Posted on 04/03/2002 2:00:26 AM PST by billorites
ISTANBUL - A 10-year-old Turkish boy shot in the chest during a melee at a circumcision party narrowly escaped with his life -- but left a hospital operating room later that day without his right kidney.
His parents accuse three local surgeons of stealing the organ -- placing the boy, now 14, at the centre of a bizarre medical drama and acrimonious lawsuit that encapsulates the most controversial aspect of the global trade in human body parts.
While Can Akan wishes his tormented father and mother would just forget about the incident, they have persevered, putting together a voluminous medical file in their efforts to prove doctors at 19 Mayis University Hospital in Samsun, on Turkey's Black Sea coast, removed one of his kidneys, without authorization, for transplant into a wealthy patient.
Stories of "organ stealing" are not uncommon, circulating around the world, from South American shantytowns to poverty-stricken Middle Eastern villages. But in all cases, the allegations are almost impossible to prove or disprove.
Can's case is fraught with problems typical of organ theft, including accusations of falsified medical records, perjury and inconclusive medical reports.
Doctors cannot confirm he was born without his right kidney, and the Akans are certain it was illicitly harvested in a country known for its thriving black market in organs.
A dozen similar cases of organ theft have surfaced recently around the world -- not in rural villages, mobile operating units or on offshore cruise ships, as urban legend has it -- but in public and private hospitals in cities such as Samsun, Sao Paulo and Buenos Aires.
Organs Watch, a Berkeley, Calif.-based group that studies the global organ trade, has documented and investigated these cases, some of which involve medical coverups and death threats to patients.
Several of the alleged victims are now involved in complex criminal and civil lawsuits.
A nephrologist (kidney specialist) at a U.S. teaching hospital says cases of organs being removed without a patient's permission do occur -- but notes it is a difficult topic.
"It is very hard to prove conclusively and medically whether someone is born without a kidney or whether it was removed in a circumstance where the person needed abdominal surgery," he said.
Can's story begins in his grandmother's hometown of Alacam, on the Black Sea, about 800 kilometres from Istanbul, where he was spending his summer vacation.
On July 25, 1998, he attended a circumcision party at an outdoor garden café. The guest of honour, a nine-year-old, sat on a large decorated bed in a colourful shirt and fez, while men danced and clapped their hands in time to the music.
Suddenly, there was the sound of guns being fired into the air. This is such a common custom at parties in this part of Turkey, Can didn't even bother to duck.
But before he knew it, he had been hit in the chest by a live bullet: This shootout was for real. Angry young men from a rival family had burst in with pistols.
"I fell down. At first I didn't understand what had happened to me. I couldn't breathe or walk," said the boy, who was rushed to the hospital in nearby Bafra.
As Can slipped in and out of consciousness, he was transferred by ambulance to a larger hospital -- 19 Mayis University Hospital in Samsun, his hometown, 70 kilometres away. He arrived all alone-- no family members made the journey with him and his parents had not yet been told of the shooting.
At 19 Mayis hospital, the emergency room doctors determined the bullet had entered just below his right nipple and he was immediately operated on.
The prognosis was poor. The surgeons made an incision from below his sternum to his pelvic bone, but they could not find the bullet or its path.
On the day of his release two weeks later, tests showed an unexpected finding that started the medical controversy: His right kidney was missing.
This was confirmed by further tests at the hospital's nuclear medicine department.
An official post-operative medical report suggested either a nephrectomy (kidney removal) had been performed or Can had been born without a kidney, a rare condition. The report also noted his left kidney was not notably enlarged, as is usual in people born with one kidney.
Can's parents, who arrived at the hospital as their son awoke from surgery, could not understand why they were not initially told by surgeons that his kidney had been removed. They did not accept he had been born without it.
The more they considered the matter, the more they came to believe it had been stolen. Further medical tests showed the existence of a channel that usually connects the kidneys to the bladder inside Can's abdomen -- something that would not be there if he had been born without a kidney.
The parents also monitored their son's remaining kidney through ultrasound scans over several months. These showed it was increasing in size to compensate for doing the work of two organs.
They saw this as further proof a kidney had been removed in Samsun and sued the three doctors in charge of the surgery.
"There is a kidney trade between Moldova and Israel, and from the international airport in Samsun, the kidneys could be sent anywhere in the world," said Mecit Akan, Can's father.
"Or it could have been used in that hospital. We have asked the hospital to research kidney transplant cases during those days."
The hospital denies its surgeons stole the boy's kidney. Officials criticize the family for going to the media and creating such a fuss.
"We saved the child's life," said a hospital press statement entitled What Did We Lose: The Kidney or Morality?: "Our university has never been blamed before for anything illegal or maltreatment."
Both a U.S. nephrologist and a Harvard transplant surgeon say it is difficult to prove whether Can had a nephrectomy without extensive pre- and post-operative medical records. This is because of the extensive damage to his organs as a result of the gunshot wound.
But the Akans feel there has been an "aura of secrecy and intimidation" around their efforts to discover the truth.
"The prosecution has accused me of trying to ruin our country's reputation. I don't feel safe in Turkey pursuing this case. I think my phones are being tapped," said Mr. Mecit.
He has found two other families in Samsun who believe doctors from the same hospital carried out illegal nephrectomies at about the same time as his son's operation and that the organs were harvested for someone else's use.
Oguzhan Ozturk, then an infant, was hospitalized several times at 19 Mayis hospital. During one visit, his abdomen was opened to remove his left kidney. But the procedure was never carried out because the surgeons told his parents when they opened him up, they discovered he had only one kidney, a condition they thought he had been born with.
Medical tests at Capa University Hospital in Istanbul later confirmed Oguzhan had fanconi anemia, a blood disorder that affects red blood cell production. A doctor there said his left kidney had been removed.
"I said, 'No, apparently it never existed.' The doctor was a bit baffled," recalled Reyhan Ozturk, mother of the boy, who is now five years old.
The family sued the same doctors involved in Can's lawsuit, alleging they stole the child's kidney. The hospital denies the claim, though some records of Oguzhan's surgery have disappeared, as also happened in the Can Akan case.
The third case -- also in the summer of 1998 -- involves a 50-year-old man who was shot in the back. He emerged from surgery with a scar similar to Can's and missing a kidney. He was not told a nephrectomy had been performed, and only learned his kidney had been removed days later during physiotherapy at another hospital.
Thousands of kilometres away in Buenos Aires, Liliana Goffi has also launched a civil and criminal lawsuit concerning her "disappeared" kidney.
On March 25, 1988, she awoke in terrible pain from surgery to remove a small growth on her adrenal gland. Her private nephrologist, Dr. Beatriz Leonor Fongi, ordered sonograms that showed she was missing her left kidney, one she knew from pre-surgical exams and records should have been there.
The Argentine National Body of Forensic Experts testified during the first of three trials that Ms. Goffi's kidney was not missing, but had mysteriously shrunk after surgery and there was no evidence of an unreported nephrectomy or of kidney theft.
But in July, 1999, Ms. Goffi travelled to Johns Hopkins Medical Center in Baltimore, where three specialists reviewed her medical file and came to a different conclusion.
The "atrophied" kidney was, in fact, surgical remains left after a nephrectomy. Dr. Kevin Rossiter of the Johns Hopkins School of Medicine Outpatient Renal Clinic stated unequivocally in her file, "There is no doubt that there is no left kidney."
However, the U.S. doctors refused to become involved in Ms. Goffi's lawsuits or comment on the actions of the Argentine forensic body.
"I am a doctor and a clinical professor, not a detective," one of the physicians told Organs Watch.
In the meantime, Ms. Gotti and her daughter are receiving anonymous death threats.
These cases may end inconclusively, or with out-of-court settlements and confidentiality agreements. But their very existence underscores a nagging fear prevalent in some parts of the world with a booming black market in organs: The young, poor or vulnerable may come to be regarded as spare body parts for corrupt doctors intent on finding a valuable and largely hidden source of kidneys.
And a good time was had by almost everyone.
They also could do a retrograde IVP: Shoot dye up. If they removed the kidney, the ureter would be left and have a straight ending. If you have a non functioning kidney, or never grew one in the first place, the ureter would be missing or small and thin and end partway up.
Stealing kidneys is an ongoing "urban legend", but there were some well documented cases in Brazil a few years ago.
Suddenly, there was the sound of guns being fired into the air. This is such a common custom at parties in this part of Turkey, Can didn't even bother to duck.
But before he knew it, he had been hit in the chest by a live bullet: This shootout was for real. Angry young men from a rival family had burst in with pistols.
Sounds like a blast!
EEeeeeeeeeew!!
He woke up in another city two days later with a bandage around his mid-section and found out that one of his kidneys was stolen.
Sounds crazy, but they wouldn't allow such a story on the internet if it weren't true.
Sounds like a press statement from Clinton
Man, I miss that class...
I can't place the name, but the fez is familiar.....
And did you hear about Gray Condit's wife losing both her thumbs in a bizarre double dog walking accident?
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