Judge Loya's death: Why an ECG has become so crucial to the case

On January 22, a three-judge bench of the Supreme Court headed by Chief Justice of India Dipak Misra began hearing petitions seeking an investigation into the death of Maharastra judge Brijgopal Harkishan Loya. In interviews to journalist Niranjan Takle, published in November by the Caravan magazine, the judge’s father and two sisters had raised suspicions about the circumstances of his death. Far from answering any of the questions raised, documents submitted to the apex court in the case have added several new questions.

The judge was handling the Sohrabuddin Sheikh fake encounter case when he died on December 1, 2014, in Nagpur. The case, investigated by the Central Bureau of Investigation, involved Bharatiya Janata Party president Amit Shah, who was later discharged.

Following the Supreme Court’s directions, the Maharashtra government handed over a set of documents related to a discreet investigation it undertook in November last year into the circumstances leading to Loya’s death.

The documents given to the petitioners show an eagerness on part of the Maharashtra police to counter allegations of foul play in the judge’s death. Permission to undertake the discreet investigation was sought by the commissioner of state intelligence from the chief justice of the Bombay High Court on November 23, two days after Caravan magazine published an investigation into Loya’s death. The clandestine enquiry was completed in five days and a report described the doubts raised on the death as “replete with falsehoods”.

However, the documents, which Scroll.in has studied, omit certain important aspects that require answers. First and foremost, the doubts over an electrocardiography or ECG done on Loya at Dande hospital, the first of the two hospitals he was taken to after he complained of chest pain in the early hours of December 1, 2014, still require a proper answer. The documents do not seem to provide this. A crucial statement of a judicial officer is incomplete and seems to be truncated exactly at the point at which he talks about this crucial ECG.

There are also discrepancies in the documents obtained by the Maharashtra intelligence from the second hospital to which Loya was taken, the Meditrina Institute of Medical Sciences, where he was given emergency treatment, including cardiopulmonary resuscitation or CPR.

The ECG

On November 27, the Indian Express published a report that sought to trace the events that led to Loya’s death. In the article, the paper reproduced a copy of an ECG, claimed to have been done by Dande hospital, the first hospital to which Loya was taken to when he complained of chest pain.

However, the set of documents provided by the Maharashtra government to the petitioners seeking an independent investigation do not contain the ECG report.

There is a mention of this ECG in the “Doctor’s Progress Notes” given by the Meditrina Hospital in Nagpur, the hospital where Loya was given cardiopulmonary resuscitation and was later declared as “brought dead”.

While the investigation report submitted to the chief justice of the Bombay High Court contains bills from the Meditrina Hospital, bills from the Dande hospital have not been filed. If an ECG was conducted at Dande, should there not be a bill to back this up?

Four judicial officers have given their statements during the discreet investigation – SM Modak, VC Barde, Shrikant Kulkarni and Roopesh Rathi. All four have said they were with Loya in the hospital when the judge was declared dead.

Of the four, only two talk about an ECG done on Loya. Barde said the medical officer at Dande hospital “checked up Shri Loya by ECG, blood pressure etc.” as per procedure. The doctor’s progress report (image above) said the ECG taken at Dande showed a ‘T’ wave, which suggested a heart attack.

However, Rathi in his statement said the nodes of the ECG machine at Dande “were broken”. The doctor, he said, “wasted some time but machine was not working”. The copy provided to the petitioners gets truncated abruptly at this point.

This is what Caravan’s first report had alleged, where Loya’s sister, Anuradha Biyani, was quoted as saying that she had learnt that the ECG at Dande hospital “was not working”.

Speaking to Indian Express in November, the director of Dande hospital, Pinak Dande, had claimed that it was only after the ECG was done that his staff had recommended that Loya be shifted to a hospital where cardiac care could be provided.

Questions were immediately raised about the ECG as the date and time on the report said it was done at 5.11 am on November 30, 2014. Loya, as per all accounts, was taken to Dande hospital in the early hours of December 1, 2014.

Pinaki Dande claimed that the wrong date was due to “a technical glitch arising out of a machine calibration issue”. “We recalibrate our machines every three months or so to prevent such glitches. But sometimes the glitch may occur in the intervening period. We stand by the fact that the ECG was taken at our hospital on December 1,” the Indian Express quoted him as saying.

The testimonies of the four judicial officers raise further doubts about the ECG. Going by Rathi’s statement that is currently available, it isn’t clear whether the ECG was actually done.

In an interview to Scroll.in in December, Pinaki Dande said the hospital had ECG or electrocardiography machine on each of its three floors. The statements from the four judicial officers state that Loya climbed to the first floor. But there is nothing that suggests that he was later taken to another floor for the ECG or if an ECG machine was brought from another floor to the first floor.

Dr NB Gawande of Meditrina, who signed the medico-legal report, told Caravan that he did not see the report of the ECG done at Dande till it was brought over the next day. However, the doctor’s progress notes, also prepared on December 1, clearly mentions the Dande hospital’s ECG. Did Gawande sign the medico-legal report without going through the doctor’s progress report?

Why is this ECG so important?

The purported ECG done at Dande hospital is the first document that seeks to establish that Loya was indeed brought to Meditrina hospital because of a heart attack. If Rathi’s full statement indeed states that no ECG was done at Dande, the most important question will be on the ECG report available with the Maharashtra police, which the Indian Express published in November, already under a cloud because of the date it bears.

It will also put under scanner the doctor’s progress notes issued at Meditrina hospital, which cites the Dande ECG report with the “T” wave.

Dr Pankaj Harkut, who administered emergency treatment to Loya, had told Scroll.in that a second ECG was done at the Meditrina hospital. This ECG showed last rhythms of the heart, indicating that Loya was on the verge of dying, Harkut had said. But that does not establish cause of death, he had explained, which was why an autopsy was ordered in the first place.

However, the bill from the hospital, which is now part of the court records, shows no charge for the ECG.

It is to be noted that the records given to the petitioners contain neither the ECG done at Dande hospital nor at Meditrina. If there are no authentic ECG reports, the conclusion that the judge died of a heart attack could be challenged.

Even if the Meditrina ECG is produced, it will not amount to much by itself. The postmortem report shows coronary artery blockage. But if the Dande ECG report seems to be suspicious, the postmortem report will also be put in doubt. Fresh questions have already been raised on the postmortem by the Congress party at a press conference on January 31.

The Meditrina hospital bill also has two peculiar entries. The hospital has charged for the consultation of Harkut as “neuro surgery”, though he is a cardiologist. Secondly, Rs 150 was charged for “diet consultation”. It is unclear if hospitals undertake diet consultation for a patient who was brought in with only a mild pulse and whom the doctors were fighting to revive.

Further, the investigation report does not contain statements from two sitting High Court judges –Justices Bhushan Gavai and Sunil Shukre – who were in the hospital at the time of Loya’s death, though the intelligence department did seek permission for recording their statements. The permission letter from the High Court only allowed the four judicial officers who are said to have accompanied Loya to the hospital to provide their accounts.

The two High Court judges, however, spoke to Indian Express in November when the investigation was underway.

The Supreme Court will hear the petitions seeking an investigation again on Friday, February 2.