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~ ~ Narayana Hrudayalaya Medical Ethics Committee Narayana Hrudayalaya Hospitals Caring with Compassion CHAIRMAN & LEGAL EXPERT Dr. S.Y. Joga Rao To, Dr Sanjay Mehrotra, Sr.Consultant cardiologist, Narayana Hrudayalaya Hospitals, No. 258/ A, Bommasandra Industrial Area, Anekal Taluk, Bangalore-560 099, India Dr. Lloyd Vincent (Academician) Ref: "UMPIRE - Use of a Multidrug fill !n Reducing card i ovascu lar~ vents". Protocol Number: 241849. EudraCT Number: 2009-016278-34. Product: Red Heart Pill. Sponsor: Imperial College London. Dr. George Cherian (Academician) Dr. P.S. Jairaj (Academician) Dr. Ashley D'cruz (Pediatric Surgeon) Dr. K.V. Nataraj (Basic Medical Scientist Pharmacologist) Sub: Ethics Committee approval for the conduct toclinical trial "UMPIRE -1!se of a Multidrug fill !n Reducing cardiovascular ~vents". Protocol Number: 241849. Rev. K. Vasudevan (Theologian) Dr. Muralidhar K. (Academician) With reference to your submission letter dated "4 oct 2010 "we wish to inform youthat the "Narayana Hrudayalaya Medical Ethics committee" reviewed and discussed your application to conduct theclinical trial entitled "UMPIRE - 1!se of a Multidrug fill!n Reducing cardiovascular ~vents" on "3 Nov 2010" Dr. Srikrishna (Academician) Dr. Murali Mohan (Academician) Dr. Anuradha B.S. (Women & Child care) Mr. Anil Shankar (General Public) Mrs. Geeta MK (Medical Social Worker) l.UMPIRE Study Protocol Version 2, dated 21 April 2010 2.Summary of changes to UMPIRE study protocol Version 1.1 dated 28 Jan 2010 to Version 2 dated 21 April 2010 3.Participant information sheet with informed consent Form: Version 2, dated 11 May 2010 (English, Hindi and Kannada) 4.Summary of changes to participant information sheet with informed consent form version 1 dated 10 Dee 2009 to Version 2 dated 11 May 2010 S.Translation certificate Dated 20 May 2010 6.DCGI approval for the conduct of UMPIRE study Dated 03 May 2010 7.Product liability Insurance # 258/A, Bommasandra Industrial Area, Anekal (Taluk), Bangalore - 560 099. Tel.: 080-27835000 to 18 (Extn.: 2124) Fax: 080-27832648 Mob: +91-95350 12356

Narayana Hrudayalaya Narayana Hrudayalaya …...Narayana Hrudayalaya Medical Ethics Committee Narayana Hrudayalaya Hospitals Caring withCompassion CHAIRMAN & LEGAL EXPERT Dr. S.Y

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Narayana HrudayalayaMedical Ethics Committee

NarayanaHrudayalayaHospitals

Caring with Compassion

CHAIRMAN &LEGAL EXPERT

Dr. S.Y. Joga Rao

To,Dr Sanjay Mehrotra,Sr.Consultant cardiologist,Narayana Hrudayalaya Hospitals,No. 258/ A, Bommasandra Industrial Area, Anekal Taluk,Bangalore-560 099, India

Dr. Lloyd Vincent(Academician)

Ref: "UMPIRE - Use of a Multidrug fill !n Reducingcard iovascu lar~ vents".Protocol Number: 241849. EudraCT Number: 2009-016278-34.Product: Red Heart Pill. Sponsor: Imperial College London.

Dr. George Cherian(Academician)

Dr. P.S. Jairaj(Academician)

Dr. Ashley D'cruz(Pediatric Surgeon)

Dr. K.V. Nataraj(Basic Medical Scientist

Pharmacologist)

Sub: Ethics Committee approval for the conduct to clinical trial"UMPIRE - 1!se of a Multidrug fill !n Reducing cardiovascular~vents". Protocol Number: 241849.

Rev. K. Vasudevan(Theologian)

Dr. Muralidhar K.(Academician)

With reference to your submission letter dated "4 oct 2010 "wewish to inform you that the "Narayana Hrudayalaya MedicalEthics committee" reviewed and discussed your application toconduct the clinical trial entitled "UMPIRE - 1!se of a Multidrugfill!n Reducing cardiovascular ~vents" on "3 Nov 2010"

Dr. Srikrishna(Academician)

Dr. Murali Mohan(Academician)

Dr. Anuradha B.S.(Women & Child care)

Mr. Anil Shankar(General Public)

Mrs. Geeta MK(Medical Social Worker)

l.UMPIRE Study ProtocolVersion 2, dated 21 April 20102.Summary of changes to UMPIRE study protocolVersion 1.1 dated 28 Jan 2010 to Version 2 dated 21 April20103.Participant information sheet with informed consentForm: Version 2, dated 11 May 2010 (English, Hindi and

Kannada)4.Summary of changes to participant information sheetwith informed consent form version 1 dated 10 Dee 2009to Version 2 dated 11 May 2010S.Translation certificateDated 20 May 20106.DCGI approval for the conduct of UMPIRE studyDated 03 May 20107.Product liability Insurance

# 258/A, Bommasandra Industrial Area, Anekal (Taluk), Bangalore - 560 099.Tel.: 080-27835000 to 18 (Extn.: 2124) Fax: 080-27832648 Mob: +91-95350 12356

Narayana HrudayalayaMedical Ethics Committee

NarayanaHrudayalayaHospitals

Caring with Compassion

CHAIRMAN &LEGAL EXPERT

Dr. S.Y. Joga Rao

The following members of the ethics committee were present at themeeting held on "3 Nay 2010 at 1:30pm Narayana HrudayalayaHospital".

Sr. Name and Qualification, Department! Role!AffiliationNo. Gender Designation Institute

Advocates,1 Dr. Joga Rao, M.L, M. Phill, PhD Solicitors and Chairman &

Gender: Male LEGALEXCEL Healthcare Legal expert!Consultants Not Affiliated

2 Dr.L1oyd MD.,DM(Neph)MSc, Sr.Consultant MemberVincent MHSc,CHE Nephrologist SecretaryGender: MaleDr. George MD, DM, (Card) Sr. Consultant- Academician

3 Cherian FRCP, FAMS, CardiologyFACC

Dr.Muralidhar Director -K, M.D (Anae) Academic Academician

4 Gender: Male NHH5 Dr. K,V. Professor of

Nataraj Ph.D (Phar) Pharmacology, Basic MedicalGender: Male Bangalore Scientist! Not

Medical College Affiliated6 Senior

Dr. P.S. Jairaj MS, FRACS (CT Consultant,Cardio AcademicianGender: Male Surgery) Thoracic Surgery

7 Dr. Ashley MS, M.Ch (Ped. Pediatric SurgeonD'cruz Surgery) MemberGender: Male

8 Dr Murali Professor, Basic MedicalMohanGender: MBBS,MD, MRCP General Medicine ScientistMale

9 Rev. Theologian,Bethal ReligiousK,Vasudevan Bachelor of Fellowship, RepresentativeGender: Male Theology Mathikere, Theologian!

Bangalore Not Affiliated

10 Dr. Anuradha MBBS, MD, DNB, ConsultantBS FN B(Reproductive GynaecologistGender: Medicine) NHH Basic ScientistFemale

11 Mrs. Geeta B.A, MSW Social Worker Medical SocialM.K Gender: NHH WorkerFemale

12 Mr. Anil Travel DeskShankar B. Sc: Manager NHI-I General Public

Dr. Lloyd Vincent(Academician)

Dr. George Cherian(Academician)

Dr. P.S. Jairaj(Academician)

Dr. Ashley D'cruz(Pediatric Surgeon)

Dr. K.V. Nataraj(Basic Medical Scientist

Pharmacologist)

Rev. K. Vasudevan(Theologian)

Dr. Muralidhar K.(Academician)

Dr. Srikrishna(Academician)

Dr. MuraU Mohan(Academician)

Dr. Anuradha B.S.(Women & Child care)

Mr. Anil Shankar(General PUblic)

Mrs. Geeta M.K.(Medical Social Worker)

# 258/A, Bommasandra Industrial Area, Anekal (Taluk), Bangalore - 560 099.Tel.: 080-27835000 to 18 (Extn.: 2124) Fax: 080-27832648 Mob.: +91-95350 12356

~

\!YNarayana Hrudayalaya

Medical Ethics Committee

III Narayana=¥= HrudayalayaIII HospitalsCaring with Compassion

CHAIRMAN &LEGAL EXPERT

Dr. S.v. Joga Rao

We approve the trial to be conducted"Narayana Hrudayalaya Hospital"

The Institutional Reveiw Board / Independent Ethics Committeeexpects to be informed about the progress of the study, any SAEoccurring in the course of the study, any changes in the protocol andpatient information / informed consent and asks to be provided a copyof the final report.

Dr. Lloyd Vincent(Academician)

The EC is organized & operates according to the requirements of ICH-GCr, Indian Council of Medical Research guidelines & Schedule Y.

Dr. George Cherian(Academician)

Dr. P.S. Jairaj(Academician)

Dr. Ashley D'cruz(Pediatric Surgeon)

Dr. K.V. Nataraj(Basic Medical Scientist

Pharmacologist)

Rev. K. Vasudevan(Theologian)

Dr. LLOYD VINCENTMember Secretary

Narayana Hrudayalaya MedicalEthics Committee

Dr. Muralidhar K.(Academician)

Dr. Srikrishna(Academician)

Dr. Murali Mohan(Academician)

Dr. Anuradha B.S.(Women & Child care)

Mr. Anil Shankar(General Public)

Mrs. Geeta M.K.(Medical Social Worker)

# 258/A, Bommasandra Industrial Area, Anekal (Taluk), Bangalore - 560 099.Tel.: 080-27835000 to 18 (Extn.: 2124) Fax: 080-27832648 Mob.: +91-95350 12356