Isabella Mariam

The High Court of Madras at Madurai, Division Bench of Justice S.M. Subramaniam and Justice G. Arul Murugan, directed the constitution of a Special Investigation Team (SIT) to probe into allegations of illegal kidney transplantation rackets across Tamil Nadu. The Bench ordered the registration of a First Information Report (FIR) based on a complaint already filed with the police, and mandated further investigations into organ trade involving private hospitals, brokers, and officials. The Court instructed that the SIT, headed by senior police officials, conduct an impartial and comprehensive inquiry into violations of the Transplantation of Human Organs and Tissues Act, 1994 and the Bharatiya Nyaya Sanhita, 2023. It further directed that reports on the progress of investigation be periodically submitted before the Registrar of the Madurai Bench of the Madras High Court, with the first report due on 24 September 2025.

The proceedings arose out of a Public Interest Litigation filed before the Madurai Bench of the Madras High Court by a practicing lawyer. The petitioner sought a writ of mandamus directing that the investigation into alleged illegal kidney trade be transferred to the Central Bureau of Investigation (CBI) for an impartial inquiry. The petitioner alleged that kidney transplantations were being conducted illegally in certain private hospitals in Tamil Nadu, in violation of statutory provisions.

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The petitioner’s case was premised on reports that certain hospitals, including Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, and Cethar Hospital, Tiruchirappalli, were involved in facilitating illegal kidney transplants. Complaints were filed alleging that brokers induced impoverished individuals to donate kidneys in exchange for money. Despite the complaints, no First Information Report (FIR) had been registered by the local police, prompting the petitioner to seek judicial intervention.

The matter was placed before a Division Bench, which noted that the State Government had constituted an enquiry committee led by Dr. S. Vineeth, I.A.S., Project Director, Tamil Nadu Health System Project (TNHSP). The team included senior medical and police officials. The committee conducted enquiries in the Pallipalayam area of Tiruchengode Taluk, Namakkal District, where illegal kidney transplantations were alleged. During the enquiry, a donor admitted to having been induced with money by a broker to donate a kidney. Medical examinations confirmed the removal of her kidney.

The committee further visited the records of the hospitals in question to verify compliance with the Transplantation of Human Organs and Tissues Act, 1994 (TOHO Act). It was discovered that documents had been fabricated to show false relationships between donors and recipients, thereby circumventing the statutory requirement that organ donations between non-relatives be permitted only under conditions of genuine affection, attachment, or other special reasons. The committee reported that brokers arranged donors for financial reasons, with the hospitals allegedly participating in the preparation of false documentation.

As a consequence of the preliminary findings, the Director of Medical and Rural Health Services suspended the licences of Dhanalakshmi Srinivasan Medical College and Cethar Hospital on 23 July 2025 under Section 16(2) of the TOHO Act, 1994. The Court was informed that the licences had subsequently been cancelled by the competent authority.

The committee’s final report, portions of which were produced before the Court, noted widespread irregularities. It concluded that private hospitals submitted false affidavits and proofs without proper documentation, enabling brokers to profit by targeting impoverished individuals for organ donations. The report stated that the legal provisions under the TOHO Act were misused to give the impression of legitimate transplants while in reality facilitating organ trade.

The petitioner contended that despite these findings, the State had failed to register an FIR. Reliance was placed on precedents from Delhi and Andhra Pradesh, where FIRs were registered in similar circumstances of organ trafficking. The petitioner also submitted a press report indicating that inter-state human organ trafficking rackets had been unearthed in Telangana and Uttarakhand, with arrests of doctors and brokers from Tamil Nadu. These reports alleged that donors were lured with false promises of employment and that recipients were charged large sums of money ranging from Rs. 55 to 60 lakhs, with donors receiving around Rs. 4 to 5 lakhs.

In response, the State argued that under Section 22 of the TOHO Act, 1994, cognizance could be taken only on a complaint made by an appropriate authority. The State submitted that the competent authority under Section 13 of the Act was in the process of investigation, and therefore, registration of an FIR by the police was not required. The State further relied on earlier judicial precedents, including a decision of the Supreme Court in Jeevan Kumar Raut v. CBI (2009) and a Division Bench of the Madras High Court in Dr. Ganesan v. State (2015), to argue against police registration of FIRs in transplantation disputes.

The sixth respondent, Dhanalakshmi Srinivasan Medical College and Hospital, denied involvement in any organ trafficking. It asserted that it maintained proper records and was not complicit in the alleged illegalities. The seventh respondent, Cethar Hospital, had not yet entered appearance when the order was passed.

The Bench examined the statutory framework, including provisions of the TOHO Act, 1994, as well as relevant provisions of the Bharatiya Nyaya Sanhita, 2023 (BNS, 2023), particularly Sections 109, 111, 303, 318, 335, and 336, and Section 143, Explanation (1). The Court noted that the allegations extended beyond violations under the TOHO Act and constituted cognizable offences under the BNS, thereby warranting police investigation and registration of FIRs.

The Court recorded that: “This Court has gone through the report of the Committee and the findings of the Committee is alarming that large scale trading of human organs are made in an illegal manner.”

The vernacular portion of the committee’s concluding report was extracted, followed by its English translation: “It has come to light in the aforementioned investigation that, contrary to the above, proofs were obtained in a wrongful manner, and false affidavits, proofs and documents without photographs of the recipient/donor together were submitted by private hospitals, and the organs were sold through brokers for money by identifying impoverished individuals for organ donation, and approval was obtained by submitting these documents to the authorization committee and the human organ transplant surgeries were conducted. It has been found in this investigation that the legal nuances of human organ transplant surgery were misused.”

The Court observed that these findings revealed offences not only under the TOHO Act but also under the BNS, 2023: “The Committee appointed by the Government itself identified several irregularities and illegalities in kidney transplantations and trading of Kidney illegally, which would constitute not only offences under the TOHO Act, 1994 but also offences under the Bharatiya Nyaya Sanhita, 2023.”

On the State’s argument that only the appropriate authority could investigate, the Court stated: “The State's objection that only the appropriate authority under Section 13 of the TOHO Act, 1994, alone has to conduct investigation is unacceptable for the simple reason that the wider allegations now raised is not only falling under the TOHO Act, 1994 but also falling under the BNS, 2023. When cognizable offences are traceable from and out of the allegations, it is the duty of the State to first register the F.I.R and thereafter conduct an investigation by following the procedures.”

The Court found the State’s reliance on the Jeevan Kumar Raut decision misplaced: “However, the Supreme Court does not prohibit investigation when certain cognizable offences are traceable with reference to the allegations raised and the findings made by the team constituted by the Government.”

It further noted: “This Court is of the considered view that trafficking in human organ would infringe the fundamental right of a citizen. Any violation would not only offends Article 21 of the Constitution of India but would result in serious health issues of the donor or recipient. It has got larger repercussions and wider implications in the matter of maintenance of public health.”

The Bench criticized the State’s hesitancy: “The State is even hesitating to register an F.I.R and arguing before the Court that there is a statutory bar in registering an F.I.R. Such a stand is unacceptable.”

The Court also took note of the petitioner’s submission that many private medical colleges and hospitals were owned by influential individuals, making impartial investigation by the State police unlikely: “Therefore, there is no possibility of a fair impartial investigation into the allegations of the human organ transplantation racket.”

The Court issued specific directions. It recorded: “Accordingly, this Court appoints the following police officials as Special Investigation Team to conduct an investigation into the large scale and wider allegations of the human organ transplantation racket, including illegal kidney transplantations.”

The SIT was to be headed by Mr. Premanand Sinha, I.P.S., Inspector General of Police, South Zone, Madurai, with four other senior officers named as members. The Court directed: “The Special Investigation Team will be headed by Mr. Premanand Sinha, I.P.S and he will assist the team of officials to conduct investigations into the allegations of a human organ transplantation racket including illegal kidney transplantations across the State of Tamil Nadu.”

Further, the Court mandated cooperation from the police hierarchy: “The Director General of Police is directed to provide all necessary assistance, including police personnel, infrastructure and other requirements to the Special Investigation Team constituted by this Court.”

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The SIT was instructed to act on the complaint already given: “The Special Investigation Team is directed to ensure that the complaint given by the Chief Medical Officer, Namakkal to the Pallipalayam Police Station is acted upon and F.I.R shall be registered based on the complaint and the report submitted by the special team appointed by the State Government. If necessary, further F.I.Rs’ can be registered with the concerned police stations, wherever such allegations or complaints are made or brought to the notice of the Special Investigation Team.”

Medical authorities were also ordered to assist: “The Director of Medical and Rural Health Services and the respective jurisdictional Joint Director of Health Services are directed to provide all necessary assistance to the Special Investigation Team to unearth the human organ transplantation scam and its illegal trading.”

The Court further directed judicial monitoring: “The Madurai Bench of Madras High Court will monitor the investigations. The Special Investigation Team is directed to submit reports before the Registrar (Additional Registrar General) or the Registrar (Judicial), Madurai Bench of Madras High Court periodically or on hearing dates, as the case may be.”

Finally, the SIT was directed to file its first report on 24 September 2025.

Advocates Representing the Parties

For the Petitioners: Mr. M. Rajarajan for Mr. R.A.S. Senthilvel

For the Respondents: Mr. J. Ashok, Additional Government Pleader; Mr. M.Ajmal Khan, Additional Advocate General, assisted by Mr. T. Senthil Kumar, Additional Public Prosecutor; Mr. K. Govindarajan, Deputy Solicitor General of India; Mr. G. Prabhu Rajadurai

Case Title: S.N. Sathishwaran v. The Chief Secretary to the Government of Tamil Nadu & Others

Case Number: W.P.(MD) No. 22623 of 2025

Bench: Justice S.M. Subramaniam, Justice G. Arul Murugan