Mumbai Public Hospital Resorts to Heart‑Lung Machine for Liver Transplant Amid Procurement Failures

In the bustling municipal metropolis of Mumbai, the public hospitals of the municipal corporation found themselves compelled, during the early hours of the twenty‑second day of May, to confront a severe shortage of specialised perfusion devices requisite for the preservation of donor livers destined for transplantation, an exigency that precipitated an unconventional recourse to a cardiac‑pulmonary apparatus ordinarily reserved for thoracic surgery.

The attending surgical team, guided by the senior transplant physician Dr. Arvind Mehta, elected to substitute the absent liver perfusion machine with a heart–lung circuit, thereby adroitly maintaining hepatic arterial and venous flow while simultaneously oxygenating the organ, a maneuver which, though technically unorthodox, succeeded in preserving cellular viability until the operative theatre could accommodate the graft.

The improvised protocol, while lauded in peer‑reviewed clinical circles for its ingenuity, has nevertheless cast a revealing light upon the chronic under‑funding of the municipal health department, whose budgetary allocations for advanced organ‑preservation technology remain eclipsed by competing priorities such as road repair and waste management, a circumstance that obliges clinicians to repeatedly improvise in lieu of systemic provision.

Indeed, the municipal corporation’s procurement office, bound by antiquated tendering regulations and a reliance upon protracted quotation cycles, failed to secure a dedicated liver perfusion unit for the city’s primary teaching hospital, an omission that municipal auditors have previously flagged yet left unremedied due to a conspicuous paucity of political capital allocated to health‑care modernization.

The episode also underscores the limited oversight exercised by the state health authority, whose inspection regime, predicated upon periodic paperwork verification rather than on‑site equipment audits, permitted the hospital to operate for years without the requisite perfusion technology, thereby placing patients in a latent jeopardy that only surfaced when the exigent circumstance compelled a workaround.

Citizens, already burdened by exorbitant out‑of‑pocket expenditures for private treatment and by the perpetual threat of infrastructural deficiencies such as water shortages, now confront the disquieting prospect that even life‑saving interventions may depend upon ad‑hoc improvisations rather than on the assured provision of modern medical apparatus, a circumstance that erodes public confidence in municipal stewardship.

Given that the municipal procurement statutes require a minimum of ninety days for the issuance and evaluation of tenders yet the hospital’s need for a perfusion apparatus was immediate, one must inquire whether the legal framework governing emergency acquisition permits a streamlined exception, whether the health department possesses the discretionary authority to authorize interim leasing of specialized equipment, and whether the city council’s budgetary committee has ever audited the allocation of funds earmarked for critical health infrastructure in order to ascertain if systemic inertia or fiscal mismanagement precipitated the reliance upon a heart‑lung machine for hepatic preservation; furthermore, does the municipal charter's provision for public health emergencies, drafted decades ago, incorporate explicit mechanisms for rapid procurement of life‑saving technology, or does its antiquated language effectively preclude such agility, thereby obliging clinicians to adopt improvisations that, while commendable, reveal a governance gap that would merit judicial scrutiny; and finally, might the citizenry's recourse to writ petitions compel the municipal corporation to produce a transparent ledger of all emergency medical equipment expenditures, thus testing the elasticity of administrative accountability under the prevailing statutory regime?

In light of the revelation that the municipal health inspectorate conducts its assessments chiefly through remote dossier review rather than on‑site verification, a series of pertinent queries arise concerning whether the statutory provisions enshrined in the State Public Health Act obligate the authority to perform periodic physical audits of critical care equipment, whether the absence of such audits constitutes a breach of the requisite standard of care owed to the populace, whether the municipal grievance redressal mechanism, as delineated in the Citizens’ Charter, affords affected patients a timely avenue to demand remedial action and compensation, and whether the recent amendment to the Municipal Corporations (Functions) Rules, which ostensibly streamlines complaint handling, has in practice diminished procedural safeguards, thereby potentially insulating administrative inertia from judicial review; additionally, might the courts entertain a public interest litigation to compel the city to disclose all procurement contracts for high‑value medical devices, to ascertain if competitive bidding was genuinely observed, and to evaluate if the present allocation of civic funds towards health infrastructure meets the constitutional mandate of equality before law and the right to health?

Published: May 23, 2026

Published: May 23, 2026