WEBVTT - Episode 2: New Beginnings 0:00:04.960 --> 0:00:08.800 My name is Hedley Thomas. Sick to Death is based 0:00:08.840 --> 0:00:11.120 on my book of the same name, and it's the 0:00:11.119 --> 0:00:15.600 true story of doctor Jayant Patel's lies and manipulation and 0:00:15.640 --> 0:00:19.560 the herculean effort it took to finally stop him. We've 0:00:19.680 --> 0:00:23.799 used voice actors throughout this series, and on occasion the 0:00:23.920 --> 0:00:27.200 real people from the story have read their words for us. 0:00:28.360 --> 0:00:31.120 It is brought to you by Me and the Australian 0:00:38.960 --> 0:00:43.199 Chapter seven the Web December two thousand and two to 0:00:43.320 --> 0:00:52.080 March two thousand and three. Jayant Patel knew little about 0:00:52.120 --> 0:00:56.520 New Zealand, and even less about Kaitaia, a small township 0:00:56.560 --> 0:01:00.720 in the country's far north. Its hospital, a modern twenty 0:01:00.760 --> 0:01:04.600 eight bed public facility, needed a doctor for a relatively 0:01:04.680 --> 0:01:09.759 undemanding position. There would be no surgery. It was a 0:01:09.800 --> 0:01:13.720 massive step down from the senior surgical positions that doctor 0:01:13.720 --> 0:01:18.360 Patel had held in Portland, Oregon until resigning in disgrace 0:01:18.520 --> 0:01:24.440 in two thousand and one. At Kaitaia, the successful candidate 0:01:24.520 --> 0:01:28.000 would be mostly involved in pre and post operative care 0:01:28.160 --> 0:01:32.640 of the patients. On rare occasions, Pateel may have been 0:01:32.720 --> 0:01:37.120 needed in the operating theater, but only to assist a surgeon. 0:01:38.120 --> 0:01:43.800 On ten December two thousand and two, he wrote this. 0:01:42.600 --> 0:01:46.000 This is exactly the position I'm looking for, a responsible 0:01:46.040 --> 0:01:48.120 practice in a small community. 0:01:48.760 --> 0:01:52.800 His enthusiasm was obvious. Although the position involved a move 0:01:52.920 --> 0:01:55.840 to the other side of the world, Patel said he 0:01:55.880 --> 0:01:58.840 would be available to travel in just three weeks. 0:02:00.000 --> 0:02:01.800 He is corgnificain if there is an interest. 0:02:03.200 --> 0:02:07.240 For months, Patel had been searching the Internet looking for work. 0:02:07.640 --> 0:02:11.280 He was bored. He had been humiliated in the Oregon 0:02:11.360 --> 0:02:16.120 medical community. He needed to go somewhere foreign, a country, 0:02:16.200 --> 0:02:19.520 and a hospital where he would be welcomed and pampered, 0:02:19.919 --> 0:02:23.600 where the doctors and nurses had no knowledge of his past. 0:02:25.680 --> 0:02:30.680 He had registered with an Australian medical recruitment company, Wavelength Consulting, 0:02:31.160 --> 0:02:33.760 which pledged in its mission statement. 0:02:34.080 --> 0:02:37.720 We will always provide our clients with first class candidates, 0:02:37.919 --> 0:02:42.960 our candidates with first class opportunities, and both with unbeatable service. 0:02:43.520 --> 0:02:46.080 We will do so ethically and with the best interests 0:02:46.120 --> 0:02:49.520 of the candidate, client and wider community in mind. 0:02:51.919 --> 0:02:56.280 Its website was busy with job descriptions and easy to navigate. 0:02:56.720 --> 0:03:02.200 Its staff responded promptly to his emails and queries. The company, 0:03:02.280 --> 0:03:05.000 which had a paid up capital of two dollars. Was 0:03:05.040 --> 0:03:08.720 owned by doctor John Bethel and Claire Ponsford in Sydney. 0:03:10.040 --> 0:03:14.360 They headhunted overseas health professionals and matched them with vacancies 0:03:14.400 --> 0:03:18.120 in hospitals and private clinics throughout Australia and New Zealand. 0:03:19.880 --> 0:03:23.880 The company earned a commission from each placement. A chronic 0:03:23.960 --> 0:03:27.440 shortage of doctors and the constant bidding up of salaries 0:03:27.480 --> 0:03:32.880 by increasingly desperate employers had created a lucrative market. Doctor 0:03:32.919 --> 0:03:35.960 Bethel found that he could make more money from his 0:03:36.320 --> 0:03:39.880 internet based business than he could earn by practicing medicine, 0:03:40.800 --> 0:03:43.880 but the hospital at Katya in New Zealand would have 0:03:43.960 --> 0:03:48.240 to make do without doctor Patel. He was flattered when 0:03:48.240 --> 0:03:51.440 a Wavelength staff member told him he would be too 0:03:51.600 --> 0:03:56.520 senior for this post. Instead, doctor Bethel had something else 0:03:56.680 --> 0:04:00.880 up his sleeve. A position as the senior medical officer 0:04:01.040 --> 0:04:05.640 at the Bunderberg Base Hospital had become available. Patel was 0:04:05.680 --> 0:04:10.200 again brimming with enthusiasm. He spoke to Bethel on the 0:04:10.240 --> 0:04:12.920 telephone and followed up in writing. 0:04:14.200 --> 0:04:16.719 I had good training and experience with a majority aspect 0:04:16.720 --> 0:04:21.400 of general and pediatric surgery, including laparoscopic procedures drama surgery, 0:04:21.560 --> 0:04:25.680 including vascular emergencies. I have excellent surgical experience and I'm 0:04:25.760 --> 0:04:29.120 very comfortable with the responsibility. I'm getting a few offers 0:04:29.120 --> 0:04:32.480 within the US, However, my first priority is overseas work. 0:04:33.920 --> 0:04:38.240 Patel explained that he was near retirement and financially secure, 0:04:39.240 --> 0:04:42.480 with a daughter in medical school and his wife KISHOREI, 0:04:42.640 --> 0:04:45.960 still practicing as a doctor. He told Bethel that he 0:04:46.080 --> 0:04:51.159 wanted an altogether different work and life experience. He wanted 0:04:51.200 --> 0:04:56.640 an adventure. Bethel liked what he heard. Doctor Patel had 0:04:56.680 --> 0:04:59.480 held a position as a staff surgeon with the same 0:04:59.560 --> 0:05:03.400 major w organization in Oregon for twelve years, and he 0:05:03.480 --> 0:05:07.240 had headed a surgery residency program which involved teaching and 0:05:07.360 --> 0:05:12.160 mentoring junior surgeons. A number of articles he wrote jointly 0:05:12.240 --> 0:05:16.719 with other surgeons had been published in journals, and unlike 0:05:16.800 --> 0:05:20.240 some of the doctors who promoted their skills through the website, 0:05:20.720 --> 0:05:25.640 Dr Patel was not overly demanding. Doctor Bethel briefed doctor 0:05:25.720 --> 0:05:31.040 keyes ndem Thunderberg Hospitals, acting director of Medical Services about 0:05:31.080 --> 0:05:31.799 doctor Patel. 0:05:33.160 --> 0:05:36.599 He would expect relocation expenses and accommodation, but does not 0:05:36.680 --> 0:05:37.520 need a big house. 0:05:38.240 --> 0:05:39.760 He needs a place to get a good cup of 0:05:39.760 --> 0:05:45.080 coffee in the morning. Patel sent glowing references from three 0:05:45.120 --> 0:05:50.480 of his US referees, doctor Peter Feldman, doctor Bawis Singh, 0:05:50.520 --> 0:05:55.080 and doctor Nora Dantas. Each of the references was written 0:05:55.080 --> 0:05:59.400 on Kaiser Permanente letterhead. Here's doctor Feldman. 0:06:00.760 --> 0:06:03.520 I've known doctor Jayant Patel ever since he came to 0:06:03.600 --> 0:06:07.400 work at Kaiser Permanente in Portland, Oregon. I have many 0:06:07.400 --> 0:06:09.960 good things to say about doctor Patel. He has been 0:06:10.000 --> 0:06:11.919 a wonderful colleague over the years and has been a 0:06:12.000 --> 0:06:15.320 very hard worker. In addition to having a very busy 0:06:15.360 --> 0:06:18.520 surgical practice, he was very active on hospital committees and 0:06:18.560 --> 0:06:22.480 in other administrative forums. He is a well above average 0:06:22.520 --> 0:06:25.440 interest in his work and a well above average knowledge 0:06:25.440 --> 0:06:27.000 of surgery. 0:06:27.680 --> 0:06:29.839 He is doctor Singh. 0:06:29.920 --> 0:06:33.080 As a former chief and staff anesthesiologist, I have had 0:06:33.080 --> 0:06:36.680 the opportunity of working with doctor Patel on numerous occasions, 0:06:36.839 --> 0:06:42.480 both in elective and emergency situations. His balanced judgment, surgical 0:06:42.520 --> 0:06:46.279 skills and decisive steps, especially in the management of high 0:06:46.360 --> 0:06:51.320 risk complex procedures, has always been appreciated by US anesthesiologists 0:06:51.360 --> 0:06:56.360 and other members of the Oregon team. Doctor Patel's professional expertise, 0:06:56.680 --> 0:07:01.360 passion and energy for quality patient care, coupled with ethical 0:07:01.480 --> 0:07:04.880 and best practices advocacy, won him the vote of his 0:07:05.000 --> 0:07:08.880 colleagues for a Distinguished Physician award in nineteen ninety five. 0:07:09.680 --> 0:07:13.680 These qualities undoubtedly will be an integral part of doctor J. 0:07:13.760 --> 0:07:19.160 Pettel's professional career, irrespective of the place of his practice. 0:07:19.280 --> 0:07:20.720 And here is doctor Dantas. 0:07:22.160 --> 0:07:24.920 I worked with him closely at our intensive care unit 0:07:25.040 --> 0:07:27.880 and saw him care for the most difficult surgical cases 0:07:27.920 --> 0:07:31.520 at our hospital. I saw the good results. The nursing 0:07:31.520 --> 0:07:34.040 staff had good things to say about his surgical skills, 0:07:34.320 --> 0:07:37.480 his compassionate care, and his relationship with the nursing and 0:07:37.600 --> 0:07:41.280 medical staff. My countless patients that he took care of 0:07:41.400 --> 0:07:44.240 for the last ten years were very satisfied of his 0:07:44.360 --> 0:07:48.320 results and his skills. And I can say categorically that 0:07:48.360 --> 0:07:51.000 no one ever gave me a negative feedback about him, 0:07:51.200 --> 0:07:53.840 which I always get as a primary care physician when 0:07:53.880 --> 0:07:54.880 patients come back to me. 0:07:56.280 --> 0:08:02.920 Patel's other testimonials were also superb. Doctor Edward Arronilo was 0:08:03.040 --> 0:08:06.400 chief of surgery at the Cause of Permanente Groups bez 0:08:06.520 --> 0:08:10.520 Cais a hospital when he hired Patel in nineteen eighty nine. 0:08:11.760 --> 0:08:16.400 According to Aarronilo. 0:08:14.920 --> 0:08:17.840 From the time he started, he dove into the work 0:08:17.920 --> 0:08:21.440 with full vigor. He generally did about one hundred and 0:08:21.480 --> 0:08:25.520 twenty cases of pediatric surgery per year, in addition to 0:08:25.680 --> 0:08:30.160 a full load of general surgery. Doctor Patel had excellent 0:08:30.240 --> 0:08:35.319 results with no serious problems or complications. As far as 0:08:35.400 --> 0:08:39.080 general surgery is concerned. He took on the easy cases 0:08:39.360 --> 0:08:43.560 and more often the more difficult, challenging and risky cases. 0:08:44.240 --> 0:08:49.079 He achieved remarkable results and successes. In so far as 0:08:49.160 --> 0:08:52.840 patients are concerned. They keep coming back to him. They 0:08:52.880 --> 0:08:55.839 trust him, and he delivers the best care he can. 0:08:57.120 --> 0:09:01.640 When doctor Bethel called doctor Feldman and Singh, they both 0:09:01.760 --> 0:09:06.520 continued the praise. Neither mentioned the most relevant chapter in 0:09:06.600 --> 0:09:11.840 their former colleague's career, his record of botchups and discipline reaction. 0:09:12.600 --> 0:09:15.800 Although doctor Feldman gave a cryptic clue when he said 0:09:15.800 --> 0:09:20.040 that Patel sometimes took on complex cases handed to him 0:09:20.080 --> 0:09:25.760 by colleagues and found it hard to say no. Doctor 0:09:25.800 --> 0:09:30.280 Bethel voiced one minor concern. It was that doctor Patel 0:09:30.400 --> 0:09:34.360 had not worked for almost eighteen months. According to his 0:09:34.480 --> 0:09:40.320 curriculum Vitae In a subsequent CV sent by Patel, the 0:09:40.480 --> 0:09:44.040 date on which he claimed to have left Kaiser Permanente 0:09:44.200 --> 0:09:47.440 in Portland had been changed from two thousand and one 0:09:47.960 --> 0:09:52.040 to two thousand and two, but the change went unnoticed. 0:09:53.440 --> 0:09:57.920 On Christmas Eve, doctor Patel received an early present a 0:09:58.040 --> 0:10:02.720 letter of appointment as seen medical officer at Bunderberg Base Hospital. 0:10:03.400 --> 0:10:07.480 He promptly signed and returned the document. His starting date 0:10:07.600 --> 0:10:12.240 was confirmed as one April two thousand and three. Before 0:10:12.280 --> 0:10:16.920 he farewell his wife, Kashoori, his daughter and friends in Oregon, 0:10:17.280 --> 0:10:20.320 there was a pile of paperwork and red tape to 0:10:20.360 --> 0:10:24.200 be dealt with. Patel needed a rubber stamp from the 0:10:24.200 --> 0:10:27.320 Medical Board of Queensland to say he was a properly 0:10:27.400 --> 0:10:31.720 credential doctor. Although the Board had a statutory duty to 0:10:31.840 --> 0:10:36.080 register doctors and protect the public from Charlatan's, its procedures 0:10:36.120 --> 0:10:41.680 were negligently lax. The Board performed no independent checks of 0:10:41.720 --> 0:10:47.319 the references or credentials of incoming doctors. Their fellow physicians 0:10:47.400 --> 0:10:52.680 were above suspicion. In Petel's case, the Board simply required 0:10:52.679 --> 0:10:57.199 a document from the Oregon Board of Medical Examiners certifying 0:10:57.240 --> 0:11:00.880 that he was properly registered and had not been disciplined. 0:11:01.960 --> 0:11:05.400 Patel gave an assurance to Susie Taurs, one of the 0:11:05.440 --> 0:11:10.360 Wavelength staff handling his file, in January, I. 0:11:10.320 --> 0:11:12.319 Will fax you the letter and put the original in 0:11:12.360 --> 0:11:12.720 the men. 0:11:13.920 --> 0:11:18.319 Tours forwarded the documents from doctor Patel to Ainsley McMullan, 0:11:18.640 --> 0:11:22.559 an officer with the Medical Board of Queensland. Neither Tours. 0:11:22.760 --> 0:11:26.720 Normcmullen noticed that the certificate from Oregon hinted at a 0:11:26.760 --> 0:11:32.439 potentially serious problem. In black and white it said standing 0:11:32.880 --> 0:11:38.400 public order on file Sea attached, but there was nothing attached. 0:11:38.920 --> 0:11:43.280 The documents setting out the details of Patel's negligence and 0:11:43.480 --> 0:11:47.800 his disciplinary history had been removed. One of the Medical 0:11:47.840 --> 0:11:52.319 Board forms requires doctors to declare whether their registration overseas 0:11:52.400 --> 0:11:58.440 has been the subject of any condition, suspension, undertaking or cancelation. Patel, 0:11:58.640 --> 0:12:04.480 in his response wrote no. McMullen processed the file, one 0:12:04.520 --> 0:12:08.160 of one hundreds she had handled for the board. Wavelength 0:12:08.200 --> 0:12:12.400 would receive thirteen thousand, nine hundred and twenty four dollars 0:12:12.440 --> 0:12:17.520 for its efforts in recruiting Dr Patel. His travel plans 0:12:17.559 --> 0:12:21.040 were locked in by the administrative staff at Bunderberg Hospital. 0:12:21.920 --> 0:12:24.400 He was scheduled to arrive in Brisbane on a Quantus 0:12:24.440 --> 0:12:27.679 flight on thirty one March, go to a twelve thirty 0:12:27.679 --> 0:12:31.320 pm meeting with a medical Board representative at Forestry House 0:12:31.360 --> 0:12:34.480 in the city, and then head back to the airport 0:12:34.600 --> 0:12:38.160 for a three thirty pm flight to Bunderberg. He wrote 0:12:38.200 --> 0:12:41.000 to the hospital's Lynn McKean, who was taking care of 0:12:41.080 --> 0:12:42.479 his travel and accommodation. 0:12:43.840 --> 0:12:45.760 I'm looking forward to meeting all of you and having 0:12:45.760 --> 0:12:46.760 a very productive year. 0:12:48.000 --> 0:12:50.800 She had booked him into one of the nicer beachside 0:12:50.800 --> 0:12:55.319 apartments in Miller Street, Aagara, a fifteen minute drive from 0:12:55.360 --> 0:12:59.760 the hospital. It offered a superb view of sand, volcanic 0:12:59.840 --> 0:13:00.959 rock and sea. 0:13:02.800 --> 0:13:05.280 We are also looking forward to your arrival and I 0:13:05.360 --> 0:13:07.000 know you will have an enjoyable year. 0:13:10.840 --> 0:13:20.040 Chapter eight, Flashback a Vicious Cycle. It was May nineteen 0:13:20.160 --> 0:13:24.840 ninety three and Jayne Patel, smiling warmly uttered his umpty 0:13:25.120 --> 0:13:28.000 self serving sentence in the twenty minutes that he and 0:13:28.120 --> 0:13:30.800 doctor Sally Eelers had been seated together. 0:13:32.200 --> 0:13:36.480 Congratulations, you've got the job. I make my decisions quickly. 0:13:37.800 --> 0:13:41.800 At twenty nine, and newly separated from her husband, the 0:13:41.840 --> 0:13:45.280 father of her four year old son, Sally Eelers found 0:13:45.320 --> 0:13:49.120 the interview disturbing. She had the job, but already she 0:13:49.240 --> 0:13:52.840 was concerned about the underlying ambitions of her new boss. 0:13:54.520 --> 0:13:57.600 She wanted the position as a second year resident in 0:13:57.640 --> 0:14:02.640 an integrated surgical Residency PROB run by Emmanuel Hospital and 0:14:02.679 --> 0:14:07.800 Health Center and Kaiser Foundation Hospitals in Portland, Oregon. She 0:14:07.960 --> 0:14:11.760 guessed that doctor Patel, the program director, had hired her 0:14:11.880 --> 0:14:16.560 because of her attractive appearance, age, and gender, not because 0:14:16.559 --> 0:14:21.400 of the strength of her impressive curriculum vitae. Driving home, 0:14:21.560 --> 0:14:25.440 doctor Eelers replayed in her mind the clues to Petel's 0:14:25.680 --> 0:14:30.040 less than subtle antics, and she recalled his repeated references 0:14:30.080 --> 0:14:33.520 to his age. He had boasted several times that he 0:14:33.760 --> 0:14:38.720 was only thirty nine. He and his wife, Kshoori, a 0:14:38.760 --> 0:14:43.080 competent physician, had bought a mansion in Beaverton, an expensive 0:14:43.120 --> 0:14:46.760 suburb in northeast Portland, two years earlier for four hundred 0:14:46.760 --> 0:14:52.000 and twenty thousand dollars US. But Patel's partner since medical 0:14:52.040 --> 0:14:58.000 college in India, rarely came up in conversation. His ego 0:14:58.280 --> 0:15:02.840 was colossal. From himself, Patel had little to talk about. 0:15:03.280 --> 0:15:06.200 He stressed how much he had achieved and how clever 0:15:06.280 --> 0:15:09.880 he was. The young surgical residents who looked up to 0:15:10.000 --> 0:15:13.280 Patel had voted him Teacher of the Year in nineteen 0:15:13.360 --> 0:15:18.080 ninety one and nineteen ninety two. He was determined to 0:15:18.280 --> 0:15:21.840 educate Sally Eelers and school her in the intricacies of 0:15:21.880 --> 0:15:27.320 a wonderful subject himself. He boasted how he had embarked 0:15:27.400 --> 0:15:31.600 on an extraordinarily successful journey in surgery and he was, still, 0:15:31.720 --> 0:15:35.600 as he put it, so young. He wanted Elers to 0:15:35.760 --> 0:15:39.680 nod and fawn in obsequious approval and flatter him with 0:15:39.800 --> 0:15:46.120 tributes to his stellar career. Patel, who shamelessly complimented himself, 0:15:46.200 --> 0:15:49.920 had turned a job interview into a flawless self appraisal, 0:15:50.600 --> 0:15:54.280 and doctor Sally Eelers concluded that he wanted her to 0:15:54.400 --> 0:16:01.040 understand something else. Their age difference was trivial. Years. Separating 0:16:01.080 --> 0:16:05.640 the chain smoking and overweight surgeon from his fit understudy 0:16:05.760 --> 0:16:09.480 was no barrier to a relationship outside the operating theater, 0:16:09.880 --> 0:16:15.720 he insisted. But it was another clumsy lie, another hopeless misrepresentation. 0:16:16.760 --> 0:16:20.040 At that time, Patel was not thirty nine. He had 0:16:20.160 --> 0:16:24.640 just turned forty three. It would take another seven years 0:16:24.640 --> 0:16:28.080 for regulators in Portland to ban Patel from a wide 0:16:28.240 --> 0:16:31.800 range of surgery, but the number of patients who were 0:16:31.880 --> 0:16:35.200 dying or suffering in pain due to his negligence was 0:16:35.240 --> 0:16:39.120 growing even before doctor Eelers received her letter of appointment. 0:16:40.360 --> 0:16:43.960 Every time his scalpels slipped and nicked an artery or 0:16:44.120 --> 0:16:48.320 vain or vital organ, Peateel lacerated the quality of life 0:16:48.360 --> 0:16:52.440 of a patient in Oregon. In at least a handful 0:16:52.480 --> 0:16:55.640 of cases, the ones that stood out for the glaring 0:16:55.760 --> 0:17:00.320 ineptitude or because the family's demanded answers. His blade was 0:17:00.440 --> 0:17:04.320 an instrument of death, and some of his colleagues had 0:17:04.359 --> 0:17:09.280 begun to express disquiet. But before Sally Eelers had seen 0:17:09.359 --> 0:17:13.240 him operate or surveyed the dreadful complications in the patients, 0:17:13.560 --> 0:17:17.600 she was busy discouraging his advances. He spoke to her 0:17:17.680 --> 0:17:20.639 in the car park a month after their first meeting. 0:17:21.960 --> 0:17:23.920 You may never get to have drinks with your program 0:17:23.960 --> 0:17:26.960 director again. What do you really need as a boyfriend? 0:17:27.840 --> 0:17:30.400 Sally Eelers replied, well. 0:17:30.240 --> 0:17:32.920 Doctor Patel, I have a boyfriend, and you know that 0:17:33.000 --> 0:17:34.359 you've met him. 0:17:34.880 --> 0:17:39.240 She had been seeing another doctor, a tool Thacka. Patel 0:17:39.359 --> 0:17:43.200 knew about their blossoming relationship because Sally had introduced them 0:17:43.280 --> 0:17:48.800 at an annual resident graduation dinner. Doctor Thacker was ethnic Indian, 0:17:48.840 --> 0:17:53.280 although the similarities with Patel ended there. He had grown 0:17:53.359 --> 0:17:56.520 up in the United States. He had graduated from the 0:17:56.520 --> 0:18:01.280 medical school at University of California, Los Angeles or UCLA, 0:18:01.600 --> 0:18:05.520 and he was a resident at Oregon Health and Science University. 0:18:06.359 --> 0:18:10.600 He was popular, and he was younger. When Patel again 0:18:10.720 --> 0:18:14.440 tried to start a relationship with doctor Elers, she told 0:18:14.480 --> 0:18:19.880 him Thaka was a serious boyfriend. Patel's demeanor changed immediately 0:18:19.920 --> 0:18:24.679 for the worse. Other young female doctors felt uncomfortable around 0:18:24.720 --> 0:18:29.560 doctor Patel. As participants in the immanual residency program, they 0:18:29.640 --> 0:18:34.160 lived in adjoining accommodation. Patel would barge into the women's 0:18:34.200 --> 0:18:38.119 area without knocking, surprising the residents in various states of 0:18:38.240 --> 0:18:42.680 undress after a shower or while changing clothes. He had 0:18:42.720 --> 0:18:47.040 no place being there. For the next three years, Patel 0:18:47.119 --> 0:18:53.800 prevented Elers from performing complex and challenging surgery in educational conferences. 0:18:53.840 --> 0:18:57.160 He was hostile and shouted her down when she offered answers. 0:18:57.720 --> 0:19:00.920 He singled her out for nasty asa words and made 0:19:01.000 --> 0:19:06.240 her feel inferior around the other resident surgeons, those surgeons 0:19:06.359 --> 0:19:10.159 in Patel's good books, those he dominated and groomed for 0:19:10.200 --> 0:19:14.280 his clique. They clamored and competed for his attention, but 0:19:14.359 --> 0:19:18.400 ELA's wanted none of it. She suspected that Patel would 0:19:18.440 --> 0:19:20.960 have been reasonable towards her if it were not for 0:19:21.080 --> 0:19:29.080 Thacker's ethnicity. The handsome, younger ethnic Indian unwittingly highlighted Patel's shortcomings. 0:19:30.160 --> 0:19:34.000 On twelve January nineteen ninety five, Patel sent her a 0:19:34.080 --> 0:19:39.040 formal letter, accusing her of being argumentative, alienating nursing staff, 0:19:39.520 --> 0:19:44.240 manipulating the people around her, resisting constructive criticism, and having 0:19:44.400 --> 0:19:49.040 little insight into her conduct. It was classic self projection. 0:19:50.000 --> 0:19:54.480 ELA's had been highly regarded and received outstanding marks before 0:19:54.760 --> 0:19:58.600 and after her contact with Patel, but he had decided 0:19:58.640 --> 0:20:02.320 to teach her a lesson. His letter to her went 0:20:02.400 --> 0:20:03.480 on to state. 0:20:04.440 --> 0:20:08.600 Your performance in your surgical residency at Emmanuel has remained unsatisfactory. 0:20:09.240 --> 0:20:12.639 This is primarily because of your attitude and behavior. You 0:20:12.680 --> 0:20:19.440 are being perceived as argumentative, disrespectful, dogmatic, and arrogant. Being disrespectful, 0:20:19.640 --> 0:20:23.480 especially to the attending staff, is an unacceptable behavior in 0:20:23.520 --> 0:20:24.639 the surgical residency. 0:20:24.680 --> 0:20:25.080 Program. 0:20:25.600 --> 0:20:29.240 I am blessing you on probation immediately. If you desire, 0:20:29.359 --> 0:20:32.560 we will be very happy to arrange for counseling. Depending 0:20:32.600 --> 0:20:35.359 on the evaluations at the end of your probationary term, 0:20:35.800 --> 0:20:38.880 you will either be removed from probation and allowed to continue, 0:20:39.280 --> 0:20:43.760 or be subject to disciplinary actions, including removal or repeat. 0:20:44.520 --> 0:20:47.840 Patel should have been more worried about his own failures 0:20:47.880 --> 0:20:51.840 in theater. The corridor. Gossip at the best Chise of 0:20:51.960 --> 0:20:55.560 medical center was spreading like a virus, with several doctors 0:20:55.600 --> 0:20:59.560 outside Betel's influence questioning the competence of the staff. Surgeon. 0:21:00.359 --> 0:21:04.360 Patel's knowledge of surgery was good. He was clearly an 0:21:04.440 --> 0:21:09.760 intelligent man, but in many procedures, particularly those involving painstaking 0:21:09.880 --> 0:21:14.520 and tedious work over several hours, his sloppiness was remarkable. 0:21:15.760 --> 0:21:19.280 Some of the doctors had a theory. They believed his 0:21:19.359 --> 0:21:22.879 addiction to smoking was a large part of the problem. 0:21:23.280 --> 0:21:26.240 Craving the nicotine of a cigarette when he should have 0:21:26.280 --> 0:21:31.080 been meticulously maneuvering his scalpel around delicate organs, he would, 0:21:31.160 --> 0:21:36.240 they suggested, lose focus and nerve. He would rush the procedures, 0:21:36.440 --> 0:21:40.119 take shortcuts, leave theater before the job was done and 0:21:40.200 --> 0:21:45.119 stride outside to light up. Sometimes his patients paid with 0:21:45.240 --> 0:21:50.159 their lives or their organs, but still none of his colleagues, 0:21:50.200 --> 0:21:54.880 who harbored these concerns went to the authorities. By late 0:21:55.000 --> 0:21:58.679 nineteen ninety five, a restructuring of the hospital set up 0:21:58.760 --> 0:22:02.560 led to Patel being assigned to work with more experienced 0:22:02.560 --> 0:22:06.280 surgeons for the first time. Until then, he had been 0:22:06.400 --> 0:22:09.520 top of the heap. He thrived on conflict and had 0:22:09.560 --> 0:22:14.080 reinforced perceptions of his aggressive nature by chastising another surgeon 0:22:14.440 --> 0:22:20.320 and questioning his expertise. But now better surgeons were seeing 0:22:20.480 --> 0:22:26.959 his handiwork. Although Jayon Patel had made a lot of 0:22:27.000 --> 0:22:31.119 money for the Kaiser Permanent Group, the legal actions brought 0:22:31.200 --> 0:22:36.480 by the victims of his incompetence were increasingly expensive. Roanila 0:22:36.720 --> 0:22:40.840 T Pei eighteen was suffering abdominal pain and a family 0:22:40.960 --> 0:22:45.520 history of polyposis, a predisposition to colon cancer when she 0:22:45.640 --> 0:22:49.480 went to Sea Patel. As her father and her uncle 0:22:49.600 --> 0:22:53.200 had died at an early age of colon cancer, Ronila 0:22:53.359 --> 0:22:57.760 was at similar risk. Despite knowing the family history, Patel 0:22:57.920 --> 0:23:01.639 ordered the wrong diagnostic test for the young woman. The 0:23:01.720 --> 0:23:05.560 limited scope of the test meant its results were inconclusive, 0:23:05.760 --> 0:23:10.720 and Patel assured Ranila that she was fined. The failure 0:23:10.800 --> 0:23:15.080 to examine her entire colon meant that polyps already present 0:23:15.400 --> 0:23:20.720 went undetected. Her death at twenty of colon cancer devastated 0:23:20.720 --> 0:23:24.040 her young husband, who was left to raise an infant son. 0:23:25.480 --> 0:23:30.679 The only consolation was financial Caizer Permanente settled the case 0:23:30.760 --> 0:23:35.879 for US one point four million dollars. The hospital group 0:23:36.000 --> 0:23:39.800 also paid out to the family of Leitras Fairchild, who 0:23:39.840 --> 0:23:43.440 died two months after Patel removed part of her stomach. 0:23:44.200 --> 0:23:48.080 The surgical wound collapsed in a hideous mess, leading to 0:23:48.200 --> 0:23:54.479 serious complications and death. Kaiser settled this one for US 0:23:54.640 --> 0:24:00.600 three hundred and seventy five thousand dollars. Throughout nineteen nine five, 0:24:00.640 --> 0:24:04.480 there were more deaths, injuries, and payouts, and a trio 0:24:04.640 --> 0:24:09.679 of shocking cases. Gerald Tucker, who bled to death that 0:24:09.840 --> 0:24:15.000 cost US nine hundred thousand dollars. Helen Brooks, whose eureta 0:24:15.240 --> 0:24:20.760 was accidentally cut. That was a confidential settlement, and another 0:24:20.840 --> 0:24:25.400 confidential settlement in relation to Susan Tomblin, whose femeral vein 0:24:25.560 --> 0:24:31.600 was cut. One of the younger surgeons tasked with assisting Patel. 0:24:31.960 --> 0:24:36.480 Doctor Sanjeev Sharma would later tell Susan Goldsmith, a senior 0:24:36.600 --> 0:24:40.760 investigative journalist at the Oregonian newspaper, of his efforts in 0:24:40.800 --> 0:24:44.879 the operating room to help Helen Brooks. He tried alerting 0:24:44.960 --> 0:24:46.480 Patel to his mistake. 0:24:47.840 --> 0:24:50.359 I tried very hard to get him to realize there 0:24:50.400 --> 0:24:51.000 was a problem. 0:24:51.119 --> 0:24:54.119 After the surgery, I spoke up about missus Brooks to 0:24:54.119 --> 0:24:59.600 Patel and he said, it's okay. It's okay. Susan Tombland 0:24:59.600 --> 0:25:03.199 discovered and how she had been unnecessarily injured when a 0:25:03.280 --> 0:25:06.280 nurse told her that the operation went terribly wrong. 0:25:07.600 --> 0:25:09.960 When I saw another doctor, he said, I was a 0:25:09.960 --> 0:25:13.280 walking time bomb from this. They said, this could kill 0:25:13.359 --> 0:25:15.400 you if a piece of this blood clock gets loose. 0:25:16.480 --> 0:25:19.520 When I mentioned that to doctor Patel, he screamed at 0:25:19.520 --> 0:25:21.800 me like I was a two year old Tommy. I 0:25:21.880 --> 0:25:23.840 wasn't to talk to anybody about what happened. 0:25:25.040 --> 0:25:28.800 The hospital's managers and lawyers elected to keep the litigation 0:25:29.080 --> 0:25:33.000 and the payouts a secret from Oregon's regulatory body, the 0:25:33.000 --> 0:25:37.840 Board of Medical Examiners. In mid nineteen ninety six, in 0:25:37.880 --> 0:25:41.720 the months after the closure of the Best Caiser Medical Center, 0:25:41.880 --> 0:25:45.600 doctor Sally Eelers went to a weekly meeting of doctors 0:25:45.680 --> 0:25:50.120 at another hospital, Providence, Saint Vincent, to compare notes on 0:25:50.280 --> 0:25:55.000 problem surgeries. That's where Sally Elers disclosed the case of 0:25:55.160 --> 0:26:00.439 Dwayne Feken, whose large intestine was removed by Patel. It 0:26:00.600 --> 0:26:04.800 was the wrong decision. Facin suffered a string of serious 0:26:04.840 --> 0:26:08.960 complications and needed several operations over a few years to 0:26:09.000 --> 0:26:14.639 rectify the damage. His wounds had also fallen apart. His 0:26:14.920 --> 0:26:19.600 poor outcomes mortified Sally EELA's. At the age of fourteen, 0:26:19.760 --> 0:26:23.800 she had been diagnosed with Hodgkin's disease. She was a 0:26:23.840 --> 0:26:28.080 cancer survivor, and doctors had told her incorrectly at eighteen 0:26:28.240 --> 0:26:32.919 that she was infertile. Her experiences gave her a unique 0:26:33.040 --> 0:26:37.080 understanding of the mental and physical pain suffered by patience. 0:26:37.960 --> 0:26:41.840 She knew that Patel, her former teacher, was dishonest and 0:26:41.960 --> 0:26:45.640 a predator, but she could not figure out why he 0:26:45.760 --> 0:26:50.520 had rushed Faicin into having the original operation. Duayne Facin 0:26:50.640 --> 0:26:55.120 had not been afflicted with alterative colitis. The young man 0:26:55.160 --> 0:26:59.640 suffered Crohn's disease, a fact established from the pathology report. 0:27:00.720 --> 0:27:04.880 It was as if Patel, whose boastfulness was legendary wanted 0:27:04.920 --> 0:27:08.640 to do the most complex procedures for his own benefit. 0:27:09.640 --> 0:27:12.919 A distressed Dodtor Eelers had been to see Patel to 0:27:13.040 --> 0:27:17.280 discuss his invasive operations and the complications that had ruined 0:27:17.359 --> 0:27:19.840 Dwayne Feakin's quality of life. 0:27:20.000 --> 0:27:23.480 She told him, I have seen the patholodiy report and 0:27:23.520 --> 0:27:25.040 it shows CRuMs to these. 0:27:25.600 --> 0:27:27.760 But the senior surgeon shrugged it off. 0:27:28.720 --> 0:27:32.080 Oh, I'm going to doctor the pathologist. I would to 0:27:32.119 --> 0:27:33.920 get that stretent note. 0:27:34.080 --> 0:27:37.720 When doctor Eelers, safely out of Patel's clutches, went to 0:27:37.840 --> 0:27:41.639 the Morbidity and Mortality meeting at Providence Saint Vincent in 0:27:41.720 --> 0:27:46.639 mid nineteen ninety six and described Vecan's clinical history, including 0:27:46.720 --> 0:27:51.399 his most recent major operation weeks earlier and an intra 0:27:51.560 --> 0:27:57.640 abdominal absess. The other surgeons were unusually somber. They had 0:27:57.720 --> 0:28:01.359 been wary of Patel before doctor e iel spoke, but now, 0:28:01.720 --> 0:28:06.080 after hearing about the pointlessness of Facan's misery, they were worried. 0:28:08.000 --> 0:28:11.879 Doctor Roger Alberti, chief of surgery at the Provident Saint 0:28:11.960 --> 0:28:16.040 Vincent Medical Center, found that other surgeons doing the same 0:28:16.119 --> 0:28:20.399 surgery as Patel were having much better outcomes In the 0:28:20.480 --> 0:28:24.359