Mumbai: Friends forced to run around as SoBo hospitals refuse autopsy

Anil Kumar Thakur’s autopsy was finally conducted at St George’s Hospital. File pic

The tossing of bodies for post-mortem from one hospital to another appears to have resurfaced, with St George's Hospital and GT Hospital in south Mumbai sending the body of a 22-year-old back and forth in the wee hours of Monday. Forensic surgeons have warned against such a practice saying it is against the hospital administration manual and circulars issued by a former police surgeon.

Anil Kumar Thakur, 22, came to work in Mumbai a year ago from Bahuara village, Bihar. A casual labourer earning Rs 500 on the days he found work, Anil shared a room at Ganesh Murti Nagar, Cuffe Parade, with three others. "On Sunday, September 24, Anil was unwell and skipped work. He consumed liquor in the evening, had egg curry with rice for dinner and fell asleep while using the mobile phone. A little past 1:30 am on September 25, Anil became restless and within the next few minutes, he became motionless. We rushed him to St George's Hospital where the doctors declared him dead," said Anil's roommate, Shivshankar, who works as a security guard at Maker Tower.

GT Hospital is the requisite post-mortem centre under Cuffe Parade police's jurisdiction. File pic

St Georges Hospital informed the Cuffe Parade police about Anil's being brought dead, which is a medico-legal case. The Cuffe Parade police registered an Accidental Death Report (ADR) under Section 174 of the Code of Criminal Procedure (CrPC).

Anil's roommates contacted his parents who insisted that a post-mortem be conducted to ascertain the reason for his death. Prem Kumar, another one of Anil's companions, said, "We conveyed the same to the St George's Hospital staff. They said that since Anil's residence fell under Cuffe Parade police station, his body should be shifted to GT Hospital for postmortem where it would be conducted faster. They said they could not provide an ambulance for a body.

So we hired a private ambulance from outside the hospital at a cost of Rs 1,200 to move to GT Hospital. However, GT Hospital said they already have two bodies waiting for autopsies and that since St George's declared Anil brought dead, they should conduct the post-mortem. So we took the body back to St George's, paying the ambulance Rs 1,200 again. St George's Hospital staff agreed to perform the autopsy after some reluctance."

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Ex-police surgeon's take

According to forensic surgeons, such situations should be avoided to prevent hardship for companions and kin of the deceased. These also risk losing biological evidence as the autopsy gets delayed. Dr S M Patil, former police surgeon, who was also the technical advisor to the state government on medico-legal cases, clarified that his November 3, 2019, notification applied only to bodies found within a police station's jurisdiction.

This step was taken to prevent all bodies from going to JJ Hospital for autopsies. Dr Patil added, "In 2008, then joint commissioner of police (administration) Hemant Karkare, issued similar directives to police stations, asking them to adhere to the jurisdictional hospitals for autopsies. However, this did not apply to people declared dead, irrespective of the police jurisdiction for the person's residence.

Hospitals were asked to inform local police, conduct the autopsy, and hand over the body to the next of kin or relatives at the earliest. Police stations were to file a Zero ADR and transfer the case to the concerned police station." "St George's Hospital had no reason to send the body to GT Hospital. The police should also have arranged an ambulance," Dr Patil said. Meanwhile, Anil's body has been taken to his village where the last rites will be performed. The Cuffe Parade police have prima facie ruled out foul play but are waiting for the final cause of death.

Hospital's take

Dr Vinayak Sawardekar, medical superintendent, St George's Hospital, told mid-day, "As the reason for death was unclear, the body was sent to GT Hospital with consent. The police surgeon notification of November 3, 2019, makes a distinction between police stations and hospitals where ADR cases must be referred to the requisite post-mortem centre. Accordingly, any dead reported within Cuffe Parade police station's jurisdiction are to be taken to GT Hospital."

"Our Resident Medical Officers (RMO), Assistant Medical Officer (AMO) or Casualty Medical Officer (CMO) are not forensic experts. One of our doctors conducted the autopsy only on humanitarian grounds. We will give the final case of death once the autopsy test findings are received," said Dr Sawardekar, adding that St George's ambulances are for in-house patients and emergencies. "Hearses are used for bodies, which St George's does not have," he said.

Police surgeon order

The ‘Hospital Administration Manual' in Chapter XII ‘Postmortem and Medico Legal Work' under subhead 12.9 Postmortem Examination, point (c), states, "Some Medical Officers refuse to accept the dead body on the ground that it is from an area outside their jurisdiction. This is, however, not correct. The Medical officer should perform the postmortem examination in the first instance and make any representation in the matter if necessary, later on." Responding to the manual, Dr Sawardekar said, "Police surgeon's order is above everybody."

To prevent such situations, Dr Sawardekar said that he would be requesting forensic resident doctors. "I have decided to write to the dean of Sir JJ Group of Hospitals (St George's, Cama Albless, GT hospitals fall under it) to send resident doctors from the Department of Forensic Medicine and Toxicology to St George's Hospital to get such medico-legal cases handled by forensic experts."

Expert view

Dr Rajesh Dhere, secretary, Maharashtra State Medico Legal Association, said, "It is with the very intent that the next of kin, of the deceased is not to made to run from one hospital to another and to ensure that vital biolgical evidences are not missed out, due to delay in conducting autopsy, directives have been issued even in the past, that the hospital declaring a person dead, can even conduct the autopsy, if they have the facilities to conduct such autopsies."

Voices

Prem Kumar victim's friend
‘St George's Hospital said that since Anil's residence fell under Cuffe Parade police station, his body should be shifted to GT Hospital. GT Hospital said since St George's declared Anil brought dead, they should conduct the autopsy. So we took the body back to St George's'

Dr Vinayak Sawardekar, medical superintendent, St George's Hospital
‘The police surgeon notification of November 3, 2019, makes a distinction between police stations and hospitals where ADR cases must be referred to the requisite post-mortem centre. Accordingly, any dead reported within Cuffe Parade police station's jurisdiction are to be taken to GT Hospital'

Dr S M Patil, former police surgeon
‘St George's Hospital had no reason to send the body to GT Hospital. The police should also have arranged an ambulance'

Rs 2,400
Amount spent on ambulance by Anil's companions