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Full details of Apollo and AIIMS medical reports of J Jayalalithaa's treatment

The TN government said Apollo Hospitals and AIIMS reports on the treatment given to late Chief Minister J Jayalalithaa has clearly suggested that she passed away on December 5 after a massive cardiac arrest.

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The Tamil Nadu government  said Apollo Hospitals and AIIMS reports on the treatment given to late Chief Minister J Jayalalithaa has clearly suggested that she passed away on December 5 after a massive cardiac arrest. It said Jayalalithaa suffered a massive cardiac arrest on December 4 while an intensivist was present at the ICU in Apollo Hospitals in Chennai.

"The late Chief Minister Jayalalithaa passed away at 11.30 PM on December 5, 2016," the report said. Meanwhile, Tamil Nadu Health Secretary J Radhakrishnan told reporters in New Delhi after receiving the report by AIIMS doctors that there "is no basis to the speculation which has been circulated in the media" on Jayalalithaa's treatment.

To quash these kinds of speculations, the medical report by AIIMS doctors has been received "from the Government of India at our request", he said.

"It is a very self-explanatory report and we have not held back anything," Radhakrishnan added. Meanwhile, the press statement quoting the report said Jayalalithaa was administered resuscitation and provided ECMO (Extracorporeal Membrance Oxygenation) support within an hour.

"Every possible clinical attempt was made to sustain her revival as per prescribed medical protocols," the statement said, quoting Radhakrishnan. He said a team of doctors, including experts from Apollo and AIIMS, assessed the situation. It was clinically concluded that there was no heart function and also no neurological improvement, denoting futility of life support. Hence, after following all procedures, the position was conveyed to senior ministers and political leaders -- O Panneerselvam (former Chief Minister), Health Minister Vijayabhaskar, Lok Sabha Deputy Speaker M Thambidurai, and AIADMK General Secretary V K Sasikala.

It was also conveyed to the chief secretary, the health secretary and other top government officials, the statement quoted him as saying. All of them understood the situation and asked the medical team to act as per the standard protocol. 

Radhakrishnan said medical practitioners are bound to not reveal details related to patients. However, "given the need to put at rest needless speculation relating to the circumstances surrounding the hospitalisation, treatment and sad demise of the late Tamil Nadu Chief Minister, the government decided to make public the discharge summary received from Apollo Hospitals and the medical report received from AIIMS, New Delhi."

On the condition in which Jayalalithaa was admitted to the hospital, it said that at around 10 PM on September 22, 2016, Apollo Hospitals received a call from the residence of the then chief minister.

When the ambulance reached there, they found her breathless with low oxygen saturation, resulting in drowsiness. "She was immediately admitted to Apollo Hospital, Greams Road, Chennai. On evaluation, she was diagnosed to be suffering from infection and dehydration, accompanied by respiratory distress," Radhakrishnan said in the statement.

There were pre-existing co-morbidities like diabetes, hypertension, asthmatic bronchitis and hypothyroidism, but clearly the "treatment report of Apollo Hospital, as well as that of AIIMS do not mention any evidence of trauma or any other event as alleged by certain political leaders," he said. Radhakrishnan said in the report that during treatment Jayalalithaa had responded well to the multi-disciplinary care in the Critical Care Unit of the Apollo Hospitals.

He said "certain insinuations" have been made that the administration had used "wrong drugs" over a period of time prior to Jayalalithaa's hospitalisation that had led to "health complications" for her and denied it.

"The medical reports indicate that except for corticosteroids administered for atopic dermatitis, the late Chief Minister was only taking oral hypoglycemic and anti-hypertensive drugs to control pre-existing diabetes mellitus and hyper tension," he said.

"Jayalalithaa interacted with family and government officials on some important issues, including the Cauvery issue. Her clinical course deteriorated later and subsequently recovered substantially to being able to take food orally," Radhakrishnan said.

She was then shifted from the advanced Critical Care Unit to the High Dependency Unit of the Apollo Hospitals where her health and vitals "continued to improve under the close monitoring by the panel of experts," he said.

"This improvement in the late Chief Minister's health condition was brought out in the reports of the AIIMS teams which visited between October 13, 2016 and October 15, 2016 and again on December 3, 2016."

On doubts by "some quarters" on the quality of treatment, he said the AIIMS reports have "consistently concurred" with the line of treatment of Apollo and had commended the "meticulous medical management imparted by the treating team," in their visit reports for October 5 to 7 last year.

"Thereafter on December 3, 2016, the AIIMS team had appreciated the high quality care imparted by the treating doctors. Hence, it is clear that the best possible medical care was afforded to the late Chief Minister," he said.

On the initial treatment, he said after she was evaluated following her admission and was continuously under the care and treatment of a team of experts from Apollo Hospitals.

"The nutrition and the essential nutrient intake was attended to by senior consultants from the dietary team. Physiotherapy was provided by the physiotherapists from the Apollo and a special team of physiotherapists from Mount Elizabeth Hospital, Singapore."

Apollo Hospitals also obtained an expert opinion from Dr Richard Beale, an international specialist and consultant from the Guy's and St Thomas Hospital London.

The Government of Tamil Nadu also had constituted (on September 30, 2016) a five-member team of Government specialist doctors to be stationed at Apollo Hospitals to provide required assistance and co-ordinate with the hospital for Jayalalithaa's treatment.

At the government's request, All India Institute of Medical Sciences (AIIMS), New Delhi, had deputed a team of specialists headed by Dr G C Khilnani, Professor, Department of Pulmonary Medicine, Radhakrishnan said in the report. 

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