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Speaker 1: My name is Hedley Thomas. Sick to Death is based

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Speaker 1: on my book of the same name, and it's the

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Speaker 1: true story of doctor Jan Patel's lies and manipulation and

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Speaker 1: the herculean effort it took to finally stop him. We've

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Speaker 1: used voice actors throughout this series, and on occasion the

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Speaker 1: real people from the story have read their words for us.

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Speaker 1: It is brought to you by Me and the Australian.

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Speaker 1: Chapter twenty four, The Outpouring October to November two thousand

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Speaker 1: and four, Tony Hoffman finally lost patience with her smug

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Speaker 1: and unresponsive managers. Her more than enough about the merits

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Speaker 1: of mediation. She did not want psychological counseling. She felt

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Speaker 1: patronized by all the talk about personality conflict with Jon Patel,

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Speaker 1: and she was angry that the nurse unit manager, Linda

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Speaker 1: Mulligan believed the problems on the wards and in the

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Speaker 1: intensive care unit might be fixed by a book called

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Speaker 1: Coping with Difficult People. Doctor Darren Keating had convinced himself

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Speaker 1: and others that much of the criticism of Patel was

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Speaker 1: the product of the surgeon's personality. Clash with Tony Hoffman.

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Speaker 1: On eighteen October, doctor Keating, Peter Leck, and Linda Mulligan

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Speaker 1: met to talk about the problems. They agreed that there

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Speaker 1: needed to be mediation. The constant bickering was having an

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Speaker 1: impact on the operations of the intensive care unit. Keating

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Speaker 1: was fed up with the stream of complaints against the

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Speaker 1: star surgeon. He made time in his diary to meet

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Speaker 1: Patel and Hoffman together. He doubted he could resolve their feud,

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Speaker 1: but he might be able to placate them for a while.

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Speaker 1: Keating had made no secret of his admiration for Patel.

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Speaker 1: Hoffman believed that it verged on sicker fancy. As Keating

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Speaker 1: told one of the ICU nurses in doctor Pateel's presence

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Speaker 1: outside the hospital canteen.

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Speaker 2: When you get to be as great as this man,

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Speaker 2: you can do what you want.

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Speaker 1: When Linda Mulligan again raised unresolved behavior and communication issues,

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Speaker 1: shortly before lunch on twenty October, Tony Hoffman made her

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Speaker 1: most forceful effort yet to bring about decisive action.

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Speaker 3: Doctor Petel's the patient for dying because of his care.

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Speaker 1: Hoffman knew that her career would probably stall or even end,

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Speaker 1: but to hell with it. In an angry outburst, she

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Speaker 1: spoke about Petel's dishonesty in describing the condition of patients,

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Speaker 1: how doctor Peter Meak refused to let his patients undergo

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Speaker 1: procedures by the Director of Surgery, and how the number

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Speaker 1: of post operative complications was without precedent. A few hours later,

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Speaker 1: in a hastily called meeting in Peter Leck's office, Tony

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Speaker 1: Hoffman repeated the serious allegations. She also told Lek about

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Speaker 1: Petel's stubborn refusal to observe hygiene and how a probable

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Speaker 1: consequence wound to Hastens from infection was not properly reported

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Speaker 1: in the patient's notes because Patel knew it would give

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Speaker 1: clues to his negligence.

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Speaker 3: Hoffman told Leck the death of mister Bramach was the

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Speaker 3: last straw. They may come back and say he would

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Speaker 3: have died anyway, but that isn't the point. It was

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Speaker 3: about Dr Pateell interfering in the process that would have

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Speaker 3: got the patient to Brisbane in time for him to

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Speaker 3: have the best chance.

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Speaker 1: Hoffman reminded Leck of how she had gone to him

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Speaker 1: eight months earlier with her concerns about doctor Petel's behavior,

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Speaker 1: and how she and doctor John Joyner had warned doctor

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Speaker 1: Keating about the dangers of the esophagectames. In mid two

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Speaker 1: thousand and three, she repeated other disturbing clues to Petel's incompetence,

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Speaker 1: including evidence of the harm caused to patients in the

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Speaker 1: renal unit because of his ineptitude with the placement of catheters.

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Speaker 1: Hoffman gave the district manager an ultimatum unless there was

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Speaker 1: a rigorous and independent audit of the outcomes for Petel's patients,

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Speaker 1: she would be forced to take further steps. As she

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Speaker 1: told Leck, I'm.

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Speaker 3: Quite happy to be proven wrong.

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Speaker 1: In an email to people two days later, she documented

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Speaker 1: the details of unnecessary suffering by a dozen of Beateell's patients.

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Speaker 3: I spoke with doctor Dieter Barons and informed him the

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Speaker 3: nursing staff were going to report their concerns with Dr

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Speaker 3: Petell to an official source. He stated he would support

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Speaker 3: us by telling the truth, but he was concerned he

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Speaker 3: would lose his job and Dr patell would be the

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Speaker 3: one left behind. It is widely believed among the medical

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Speaker 3: and nursing staff that Dr Petell was very powerful, that

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Speaker 3: he was wholeheartedly supported by Peter Leck and Darren Keating,

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Speaker 3: and was untouchable anyone who tried to alert the authorities

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Speaker 3: about their concerns would lose their jobs. This perception was

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Speaker 3: indeed perpetrated by Dr Petell on a daily basis. Many

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Speaker 3: of the principal house officers have expressed their concern doctor

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Speaker 3: Alex Davis and doctor David Risen, but were unsure of

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Speaker 3: what to do because of the wide spa read belief

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Speaker 3: Dr Patel was protected by executive.

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Speaker 1: On the day Lek received Hoffman's written report, doctor Keating

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Speaker 1: and doctor Miak had an angry row over Patel's competence,

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Speaker 1: but still nothing was done to restrict any of Patel's work.

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Speaker 1: The surgical wards were full of patients. They were still

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Speaker 1: being led into theater like lambs to a slaughter. Leck

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Speaker 1: briefly considered suspending Patel on full pay, but Patel was

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Speaker 1: much too valuable to the hospital and the campaign to

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Speaker 1: reduce the waiting lists for surgery. Lek brought time. He

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Speaker 1: decided to test Hoffmann's serious allegations. Lek and Keating interviewed

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Speaker 1: doctor Dieter Bearns, one of the anesetus, who questioned Patel's

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Speaker 1: competence and judgment in undertaking some operations. Doctor Barons bluntly

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Speaker 1: described Patel as dishonest about his mistakes and so rigid

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Speaker 1: he refused to consider alternative and safe clinical options for

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Speaker 1: the patients. Doctor David Risson, a relatively junior doctor, revealed

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Speaker 1: that he had concerns about the number of post operative

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Speaker 1: complications and infections. Patel's dismantling of one of the reporting

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Speaker 1: mechanisms meant that the surgical audit process was a bad joke.

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Speaker 1: When doctor Risson had previously raised a wounddhesiance, Peatel tried

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Speaker 1: to change the definition of dhesiince Patel had said.

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Speaker 4: We should be careful what we call woundhesions and what

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Speaker 4: we're class Woundehessins.

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Speaker 1: The director of surgery, was trying to minimize the number

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Speaker 1: of complications being recorded. The next doctor to be interviewed,

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Speaker 1: Martin Strawn, had nothing to lose for speaking his mind.

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Speaker 1: He was a visiting medical officer who helped out at

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Speaker 1: the hospital when he had time away from his full

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Speaker 1: time job elsewhere. He described Patel's misdiagnosis of a woman

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Speaker 1: upon whom the Director of surgery was determined to perform

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Speaker 1: an extremely complex Whipple's procedure. She died several days later.

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Speaker 1: Martin Strawn was convinced that Patel believed he was invincible,

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Speaker 1: a Johnny come Lately, as the doctor called Patel, but

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Speaker 1: with aggressive trays, who was strongly supported by management to

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Speaker 1: take a scalpel to the waiting lists. Doctor Strawn also

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Speaker 1: emphasized the dangerous vacuum into which Patel had arrived. The

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Speaker 1: director of surgery, who saw himself as a self declared

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Speaker 1: expert from the first world to help the third world

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Speaker 1: of Bunderberg, had been permitted to operate without any form

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Speaker 1: of peer review. Keating and Les did not bother asking

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Speaker 1: doctor Meak, the most qualified and experienced specialist in the district,

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Speaker 1: but in early November two thousand and four, doctor Meak

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Speaker 1: handed to Keating another scathing indictment of doctor Patel. It

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Speaker 1: was a letter written by doctor Jason Jenkins, a vascular

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Speaker 1: surgeon at the Royal Brisbane Hospital who was held in

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Speaker 1: high regard for his specialist skills and integrity. He sent

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Speaker 1: it to doctor Meak and to Patel. Only rarely would

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Speaker 1: doctor's blast colleagues in writing over the care of patients,

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Speaker 1: but doctor Jenkins was enraged after he examined Marylyn Daisy

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Speaker 1: on one November for her diabetes problems. When he saw

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Speaker 1: Marylyn Daisy, doctor Jenkins asked the.

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Speaker 5: Question, when did you get that done?

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Speaker 1: Doctor Jenkins asked, when he saw the bandage on her

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Speaker 1: below knee amputation.

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Speaker 2: Six weeks ago, do you mind if I have a

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Speaker 2: look at it? Has it not healed yet?

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Speaker 1: It was clear that not only had the wound not healed,

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Speaker 1: the sutures were still in Daisy's amputation stump. Six weeks later,

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Speaker 1: there was also an area of gangrene.

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Speaker 5: So have you seen the surgeon since the operation? What's

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Speaker 5: you going to do about this? Did he offer you

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Speaker 5: a chance of saving your leg?

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Speaker 3: I haven't seen the surgeon since the procedure. No, they

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Speaker 3: just said that I need my leg off.

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Speaker 1: Patel had not offered Daisy the option of trying to

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Speaker 1: save her leg with a bypass operation. In his letter,

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Speaker 1: Jenkins wrote.

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Speaker 5: These suitures were heavily buried within the tissue and very

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Speaker 5: difficult and painful to remove. I find it mind boggling

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Speaker 5: that someone could leave sutures in for this long. It

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Speaker 5: shows a complete lack of understanding of diabetic disease and

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Speaker 5: how to form an operation. I have suggested to her

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Speaker 5: that when she comes to Brisbane that she will require

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Speaker 5: a de bridement of this stump, and if it fails

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Speaker 5: to heal, then she may require an above knee amputation.

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Speaker 5: I think if procedures can't be performed appropriate with the

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Speaker 5: Bunderberg Hospital, then they should not be performed at all.

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Speaker 1: In the months before days he sought help in Brisbane,

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Speaker 1: Jenkins had noted a disturbing pattern in patients who underwent

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Speaker 1: vascular surgery by Patel. Jenkins quickly determined that the director

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Speaker 1: of surgery was doing more harm than good. He was

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Speaker 1: astounded when doctor Peter Meak told him how he had

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Speaker 1: tried to stop Patel, but to no avail. Patel would

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Speaker 1: go and find patients in the wards and operate without

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Speaker 1: meac knowing. Before writing the letter, Jenkins telephoned Patel and

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Speaker 1: threatened to report him to the medical board if he

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Speaker 1: kept doing vascular work.

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Speaker 5: Look, you know, if you keep doing this then there

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Speaker 5: are going to be consequences.

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Speaker 1: But Patel was unmoved. For as long as the hospital

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Speaker 1: let him do such operations, he had no intention of stopping.

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Speaker 1: Peter Meak gave doctor Keating the written complaint on the

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Speaker 1: same day that the Health Practitioner's Tribunal in Brisbane was

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Speaker 1: delivering its own verdict. The wheels of justice had turned

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Speaker 1: slowly for Elise Neville, her parents, and doctor Andrew Donovan,

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Speaker 1: who was pleading guilty to unsatisfactory professional conduct to save

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Speaker 1: himself and his family further trauma and crippling legal fees.

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Speaker 1: In her findings, District Court Judge DeBie Richards wrote.

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Speaker 6: The tragedy has had an enormous impact on the Neville

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Speaker 6: family and no doubt others who knew and loved young Elise.

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Speaker 6: Doctor Donovan must have been fatigued by the hours he

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Speaker 6: was working. It seems extraordinary in this day and age

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Speaker 6: that anyone, let alone someone in a position of such responsibility,

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Speaker 6: should be asked to work such long hours. One does

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Speaker 6: not need medical evidence to know that anyone who's in

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Speaker 6: the twentieth hour of a continuous duty must have reduced

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Speaker 6: capacity to assess the situation when it presents itself. If

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Speaker 6: this tragedy leads to nothing else, it should lead to

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Speaker 6: the abolition of such brutally long shift hours.

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Speaker 1: Judge Richards concluded that Andrew Donovan's treatment of Elease was

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Speaker 1: deficient in a number of respects.

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Speaker 6: She ruled his interpretation of the history and physical findings

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Speaker 6: based on limited examination and his lack of appreciation of

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Speaker 6: the parents' concerns were wrong and errors of judgment which

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Speaker 6: eventually denied at least the chance of survival. Accordingly, the

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Speaker 6: Tribunal concurs with the board submissions that stringent conditions should

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Speaker 6: be placed on doctor Donovan's continuing right now to practice.

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Speaker 1: The disciplinary orders compelled doctor Andrew Donoman to work in

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Speaker 1: a supervised position for twelve months with ongoing assessment and

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Speaker 1: reporting of his competence to assess patients. After the delivery

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Speaker 1: of the judgment, I walked to a nearby cafe to

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Speaker 1: talk to Gered and Lorraine. They still had unfinished business.

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Speaker 1: Gered pledged the system was yet to reform itself. When

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Speaker 1: the pain in Trevor Holter's stomach had become too much,

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Speaker 1: he went to see his GP doctor Ken Hornsby. At

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Speaker 1: fifty four, Halter regarded himself as being in reasonably good shape,

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Speaker 1: as fit as a Malley bull, he half jokingly boasted,

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Speaker 1: but the pain was constant. Even Halter, a part time

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Speaker 1: race caller who rolled beer kegs around the club where

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Speaker 1: he did odd jobs, had to concede he needed help.

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Speaker 1: Dr Hornsby wrote a referral letter for him to attend

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Speaker 1: the patients department at Bunderberg Hospital. Trevor Halter had gallstones. Fortunately,

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Speaker 1: he learned that the condition was easily remedied. J. N.

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Speaker 1: Patel spoke to.

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Speaker 4: Him, you're probably better off having your golde blooder out

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Speaker 4: because you don't really need it, and so you may

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Speaker 4: as well have it out. I do four to five

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Speaker 4: a week and there's nothing to it. It's keyhold surgery.

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Speaker 1: The routine corrective procedure laparoscopic color systectomy was on a

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Speaker 1: par with having your tonsils out. Trevor Halter learned that

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Speaker 1: he would need to stay just one night in the

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Speaker 1: hospital after the operation, he awoke in agony. He spent

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Speaker 1: the next seven weeks in hospital. Two of those weeks

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Speaker 1: were in the intensive care unit as he fought for

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Speaker 1: his life. His children were told his lungs had collapsed,

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Speaker 1: his liver had failed, and he contracted pneumonia and septo semia.

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Speaker 1: Then his heart went. He was finally transferred by helicopter

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Speaker 1: to Brisbane on four December for life saving treatment, all

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Speaker 1: from a routine gallbladder operation bungled by doctor Patel. Months later,

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Speaker 1: Halter was still in pain and undergoing corrective surgery, Chapter

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Speaker 1: twenty five, The blood Letting. December two thousand and four,

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Speaker 1: when Judy and Jerry Kemps looked back on their lives

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Speaker 1: and the fruits of a close marriage of fifty years,

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Speaker 1: they felt blessed. They were weared on twenty three October

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Speaker 1: nineteen fifty four in Saint Patrick's Cathedral, rule in Melbourne.

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Speaker 1: Judy had given birth to three healthy and happy children, Jackie,

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Speaker 1: John and Bernie. They had relaxed into the gentle pace

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Speaker 1: and tranquility of Bunderberg after a stint overseas. They set

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Speaker 1: up a photographic studio and continued to raise their three children.

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Speaker 1: The couple remained active as they aged. They went bushwalking

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Speaker 1: together and enjoyed regular tennis and golf. Kemps was one

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Speaker 1: of those fortunate people who never had a sick day

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Speaker 1: in his life, but by two thousand and two his

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Speaker 1: health began to deteriorate. His blood pressure was erratic, he

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Speaker 1: got gout, he suffered back pain. When he received a

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Speaker 1: letter from Queensland Health offering a free checkup, an appointment

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Speaker 1: was made at the local Burrham Street medical practice. The

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Speaker 1: tests on his urine sample pointed to a problem as

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Speaker 1: they ate lunch. Ten days later, Judy told her husband,

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Speaker 1: you look yellow.

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Speaker 4: You look anemic to me.

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Speaker 1: By six December, further tests at Bunderberg Hospital showed that

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Speaker 1: Kemps was bleeding internally. The endoscope had identified a large

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Speaker 1: malignant tumor about four centimeters in size in the lower esophagus.

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Speaker 1: The CT scans showed that the cancer had spread beyond

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Speaker 1: the esophagus. There were shadows on both lungs. There were

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Speaker 1: enlarged lymph nodes where the trachea splits into the left

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Speaker 1: and right main branches. Dr Dorge Smallburger was adamant that

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Speaker 1: Kemps needed to go to Brisbane for keyhole surgery. Nothing

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Speaker 1: too radical was proposed. The cancer was such that the

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Speaker 1: patient might have just twelve months to live. Under the circumstances,

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Speaker 1: Dr Smalberger wanted to ensure Jerry Kemps received the best

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Speaker 1: care and quality of life possible for the time he

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Speaker 1: had left. He did not contemplate an aesophagectomy, even for

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Speaker 1: a highly competent surgeon. Such a complex procedure was far

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Speaker 1: too risky, but with the presence of secondary cancers, it

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00:19:20,480 --> 00:19:25,280
Speaker 1: was also pointless. Dr Smolberger decided that the best course

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Speaker 1: of action was a stent to make it easier for

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Speaker 1: Jerry Kemp's to swallow his food. The protocol for a

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Speaker 1: transfer of a patient from Bunderberg to another hospital surgical

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Speaker 1: department required the decision to be signed off by a

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Speaker 1: surgeon in Bunderberg. Unfortunately, for Jerry Kemps, he was seen

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Speaker 1: by Jayan Patel. The safe and conservative course was suddenly

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Speaker 1: turned on its head by the director of surgery. Patel

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00:19:56,680 --> 00:20:00,399
Speaker 1: told the couple that the keyhole surgery recommended by doctor

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Speaker 1: Smallberger was just patch up work, and that what he

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00:20:04,720 --> 00:20:10,240
Speaker 1: really needed was an esophagectomy. Patel explained how he would

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Speaker 1: remove part of the stomach and part of the esophagus

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Speaker 1: and join what was left back together again, no problems.

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Speaker 4: It is the big operation, but it is nothing because

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00:20:21,880 --> 00:20:23,440
Speaker 4: I've done hundreds of them.

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Speaker 1: His confidence was contagious. Neither Kemp's nor his wife was

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Speaker 1: given any reason to doubt Patel. Theater nurse Damien Gadds

285
00:20:35,560 --> 00:20:38,600
Speaker 1: went to work early to start preparing for the operation

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00:20:38,720 --> 00:20:42,520
Speaker 1: on Jerry Kemp's, but there was a problem. The intensive

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00:20:42,600 --> 00:20:47,640
Speaker 1: care unit already had two patients on ventilators. They would

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00:20:47,640 --> 00:20:52,320
Speaker 1: be unable to cope with Jerry. Nurse Gads called doctor

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00:20:52,400 --> 00:20:57,240
Speaker 1: Deta Berens, who agreed the operation should be postponed, But

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00:20:57,320 --> 00:21:01,399
Speaker 1: when Gads reached Jayon Patel on his mobile telephone, the

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00:21:01,480 --> 00:21:05,119
Speaker 1: director of surgery was furious.

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Speaker 4: That brin dead beat and should have been switched off

293
00:21:06,720 --> 00:21:07,160
Speaker 4: last night.

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Speaker 1: At eight pm. The day before, Patel had told a

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Speaker 1: nurse to call doctor John Joyner and ask him to

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00:21:14,960 --> 00:21:18,320
Speaker 1: turn off the life support keeping a critically ill woman,

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00:21:18,640 --> 00:21:24,439
Speaker 1: Robin Turton, sixty three alive. Turton had slipped in the

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00:21:24,520 --> 00:21:29,040
Speaker 1: bath and hit her head on Saturday, suffering a cerebral bleed.

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00:21:30,200 --> 00:21:33,880
Speaker 1: Her family was aware that her prospects were poor. Her

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00:21:33,960 --> 00:21:37,240
Speaker 1: death would free up an ICU bed, and could tell

301
00:21:37,400 --> 00:21:43,360
Speaker 1: wanted it for Jerry Kemp's, but Joyner flatly refused. He

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00:21:43,560 --> 00:21:46,679
Speaker 1: was offended at the indecent haste to end the life

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00:21:46,720 --> 00:21:49,720
Speaker 1: of a woman who had not yet undergone formal brain

304
00:21:49,840 --> 00:21:55,040
Speaker 1: death tests. Although it was probable from the CT scans

305
00:21:55,080 --> 00:21:59,840
Speaker 1: that she was brain dead, doctor Joyner prudently decided to wait.

306
00:22:01,640 --> 00:22:05,720
Speaker 1: Patel had little time for doctor Joyner, the anesthetist who

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00:22:06,000 --> 00:22:09,679
Speaker 1: eighteen months earlier had express concern to management about the

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00:22:09,840 --> 00:22:13,600
Speaker 1: risks of performing aesophagectamies in a small hospital with a

309
00:22:13,640 --> 00:22:21,000
Speaker 1: limited icee you. As Patel did his ward rounds on

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Speaker 1: Monday morning, he bad mouthed doctor Joyner. Patel told Martin Brennan,

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00:22:27,119 --> 00:22:27,480
Speaker 1: one of.

312
00:22:27,440 --> 00:22:29,960
Speaker 4: The nurses, I have a theater chise to do.

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00:22:31,080 --> 00:22:34,600
Speaker 1: The theater nurse was astonished at Patel's cavalier approach to

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00:22:34,760 --> 00:22:38,560
Speaker 1: ending Turton's life before the necessary brain death tests had

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00:22:38,640 --> 00:22:43,760
Speaker 1: been done. Martin Brennan did not trust doctor Patel. He

316
00:22:43,840 --> 00:22:47,640
Speaker 1: had heard the surgeon intimidate and bully the nurses and

317
00:22:47,760 --> 00:22:52,160
Speaker 1: threaten to harm their careers. Patel had created a climate

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00:22:52,200 --> 00:22:55,639
Speaker 1: of fear in the operating theater and in the intensive

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00:22:55,720 --> 00:22:59,720
Speaker 1: care unit. All the nurses doubted that they would be

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00:22:59,760 --> 00:23:04,000
Speaker 1: bad by management. In a showdown, as Patel often boasted

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Speaker 1: of his influence over Darren keating.

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00:23:07,640 --> 00:23:09,520
Speaker 4: I can get what I want from Darren as I've

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00:23:09,600 --> 00:23:12,320
Speaker 4: just made this hospital five hundred thousand dollars.

324
00:23:13,440 --> 00:23:18,080
Speaker 1: Patel stormed into doctor Martin Carter's office and denounced doctor Joyner.

325
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Speaker 1: He pressured Carter to end Robin Turton's life and free

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00:23:22,800 --> 00:23:28,040
Speaker 1: up a bed for the esophagectomy. Nurse Vivian Tapiolus witnessed

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00:23:28,040 --> 00:23:32,000
Speaker 1: Betel's insistence on the withdrawal of life support for Turton,

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00:23:32,359 --> 00:23:35,600
Speaker 1: whose children were in the waiting room at the ICU,

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00:23:36,000 --> 00:23:40,679
Speaker 1: as Pateel pressed doctor Carter to make a decision. After

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00:23:40,720 --> 00:23:44,680
Speaker 1: a review of the charts, Tapiolus and the two doctors

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00:23:44,680 --> 00:23:49,840
Speaker 1: spoke to the family about ending Turton's life. Patel walked

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00:23:49,880 --> 00:23:53,080
Speaker 1: back into the ICU with a spring in his step.

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00:23:54,320 --> 00:23:56,280
Speaker 4: Now I can perform the esophagectomy.

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00:23:57,640 --> 00:24:01,359
Speaker 1: Doctor Carter switched off life support at eight fifty five

335
00:24:01,440 --> 00:24:06,399
Speaker 1: am on Monday, despite the absence of the formal brain

336
00:24:06,520 --> 00:24:11,080
Speaker 1: death tests. Carter decided that there was sufficient clinical evidence

337
00:24:11,119 --> 00:24:15,879
Speaker 1: to show Turton had suffered massive and irreparable brain damage.

338
00:24:16,440 --> 00:24:20,720
Speaker 1: He wrote, in view of the dreadful prognosis this lady

339
00:24:20,800 --> 00:24:25,399
Speaker 1: has and following discussion with family, ventilator support is to

340
00:24:25,400 --> 00:24:31,960
Speaker 1: be withdrawn. Importantly, for Patel, he now had a spare bed.

341
00:24:33,560 --> 00:24:36,959
Speaker 1: At nine to fifty two am on Monday, twenty December,

342
00:24:37,280 --> 00:24:39,959
Speaker 1: less than an hour after the death of Robin Turton,

343
00:24:40,359 --> 00:24:44,960
Speaker 1: the operation on Jerry Kemp's began. Patel was flanked in

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00:24:45,080 --> 00:24:50,320
Speaker 1: theater by the anesthetis doctor Dieter Behrens, two principal House officers,

345
00:24:50,480 --> 00:24:57,080
Speaker 1: doctor Sanjeeva carr Owasam and doctor Anthony Athanasiov and the nurses.

346
00:24:58,400 --> 00:25:01,760
Speaker 1: Doctor Karyoasam had spent much of his time at the

347
00:25:01,840 --> 00:25:07,119
Speaker 1: hospital as Patel's shadow. They got along well. Patel was

348
00:25:07,119 --> 00:25:11,040
Speaker 1: only too happy to explain the complexities of surgery to

349
00:25:11,160 --> 00:25:15,840
Speaker 1: his eager apprentice. Together they used to undertake what Patel

350
00:25:15,880 --> 00:25:19,520
Speaker 1: would call a blitz. In one week, there would be

351
00:25:19,520 --> 00:25:23,880
Speaker 1: a swag of colonoscopy procedures. In another week there would

352
00:25:23,880 --> 00:25:27,879
Speaker 1: be a run of gallbladder operations. It was part of

353
00:25:27,920 --> 00:25:31,879
Speaker 1: Patel's ongoing assault on the waiting lists, and it kept

354
00:25:31,960 --> 00:25:37,040
Speaker 1: him in management's good books. Korea Withsam often heard Patel

355
00:25:37,200 --> 00:25:40,840
Speaker 1: boasting about how successful he had been in reducing the

356
00:25:40,880 --> 00:25:46,879
Speaker 1: lists and establishing rapport with Keating. The esophagectomy appeared to

357
00:25:46,920 --> 00:25:50,639
Speaker 1: go well at first. Jerry Kemps's abdomen needed to be

358
00:25:50,760 --> 00:25:56,520
Speaker 1: opened to permit access to the esophagus and the stomach. Suddenly, however,

359
00:25:56,680 --> 00:26:00,840
Speaker 1: he became unstable with plunging blood pressure and a rising

360
00:26:00,960 --> 00:26:05,600
Speaker 1: pulse rate. Kemp's was turned onto his side for the

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00:26:05,680 --> 00:26:11,160
Speaker 1: thorochotomy part the opening of the chest cavity. As Patel

362
00:26:11,280 --> 00:26:14,959
Speaker 1: resected the tumor in the chest. The blood continued to

363
00:26:15,000 --> 00:26:19,159
Speaker 1: pour freely into the drain. The heavy bleeding in the

364
00:26:19,200 --> 00:26:24,480
Speaker 1: abdominal cavity was obvious to everyone. Doctor Barons was worried.

365
00:26:25,040 --> 00:26:27,560
Speaker 1: Apart from the blood loss, he could see that the

366
00:26:27,640 --> 00:26:31,120
Speaker 1: director of surgery lacked the skill to be attempting such

367
00:26:31,119 --> 00:26:36,160
Speaker 1: an operation. Patel's roughness around the heart and the vessels

368
00:26:36,359 --> 00:26:40,720
Speaker 1: was all too obvious, nor did he appear interested in

369
00:26:40,760 --> 00:26:44,160
Speaker 1: the monitoring being done by doctor Barons of blood pressure

370
00:26:44,520 --> 00:26:49,879
Speaker 1: and other vital signs. Barons was shocked. It was as

371
00:26:49,960 --> 00:26:54,399
Speaker 1: if Patel could not acknowledge a major problem. Unless the

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00:26:54,480 --> 00:26:59,920
Speaker 1: blood stopped flowing, Kemps would surely die. Nurse Damien Gas

373
00:27:00,480 --> 00:27:04,800
Speaker 1: raised the alarm. Dr Patel, the Bellovac draine is over

374
00:27:04,880 --> 00:27:08,320
Speaker 1: half full with no vacuum and is still draining freely.

375
00:27:09,480 --> 00:27:11,360
Speaker 4: That's what dreams are forward Demian.

376
00:27:12,600 --> 00:27:15,800
Speaker 1: To the amazement of doctor Barons and the theater nurses,

377
00:27:15,880 --> 00:27:19,960
Speaker 1: who were alarmed by the obvious and heavy bleeding, Patel

378
00:27:20,040 --> 00:27:24,760
Speaker 1: gave instructions for Kemps to go to the ICU. From

379
00:27:24,800 --> 00:27:28,440
Speaker 1: that moment it was inevitable that he would not survive.

380
00:27:29,800 --> 00:27:33,920
Speaker 1: At two PM, Patel called Judy at her home. He

381
00:27:33,960 --> 00:27:37,679
Speaker 1: told her it was a great success. We've got it all.

382
00:27:38,440 --> 00:27:40,639
Speaker 1: There's a little bit of bleeding there, but that's nothing.

383
00:27:42,240 --> 00:27:45,880
Speaker 1: When Judy went to the intensive care unit soon afterwards,

384
00:27:46,000 --> 00:27:50,320
Speaker 1: she saw a nurse frantically pumping blood into her husband's body.

385
00:27:51,359 --> 00:27:55,200
Speaker 1: Jerry Kemps received more than thirty bags of blood altogether.

386
00:27:56,119 --> 00:28:01,440
Speaker 1: His abdomen was distended as bright blood drained away. Three

387
00:28:01,520 --> 00:28:05,560
Speaker 1: nurses were needed at his bedside for fluid management, and

388
00:28:05,680 --> 00:28:08,359
Speaker 1: one ran back and forth from the blood bank for

389
00:28:08,480 --> 00:28:13,200
Speaker 1: products and to page the doctors. Doctor Barons was using

390
00:28:13,359 --> 00:28:16,879
Speaker 1: large quantities of a drug to maintain blood pressure and

391
00:28:16,920 --> 00:28:21,920
Speaker 1: support the heart. Another nurse took Judy aside and told

392
00:28:21,960 --> 00:28:25,600
Speaker 1: her Jerry is a very sick man and he is

393
00:28:25,640 --> 00:28:30,880
Speaker 1: on life support. Judy, joined by her son John, went

394
00:28:31,040 --> 00:28:35,199
Speaker 1: over to his bedside and gave Jerry a kiss. I

395
00:28:35,280 --> 00:28:40,520
Speaker 1: love you, she said. He tried to sit up. At

396
00:28:40,560 --> 00:28:44,760
Speaker 1: five pm, Judy was told of the need for another operation.

397
00:28:45,720 --> 00:28:48,000
Speaker 4: I have to take him back into theater again. It

398
00:28:48,040 --> 00:28:50,800
Speaker 4: can only be the spleen. I'll dig it out because

399
00:28:50,800 --> 00:28:51,840
Speaker 4: he doesn't need it anyway.

400
00:28:52,960 --> 00:28:56,640
Speaker 1: But Patel had begun another operation on a different patient,

401
00:28:56,920 --> 00:29:01,520
Speaker 1: which led to another complication. Kemps was not taken back

402
00:29:01,600 --> 00:29:07,040
Speaker 1: into theatre until after six thirty pm. The situation was

403
00:29:07,120 --> 00:29:11,200
Speaker 1: critical when doctor David Risson, who had not been involved

404
00:29:11,280 --> 00:29:15,880
Speaker 1: in the esophagectomy, came to theatre to help. Doctor Risson

405
00:29:16,080 --> 00:29:20,760
Speaker 1: was surprised to see doctor Sanjeeva Carrio asam a junior doctor,

406
00:29:21,160 --> 00:29:25,760
Speaker 1: identifying problems and tactfully pointing them out to Patel, who

407
00:29:25,800 --> 00:29:28,560
Speaker 1: seemed out of his depth and at a loss to

408
00:29:28,640 --> 00:29:35,360
Speaker 1: pinpoint the torrential bleeding. Patel reopened Jerry's abdominal cavity and

409
00:29:35,440 --> 00:29:40,880
Speaker 1: the chess cavity. As scout nurse Janelle Law's tasks included

410
00:29:40,920 --> 00:29:45,360
Speaker 1: finding sutures, sponges, and anything else that might be needed

411
00:29:45,400 --> 00:29:49,240
Speaker 1: for the operation. Janelle lost track of the amount of

412
00:29:49,320 --> 00:29:53,360
Speaker 1: blood spilling from Kemps on the operating table, but she

413
00:29:53,480 --> 00:29:58,320
Speaker 1: counted seventy five large sponges and fifteen gauze squares to

414
00:29:58,400 --> 00:30:03,480
Speaker 1: absorb the blood. It was everywhere. As the nurses moved

415
00:30:03,480 --> 00:30:06,880
Speaker 1: around theater, they left footsteps of blood on the floor.

416
00:30:07,720 --> 00:30:10,320
Speaker 4: This man's going to die. He's going to die on

417
00:30:10,360 --> 00:30:13,840
Speaker 4: the deva. I can't do anything. Get the family, Get

418
00:30:13,840 --> 00:30:14,360
Speaker 4: the family.

419
00:30:15,440 --> 00:30:20,560
Speaker 1: Janelle Law watched Patel becoming more agitated, defending his surgery

420
00:30:20,600 --> 00:30:24,120
Speaker 1: and saying that the bleeding had nothing to do with him.

421
00:30:24,440 --> 00:30:27,040
Speaker 4: This isn't my fault. This has nothing to do with

422
00:30:27,040 --> 00:30:29,400
Speaker 4: my surgery. This isn't my fault.

423
00:30:30,680 --> 00:30:34,680
Speaker 1: But Patel also had a rare moment of insight. He

424
00:30:34,920 --> 00:30:39,080
Speaker 1: was shaken by the demise of Jerry Kemp's He said

425
00:30:39,120 --> 00:30:40,640
Speaker 1: in the operating theater.

426
00:30:41,640 --> 00:30:46,360
Speaker 4: Maybe they're right. Maybe we shouldn't be doing aesophagectamies. Maybe

427
00:30:46,360 --> 00:30:48,720
Speaker 4: I should start thinking about not doing these type of

428
00:30:48,760 --> 00:30:49,720
Speaker 4: procedures anymore.

429
00:30:50,880 --> 00:30:54,880
Speaker 1: Janelle Law opened the theater door for Patel to go outside

430
00:30:54,960 --> 00:30:58,520
Speaker 1: to talk to Judy and her two sons. Patel was

431
00:30:58,640 --> 00:31:00,320
Speaker 1: covered in his patient's blood.

432
00:31:01,560 --> 00:31:03,440
Speaker 4: I've taken the spleen out, but it was all right.

433
00:31:04,080 --> 00:31:05,480
Speaker 4: I had a look at the lungs and they were

434
00:31:05,520 --> 00:31:07,600
Speaker 4: all right. So the bleeding must have come from the

435
00:31:07,680 --> 00:31:11,280
Speaker 4: hot I can't do anything about it, but he will

436
00:31:11,360 --> 00:31:12,280
Speaker 4: be lucky to last the.

437
00:31:12,280 --> 00:31:17,479
Speaker 1: Night, Patel repeatedly told the shocked Kemp's family that his

438
00:31:17,640 --> 00:31:24,000
Speaker 1: surgery was perfect. The longest night in Judy's life was

439
00:31:24,040 --> 00:31:28,400
Speaker 1: spent with her dying husband in Tony Hoffman's intensive care unit.

440
00:31:29,400 --> 00:31:35,640
Speaker 1: Jerry's demise was inevitable. The equipment supporting him was gradually removed.

441
00:31:37,040 --> 00:31:42,800
Speaker 1: Judy noticed something else. The nursing staff seemed strangely uncomfortable

442
00:31:42,800 --> 00:31:48,560
Speaker 1: around her. Their body language was defensive, they avoided eye contact.

443
00:31:52,200 --> 00:31:55,600
Speaker 1: Jerry Camps died at nine to twenty am on twenty

444
00:31:55,640 --> 00:32:00,640
Speaker 1: one December two thousand and four. Doctor Patel had notched

445
00:32:00,720 --> 00:32:05,760
Speaker 1: up another lucrative procedure for Bunderberg based hospital, which received

446
00:32:05,840 --> 00:32:10,600
Speaker 1: its financial bonus irrespective of whether the patient survived the operation,

447
00:32:11,800 --> 00:32:16,160
Speaker 1: and the intensive care unit bed was vacant again already.

448
00:32:17,880 --> 00:32:22,560
Speaker 1: Doctor Athanasiov, given the task of filling in the death certificate,

449
00:32:22,760 --> 00:32:26,720
Speaker 1: was discouraged by Patel from referring the case to the coroner.

450
00:32:27,600 --> 00:32:29,640
Speaker 4: We know the cause of death. It was due to

451
00:32:29,680 --> 00:32:30,760
Speaker 4: a bleed in the aoder.

452
00:32:32,040 --> 00:32:37,000
Speaker 1: The theater staff were furious with Patel. Doctor Barons was alarmed.

453
00:32:37,440 --> 00:32:41,000
Speaker 1: He could not understand why Patel would send a bleeding

454
00:32:41,120 --> 00:32:45,560
Speaker 1: patient to the intensive care unit, nor could he understand

455
00:32:45,560 --> 00:32:50,280
Speaker 1: Patel's inability hours later to discover the source of the bleeding.

456
00:32:51,560 --> 00:32:55,320
Speaker 1: Doctor Barons and doctor Martin Carter agreed the death should

457
00:32:55,360 --> 00:33:00,240
Speaker 1: be reported for formal autopsy. The Coroner's act referred to

458
00:33:00,920 --> 00:33:05,160
Speaker 1: a death being reportable where it was not reasonably expected

459
00:33:05,200 --> 00:33:10,520
Speaker 1: to be the outcome of a health procedure. But by

460
00:33:10,560 --> 00:33:13,920
Speaker 1: the time the two anisthetis had come to this view

461
00:33:14,360 --> 00:33:18,680
Speaker 1: it was too late. A notice in the Bunderberg news

462
00:33:18,760 --> 00:33:22,120
Speaker 1: mail showed that Kemp's was being buried in a few hours.

463
00:33:23,280 --> 00:33:26,440
Speaker 1: Doctor Barons was struck by the lack of interest from

464
00:33:26,480 --> 00:33:30,720
Speaker 1: doctor Darren Keating when it came to investigating. Even when

465
00:33:30,800 --> 00:33:34,760
Speaker 1: doctor Carter explained his concerns about the survival rates of

466
00:33:34,840 --> 00:33:41,120
Speaker 1: Ptel's patients, Nurses Janelle Law and Damien Gadds decided to

467
00:33:41,160 --> 00:33:46,120
Speaker 1: make a formal complaint they believed doctor Petel had killed Kemps.

468
00:33:47,720 --> 00:33:51,520
Speaker 1: In the afternoon after Kemps's death, Peter Lex saw a

469
00:33:51,640 --> 00:33:56,000
Speaker 1: note blandly advising the outcome of the complex procedure performed

470
00:33:56,040 --> 00:34:00,680
Speaker 1: by the director of surgery. Leck asked doctor Keating a question.

471
00:34:01,800 --> 00:34:06,760
Speaker 7: The esophagectomy concerns me somewhat. Have any of these patients survived.

472
00:34:22,560 --> 00:34:27,520
Speaker 1: Chapter twenty six, Life and Limb Late December two thousand

473
00:34:27,600 --> 00:34:36,640
Speaker 1: and four to January two thousand and five, Shannon Mobs

474
00:34:36,640 --> 00:34:40,680
Speaker 1: fell spectacularly from his friend's trailbike at ten am on

475
00:34:40,840 --> 00:34:45,120
Speaker 1: twenty three December the day duty Kemp's farewelled her husband

476
00:34:45,200 --> 00:34:49,520
Speaker 1: at his funeral in Bunderberg. The teenager had struck a

477
00:34:49,600 --> 00:34:52,880
Speaker 1: tree stump hidden by long grass on a winding track

478
00:34:52,920 --> 00:34:57,080
Speaker 1: at Woodgate south of Bunderberg. The fifteen year old was

479
00:34:57,120 --> 00:35:01,400
Speaker 1: flown by helicopter to Bunderberg Hospital after his friend sped

480
00:35:01,480 --> 00:35:05,839
Speaker 1: ten kilometers along the track to raise the alarm. By

481
00:35:05,880 --> 00:35:08,719
Speaker 1: the time he was in the operating theater for life

482
00:35:08,800 --> 00:35:12,759
Speaker 1: saving surgery by Jayon Patel, the boy had lost a

483
00:35:12,840 --> 00:35:15,560
Speaker 1: massive amount of blood from a deep slash in his

484
00:35:15,680 --> 00:35:21,720
Speaker 1: groin an lacerated femeral vein in his thigh. His condition

485
00:35:21,960 --> 00:35:25,520
Speaker 1: was so perilous that the boy was initially transfused with

486
00:35:25,600 --> 00:35:28,560
Speaker 1: blood that did not match his type, but at least

487
00:35:28,560 --> 00:35:36,160
Speaker 1: it kept him alive. After the first operation, Patella merged

488
00:35:36,160 --> 00:35:41,640
Speaker 1: from theater to reassure Mobs's mother, Karen Oriole. The surgeon

489
00:35:41,680 --> 00:35:45,720
Speaker 1: talked about himself for the first ten minutes, falsely claiming

490
00:35:45,760 --> 00:35:48,279
Speaker 1: that he had been in charge of the trauma and

491
00:35:48,360 --> 00:35:51,600
Speaker 1: emergency ward of a New York hospital for a decade.

492
00:35:52,840 --> 00:35:56,640
Speaker 1: Karen Oriole was relieved when the director of surgery told

493
00:35:56,680 --> 00:36:00,319
Speaker 1: her he had stopped the bleeding. He assured her that

494
00:36:00,440 --> 00:36:03,799
Speaker 1: her son was fine and would make a complete recovery,

495
00:36:04,640 --> 00:36:10,760
Speaker 1: all thanks to Patel's vascular surgery. Over the next twelve hours,

496
00:36:11,040 --> 00:36:17,000
Speaker 1: Dr Pittell performed another two operations on Shannon Mobs. Despite

497
00:36:17,000 --> 00:36:21,920
Speaker 1: the initial life saving surgery and then serious complications demanding

498
00:36:22,200 --> 00:36:26,640
Speaker 1: more major surgery. Dr Pittell told the other doctors and

499
00:36:26,800 --> 00:36:29,960
Speaker 1: Karen Oriole that there was no need to transfer the

500
00:36:30,000 --> 00:36:34,399
Speaker 1: boy to Brisbane. Pettell left the hospital on Boxing Day

501
00:36:34,480 --> 00:36:37,920
Speaker 1: to fly to the United States for annual leave, but

502
00:36:38,000 --> 00:36:40,960
Speaker 1: not before instructing the medical staff to keep the boy

503
00:36:41,160 --> 00:36:45,960
Speaker 1: in the surgical ward. He had extracted something from Darren

504
00:36:46,040 --> 00:36:50,760
Speaker 1: Keating on Christmas Eve. It was another Dear j letter.

505
00:36:51,600 --> 00:36:54,600
Speaker 1: It set out the terms of a four year extension

506
00:36:54,719 --> 00:36:58,719
Speaker 1: of his current contract. Keating wrote, I.

507
00:36:58,719 --> 00:37:01,800
Speaker 2: Would like to offer my congrettions on your ongoing appointment

508
00:37:02,160 --> 00:37:04,880
Speaker 2: and hope that you'll work with the Bunderberg Health Service

509
00:37:04,960 --> 00:37:08,520
Speaker 2: District will continue to be both beneficial and rewarding.

510
00:37:10,120 --> 00:37:13,879
Speaker 1: The many serious issues raised by Tony Hoffman were yet

511
00:37:13,960 --> 00:37:18,440
Speaker 1: to be formally investigated. She was at home mourning the

512
00:37:18,520 --> 00:37:22,040
Speaker 1: death of her grandmother at ninety eight, preparing for the

513
00:37:22,120 --> 00:37:25,680
Speaker 1: funeral in Sydney and worrying about the condition of young

514
00:37:25,719 --> 00:37:30,000
Speaker 1: Shannon Mobs. Although Tony was supposed to be on annual

515
00:37:30,080 --> 00:37:34,720
Speaker 1: leave and entertaining her parents, her sister Marie and husband Matthew,

516
00:37:34,960 --> 00:37:37,839
Speaker 1: and their two kids, she could not let go of

517
00:37:37,880 --> 00:37:41,480
Speaker 1: the problems with Patel. She stayed in touch with the

518
00:37:41,640 --> 00:37:45,480
Speaker 1: hospital by telephone and repeatedly urged the nurses in the

519
00:37:45,520 --> 00:37:48,800
Speaker 1: intensive care unit to do what they could to influence

520
00:37:48,840 --> 00:37:50,120
Speaker 1: the transfer of Shannon.

521
00:37:50,920 --> 00:37:53,120
Speaker 3: You've got to get that boy to Brisbane.

522
00:37:54,239 --> 00:37:57,919
Speaker 1: Tony's brother in law, Matthew, was also worried. He could

523
00:37:57,960 --> 00:38:00,600
Speaker 1: see the high levels of stress that she was under

524
00:38:00,680 --> 00:38:04,480
Speaker 1: when she was supposed to be on holidays. Tony showed

525
00:38:04,560 --> 00:38:07,799
Speaker 1: him the lengthy letter of complaints she had written and

526
00:38:07,880 --> 00:38:10,800
Speaker 1: spoke to him about her pleas for a clinical audit.

527
00:38:12,160 --> 00:38:14,359
Speaker 1: He told her that at least you will be able

528
00:38:14,400 --> 00:38:18,320
Speaker 1: to sleep at night, but Hoffmann was finding sleep difficult

529
00:38:21,800 --> 00:38:24,640
Speaker 1: For most of the nine days Shannon Mobs remained in

530
00:38:24,719 --> 00:38:28,080
Speaker 1: the hospital. There was no pulse in his left foot.

531
00:38:29,080 --> 00:38:33,040
Speaker 1: The foot was dying. Contrary to the claims Patel had

532
00:38:33,080 --> 00:38:36,960
Speaker 1: made in the notes about repairing Mobs's femeral vein, he

533
00:38:37,040 --> 00:38:42,200
Speaker 1: had simply tied it off after doctor Pateell went on holidays,

534
00:38:42,680 --> 00:38:46,040
Speaker 1: handing over to doctor Jim Gaffield. The boy was in

535
00:38:46,120 --> 00:38:50,799
Speaker 1: excruciating pain, with a fractured pelvis, huge muscle tears in

536
00:38:50,840 --> 00:38:57,440
Speaker 1: his thigh, raging temperatures, sepsis and gangrene. It took until

537
00:38:57,520 --> 00:39:01,239
Speaker 1: one January and a snap decision by and appalled Dr

538
00:39:01,320 --> 00:39:04,920
Speaker 1: David Risson on his return from leave, for Mobs to

539
00:39:04,960 --> 00:39:09,600
Speaker 1: be airlifted to the Royal Brisbane Hospital. There, doctor Mark

540
00:39:09,719 --> 00:39:13,000
Speaker 1: Ray diagnosed him on New Year's Day as the sickest

541
00:39:13,120 --> 00:39:17,200
Speaker 1: fifteen year old he had ever seen. Doctor Ray could

542
00:39:17,280 --> 00:39:20,839
Speaker 1: smell the septic and grossly infected leg from the other

543
00:39:20,920 --> 00:39:24,920
Speaker 1: side of the emergency department. He did not expect Mobs

544
00:39:24,960 --> 00:39:28,400
Speaker 1: to survive the night. If he did survive, he would

545
00:39:28,440 --> 00:39:33,680
Speaker 1: need more surgery to amputate his leg through the knee.

546
00:39:33,800 --> 00:39:37,920
Speaker 1: The operation by doctor Jason Jenkins and doctor Ray showed

547
00:39:37,960 --> 00:39:41,400
Speaker 1: that both ends of the femoral vein had been suture

548
00:39:41,560 --> 00:39:46,520
Speaker 1: legated instead of being reconstructed. Blood had been going to

549
00:39:46,640 --> 00:39:49,960
Speaker 1: Shannon's limb through the femoral artery, but it could not

550
00:39:50,200 --> 00:39:54,560
Speaker 1: drain away through the femoral vein. This had led to

551
00:39:54,640 --> 00:40:00,000
Speaker 1: gross swelling and a range of serious life threatening implications.

552
00:40:00,000 --> 00:40:03,879
Speaker 1: Steve Rashford, who organized the emergency airlift, and the two

553
00:40:03,920 --> 00:40:08,600
Speaker 1: Brisbane surgeons Jenkins and Ray, were disgusted by the care

554
00:40:08,680 --> 00:40:13,680
Speaker 1: Mobs had received in Bunderberg. There was no excuse for

555
00:40:13,719 --> 00:40:17,239
Speaker 1: the failure to send him to Brisbane after the initial surgery.

556
00:40:18,200 --> 00:40:21,560
Speaker 1: They believed that the athletic two meter tall boy who

557
00:40:21,600 --> 00:40:25,440
Speaker 1: wanted to be a professional basketballer might have kept his

558
00:40:25,560 --> 00:40:30,200
Speaker 1: leg if he had been transferred immediately after the major operation.

559
00:40:31,760 --> 00:40:35,800
Speaker 1: On four January, Michelle Hunter, the nurse who had alerted

560
00:40:35,800 --> 00:40:39,319
Speaker 1: the doctors to Shannon's shocking condition on New Year's Eve,

561
00:40:39,719 --> 00:40:43,640
Speaker 1: resolved to do something. She had come to the conclusion

562
00:40:43,719 --> 00:40:48,000
Speaker 1: that Patel was a serial danger. She had never seen

563
00:40:48,280 --> 00:40:52,960
Speaker 1: so many instances of woundehesince, and the Internet search she

564
00:40:53,000 --> 00:40:57,480
Speaker 1: had done months earlier was still on her mind. Patel's

565
00:40:57,560 --> 00:41:02,080
Speaker 1: treatment of Shannon Mobs, the eyeing off of his feneral vein,

566
00:41:02,200 --> 00:41:06,720
Speaker 1: which effectively destroyed his leg, persuaded Michelle Hunter to act.

567
00:41:10,160 --> 00:41:12,919
Speaker 1: She went to see Tony Hoffman, who was back from

568
00:41:13,040 --> 00:41:17,200
Speaker 1: Christmas leave, but the nurse in charge of the ICU

569
00:41:17,440 --> 00:41:20,920
Speaker 1: had still not heard anything from Peter Leck or Darren

570
00:41:21,040 --> 00:41:26,600
Speaker 1: Keating about an investigation. Despite her increasingly detailed and grave

571
00:41:26,719 --> 00:41:31,920
Speaker 1: complaints made during two thousand and four, Hunter decided to

572
00:41:31,960 --> 00:41:36,279
Speaker 1: make her own complaint. She considered going directly to the

573
00:41:36,320 --> 00:41:40,920
Speaker 1: Health Rights Commission. First, she sent a MIMO to Linda

574
00:41:41,000 --> 00:41:44,560
Speaker 1: Mulligan setting out her concerns over the Mob's case.

575
00:41:45,880 --> 00:41:48,960
Speaker 8: My concerns are with the surgeon that performed his initial

576
00:41:49,040 --> 00:41:52,520
Speaker 8: three operations. I'm concerned that if the patient had been

577
00:41:52,520 --> 00:41:55,960
Speaker 8: transferred to Brisbane initially, he may not have lost his

578
00:41:56,080 --> 00:41:59,240
Speaker 8: leg or be in such a grave condition. I would

579
00:41:59,280 --> 00:42:01,960
Speaker 8: like his treatment the hospital investigated, as I fear his

580
00:42:02,040 --> 00:42:05,319
Speaker 8: health and well being has now been compromised by inadequate

581
00:42:05,680 --> 00:42:07,759
Speaker 8: substandard treatment by the medical team.

582
00:42:09,760 --> 00:42:13,400
Speaker 1: There was a similar expression of concern from doctor Rashford

583
00:42:13,440 --> 00:42:16,920
Speaker 1: in Brisbane, who wrote to the most senior administrators in

584
00:42:17,040 --> 00:42:20,759
Speaker 1: Queensland Health and he copied his memo to Peter Leck

585
00:42:21,120 --> 00:42:26,439
Speaker 1: and Darren Keating. Pressure was mounting, but doctor Keating, who

586
00:42:26,520 --> 00:42:30,160
Speaker 1: wanted Patel to return from holidays to a new four

587
00:42:30,239 --> 00:42:34,640
Speaker 1: year contract, produced a report stating that no external probe

588
00:42:34,920 --> 00:42:40,239
Speaker 1: was necessary. Linda Mulligan was now starting to worry. From

589
00:42:40,239 --> 00:42:45,400
Speaker 1: the beginning, she had downplayed Tony Hoffman's concerns. She believed

590
00:42:45,440 --> 00:42:48,839
Speaker 1: that the nurse and the top surgeons simply loathed each

591
00:42:48,840 --> 00:42:53,239
Speaker 1: other and that Hoffman's complaints were motivated by emotional rather

592
00:42:53,280 --> 00:42:58,880
Speaker 1: than clinical issues. But on seven January, three distraught nurses

593
00:42:58,960 --> 00:43:04,240
Speaker 1: from the operating Things Katrina's Wolak, Damien Gadd's a Janelle

594
00:43:04,360 --> 00:43:09,440
Speaker 1: Law had decided to unite in an unprecedented complaint. They

595
00:43:09,480 --> 00:43:12,000
Speaker 1: went to Mulligan and they told her that Patel was

596
00:43:12,040 --> 00:43:17,799
Speaker 1: a shocking surgeon whose patients were dying unnecessarily. Katrina and

597
00:43:17,960 --> 00:43:22,680
Speaker 1: Janelle were weeping as they told of the falsification of patients'

598
00:43:22,800 --> 00:43:26,640
Speaker 1: records by Patel and of how staff had felt powerless

599
00:43:26,760 --> 00:43:29,920
Speaker 1: because of his claims to have management in his pocket.

600
00:43:31,120 --> 00:43:35,799
Speaker 1: Linda Mulligan immediately tipped lek Off about this dramatic new development.

601
00:43:36,719 --> 00:43:40,759
Speaker 8: She told him they displayed different degrees of emotion to

602
00:43:40,800 --> 00:43:43,080
Speaker 8: the point of one stating that the whole issue was

603
00:43:43,160 --> 00:43:44,200
Speaker 8: keeping them from sleeping.

604
00:43:45,360 --> 00:43:49,840
Speaker 1: All of Tony Hoffman's claims were being corroborated, and still

605
00:43:50,120 --> 00:44:00,440
Speaker 1: a clinical audit of Patel's work was not begun. Chapter

606
00:44:00,480 --> 00:44:06,880
Speaker 1: twenty seven Executive Decisions thirteen to fourteen January two thousand

607
00:44:07,000 --> 00:44:14,560
Speaker 1: and five. Peter Leck was showing the first signs of

608
00:44:14,719 --> 00:44:18,000
Speaker 1: acute panic by the time J. N. Patel had returned

609
00:44:18,040 --> 00:44:22,640
Speaker 1: to work in early January. Leck worried about his own

610
00:44:22,800 --> 00:44:26,800
Speaker 1: failure to conduct any sort of review of Patel, despite

611
00:44:26,840 --> 00:44:30,480
Speaker 1: a trial of dead and maimed patients and a string

612
00:44:30,520 --> 00:44:34,760
Speaker 1: of complaints. He had broken his own promise to Hoffman

613
00:44:34,840 --> 00:44:38,359
Speaker 1: to have the concerns properly checked. He had not even

614
00:44:38,440 --> 00:44:41,880
Speaker 1: told her what he was doing. Peter Leck had dithered.

615
00:44:42,480 --> 00:44:49,600
Speaker 1: He had been indecisive, weak, and interminably slow. On thirteen January,

616
00:44:49,960 --> 00:44:52,799
Speaker 1: Lek raised the concerns for the first time with the

617
00:44:52,840 --> 00:44:55,880
Speaker 1: Acting Director General of Health, doctor John Scott.

618
00:44:56,960 --> 00:44:58,920
Speaker 7: I was just wanting to flag that I actually do

619
00:44:59,000 --> 00:45:02,560
Speaker 7: have some concerns the outcomes of some of doctor Pateell's surgery.

620
00:45:03,960 --> 00:45:07,920
Speaker 1: He also told Scott about the nurses fears over injuries

621
00:45:07,960 --> 00:45:12,640
Speaker 1: and deaths, adding that doctor Darren Keating believed that the concerns.

622
00:45:12,120 --> 00:45:16,359
Speaker 7: Were completely driven by the personality conflict. However, he has

623
00:45:16,400 --> 00:45:19,160
Speaker 7: now expressed some concern although he still believes most of

624
00:45:19,200 --> 00:45:20,720
Speaker 7: the issues are personality driven.

625
00:45:21,920 --> 00:45:25,560
Speaker 1: He was silent about the backing of Hoffman's concerns by

626
00:45:25,600 --> 00:45:29,960
Speaker 1: the three doctors. Doctor Martin Carter, doctor David Risson, and

627
00:45:30,080 --> 00:45:37,160
Speaker 1: doctor Dieter Behrens, who had been interviewed. Keating was angry

628
00:45:37,160 --> 00:45:39,759
Speaker 1: that it had come to this. He did not like

629
00:45:39,840 --> 00:45:44,480
Speaker 1: confrontations with Patel, particularly as he had exceeded the surgery

630
00:45:44,520 --> 00:45:48,400
Speaker 1: targets and made Keating and the hospital look good, but

631
00:45:48,560 --> 00:45:53,600
Speaker 1: the ICU and theatre staff were close to rebellion. Something

632
00:45:53,760 --> 00:45:56,560
Speaker 1: had to give. Keating told Leck.

633
00:45:57,120 --> 00:45:59,160
Speaker 2: Look, we need to make sure that doctor Patel is

634
00:45:59,200 --> 00:46:02,360
Speaker 2: aware of the investigtion and give him as much information

635
00:46:02,520 --> 00:46:03,200
Speaker 2: as possible.

636
00:46:04,440 --> 00:46:08,320
Speaker 1: In a meeting in Lex's office on thirteen January, Patel

637
00:46:08,480 --> 00:46:11,960
Speaker 1: was told for the first time about the complaints concerning

638
00:46:12,120 --> 00:46:15,640
Speaker 1: his handling of Shannon Mobs as well as other patients.

639
00:46:16,280 --> 00:46:20,160
Speaker 1: Patel was told that there would be an investigation and

640
00:46:20,200 --> 00:46:24,600
Speaker 1: that in the meantime he could continue doing surgery, just

641
00:46:24,760 --> 00:46:31,080
Speaker 1: not cases requiring admission to the ICU. Patel scoffed at

642
00:46:31,120 --> 00:46:35,440
Speaker 1: the notion that his surgery was below standard, but for

643
00:46:35,480 --> 00:46:38,680
Speaker 1: the third time in his career he faced a thorough

644
00:46:38,680 --> 00:46:44,040
Speaker 1: investigation with potentially grave findings. He was indignant.

645
00:46:44,719 --> 00:46:46,280
Speaker 4: I will be considering my position.

646
00:46:47,680 --> 00:46:51,239
Speaker 1: The next day, Patel told doctor Keating that he would

647
00:46:51,280 --> 00:46:54,880
Speaker 1: not be taking up the four year contract after one April,

648
00:46:55,440 --> 00:46:59,400
Speaker 1: but he had no plans to leave Australia. Patel still

649
00:46:59,440 --> 00:47:02,239
Speaker 1: believed that he could remain as a surgeon on a

650
00:47:02,320 --> 00:47:06,480
Speaker 1: special contract, despite the trouble he would be in if

651
00:47:06,520 --> 00:47:10,319
Speaker 1: the easily discovered details of his past came to light.

652
00:47:10,719 --> 00:47:13,840
Speaker 1: He chose not to flee, at least not yet.

653
00:47:14,520 --> 00:47:17,279
Speaker 4: He told Keating, I would like to thank you for

654
00:47:17,320 --> 00:47:20,000
Speaker 4: your support over the past two years. My sted Bunderberg

655
00:47:20,040 --> 00:47:23,200
Speaker 4: has been challenging at times, but mostly enjoyable and roareding.

656
00:47:25,040 --> 00:47:28,960
Speaker 1: Keating replied with a glowing appraisal of Patel's troubled time

657
00:47:29,040 --> 00:47:31,359
Speaker 1: at the hospital, thanking him for.

658
00:47:31,320 --> 00:47:37,319
Speaker 2: His sustained commitment, ongoing enthusiasm and strong work ethic. I

659
00:47:37,400 --> 00:47:40,320
Speaker 2: have greatly valued your advice, inside and support over the

660
00:47:40,400 --> 00:47:42,799
Speaker 2: last two years, and I wish you well in the

661
00:47:42,840 --> 00:47:45,319
Speaker 2: future in whatever endeavors you may take.

662
00:47:46,560 --> 00:47:50,799
Speaker 1: Patel kept Keating's note for his curriculum vitae. It was

663
00:47:50,880 --> 00:47:54,719
Speaker 1: the sort of adulation not dissimilar to the praise bestowed

664
00:47:54,800 --> 00:47:58,160
Speaker 1: by his peers in New York State and Oregon when

665
00:47:58,200 --> 00:48:02,960
Speaker 1: he had been in trouble. Seeking further reassurance and comfort,

666
00:48:03,000 --> 00:48:07,879
Speaker 1: Patel turned to the junior surgeons, doctor Anthony Athanasiov and

667
00:48:07,920 --> 00:48:12,840
Speaker 1: doctor Sanjeeva Carrio Asam. They were upset at the story

668
00:48:12,920 --> 00:48:15,839
Speaker 1: told by their mentor, the man who had bought their

669
00:48:15,880 --> 00:48:20,680
Speaker 1: meals and passed on his surgical prowess. They teamed up

670
00:48:20,719 --> 00:48:24,240
Speaker 1: with three other junior doctors to lobby on Patel's behalf.

671
00:48:25,239 --> 00:48:28,279
Speaker 1: In a note to doctor Keating, they wrote.

672
00:48:28,520 --> 00:48:31,200
Speaker 9: Doctor Patel is now in a position whereby he feels

673
00:48:31,239 --> 00:48:33,560
Speaker 9: it is not in his best interest to stay at Bunderberg,

674
00:48:34,000 --> 00:48:36,680
Speaker 9: and we believe the hospital should consider this very carefully.

675
00:48:37,320 --> 00:48:40,320
Speaker 9: Doctor Petel's approach to his work is nothing short of admirable.

676
00:48:40,760 --> 00:48:44,960
Speaker 9: He is dedicated, hard working, efficient and knowledgeable. His efforts

677
00:48:44,960 --> 00:48:48,040
Speaker 9: to ensure his patients received the best care go above

678
00:48:48,080 --> 00:48:51,239
Speaker 9: and beyond the call of his duties. He consistently goes

679
00:48:51,280 --> 00:48:54,400
Speaker 9: out of his way to provide timely expert management for

680
00:48:54,440 --> 00:48:58,000
Speaker 9: a wide variety of surgical problems. In summary, we are

681
00:48:58,040 --> 00:49:02,160
Speaker 9: concerned about the circumstances surrounding Dr Patel's departure and we

682
00:49:02,200 --> 00:49:03,920
Speaker 9: believe his leading would be a great loss for the

683
00:49:03,920 --> 00:49:06,440
Speaker 9: hospital and also for the Bunderberg community.

684
00:49:10,360 --> 00:49:14,320
Speaker 1: By the end of January, Keating had hatched a devious plan.

685
00:49:14,920 --> 00:49:18,480
Speaker 1: He was annoyed that impertinent nursing staff had dashed his

686
00:49:18,640 --> 00:49:22,280
Speaker 1: hopes of retaining Jon Patel as the director of surgery

687
00:49:22,360 --> 00:49:26,920
Speaker 1: until two thousand and nine, Doctor Keating decided to flex

688
00:49:26,960 --> 00:49:30,960
Speaker 1: his management muscle, panned to Patel and put the nurses

689
00:49:31,000 --> 00:49:36,480
Speaker 1: back in their place, all with one big decision. In

690
00:49:36,520 --> 00:49:40,319
Speaker 1: early February, he offered Patel a senior surgical role with

691
00:49:40,400 --> 00:49:44,000
Speaker 1: a daily rate of one thousand, one hundred and fifty dollars,

692
00:49:44,560 --> 00:49:48,400
Speaker 1: a significant enhancement on his existing two hundred thousand dollars

693
00:49:48,440 --> 00:49:52,720
Speaker 1: a year package. Keating had also given the medical Board

694
00:49:52,840 --> 00:49:55,680
Speaker 1: another glowing appraisal of Patel's work.

695
00:49:56,960 --> 00:50:00,759
Speaker 2: Dr. Patel is a very committed and enthusiastically who has

696
00:50:00,880 --> 00:50:04,160
Speaker 2: continued to be a very effective member of staff and

697
00:50:04,400 --> 00:50:07,960
Speaker 2: director of surgery. He has a very strong work ethic,

698
00:50:08,239 --> 00:50:09,920
Speaker 2: which is a model for others.

699
00:50:12,040 --> 00:50:16,200
Speaker 1: Keating told the board that there were nil significant areas

700
00:50:16,239 --> 00:50:20,200
Speaker 1: for improvement in Pateel's performance, and he rated the surgeon's

701
00:50:20,280 --> 00:50:25,319
Speaker 1: performance as excellent. Keating had paved the way for the

702
00:50:25,360 --> 00:50:30,040
Speaker 1: four year extension offered previously. He wrote to the Department

703
00:50:30,080 --> 00:50:34,000
Speaker 1: of Immigration and confirmed that the hospital planned to employ

704
00:50:34,040 --> 00:50:38,560
Speaker 1: Patel until two thousand and nine, Patel was elated as

705
00:50:38,600 --> 00:50:42,000
Speaker 1: he boasted to Nurse Janelle Law in the operating theater

706
00:50:42,239 --> 00:50:44,400
Speaker 1: during an endoscopy procedure.

707
00:50:45,719 --> 00:50:47,520
Speaker 4: They're going to be me as much for three months

708
00:50:47,560 --> 00:50:48,640
Speaker 4: as what I get in a year.

709
00:50:49,719 --> 00:50:52,840
Speaker 1: The nurse was appalled. She had been looking forward to

710
00:50:52,840 --> 00:50:55,680
Speaker 1: seeing the back of Patel and all the problems he

711
00:50:55,760 --> 00:50:58,880
Speaker 1: brought to the hospital. Now it seemed he was to

712
00:50:58,920 --> 00:51:12,239
Speaker 1: be showered with money and kept on Chapter twenty eight

713
00:51:12,880 --> 00:51:21,120
Speaker 1: the Investigation. February to March two thousand and five, Jerry

714
00:51:21,120 --> 00:51:26,280
Speaker 1: Fitzgerald spread the email printouts, memos, reports and letters across

715
00:51:26,320 --> 00:51:31,000
Speaker 1: his desk at Queensland Health Headquarters in Charlotte Street, Brisbane.

716
00:51:31,200 --> 00:51:34,879
Speaker 1: The Chief Health Officer of Queensland had given himself an

717
00:51:34,960 --> 00:51:40,520
Speaker 1: unenviable assignment a clinical audit of Jon Patel's surgical outcomes.

718
00:51:41,840 --> 00:51:45,080
Speaker 1: The documentary material was the first part of the puzzle.

719
00:51:45,800 --> 00:51:49,480
Speaker 1: Doctor Fitzgerald had already been advised by Peter Leck that

720
00:51:49,560 --> 00:51:54,120
Speaker 1: there were personality differences between Patel and his principal accuser,

721
00:51:54,480 --> 00:51:59,719
Speaker 1: Tony Hoffman. Fitzgerald also knew how valuable Patel was too

722
00:51:59,760 --> 00:52:04,120
Speaker 1: Burg hospital. The surgeon's role in slicing through the waiting

723
00:52:04,160 --> 00:52:10,399
Speaker 1: lists had been repeatedly stressed by Leck. Mindful of the

724
00:52:10,440 --> 00:52:14,640
Speaker 1: sensitivities of the people involved, Fitzgerald made plans to visit

725
00:52:14,680 --> 00:52:17,880
Speaker 1: Bunderberg to interview Patel as well as the nursing and

726
00:52:18,000 --> 00:52:21,280
Speaker 1: medical staff. He wrote to Peter Leck.

727
00:52:22,280 --> 00:52:26,399
Speaker 10: At this point, we will be simply collecting information and

728
00:52:26,480 --> 00:52:31,120
Speaker 10: not seeking to validate or evaluate any particular concerns raised.

729
00:52:31,600 --> 00:52:34,760
Speaker 10: Would you mind asking Dr Patel if he can spare

730
00:52:34,840 --> 00:52:37,920
Speaker 10: some time to meet with me to discuss any concern

731
00:52:38,239 --> 00:52:42,759
Speaker 10: he may have. Dr Patel is definitely entitled under the

732
00:52:42,800 --> 00:52:47,000
Speaker 10: principles of natural justice to be confronted with the details

733
00:52:47,040 --> 00:52:50,920
Speaker 10: of the complaints made against him. He may decline to

734
00:52:50,960 --> 00:52:54,120
Speaker 10: meet with me until he has had the opportunity to

735
00:52:54,200 --> 00:52:58,719
Speaker 10: respond to the complaints. I hope he does not do so.

736
00:52:58,800 --> 00:53:01,560
Speaker 10: Our main intent is to find the facts and to

737
00:53:01,600 --> 00:53:03,839
Speaker 10: seek a resolution asap.

738
00:53:07,560 --> 00:53:11,560
Speaker 1: Anyone else who risked being exposed as a clinical fraud

739
00:53:11,600 --> 00:53:14,960
Speaker 1: would have skipped overseas on the eve of an investigation

740
00:53:15,120 --> 00:53:19,520
Speaker 1: by the Chief Health Officer, but not Jaunt. Patel, his

741
00:53:19,840 --> 00:53:23,520
Speaker 1: ego and self belief, refuse to entertain the idea that

742
00:53:23,560 --> 00:53:27,680
Speaker 1: he might be found out. Patel also knew that the

743
00:53:27,760 --> 00:53:32,879
Speaker 1: hospital still desperately needed him. On eight February, Keating had

744
00:53:33,000 --> 00:53:36,279
Speaker 1: all but pleaded for Patel and other staff to work

745
00:53:36,400 --> 00:53:40,600
Speaker 1: harder on those waiting lists. The hospital was ninety two

746
00:53:40,719 --> 00:53:46,240
Speaker 1: operations behind its target. Kidding wrote a memo to senior staff.

747
00:53:47,400 --> 00:53:51,520
Speaker 2: Should the target not be achieved, Bunderberg Health Service District

748
00:53:51,760 --> 00:53:54,759
Speaker 2: will not get another chance to upgrade the target and

749
00:53:54,840 --> 00:54:00,000
Speaker 2: hence lose flexibility and significant dollars. Therefore, it is imperished

750
00:54:00,280 --> 00:54:04,960
Speaker 2: that everyone continue to pull together and maximize elective surgery

751
00:54:05,040 --> 00:54:10,120
Speaker 2: throughput until thirty June. All cancelations should be minimal, with

752
00:54:10,200 --> 00:54:13,160
Speaker 2: these cases pushed through as much as possible.

753
00:54:15,000 --> 00:54:19,080
Speaker 1: In the executive meeting room on fourteen February, Fitzgerald and

754
00:54:19,280 --> 00:54:22,840
Speaker 1: Brisbane colleague Sue Jenkins began working their way through a

755
00:54:22,880 --> 00:54:26,839
Speaker 1: list of about thirty nurses and doctors. Some of the

756
00:54:26,840 --> 00:54:31,840
Speaker 1: interviews lasted just fifteen minutes, others went for over an hour.

757
00:54:32,600 --> 00:54:37,040
Speaker 1: The nurse Karen Jenna wondered how seriously the investigation was

758
00:54:37,120 --> 00:54:37,800
Speaker 1: being taken.

759
00:54:38,840 --> 00:54:41,320
Speaker 3: This is not an investigation of doctor Patel.

760
00:54:41,680 --> 00:54:42,400
Speaker 1: This is US.

761
00:54:42,280 --> 00:54:44,759
Speaker 6: Gathering information to find out whether or not it is

762
00:54:44,800 --> 00:54:47,640
Speaker 6: important to have an investigation into doctor Patel.

763
00:54:48,719 --> 00:54:51,719
Speaker 1: When Patel strolled in, he acted as if he did

764
00:54:51,760 --> 00:54:54,840
Speaker 1: not have a care in the world. He had spared

765
00:54:54,880 --> 00:54:58,399
Speaker 1: about twenty five minutes for the chief health officer, who

766
00:54:58,520 --> 00:55:05,000
Speaker 1: immediately identified and arrogance bordering on megalomania. Patel's self confidence

767
00:55:05,120 --> 00:55:10,239
Speaker 1: was almost pathological. It was a personality that Fitzgerald, a

768
00:55:10,360 --> 00:55:16,000
Speaker 1: naturally shy and disarming man, could not easily understand. Patel

769
00:55:16,160 --> 00:55:20,080
Speaker 1: proceeded to boast about how much surgical experience he had

770
00:55:20,200 --> 00:55:24,600
Speaker 1: in the United States. He repeatedly spoke of his expertise

771
00:55:24,800 --> 00:55:29,920
Speaker 1: in complex procedures. He was clearly agitated at the scrutiny

772
00:55:30,000 --> 00:55:32,759
Speaker 1: being applied to his work, but he brushed it off

773
00:55:32,800 --> 00:55:35,680
Speaker 1: as the product of flaws in other people.

774
00:55:36,800 --> 00:55:41,000
Speaker 4: He told Fitzgerald, nurses have been complaining about doctors for centuries.

775
00:55:41,560 --> 00:55:44,319
Speaker 4: Some of them are lazy. They don't want to work hard.

776
00:55:44,960 --> 00:55:47,239
Speaker 1: Patel offered an olive branch.

777
00:55:48,040 --> 00:55:50,320
Speaker 4: Well, if you don't want to do these procedures anymore,

778
00:55:50,400 --> 00:55:51,319
Speaker 4: we won't do them here.

779
00:55:52,760 --> 00:55:56,880
Speaker 1: After hearing from doctor Peter Meak and several mercers about

780
00:55:56,920 --> 00:56:00,919
Speaker 1: the Catholic problems and the lack of hygiene, Gerald too

781
00:56:01,200 --> 00:56:04,319
Speaker 1: was doubting the competence of the director of surgery at

782
00:56:04,360 --> 00:56:08,600
Speaker 1: the Bunderberg Base Hospital, but was the hospital better off

783
00:56:08,760 --> 00:56:13,160
Speaker 1: with Patel than with no senior surgeon at all. When

784
00:56:13,200 --> 00:56:16,960
Speaker 1: Fitzgerald asked Tony Hoffman this question, she was certain of

785
00:56:17,000 --> 00:56:20,600
Speaker 1: the answer. She told him that the patients would be

786
00:56:20,719 --> 00:56:25,480
Speaker 1: much better off if Patel were immediately suspended. As she

787
00:56:25,600 --> 00:56:27,799
Speaker 1: told the chief health officer, we.

788
00:56:27,800 --> 00:56:31,200
Speaker 3: Don't like this guy, but that's not the issue. The

789
00:56:31,280 --> 00:56:35,440
Speaker 3: issue is he's doing these things here and it's harming people.

790
00:56:36,520 --> 00:56:40,239
Speaker 10: He replied, well, we can't do anything because nothing's been

791
00:56:40,320 --> 00:56:41,719
Speaker 10: proved at this stage.

792
00:56:42,680 --> 00:56:46,920
Speaker 1: Hoffman was chres fallen. She wondered, what on earth can

793
00:56:46,960 --> 00:56:51,680
Speaker 1: we possibly do to stop this man. Fitzgerald asked Darren Keating,

794
00:56:52,320 --> 00:56:53,640
Speaker 1: what do the patients feel?

795
00:56:54,280 --> 00:56:57,719
Speaker 10: What's the level of patient satisfaction? Have there been any

796
00:56:57,760 --> 00:57:00,200
Speaker 10: complaints against doctor pateell by patients.

797
00:57:01,480 --> 00:57:05,640
Speaker 1: Keating had a folder of complaints, but he assured Fitzgerald

798
00:57:05,640 --> 00:57:11,640
Speaker 1: that there were none. Patel had given an undertaking to

799
00:57:11,640 --> 00:57:16,640
Speaker 1: stop doing the esophagectamies and other complex surgery needing intensive

800
00:57:16,680 --> 00:57:21,280
Speaker 1: care unit support, but he was still causing serious damage.

801
00:57:21,640 --> 00:57:25,600
Speaker 1: Three days before Fitzgerald's arrival at the hospital, Jenny White

802
00:57:25,760 --> 00:57:28,560
Speaker 1: was the scrub nurse for a procedure to remove part

803
00:57:28,600 --> 00:57:32,560
Speaker 1: of the cancerous bowel of a patient Jean Stuart Sutherland.

804
00:57:33,520 --> 00:57:37,600
Speaker 1: Patel cut the healthy part of her bowl. If he

805
00:57:37,760 --> 00:57:40,480
Speaker 1: noticed his error, he did not acknowledge it until a

806
00:57:40,560 --> 00:57:45,280
Speaker 1: junior doctor pointed it out. Nurse White shook her head

807
00:57:45,320 --> 00:57:49,920
Speaker 1: in disbelief. How Patel could have overlooked the four centimeter

808
00:57:50,120 --> 00:57:55,000
Speaker 1: cut was unfathomable. When the patient returned to theater in

809
00:57:55,080 --> 00:57:59,800
Speaker 1: late February because of the inevitable complications from the earlier incompetence,

810
00:58:00,280 --> 00:58:04,320
Speaker 1: Jenny White saw the terrible state of the bowl. It

811
00:58:04,480 --> 00:58:08,800
Speaker 1: was leaking. More than one liter of bile stained fluid

812
00:58:08,880 --> 00:58:12,560
Speaker 1: needed to be drained. There was also a gross infection.

813
00:58:18,320 --> 00:58:22,160
Speaker 1: The blood from the carotid artery of Harry petra Helos

814
00:58:22,200 --> 00:58:26,360
Speaker 1: spurted in a fine but steady stream. It happened suddenly

815
00:58:26,480 --> 00:58:29,479
Speaker 1: when one of the doctors in the coronary unit tried

816
00:58:29,520 --> 00:58:33,080
Speaker 1: to put a central line into his neck, missing the

817
00:58:33,200 --> 00:58:38,520
Speaker 1: vein but piercing the artery. Because arterial pressure is greater

818
00:58:38,600 --> 00:58:44,280
Speaker 1: than venus pressure, petra Helos began losing blood fast. He

819
00:58:44,400 --> 00:58:47,240
Speaker 1: was already in poor shape. He had suffered a heart

820
00:58:47,240 --> 00:58:51,080
Speaker 1: attack and was also battling severe kidney failure, which made

821
00:58:51,160 --> 00:58:55,840
Speaker 1: him anemic, He took blood thinning substances for a condition

822
00:58:56,000 --> 00:59:01,280
Speaker 1: called atrial fibrillation and irregularity of the heart. He had

823
00:59:01,320 --> 00:59:06,200
Speaker 1: one more disadvantage. Petra Helos was a Jehovah's Witness, which

824
00:59:06,240 --> 00:59:09,440
Speaker 1: meant he would not be a candidate for blood transfusion.

825
00:59:10,520 --> 00:59:13,960
Speaker 1: His delicate condition and complications meant he had to be

826
00:59:14,000 --> 00:59:18,600
Speaker 1: handled with extreme care. Any operation was a grave danger

827
00:59:18,680 --> 00:59:22,240
Speaker 1: because of the potential for petra Helos to bleed to death.

828
00:59:23,600 --> 00:59:27,040
Speaker 1: When Jayon Patel saw the commotion on for March and

829
00:59:27,160 --> 00:59:30,440
Speaker 1: asked what was going on, a nurse explained that Petra

830
00:59:30,560 --> 00:59:35,880
Speaker 1: Helos was one of doctor Peter Meak's patients. Patel replied, okay,

831
00:59:36,160 --> 00:59:40,040
Speaker 1: I won't touch him. Then. The rift between doctor Miak

832
00:59:40,200 --> 00:59:43,640
Speaker 1: and doctor Patel had only widened in the years since

833
00:59:43,680 --> 00:59:46,959
Speaker 1: the Director of Medicine banned the Director of Surgery from

834
00:59:47,000 --> 00:59:51,720
Speaker 1: handling certain patients. Doctor Miak had made it clear in

835
00:59:51,840 --> 00:59:55,080
Speaker 1: his interview with doctor Jerry Fitzgerald in February that Patel

836
00:59:55,240 --> 00:59:59,960
Speaker 1: was dangerous and incompetent. Miak had even taken the un

837
01:00:00,120 --> 01:00:03,480
Speaker 1: usual step several months earlier of asking to see Patel's

838
01:00:03,520 --> 01:00:07,720
Speaker 1: personnel file and CV. He flicked through it in a

839
01:00:07,760 --> 01:00:11,440
Speaker 1: couple of minutes, expecting to find a red flag pointing

840
01:00:11,480 --> 01:00:15,080
Speaker 1: to the incompetence of the man, but it seemed in order.

841
01:00:16,200 --> 01:00:20,320
Speaker 1: Peter Miak had walked back to the ward perplexed, but

842
01:00:20,440 --> 01:00:23,960
Speaker 1: Patel could not walk away. He told the theater nurses

843
01:00:24,040 --> 01:00:28,360
Speaker 1: to prepare for an operation. Patel wanted to operate on

844
01:00:28,440 --> 01:00:33,720
Speaker 1: the punctured artery of Petra Helos. The nursing and junior

845
01:00:33,760 --> 01:00:37,760
Speaker 1: medical staff were immediately alarmed. Someone called Dtor Miak and

846
01:00:37,840 --> 01:00:41,600
Speaker 1: asked him to come to the ICU urgently. He walked

847
01:00:41,640 --> 01:00:46,880
Speaker 1: into a bizarre and tense situation. Dr Patel, all scrubbed

848
01:00:46,960 --> 01:00:50,200
Speaker 1: up in his surgical gear, was intent on taking Petro

849
01:00:50,280 --> 01:00:54,680
Speaker 1: Helos into theater. The nurses were pleading with their eyes

850
01:00:54,720 --> 01:00:58,960
Speaker 1: and body language to prevent another death. Miak gave an

851
01:00:59,000 --> 01:01:00,360
Speaker 1: instruction to one of the.

852
01:01:00,320 --> 01:01:03,040
Speaker 11: Doctors, just put pressure on it.

853
01:01:04,000 --> 01:01:07,360
Speaker 1: Patel loudly insisted on an operation to put a couple

854
01:01:07,360 --> 01:01:11,440
Speaker 1: of stitches in the carotid artery. It was a delicate

855
01:01:11,480 --> 01:01:15,480
Speaker 1: procedure under ideal conditions, but in the hands of Patel

856
01:01:15,560 --> 01:01:20,440
Speaker 1: it promised to be a disaster. Doctor Meak refused to budge.

857
01:01:20,760 --> 01:01:24,080
Speaker 1: He believed that there was absolutely no chance the man

858
01:01:24,160 --> 01:01:28,080
Speaker 1: would survive the operation that Patel seemed determined to perform.

859
01:01:28,960 --> 01:01:32,920
Speaker 1: He told Patel, look, the corota doesn't need fixing. His

860
01:01:33,040 --> 01:01:38,320
Speaker 1: priorities are his heart, his anemia, everything else. Miak knew

861
01:01:38,400 --> 01:01:42,360
Speaker 1: that by maintaining pressure on the small hole in the carotid,

862
01:01:42,880 --> 01:01:47,000
Speaker 1: the bleeding would eventually stop. He gave firm instructions to

863
01:01:47,040 --> 01:01:50,600
Speaker 1: a junior doctor, but he still had to silence Patel,

864
01:01:50,800 --> 01:01:52,720
Speaker 1: who was angry and embarrassed.

865
01:01:53,480 --> 01:01:55,680
Speaker 11: Look, this man is not going to theater and that's

866
01:01:55,680 --> 01:01:58,240
Speaker 11: the end of it. He's going to Brisbane.

867
01:01:58,280 --> 01:02:02,520
Speaker 1: Tony Hoffman watched the drama with mounting alarm. Why had

868
01:02:02,520 --> 01:02:06,000
Speaker 1: it come to this? She had prayed that an investigation

869
01:02:06,200 --> 01:02:09,440
Speaker 1: by the Chief Health Officer would result in decisive and

870
01:02:09,560 --> 01:02:14,960
Speaker 1: immediate action, but instead Patel was still wreaking havoc, still

871
01:02:15,000 --> 01:02:18,560
Speaker 1: boasting about the renewal of his contract and his massive

872
01:02:18,680 --> 01:02:22,520
Speaker 1: salary boost. Miac constructed Hoffman.

873
01:02:22,960 --> 01:02:26,320
Speaker 11: Whatever you do, don't leave this patient's bedside, and if

874
01:02:26,360 --> 01:02:29,520
Speaker 11: doctor Patel goes near him, telephone me immediately.

875
01:02:30,640 --> 01:02:34,360
Speaker 1: As Hoffman stayed by Petro Helos to await the Royal

876
01:02:34,400 --> 01:02:38,440
Speaker 1: Flying Doctor for an emergency flight to Brisbane, a leader

877
01:02:38,480 --> 01:02:41,640
Speaker 1: of the Jehovah's Witness church in Bunderberg, came to the

878
01:02:41,680 --> 01:02:46,560
Speaker 1: intensive care unit. Tony Hoffman already knew from contacts close

879
01:02:46,600 --> 01:02:50,400
Speaker 1: to the church that Patel had ingratiated himself with the flock.

880
01:02:51,280 --> 01:02:54,840
Speaker 1: She had been suspicious when first told of the charm offensive.

881
01:02:55,840 --> 01:02:58,720
Speaker 1: Now one of the men who knew petro Helos as

882
01:02:58,720 --> 01:03:02,360
Speaker 1: well as Patel, was in the intensive care unit. He

883
01:03:02,440 --> 01:03:06,320
Speaker 1: asked if doctor Patel was available. Hoffman was in a panic.

884
01:03:06,840 --> 01:03:09,720
Speaker 1: If she put a call through to Patel, the patient's

885
01:03:09,720 --> 01:03:14,680
Speaker 1: fate would be sealed. Hoffman knew how persuasive Patel could be.

886
01:03:15,520 --> 01:03:18,480
Speaker 1: He would tell the church elder that an operation to

887
01:03:18,560 --> 01:03:23,919
Speaker 1: repair Petrohelos's carotid artery was absolutely imperative, and he would

888
01:03:24,000 --> 01:03:27,320
Speaker 1: prevail upon the elder to demand that the operation by

889
01:03:27,400 --> 01:03:31,880
Speaker 1: Patel should go ahead. Tony Hoffman decided that she could

890
01:03:31,880 --> 01:03:32,880
Speaker 1: not let that happen.

891
01:03:33,680 --> 01:03:37,360
Speaker 3: She told the elder, doctor Pateel isn't here at the moment,

892
01:03:37,480 --> 01:03:40,680
Speaker 3: but the patient is going to be fine.

893
01:03:40,760 --> 01:03:44,400
Speaker 1: Ten days later, doctor Martin Strawn decided to use an

894
01:03:44,560 --> 01:03:48,080
Speaker 1: endoscope to examine the stomach of Joan Cameron, who had

895
01:03:48,120 --> 01:03:51,320
Speaker 1: been admitted to the medical ward with vomiting and bleeding,

896
01:03:52,360 --> 01:03:56,560
Speaker 1: Strawn discovered an obstruction in the second part of her duodenum.

897
01:03:57,360 --> 01:04:01,280
Speaker 1: He strongly suspected it was a secondary which would require

898
01:04:01,400 --> 01:04:07,640
Speaker 1: further investigation and possibly surgery in Brisbane. In the corridor

899
01:04:07,680 --> 01:04:12,480
Speaker 1: outside the theater, Patel asked Strawn about the finding. Patel

900
01:04:12,600 --> 01:04:13,360
Speaker 1: told him.

901
01:04:14,000 --> 01:04:16,240
Speaker 4: Oh, well, that will be a primary toma in the

902
01:04:16,320 --> 01:04:19,360
Speaker 4: duo Dunham. The patient needs an operation to remove it,

903
01:04:19,440 --> 01:04:21,600
Speaker 4: and I'll put the patient in the surgical ward and

904
01:04:21,680 --> 01:04:23,000
Speaker 4: I'll do it early next week.

905
01:04:23,800 --> 01:04:27,640
Speaker 1: Doctor Strawn suspected that Patel was wrong and would attempt

906
01:04:27,760 --> 01:04:32,200
Speaker 1: more complex surgery after opening the patient up. He was

907
01:04:32,280 --> 01:04:37,560
Speaker 1: determined to prevent Patel from operating, but how When Joan

908
01:04:37,680 --> 01:04:41,600
Speaker 1: Cameron developed a chest infection a few days later, Strawn

909
01:04:41,760 --> 01:04:45,760
Speaker 1: seized the opportunity to remove the patient from Patel's grasp.

910
01:04:46,600 --> 01:04:50,120
Speaker 1: He spoke to Dr Miak, Doctor Martin Carter, and Tony

911
01:04:50,120 --> 01:04:53,560
Speaker 1: Hoffman about a plan to hide the patient in the ICU,

912
01:04:54,200 --> 01:04:58,120
Speaker 1: a safe refuge. Since Petel no longer ventured there. From

913
01:04:58,160 --> 01:05:02,520
Speaker 1: the ICU, Joan Ca could be quietly transferred to Brisbane.

914
01:05:03,080 --> 01:05:08,600
Speaker 1: They were all in agreement behind Patel's back. At the

915
01:05:08,680 --> 01:05:12,640
Speaker 1: time Strawn regarded it as outrageous behavior to have to

916
01:05:12,680 --> 01:05:15,880
Speaker 1: resort to a ruse to keep an ill patient away

917
01:05:16,040 --> 01:05:19,680
Speaker 1: from the director of surgery. He was also worried about

918
01:05:19,760 --> 01:05:23,720
Speaker 1: how Patel might retaliate when he found out, But the

919
01:05:23,760 --> 01:05:28,240
Speaker 1: bizarre episode had made a more profound impression on Tony Hoffman.

920
01:05:28,960 --> 01:05:32,200
Speaker 1: Her mind was made up. Now she had to fully

921
01:05:32,280 --> 01:06:00,440
Speaker 1: expose Patel and worry about the consequences later. Sick to

922
01:06:00,480 --> 01:06:04,120
Speaker 1: Death is written and presented by me Headley Thomas, the

923
01:06:04,160 --> 01:06:10,400
Speaker 1: Australian's National Chief correspondent. Claire Harvey is The Australian's editorial director.

924
01:06:11,000 --> 01:06:15,800
Speaker 1: Audio editing, production and music have been done by Jasper Leik,

925
01:06:16,080 --> 01:06:21,240
Speaker 1: with assistance from Leah Sammaglu and Neil Sutherland. Our producer

926
01:06:21,360 --> 01:06:27,040
Speaker 1: is Christin Amias. Production management by Stephanie Coombs. Artwork by

927
01:06:27,160 --> 01:06:32,920
Speaker 1: Sean Callanan. Thanks to Ryan Osland, Matthew Condon, Karina Berger,

928
01:06:33,240 --> 01:06:39,360
Speaker 1: Ellie Dudley, David Murray, Dominique McDermott, Zach Sculander and all

929
01:06:39,440 --> 01:06:43,480
Speaker 1: our family, friends and colleagues who helped in this series

930
01:06:43,720 --> 01:06:48,520
Speaker 1: and contributed voice acting and special thanks to Tony Hoffman

931
01:06:48,920 --> 01:06:54,440
Speaker 1: and Rob Messenger. Subscribers to the Australian here. New episodes

932
01:06:54,480 --> 01:06:58,520
Speaker 1: of Sick to Death first at Sick to Death podcast

933
01:06:58,680 --> 01:07:03,760
Speaker 1: dot com and on Apple Podcasts. You can get exclusive

934
01:07:03,840 --> 01:07:26,520
Speaker 1: access to photographs, videos, timelines and more at the website