Quoting Indian police sources, a Canadian news agency Wednesday said Kumar could have fled to Canada just before last week's raid at his house, from where he conducted his operations in Gurgaon.

According to the sources, the scamster is said to have false Canadian and Nepalese passports.

Though the Royal Canadian Mounted Police (RCMP) have not shed much light on Kumar's Canadian connection, the news agency quoted the sources as saying that the Indian doctor was partly directing his global organ transplant scam from an unknown location in Canada where his family is living.

"We can, however, say that Interpol-Ottawa has been in communication with Interpol-New Delhi about this case," media quoted RCMP officer Sylvie Tremblay as saying.

Gurgaon police commissioner Mohinder Lal said in the township near Delhi on Monday: "We strongly suspect that Amit has left the country through illegal channels and he might be in Canada."

He said efforts were being made via Interpol to track him.

The kidney scam came to light Jan 24 when police raided a private clinic in Gurgaon after a tip-off by a victim.

It is perhaps that same network that has prevented the police from nabbing Amit, as details of the multi-million-rupee kidney racket come to light. While Gurgaon, the posh Haryana town on the outskirts of the national capital, is where he was running the illegal transplant 'hospital' from, his connections saw him reach out to clients in many countries.

A graduate of ayurvedic medicine from Akola, near Nagpur in Maharashtra, Amit, now in his early 50s, was first arrested in 1993 with 12 other medicos, including some from government hospitals, in a Mumbai police raid on Kaushalya Clinic in Khar, northwest Mumbai.

During his association with Kaushalya clinic, the police reckon, Amit carried out over 300 kidney transplants that roughly worked out to Rs.450 million ($12 million.)

That was his first brush with the law.

The following year, in August 1994, the Mumbai Police's Crime Branch raided the clinic again following complaints of his involvement in a thriving kidney transplant racket, said a former member of the raiding party, Suhel Buddha.

The raids at that time followed complaints by three poor labourers from Hyderabad that Raut and his team had cheated them. He had promised to pay them Rs.60,000 each for a kidney, but short-changed them.

Police found him living in the posh Gulmohar area at Juhu - part of Mumbai's Glamour Crescent that stretches from Bandra to Andheri.

"He secured bail and was back to his practice. Barely two months later, his premises were again raided by the police in a separate case," recalls Buddha, who left the police force some years back and is now executive vice-president, STAR TV.

Following this raid, alarm bells began to ring. One patient, who had undergone a kidney transplant, did not get the obligatory post-operative care and died in the clinic, Buddha added.

According to another police officer, Manohar Dhanawade, who was part of the special squad that raided him in 1993, Raut came to Mumbai in the mid-1970s and ran a private consultation clinic in Khar before joining the Kaushalya Clinic.

"It was here that Amit made his impact with scores of foreign patients in need of kidneys and who were ever so willing to offer vast amounts to save their lives," Dhanawade told IANS.

Amit - who was assisted in the racket by his brothers, Jeewan and Ganesh, who were not medically qualified but probably acted as agents to procure gullible kidney donors and needy patients - was once again released on bail.

At the first available opportunity, Amit jumped bail and disappeared - only to surface in Turkey around 1995-96. He returned to India a couple of years later, and Buddha suspects the reasons were the same.

The lure of money was just irresistible.

Despite the meticulous efforts to book Amit, there were many in the police department who allegedly defended him in return for a hefty compensation, officials admit privately.

Nabbing him was difficult as he moved around and operated under false identities and procured fake passports.

Amit proved elusive even the National Capital Region - Delhi and its environs - where he ran his unlawful activities.

Gurgaon Police Commissioner Mahender Lal said Delhi Police had arrested Amit in 2001 after a case of illegal kidney transplant was registered against him at the Nizammudin police station.

A year later, a similar case was registered against him and an associate in Guntur district of Andhra Pradesh.

A few years down the line, Amit shifted his base to Gurgaon, a rising IT hub on the outskirts of the Indian capital. Amit along with his brother Jeewan and associates, Upendra Aggarwal and Saraj Kumar, formed a well-oiled ring by including drivers and his servants who worked as agents.

"It was also not clear what methods he adopted to change his identity regularly since that would require an official gazette notification," said one police officer.

In the early 1990s, while a donor got a measly Rs.50,000-100,000 (depending on his physical condition) for a kidney, the middlemen made a whopping Rs.350,000, the operating doctor and his team netted a clean million rupees that included the post-operative costs.

Amit's father Rameshwar Raut, now 93 years old, has disowned his son after he brought disgrace to the family.

"I had a misunderstanding with him and we have parted ways. Everyone in my village knows about my integrity. I am a freedom fighter and everybody knows this. He has made a mistake and put me to shame. One should never lie come what may. He was a big liar," Raut said in Mumbai.

Even though a nationwide manhunt has been launched for Amit, police suspect the worst. Some are certain that he has bribed his way out of India through Nepal or Bangaldesh before proceeding to Canada.

According to unconfirmed reports, it is believed that Raut and his brothers are worth approximately Rs.10 billion, but nobody knows where the trio could have stashed such huge funds.

In the latest exposé, a complaint by a labourer, Vidya Prakash Jatav of Purva Mahavir Village in Meerut, blew the lid off Amit's activities.

Mumbai police officials aver that Amit's racket was extremely well organised, secretive and tight-knit involving touts ranging from doctors in prestigious hospitals to cabbies and travel agents.

Four persons, including a nurse, two cooks and a driver working with the two quacks who ran an illegal kidney transplant racket for almost a decade were arrested today even as the kingpins still eluded the police dragnet that fanned out to several Indian states.

Police continued searches at several premises allegedly owned and used by Amit, who some officials believe might have escaped abroad, probably to Canada.

With this the total number of arrests in a racket that had global ramifications, with desperate patients requiring urgent kidney transplants coming as far as from the United States, Britain, Greece and Saudi Arabia, have risen to 11.

"We have arrested four people identified as Linda, Harpal, Ramesh and Suresh from Delhi's Mahipalpur area for their involvement in the kidney scam," Joint Commissioner of Gurgaon Police Mahender Singh Ahlawat said.

"Linda, a Manipur resident and nursing attendant with the Ram Manohar Lohia Hospital, had links with kingpin Amit Kumar alias Santosh Rameshwar Raut since 2006 and was assisting him in kidney transplants," Ahlawat told reporters.

All the arrested, including the driver and cooks, have been sent to two-day police remand.

Ahlawat said: "Linda in her interrogations revealed that Amit, his brother Jeewan and Saraj Kumar used to perform the surgeries, while doctor Upendra used to take care of patients post-operations.

"The joint interrogations of all the arrested people also revealed that they used to carry out around 50-60 kidney transplants each year," the top cop said.

Police sources said besides Delhi, Haryana and Uttar Pradesh, Maharashtra and Andhra Pradesh, the well-oiled network behind the scam had spread its tentacles in Jammu Kashmir and Goa.

Among the countries from where patients came for kidney transplants included Canada, Saudi Arabia, the US, Britain, Greece, and Lebanon, police said.

The kidney racket was busted Friday in Gurgaon, an emerging IT hub on the outskirts of the national capital, after the Uttar Pradesh and Haryana police swooped down on two properties -- in Sector-23 Palam Vihar and in DLF area -- owned by Amit.

Five people including Upendra were arrested then but Amit, Jeewan and Saraj managed to flee just before the police raid, allegedly following a tip-off.

At the heart of the mind-boggling racket was Amit, who allegedly carried out hundreds of kidney transplants along with fellow doctors that included his brother, cashing in on the huge demand-supply gap for this vital body organ.

What was especially shocking was that the two, who called themselves doctors, had degrees in Ayurveda, the traditional Indian herb-based system of medicine, but none was a qualified surgeon.

Using persuasion, trickery and threats, occasionally at gunpoint, they forced poor patients as well as labourers to part with one of their kidneys for a pittance, which were then sold off to wealthy clients from India and abroad at huge profits.

According to police, the doctors had carried out at least 600 illegal kidney transplants over the last nine years.

Jeewan's wife Puja and Amit's driver Umesh were arrested Wednesday for the involvement in the scam.

The Moradabad police Thursday took Upendra to Delhi and conducted searches in some prestigious hospitals and labs.

"An investigation team was sent to the Indraprastha Apollo and the Batra hospitals. It was found that tests related to kidney transplant were conducted there, but there is no evidence of their involvement yet," Senior Superintendent of Moradabad police Prem Prakash said.

"Records are being verified about their possible involvement in the scam," Prakash added.

Meanwhile, the Indraprastha Apollo said in a statement: "We would like to clarify that no police raid has been conducted regarding this case and the hospital is willing to extend all help necessary to the police with regards to this case.

"As a responsible healthcare provider we maintain the highest level of excellence in our healthcare delivery and would like to reassure our patients of the level of treatment rendered across all specialties is comparable to the best in the world," it added.

—IANS