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Australia's suspect surgeon

Jayant Patel (archive picture)
Jayant Patel's whereabouts are currently unknown

Not often are doctors so bad at their jobs that nurses actually resort to hiding patients from them.

But that is precisely what happened at Queensland's Bundaberg Hospital after Dr Jayant Patel started working there in 2003, according to hospital staff.

The realisation of just how many botched operations were carried out by Dr Patel is only now coming to light.

An investigation was launched in March after nurse Toni Hoffmann complained about the large number of procedures performed by Dr Patel which had led to serious complications.

An interim report published on Friday recommended that he should be charged with both murder and negligence - if he is ever found.

Dr Patel fled Australia in April, and while Queensland state authorities want to seek his extradition, his current whereabouts remain unknown.

The case of Dr Patel - whom local media have dubbed "Dr Death" - has caused huge controversy in Australia, not least because it highlights a potentially worrying lapse in checks on overseas medical staff.

Unbeknown to his colleagues, Dr Patel had already been banned from surgery in the US states of New York and Oregon before his arrival in Australia.

Fatal mistakes

The inquiry into Dr Patel's alleged malpractice at Bundaberg Hospital has linked him to as many as 87 patient deaths.

Nurse Toni Hoffman
We'd taken to hiding patients. We just thought 'What on earth can we do to stop this man'
Toni Hoffmann, the nurse who called attention to Dr Patel's poor surgical record

In an interim report published on Friday, the head of the inquiry team, Tony Morris, said the surgeon should be charged with the murder of James Edward Phillips, who died shortly after Dr Patel surgically removed part of his oesophagus.

Other medical staff at the hospital said they had refused to carry out the surgery, because it was too risky.

Dr Peter Miach, a renal specialist at the hospital, said the operation was "fraught with danger" and that he "would have been very surprised if [the patient] would have survived".

The inquiry concluded that in the case of James Phillips, "the surgical procedure undertaken by Patel... was, objectively, likely to endanger human life".

But the report also catalogues many other cases of alleged malpractice and recommends that Dr Patel is also charged with negligence causing harm.

One charge relates to the care of Aboriginal woman Marilyn Daisy, who developed gangrene in her leg after she was allegedly left without treatment for weeks following an amputation.

"There was no follow-up, the stitches in the stump were left there for six weeks...there were areas of infection, areas of gangrene, areas of necrosis and, in fact...there was quite a concern whether... this lady might lose a bit more of her leg," the inquiry heard.

In another case, a woman's life support machine was reportedly turned off because Dr Patel allegedly wanted her bed to operate on another patient.

Nurse Toni Hoffmann told the inquiry that Dr Patel had tried to drain blood from a man's heart with a "stabbing motion". The man died later that night.

"All the nurses in intensive care were seeing these patients dying every day and we couldn't do anything," Ms Hoffman told the inquiry in March.

"We'd taken to hiding patients. We just thought 'What on earth can we do to stop this man'," she said.

Falsifying records

Dr Patel has also been accused of fraud for allegedly falsifying his application to practise medicine in Australia, by removing any mention of his previous blemished record in the US.

After studying medicine in India, Dr Patel moved to New York, where the first complaints against him were made in 1984, when he was found not to be examining patients adequately before surgery.

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He moved to Oregon in 1989, to work for Kaiser Permanente in Portland as a general surgeon. Due to concerns over his work, Kaiser restricted him from carrying out certain types of operations - such as liver and pancreatic surgeries - in 1998.

In September 2000, the Oregon Board of Medical Examiners made these restrictions state-wide, and the year after that Dr Patel was forced to surrender his US medical licence in New York.

Dr Patel's case has raised concerns over the recruitment of overseas doctors in rural parts of Australia, where there is a current shortage of medical personnel.

Queensland Premier Peter Beattie said his government would adopt all the recommendations put forward in the commission's interim report, and that it would act immediately to keep "charlatans like Patel out of Queensland".

"This happened on our watch. This will be a matter on our consciences until the day we die," Mr Beattie told the Australian Associated Press.

The new recommendations include harsh penalties for doctors who provide false information on their registration forms.



SEE ALSO
Australia hunts suspect surgeon
10 Jun 05 |  Asia-Pacific

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