Question: What happens if the wrong player starts the game?

Answer: If the wrong player initiates a game out of turn, the hand is played to the end, and the winner is paid. At the start of the next game, the rightful East starts the game. The player who began as East incorrectly skips one turn at being East. If this happens, the player who began as East accidentally would have too few tiles and at some point, if noticed by another player, their hand should be declared dead. 

Since the publication of the 2020 Mah Jongg Made Easy, a player called the league about this rule which was unclear and this is what was said; If a player mistakenly discards a tile thinking they are East and the error is caught immediately, the player can take the tile back and the correct East can discard. If it’s noticed later in the game that one or more players have the wrong number of tiles, those hands should be declared dead. This ruling is in part in Mah Jongg Made Easy