No conspiracy, mystery in Jayalalithaa's death: British doctor

As questions continued to rage over the death of J Jayalalithaa, London-based specialist Richard Beale, Apollo and government doctors today ruled out poisoning as the cause and asserted that there was "no conspiracy" or mystery in either the treatment or what led to her end.
Beale faced a number of questions including some hostile ones as he and the other doctors sought to clear the air at a government arranged press conference at a star hotel on the health of the AIADMK supremo and Tamil Nadu Chief Minister when she was rushed to the Apollo Hospitals here on September 22 last.

One of the questioners even told Dr Beale that the anwsers were "unconvincing", to which he responded with wonder and surprise. To another question, he said he had seen in his career similar cases but this was the first time he was justifying the line of treatment.
He said Jayalalithaa was conscious while being brought from her home and that the process of treatment was "perfectly straightforward".
Jayalalithaa was declared dead at Apollo hospital at 11.30 PM on December 5, a day after she suffered a massive cardiac arrest. "It was a witnessed cardiac arrest," doctors said.
Beale, who is a world renowned intensive care specialist, said Jayalalithaa had sepsis when she was brought into Apollo Hospital in a conscious state and the source of infection was unknown.

The late Chief Minister was on and off ventilator and often also interacted after being admitted for fever and dehydration, Beale said.

Beale was flanked by P Balaji of Madras Medical College and K Babu of Apollo Hospitals, who had signed in election forms on which her thumb impression was taken. This was for nominating AIADMK candidates for elections to two seats and bypoll to one segment last year.
Dr Beale said the AIADMK leader was given the best possible treatment and even intermittently conscious for days during her prolonged hospitalisation.
The press conference is being facilitated by the government, he said, adding that the government asked him to come now.

The press conference, which was called to dispel rumours on the late chief minister's death, comes a day after V K Sasikala, shadow of Jayalalithaa for nearly three decades, was elected leader of the AIADMK legislature party by its MLAs and set to become chief minister succeeding O Panneerselvam who tendered his resignation from the post citing 'personal reasons'.
"We want to dispel rumours on Jayalalithaa's condition, treatment," the doctors said.
Beale said the process of treatment was "perfectly straightforward" amid allegations that Jayalalithaa was not given proper treatment, which was couched in unusual secrecy.
"The process of the case that was followed was perfectly straightforward. There was no conspiracy. Nothing strange happened. There is no question of it being a case of poisoning. I don't know where this all came from but if anyone with the understanding with detailed care that goes on in Intensive Care Unit then anyone will realise how silly it is.

"It was clear what the disease process was. There is nothing mysterious about it."
Beale said he met Sasikala on a number of occasions.
"Sasikala was present much of the time and was closely engaged in the care in supportive manner," Beale said.
He also said any question of exhuming the body of Jayalithaa was "ridiculous".
Beale clarified that it was possible for sepsis, the body's response to infection, to spread fast and damage other organs though Jayalalithaa showed signs of recovery during her 75-day stay at the Apollo Hospital.
On the day she was admitted "she became short of breath at home and very short of breath when the ambulance brought her to the hospital...There was an infection resulting in damage to organs and contributing to shortness of breath".

He said at that time "it was not clear" what the source of infection was "but subsequent tests showed there was indeed infection in her blood".
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On the final moments of Jayalalithaa, Dr Beale said it was a "completely unexpected collapse".
"Why it happened we don't know, except that Jayalalithaa was of mature years with chronic diseases like hypertension, diabetes, with recovering sepsis and an infection in the heart," he said.
The doctors said AIADMK general secretary Sasikala and other top state officials were briefed on a daily basis about the progress in treatment.
They said there was "no political pressure" to hold the press conference.

Beale said Governor Ch Vidyasagar Roa, on his second visit, had gone into the ICU and flashed a thumbs up to Jayalalithaa which she responded to.
Beale further explained that Jayalalithaa was diagnosed with Septicemia. "Sepsis can come on extrememly quickly, and its consequences can be severe," he said, adding that diabetes and high blood pressure had increased her vulnerability.
Dr Babu and Dr Balaji said she was "admitted with uncontrolled diabtetes alongside septicemia and the best of treatment was given."
They, along with Beale, said that when admitted, Jayalalithaa had fever and dehydration and when evaluated, it was also found that her sugar levels were uncontrolled. She also had "urinary infection" and since it was "sepsis increased", it had "cascading effects."

She was treated with non-invasive ventilation which involves putting a mask to the face. Her condition improved somewhat initially and she was conscious and responding.
"Unfortunately as the sepsis progressed she got more tired she was put on ventilator fully."
Dr Balaji reiterated that he attested the signature of Jayalalithaa for the bypoll papers and it was witnessed by Dr Babu. "She was conscious when she put her thumb impression, I spoke to her."
She could not sign the papers as her hand was inflamed due to administration of IV fluids, he added.