“Even the government’s own doctors considered this diagnostic test medically necessary,” Akram said.

However, the test was not performed even after Khan was taken to PIMS on August 20, Akram said. Hospital officials told him the required equipment was unavailable, a claim that he rejected. He said a functional CT scanner capable of carrying out the test was present in the hospital’s radiology department.

PTI calls it a pattern, not a one-off incident

Akram described the episode as part of a larger issue in how Khan’s health has been managed in custody.

“A former prime minister was taken to a government hospital in the middle of the night, assessed by doctors who recommended an essential cardiac investigation, and then returned to Adiala Jail without the test being conducted. This cannot be dismissed as an isolated administrative lapse; it reflects a deeply troubling pattern,” he said.

PTI wants the scan carried out at Shifa International Hospital, under independent specialists and Khan’s own physicians. The party has also asked that his medical reports and diagnostic results be shared with his family, personal medical team, and lawyers.

A court order that was not followed

The dispute centres on a Supreme Court directive from August 18, in which a three-judge bench of Justice Shahid Waheed, Justice Naeem Akhtar Afghan, and Justice Ishtiaq Ibrahim ordered that Khan be shifted to Shifa International Hospital within two days for examination and treatment, and that a specialised medical board be formed for his care.

However, on August 20, the government took Khan to PIMS, a public hospital, rather than Shifa, a private facility. Akram questioned that decision directly.

“When the necessary facilities were available at Shifa International, deliberately taking Imran to a hospital unable or unwilling to perform the procedure raises a grave question: was the decision made in advance to prevent the CT Coronary Angiography from being conducted?” he asked. “Authorities must explain why he was not taken to the facility specifically designated for his medical care.”

Government’s version of events

Information Minister Attaullah Tarar wrote on X that a team of doctors, including an ophthalmologist, a cardiologist, and a physician, examined Khan and found him fit to remain in custody.

“A team of qualified doctors, including an ophthalmologist, a cardiologist, and a physician, conducted a detailed examination of him and declared him medically fit,” Tarar wrote. “After the completion of this entire process, he was transferred back to Adiala Jail.”

Pakistan’s Law Minister Azam Nazeer Tarar had earlier argued that a convicted prisoner should be treated inside jail or at a public hospital under the law, and had asked that Khan’s tests be done at a government facility rather than a private one. Parliamentary Affairs Minister Tariq Fazal Chaudhry later said the government intended to fully comply with the Supreme Court’s ruling and had not meant to delay it.

What Khan’s sister said

Khan’s sister, Uzma Khan, told reporters she was called late at night, along with Khan’s personal physician Dr Faisal Sultan, to come to Adiala Jail. She said officials later separated her from Dr Sultan and took her to PIMS under police escort.

“I asked them why you have brought me here; the Supreme Court has instructed for (Imran’s) treatment at Shifa International Hospital. At that, they told me we were there for a follow-up of Imran’s eye treatment,” she said.

Khan has been treated at PIMS multiple times before for an eye condition, right central retinal vein occlusion, which came to light in late January.

An inquiry, and a wider political backdrop

Prime Minister Shehbaz Sharif has since set up an inquiry committee to look into why the recommended scan was not carried out. PTI said the inquiry itself raises further questions, including whether coordination between departments broke down and why the court’s direction on Shifa was not followed. The party has rejected the government’s position that Khan is receiving adequate care and wants a transparent inquiry into who was responsible for the test not being conducted.

Khan, 73, has been in prison since August 2023 on a series of corruption convictions that followed his removal from office in 2022. He maintains the cases against him are politically motivated, a charge the government denies.

Writing for The Diplomat, analyst Umair Jamal noted that the Supreme Court’s order shifting Khan to hospital came after months of the top court sitting on the matter, and suggested it fits into a broader pattern of the government and opposition quietly easing tensions rather than a purely independent judicial decision. He pointed to ongoing discussions about administrative reforms in Pakistan, alongside PTI’s planned protest march set for September 27, led by Khyber Pakhtunkhwa Chief Minister Sohail Afridi, which could be deferred if Khan is given more access to family and doctors.

Reacting to the court’s order directing Khan’s transfer to Shifa, Prime Minister Sharif’s adviser Rana Sanaullah said PTI had taken too long to pursue legal channels.

“The PTI placed its case before the right forum, and the decision has come on merit,” Sanaullah said, urging the party to respect court rulings even when they do not favour it.

(With inputs from agencies)