Hamilton Naki - Controversy Concerning Participation in 1967 Heart Transplantation

Controversy Concerning Participation in 1967 Heart Transplantation

After Naki's death, obituaries published 9 June 2005 to 2 July 2005 in at least two medical journals (BMJ and The Lancet), one magazine (The Economist), two newspapers (The Independent and The New York Times), and an unknown number of newspapers publishing Associated Press stories, printed obituaries that made the following claims about Naki's participation in the world's first human-to-human heart transplantation:

• That Barnard had asked Groote Schuur Hospital for permission for Naki to be on the transplant team, and that permission was given in secret because of hospital rules and apartheid laws. Under apartheid, black health care providers could not have contact with white patients.
• That on 3 December 1967, Naki removed the heart of the deceased Denise Darvall, who was white, for transplantation into Louis Washkansky by Barnard.

Between 14 July 2005 and 3 September 2005, the five aforementioned periodicals and the Associated Press issued formal retractions of statements in their obituaries of Naki that claimed that he participated in the world's first human-to-human heart transplantation. The reasons given for the initial mistakes included:

• The Economist stated that its obituary was based on Naki's "own words in interviews," but that Naki's role "was gradually embellished in post-apartheid, black-ruled South Africa" and that Naki came to believe the story himself. Furthermore, the magazine reported that the University of Cape Town did not initially deny the story because it appeared "ridiculous."
• The author of the BMJ and The Independent obituaries wrote that she had "relied on secondary sources" such as The Economist.
• In an article published the same day as its correction, the New York Times concluded that reports that Naki was involved in the 1967 transplantation emerged "most prominently" in a 2003 article in The Guardian. The 2003 article mentioned that "a team led by Mr. Naki went to work, a 48-hour marathon" to remove the donor heart.
• The Associated Press cited a reliance on previous (1993 and 2003) Associated Press articles.

Evidence cited in 2005 that Naki was not present at the first transplant included:

• Surgeons at the hospital where the 1967 transplantation was performed "assured" The Economist that Naki "was nowhere near the operating theatre."
• The Economist reported that "a source close to" Naki said that Naki said that he had heard of the first heart transplant "on the radio."
• The chief of the laboratory in which Naki worked as of 1967 stated that Naki at the time was a scrub nurse and that Victor Pick was the surgical assistant; Naki became surgical assistant only after Pick died in the early 1970s and only "at the experimental surgical operating table."
• Hickman was quoted as saying that Naki "was an honest man and he wouldn't have made that claim ".
• Filmmaker Dirk de Villiers stated that heard Naki "tell other people" that he assisted in the transplant but did not say this to de Villiers in private.
• David Dent, Acting Dean of the Faculty of Health Sciences at Cape Town University as of 2005, asserted that he worked with Naki "on transplanting pigs' livers" in 1967, but that technicians such as Naki did not perform surgeries in hospitals.
• In a letter to BMJ, Dent wrote that Naki "did not participate in the first heart transplant, did not ever operate on humans, nor ever work in Groote Schuur Hospital…. The suggestion that Hamilton Naki performed the donor operation was never mentioned in life by the man himself, by the department of cardiac surgery, or by the university in his citation for his honorary degree in 2003. It was not mentioned after his death at his family funeral, or at the memorial service in the medical school experimental laboratory."
• Chris Logan, author of a biography of Barnard, wrote that Naki "did not at any stage assist in the first or subsequent human heart transplant operations, nor could he have done under the apartheid laws at the time".

Instead, the surgeons who removed the heart from the donor were Marius Barnard (Christiaan Barnard's brother) and Terry O'Donovan.

Despite the retractions, the claim that Naki participated in the 1967 heart transplantation has been perpetuated in journal articles and books published after 2005. Examples include:

• "In December 1967… Naki, with amazing dexterity, removed the donor heart from Darval, irrigated it with electrolyte solution and passed it to Barnard."
• "1967 Dr. Christiaan N. Barnard of South Africa performed the world's first human heart transplant operation… Working with a team that included… black South African surgeon Hamilton Naki…."
• "One of the most interesting people I learned and read about was Hamilton Naki. He assisted Dr. Barnard with the first transplant in 1967…."

A 2007 book traced the origin of the incorrect story to a 1993 article in the Associated Press that stated "Barnard had Naki on his heart-transplant backup team. … When Barnard performed the first heart transplant in 1967, Naki was part of the backup team at Groote Schuur Hospital in Cape Town." The story's "blossom into accepted fact" was partly attributed to neither Barnard's nor Naki's taking steps to refute the story. The 2007 book noted that the 2005 corrections in the newsmedia "did not include any statement about adopting new procedures to prevent the same thing from happening again."

A documentary film Hidden Heart which was released widely in 2009 included interviews with Christiaan Barnard and Naki suggesting that Naki was present at the 1967 heart transplantation. Marius Barnard was quoted as describing the claims in the film that Naki removed the donor heart as "rubbish, a joke, it’s a total distortion of the facts" and as stating that Naki was at the time "in his bed, about 8 km away from Groote Schuur". The co-director of the film "acknowledge that Naki was not present the night of the operation." A South African Broadcasting Corporation investigation after the release of the film quoted five people about the event:

• Tollie Lambrechts, a member of the transplantation team, said Naki "was definitely not in the operating room on that night."
• Dene Friedmann, a member of the transplantation team, said Naki "was not here that night, the only people here were the ones that would actually do the work. Hamilton never worked in the theatres. He wasn’t allowed to operate on a human being without a medical and surgical degree."
• Hickman said that Naki's being there was "highly unlikely."
• Naki’s youngest son said that Naki was "the one who took out the heart and gave it to Chris Barnard."
• The former wife of Barnard stated that Barnard "never mentioned Naki was there the evening of the first transplant."