, the Assam government has ordered an official inquiry into whether a pig’s heart was actually transplanted into a human being at a hospital near Guwahati last Sunday.
The so- called ‘unique surgical feat’ was claimed to have been carried out successfully by Dr Dhaniram Baruah assisted by a team of 16 doctors including two veterinary surgeons at his heart institute and research centre located at Sonapur, about 25 km from Guwahati. The patient was one Puna Saikia (32) from Golaghat.
What made the event highly suspect in the eyes of most of the medical fraternity as well as the local media was that Dr Dhaniram Baruah had rung up newspapers and news agencies well before the operation asking for reporters and photographers to be present to record the ‘historic feat.’
While most of the media expressed scepticism given the elementary state of cardiac facilities available in the northeastern region, two local newspapers made a media circus out of the so- called transplant operation.
These two newspapers not only published ‘curtain raisers’ boosting Dr. Baruah a day before the operation but also published photographs of the patient and the pig on the operating table while the surgical procedure was being carried out. Pictures of the patient recovering after surgery were also published.
The published accounts, however, did not make it clear whether a pig’s heart was actually transplanted into the patient. It would appear that what was actually performed was an operation to repair a hole in the heart ventricle. Dr Baruah himself and other doctors associated with the so- called ‘transplant’ would give only evasive replies to media queries after the first reports were published by the two newspapers.
What made matters worse was that a national news agency picked up the reports in the local newspapers and circulated them both nationally and internationally.
Rival newspapers quoting other cardiac specialists here termed the ‘pig- to- man’ heart transplant operation a hoax and fraud. Dr Baruah had earlier received much all-India publicity by claiming to have invented a new type of heart valve and an artificial heart.
He was also in the news last August for confining three engineers of a medical equipment company at gunpoint in his heart institute demanding compensation of Rs. 8.5 lakh for allegedly supplying defective equipment. Following a complaint by the company, police obtained an arrest warrant for Dr. Baruah who obtained anticipatory bail. He was chargesheeted in the case at the end of November.
Reputed cardiologists here have termed Dr Baruah’s claim of having transplanted a pig’s heart into a man as a hoax and a publicity stunt.
"In the entire north- eastern region there are no facilities even to carry out an angiogram. Patients have to travel to Delhi or Madras for a heart by- pass operation. How can this man claim to have transplanted a pig’s heart into a man? What facilities does he have in his institute?" asked an eminent cardiologist.
"Such claims give a bad name to the medical profession as a whole and Indian scientists in particular," said Dr. A. K. Baruah, Principal of the Guwahati Medical College and himself an eminent cardiologist. "This is nothing but a publicity stunt." Several other cardiac specialists expressed similar views, some even questioning Dr. Dhaniram Baruah’s professional credentials.
Interestingly, the news of the pig- to- man transplant came out even as it was reported that the British government had put off the first scheduled transplants of pig organs into human beings for fear of animal viruses being carried over into humans. Alarmed by the uproar over the whole affair, the Assam Government ordered an enquiry into whether a pig’s heart was actually transplanted into a human being.
The enquiry committee, comprising Dr. Ramesh Verma, joint director of health K. N. Das and Professor of Cardiology B. K. Das of the Guwahati Medical College, visited the Dhaniram Baruah Heart Institute and Research Centre on Wednesday to begin their investigation.
They were denied entry at the gate. Dr Baruah and other doctors at the institute also refused to meet the enquiry team saying they were too busy attending to the patient.
Dr Baruah has also threatened to slap a Rs. 50 crore suit against the national news agency concerned for allegedly ‘misreporting’ the surgical procedure carried out. The agency, however, says it had reported on the basis of a press release issued by Dr. Baruah.
It is as if it had never happened. Called a fraud by the State Government, Dhani Ram Baruah withdrew his fantastic claim that he had ‘successfully transplanted the heart of a pig in a man’. Today, barely a fortnight after the outcry died down, the doctor is back to his experiments.
His guinea pig is 32- year- old Purna Saikia; whom he advertised as the recipient of a pig’s heart. Today, Saikia lies unconscious in ‘Heart City’, Baruah’s heart care centre at Sonapur, 20 km from Guwahati. Baruah has got the family to sign another ‘bond’ which permits him to perform a second transplant of a pig’s heart.
According to his relatives, Purna was quite hale and hearty before the mysterious 12- hour operation that Baruah conducted on 15 December. "On 15 December, we were treated to a meal of pork and rice," recalls Someshwar. "The hospital cook told us the meat was from the pig killed for the heart."
Today, Saikia’s family is worried. "On 21 December we were informed that his condition had become serious and that he had lost consciousness. We have not been permitted to see him again," says Someshwar, Purna’s eldest brother.
The Saikias are middle- class farmers from Golaghat in Upper Assam. Purna is the third of five brothers. Afflicted with a congenital heart problem, he seems to have been the victim of typical apathy with which doctors regard poor patients.
It was a newspaper advertisement which drew the Saikias to ‘Heart City’. "After a preliminary check- up, Baruah admitted him and a few days later we signed the first bond for the operation," says Prafulla Gogoi, a relative. Curiously, Baruah did not think it necessary to explain to the Saikias what a ‘pig heart transplant’ meant.
The Saikias say they paid Baruah Rs. 1, 00,000 for the operation.
Despite several attempts Baruah could not be contacted. His hospital is heavilv guarded and no outsider is allowed access.
Health Minister Kamla Kalita, in his statement to the State Assembly, said on 23 December that the Government ‘was examining all legal possibilities so that adequate action can be taken against him for trying to sansationalise the issue’.
Three doctors who had claimed to have transplanted pigs organs in a patient were arrested late on Thursday (9 January) night. The doctors, Dhani Ram Baruah, Jonathan Ho and C. J. James, were produced before the court of the chief judicial magistrate of Kamrup on Friday where their bail pleas were rejected.
The magistrate said in his order that such transplantations were not allowed under the provisions of the Transplantation of Human Organs Act, The case was registered under Section 304, IPC, and Section 18 of the Act.
Counsel for Dr. Baruah said that his (Dr. Baruah’s) action was not covered by the organ transplantation act as it covered human organs while in this case, pig’s organs were involved. The transplantation was done in good faith and the consent of the relatives of the patient was obtained.
Doctors carrying out the postmortem (examination) on Purna Saikia’s body refused to give details on the grounds that the case wassub judice.
Talking to the reporter fromIndia Todayafter transplanting a pig’s heart into Purna Saikia, Dr. Dhani Ram Baruah said, "Medical science has taken a giant leap forward."
Baruah claimed he used a secret solution of chemicals that blinds the immune system. Saikia’s heart was treated with the magic solution for 30 minutes, washed and then implanted in the 15 hour operation, Baruah explained. Baruah disowned a subsequent statement which said that he had transplanted a pig’s heart, stating that the confession was signed only because they threatened to close down his hospital if he did not do so.
India Todaylearned that
Drs. Baruah and Ho have achieved infamy in the past. They implanted heart valves made of animal tissue - developed by Dr. Baruah - in 12 patients in Hong Kong in 1992. A year later six patients died. TheAsian Medical Newsreported that ‘grave concerns were expressed over the the implantation’.
When Dr. Baruah was asked about the ethics of his transplantation of the pig’s heart, he said angrily: "To hell with controversies. I will go ahead with what I am supposed to do."
The death of 32- year- old Purna Saikia following a controversial pig- to- man heart, kidney and lungs transplant surgery done by Dr. Dhani Ram Baruah along with his associates Dr. Jonathan Ho of the Hong Kong- based Prince of Wales Medical Institute and Dr. C. S. James, raises the basic issues of public morality, professional ethics and the challenges facing law enforcement agencies in a fast changing technological environment. Dr. Baruah and his colleagues have since been arrested by the local police for alleged violation of the Transplantation of Human Organs Act, 1994. Findings of the postmortem done on the body of Saikia by a medical team are not available yet.
The veracity of Dr. Baruah’s claim that the patient died a week after the operation can be proved only by the post- mortem results. Dr. Baruah has also claimed that he had the consent of the patient for the pig heart transplant but this does not absolve him of the responsibility for the serious consequences of the surgery which was plainly illegal as the law does not permit transplantation of an animal organ in a human being. On his part, Dr. Baruah has asserted that the operation was not only successful but also unique and that the patient had responded to the treatment well. He has attributed Saikia’s death to secondary causes arising from infection. The public uproar over Saikia’s death has predictably caused much embarrassment to the Government and the State Health Minister has even suspected ‘fraud’ on the part of the doctor in performing the operation.
The episode has naturally attracted worldwide attention for obvious reasons. As the eminent cardiac surgeon, who is heading the Madras Medical Mission, Dr. K. M. Cherian, says, lack of transparency on the part of medical professionals in conducting new experiments could pose a serious threat to public health. A North American organisation planned to undertake transplantation with transgenic pigs, but according to the latest information, it has postponed the experiment. The acceptance of the animal organ by the human body is yet to be fully established.
In view of the revolutionary strides made in cadaver transplantation and cardiac surgery, controversial experiments should be overseen by a technical committee of specialists to ensure that the law is not violated. Professional and government- run institutions should also be vigilant in protecting the public interest by taking penal action against unscrupulous and misguided professionals. Political intervention to protect the guilty can only harm the medical profession. The Guwahati episode should be an eye- opener as the legal and ethical issues it raises need to be addressed by the specialists and the authorities. The future of transplant surgery hinges on the response of the professional and government agencies in guiding its development on the right course.
After being released on bail, Dr. Dhani Ram Baruah claimed he would prove his achievement before the international medical community. Dr. Baruah said Puma Saikia had died seven days after the transplant operation due to bacterial infection he had acquired earlier.
He announced his plans to travel to Barcelona and Sydney to present his achievements before cardiac surgeons. He claimed that his success lay in preventing hyperacute rejection of the pig organs using his antigen- suppressing agent. He felt that his experiments with xenotransplantation should not stop just because there were chances of infectious disease being transferred to the patient. "If any unknown virus is transferred to human beings from pigs, the virologist can take care of it," he stated.
Dr. Baruah alleged that there was an international consipracy to undermine his achievement. He said he would seek the permission of the Indian Medical Council to perform more such operations.
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