Speaker 1: My name is Hedley Thomas. Sick to Death is based
Speaker 1: on my book of the same name, and it's the
Speaker 1: true story of doctor Jan Patel's lies and manipulation and
Speaker 1: the herculean effort it took to finally stop him. We've
Speaker 1: used voice actors throughout this series, and on occasion the
Speaker 1: real people from the story have read their words for us.
Speaker 1: It is brought to you by Me and the Australian.
Speaker 1: Chapter twenty four, The Outpouring October to November two thousand
Speaker 1: and four, Tony Hoffman finally lost patience with her smug
Speaker 1: and unresponsive managers. Her more than enough about the merits
Speaker 1: of mediation. She did not want psychological counseling. She felt
Speaker 1: patronized by all the talk about personality conflict with Jon Patel,
Speaker 1: and she was angry that the nurse unit manager, Linda
Speaker 1: Mulligan believed the problems on the wards and in the
Speaker 1: intensive care unit might be fixed by a book called
Speaker 1: Coping with Difficult People. Doctor Darren Keating had convinced himself
Speaker 1: and others that much of the criticism of Patel was
Speaker 1: the product of the surgeon's personality. Clash with Tony Hoffman.
Speaker 1: On eighteen October, doctor Keating, Peter Leck, and Linda Mulligan
Speaker 1: met to talk about the problems. They agreed that there
Speaker 1: needed to be mediation. The constant bickering was having an
Speaker 1: impact on the operations of the intensive care unit. Keating
Speaker 1: was fed up with the stream of complaints against the
Speaker 1: star surgeon. He made time in his diary to meet
Speaker 1: Patel and Hoffman together. He doubted he could resolve their feud,
Speaker 1: but he might be able to placate them for a while.
Speaker 1: Keating had made no secret of his admiration for Patel.
Speaker 1: Hoffman believed that it verged on sicker fancy. As Keating
Speaker 1: told one of the ICU nurses in doctor Pateel's presence
Speaker 1: outside the hospital canteen.
Speaker 2: When you get to be as great as this man,
Speaker 2: you can do what you want.
Speaker 1: When Linda Mulligan again raised unresolved behavior and communication issues,
Speaker 1: shortly before lunch on twenty October, Tony Hoffman made her
Speaker 1: most forceful effort yet to bring about decisive action.
Speaker 3: Doctor Petel's the patient for dying because of his care.
Speaker 1: Hoffman knew that her career would probably stall or even end,
Speaker 1: but to hell with it. In an angry outburst, she
Speaker 1: spoke about Petel's dishonesty in describing the condition of patients,
Speaker 1: how doctor Peter Meak refused to let his patients undergo
Speaker 1: procedures by the Director of Surgery, and how the number
Speaker 1: of post operative complications was without precedent. A few hours later,
Speaker 1: in a hastily called meeting in Peter Leck's office, Tony
Speaker 1: Hoffman repeated the serious allegations. She also told Lek about
Speaker 1: Petel's stubborn refusal to observe hygiene and how a probable
Speaker 1: consequence wound to Hastens from infection was not properly reported
Speaker 1: in the patient's notes because Patel knew it would give
Speaker 1: clues to his negligence.
Speaker 3: Hoffman told Leck the death of mister Bramach was the
Speaker 3: last straw. They may come back and say he would
Speaker 3: have died anyway, but that isn't the point. It was
Speaker 3: about Dr Pateell interfering in the process that would have
Speaker 3: got the patient to Brisbane in time for him to
Speaker 3: have the best chance.
Speaker 1: Hoffman reminded Leck of how she had gone to him
Speaker 1: eight months earlier with her concerns about doctor Petel's behavior,
Speaker 1: and how she and doctor John Joyner had warned doctor
Speaker 1: Keating about the dangers of the esophagectames. In mid two
Speaker 1: thousand and three, she repeated other disturbing clues to Petel's incompetence,
Speaker 1: including evidence of the harm caused to patients in the
Speaker 1: renal unit because of his ineptitude with the placement of catheters.
Speaker 1: Hoffman gave the district manager an ultimatum unless there was
Speaker 1: a rigorous and independent audit of the outcomes for Petel's patients,
Speaker 1: she would be forced to take further steps. As she
Speaker 1: told Leck, I'm.
Speaker 3: Quite happy to be proven wrong.
Speaker 1: In an email to people two days later, she documented
Speaker 1: the details of unnecessary suffering by a dozen of Beateell's patients.
Speaker 3: I spoke with doctor Dieter Barons and informed him the
Speaker 3: nursing staff were going to report their concerns with Dr
Speaker 3: Petell to an official source. He stated he would support
Speaker 3: us by telling the truth, but he was concerned he
Speaker 3: would lose his job and Dr patell would be the
Speaker 3: one left behind. It is widely believed among the medical
Speaker 3: and nursing staff that Dr Petell was very powerful, that
Speaker 3: he was wholeheartedly supported by Peter Leck and Darren Keating,
Speaker 3: and was untouchable anyone who tried to alert the authorities
Speaker 3: about their concerns would lose their jobs. This perception was
Speaker 3: indeed perpetrated by Dr Petell on a daily basis. Many
Speaker 3: of the principal house officers have expressed their concern doctor
Speaker 3: Alex Davis and doctor David Risen, but were unsure of
Speaker 3: what to do because of the wide spa read belief
Speaker 3: Dr Patel was protected by executive.
Speaker 1: On the day Lek received Hoffman's written report, doctor Keating
Speaker 1: and doctor Miak had an angry row over Patel's competence,
Speaker 1: but still nothing was done to restrict any of Patel's work.
Speaker 1: The surgical wards were full of patients. They were still
Speaker 1: being led into theater like lambs to a slaughter. Leck
Speaker 1: briefly considered suspending Patel on full pay, but Patel was
Speaker 1: much too valuable to the hospital and the campaign to
Speaker 1: reduce the waiting lists for surgery. Lek brought time. He
Speaker 1: decided to test Hoffmann's serious allegations. Lek and Keating interviewed
Speaker 1: doctor Dieter Bearns, one of the anesetus, who questioned Patel's
Speaker 1: competence and judgment in undertaking some operations. Doctor Barons bluntly
Speaker 1: described Patel as dishonest about his mistakes and so rigid
Speaker 1: he refused to consider alternative and safe clinical options for
Speaker 1: the patients. Doctor David Risson, a relatively junior doctor, revealed
Speaker 1: that he had concerns about the number of post operative
Speaker 1: complications and infections. Patel's dismantling of one of the reporting
Speaker 1: mechanisms meant that the surgical audit process was a bad joke.
Speaker 1: When doctor Risson had previously raised a wounddhesiance, Peatel tried
Speaker 1: to change the definition of dhesiince Patel had said.
Speaker 4: We should be careful what we call woundhesions and what
Speaker 4: we're class Woundehessins.
Speaker 1: The director of surgery, was trying to minimize the number
Speaker 1: of complications being recorded. The next doctor to be interviewed,
Speaker 1: Martin Strawn, had nothing to lose for speaking his mind.
Speaker 1: He was a visiting medical officer who helped out at
Speaker 1: the hospital when he had time away from his full
Speaker 1: time job elsewhere. He described Patel's misdiagnosis of a woman
Speaker 1: upon whom the Director of surgery was determined to perform
Speaker 1: an extremely complex Whipple's procedure. She died several days later.
Speaker 1: Martin Strawn was convinced that Patel believed he was invincible,
Speaker 1: a Johnny come Lately, as the doctor called Patel, but
Speaker 1: with aggressive trays, who was strongly supported by management to
Speaker 1: take a scalpel to the waiting lists. Doctor Strawn also
Speaker 1: emphasized the dangerous vacuum into which Patel had arrived. The
Speaker 1: director of surgery, who saw himself as a self declared
Speaker 1: expert from the first world to help the third world
Speaker 1: of Bunderberg, had been permitted to operate without any form
Speaker 1: of peer review. Keating and Les did not bother asking
Speaker 1: doctor Meak, the most qualified and experienced specialist in the district,
Speaker 1: but in early November two thousand and four, doctor Meak
Speaker 1: handed to Keating another scathing indictment of doctor Patel. It
Speaker 1: was a letter written by doctor Jason Jenkins, a vascular
Speaker 1: surgeon at the Royal Brisbane Hospital who was held in
Speaker 1: high regard for his specialist skills and integrity. He sent
Speaker 1: it to doctor Meak and to Patel. Only rarely would
Speaker 1: doctor's blast colleagues in writing over the care of patients,
Speaker 1: but doctor Jenkins was enraged after he examined Marylyn Daisy
Speaker 1: on one November for her diabetes problems. When he saw
Speaker 1: Marylyn Daisy, doctor Jenkins asked the.
Speaker 5: Question, when did you get that done?
Speaker 1: Doctor Jenkins asked, when he saw the bandage on her
Speaker 1: below knee amputation.
Speaker 2: Six weeks ago, do you mind if I have a
Speaker 2: look at it? Has it not healed yet?
Speaker 1: It was clear that not only had the wound not healed,
Speaker 1: the sutures were still in Daisy's amputation stump. Six weeks later,
Speaker 1: there was also an area of gangrene.
Speaker 5: So have you seen the surgeon since the operation? What's
Speaker 5: you going to do about this? Did he offer you
Speaker 5: a chance of saving your leg?
Speaker 3: I haven't seen the surgeon since the procedure. No, they
Speaker 3: just said that I need my leg off.
Speaker 1: Patel had not offered Daisy the option of trying to
Speaker 1: save her leg with a bypass operation. In his letter,
Speaker 1: Jenkins wrote.
Speaker 5: These suitures were heavily buried within the tissue and very
Speaker 5: difficult and painful to remove. I find it mind boggling
Speaker 5: that someone could leave sutures in for this long. It
Speaker 5: shows a complete lack of understanding of diabetic disease and
Speaker 5: how to form an operation. I have suggested to her
Speaker 5: that when she comes to Brisbane that she will require
Speaker 5: a de bridement of this stump, and if it fails
Speaker 5: to heal, then she may require an above knee amputation.
Speaker 5: I think if procedures can't be performed appropriate with the
Speaker 5: Bunderberg Hospital, then they should not be performed at all.
Speaker 1: In the months before days he sought help in Brisbane,
Speaker 1: Jenkins had noted a disturbing pattern in patients who underwent
Speaker 1: vascular surgery by Patel. Jenkins quickly determined that the director
Speaker 1: of surgery was doing more harm than good. He was
Speaker 1: astounded when doctor Peter Meak told him how he had
Speaker 1: tried to stop Patel, but to no avail. Patel would
Speaker 1: go and find patients in the wards and operate without
Speaker 1: meac knowing. Before writing the letter, Jenkins telephoned Patel and
Speaker 1: threatened to report him to the medical board if he
Speaker 1: kept doing vascular work.
Speaker 5: Look, you know, if you keep doing this then there
Speaker 5: are going to be consequences.
Speaker 1: But Patel was unmoved. For as long as the hospital
Speaker 1: let him do such operations, he had no intention of stopping.
Speaker 1: Peter Meak gave doctor Keating the written complaint on the
Speaker 1: same day that the Health Practitioner's Tribunal in Brisbane was
Speaker 1: delivering its own verdict. The wheels of justice had turned
Speaker 1: slowly for Elise Neville, her parents, and doctor Andrew Donovan,
Speaker 1: who was pleading guilty to unsatisfactory professional conduct to save
Speaker 1: himself and his family further trauma and crippling legal fees.
Speaker 1: In her findings, District Court Judge DeBie Richards wrote.
Speaker 6: The tragedy has had an enormous impact on the Neville
Speaker 6: family and no doubt others who knew and loved young Elise.
Speaker 6: Doctor Donovan must have been fatigued by the hours he
Speaker 6: was working. It seems extraordinary in this day and age
Speaker 6: that anyone, let alone someone in a position of such responsibility,
Speaker 6: should be asked to work such long hours. One does
Speaker 6: not need medical evidence to know that anyone who's in
Speaker 6: the twentieth hour of a continuous duty must have reduced
Speaker 6: capacity to assess the situation when it presents itself. If
Speaker 6: this tragedy leads to nothing else, it should lead to
Speaker 6: the abolition of such brutally long shift hours.
Speaker 1: Judge Richards concluded that Andrew Donovan's treatment of Elease was
Speaker 1: deficient in a number of respects.
Speaker 6: She ruled his interpretation of the history and physical findings
Speaker 6: based on limited examination and his lack of appreciation of
Speaker 6: the parents' concerns were wrong and errors of judgment which
Speaker 6: eventually denied at least the chance of survival. Accordingly, the
Speaker 6: Tribunal concurs with the board submissions that stringent conditions should
Speaker 6: be placed on doctor Donovan's continuing right now to practice.
Speaker 1: The disciplinary orders compelled doctor Andrew Donoman to work in
Speaker 1: a supervised position for twelve months with ongoing assessment and
Speaker 1: reporting of his competence to assess patients. After the delivery
Speaker 1: of the judgment, I walked to a nearby cafe to
Speaker 1: talk to Gered and Lorraine. They still had unfinished business.
Speaker 1: Gered pledged the system was yet to reform itself. When
Speaker 1: the pain in Trevor Holter's stomach had become too much,
Speaker 1: he went to see his GP doctor Ken Hornsby. At
Speaker 1: fifty four, Halter regarded himself as being in reasonably good shape,
Speaker 1: as fit as a Malley bull, he half jokingly boasted,
Speaker 1: but the pain was constant. Even Halter, a part time
Speaker 1: race caller who rolled beer kegs around the club where
Speaker 1: he did odd jobs, had to concede he needed help.
Speaker 1: Dr Hornsby wrote a referral letter for him to attend
Speaker 1: the patients department at Bunderberg Hospital. Trevor Halter had gallstones. Fortunately,
Speaker 1: he learned that the condition was easily remedied. J. N.
Speaker 1: Patel spoke to.
Speaker 4: Him, you're probably better off having your golde blooder out
Speaker 4: because you don't really need it, and so you may
Speaker 4: as well have it out. I do four to five
Speaker 4: a week and there's nothing to it. It's keyhold surgery.
Speaker 1: The routine corrective procedure laparoscopic color systectomy was on a
Speaker 1: par with having your tonsils out. Trevor Halter learned that
Speaker 1: he would need to stay just one night in the
Speaker 1: hospital after the operation, he awoke in agony. He spent
Speaker 1: the next seven weeks in hospital. Two of those weeks
Speaker 1: were in the intensive care unit as he fought for
Speaker 1: his life. His children were told his lungs had collapsed,
Speaker 1: his liver had failed, and he contracted pneumonia and septo semia.
Speaker 1: Then his heart went. He was finally transferred by helicopter
Speaker 1: to Brisbane on four December for life saving treatment, all
Speaker 1: from a routine gallbladder operation bungled by doctor Patel. Months later,
Speaker 1: Halter was still in pain and undergoing corrective surgery, Chapter
Speaker 1: twenty five, The blood Letting. December two thousand and four,
Speaker 1: when Judy and Jerry Kemps looked back on their lives
Speaker 1: and the fruits of a close marriage of fifty years,
Speaker 1: they felt blessed. They were weared on twenty three October
Speaker 1: nineteen fifty four in Saint Patrick's Cathedral, rule in Melbourne.
Speaker 1: Judy had given birth to three healthy and happy children, Jackie,
Speaker 1: John and Bernie. They had relaxed into the gentle pace
Speaker 1: and tranquility of Bunderberg after a stint overseas. They set
Speaker 1: up a photographic studio and continued to raise their three children.
Speaker 1: The couple remained active as they aged. They went bushwalking
Speaker 1: together and enjoyed regular tennis and golf. Kemps was one
Speaker 1: of those fortunate people who never had a sick day
Speaker 1: in his life, but by two thousand and two his
Speaker 1: health began to deteriorate. His blood pressure was erratic, he
Speaker 1: got gout, he suffered back pain. When he received a
Speaker 1: letter from Queensland Health offering a free checkup, an appointment
Speaker 1: was made at the local Burrham Street medical practice. The
Speaker 1: tests on his urine sample pointed to a problem as
Speaker 1: they ate lunch. Ten days later, Judy told her husband,
Speaker 1: you look yellow.
Speaker 4: You look anemic to me.
Speaker 1: By six December, further tests at Bunderberg Hospital showed that
Speaker 1: Kemps was bleeding internally. The endoscope had identified a large
Speaker 1: malignant tumor about four centimeters in size in the lower esophagus.
Speaker 1: The CT scans showed that the cancer had spread beyond
Speaker 1: the esophagus. There were shadows on both lungs. There were
Speaker 1: enlarged lymph nodes where the trachea splits into the left
Speaker 1: and right main branches. Dr Dorge Smallburger was adamant that
Speaker 1: Kemps needed to go to Brisbane for keyhole surgery. Nothing
Speaker 1: too radical was proposed. The cancer was such that the
Speaker 1: patient might have just twelve months to live. Under the circumstances,
Speaker 1: Dr Smalberger wanted to ensure Jerry Kemps received the best
Speaker 1: care and quality of life possible for the time he
Speaker 1: had left. He did not contemplate an aesophagectomy, even for
Speaker 1: a highly competent surgeon. Such a complex procedure was far
Speaker 1: too risky, but with the presence of secondary cancers, it
Speaker 1: was also pointless. Dr Smolberger decided that the best course
Speaker 1: of action was a stent to make it easier for
Speaker 1: Jerry Kemp's to swallow his food. The protocol for a
Speaker 1: transfer of a patient from Bunderberg to another hospital surgical
Speaker 1: department required the decision to be signed off by a
Speaker 1: surgeon in Bunderberg. Unfortunately, for Jerry Kemps, he was seen
Speaker 1: by Jayan Patel. The safe and conservative course was suddenly
Speaker 1: turned on its head by the director of surgery. Patel
Speaker 1: told the couple that the keyhole surgery recommended by doctor
Speaker 1: Smallberger was just patch up work, and that what he
Speaker 1: really needed was an esophagectomy. Patel explained how he would
Speaker 1: remove part of the stomach and part of the esophagus
Speaker 1: and join what was left back together again, no problems.
Speaker 4: It is the big operation, but it is nothing because
Speaker 4: I've done hundreds of them.
Speaker 1: His confidence was contagious. Neither Kemp's nor his wife was
Speaker 1: given any reason to doubt Patel. Theater nurse Damien Gadds
Speaker 1: went to work early to start preparing for the operation
Speaker 1: on Jerry Kemp's, but there was a problem. The intensive
Speaker 1: care unit already had two patients on ventilators. They would
Speaker 1: be unable to cope with Jerry. Nurse Gads called doctor
Speaker 1: Deta Berens, who agreed the operation should be postponed, But
Speaker 1: when Gads reached Jayon Patel on his mobile telephone, the
Speaker 1: director of surgery was furious.
Speaker 4: That brin dead beat and should have been switched off
Speaker 4: last night.
Speaker 1: At eight pm. The day before, Patel had told a
Speaker 1: nurse to call doctor John Joyner and ask him to
Speaker 1: turn off the life support keeping a critically ill woman,
Speaker 1: Robin Turton, sixty three alive. Turton had slipped in the
Speaker 1: bath and hit her head on Saturday, suffering a cerebral bleed.
Speaker 1: Her family was aware that her prospects were poor. Her
Speaker 1: death would free up an ICU bed, and could tell
Speaker 1: wanted it for Jerry Kemp's, but Joyner flatly refused. He
Speaker 1: was offended at the indecent haste to end the life
Speaker 1: of a woman who had not yet undergone formal brain
Speaker 1: death tests. Although it was probable from the CT scans
Speaker 1: that she was brain dead, doctor Joyner prudently decided to wait.
Speaker 1: Patel had little time for doctor Joyner, the anesthetist who
Speaker 1: eighteen months earlier had express concern to management about the
Speaker 1: risks of performing aesophagectamies in a small hospital with a
Speaker 1: limited icee you. As Patel did his ward rounds on
Speaker 1: Monday morning, he bad mouthed doctor Joyner. Patel told Martin Brennan,
Speaker 1: one of.
Speaker 4: The nurses, I have a theater chise to do.
Speaker 1: The theater nurse was astonished at Patel's cavalier approach to
Speaker 1: ending Turton's life before the necessary brain death tests had
Speaker 1: been done. Martin Brennan did not trust doctor Patel. He
Speaker 1: had heard the surgeon intimidate and bully the nurses and
Speaker 1: threaten to harm their careers. Patel had created a climate
Speaker 1: of fear in the operating theater and in the intensive
Speaker 1: care unit. All the nurses doubted that they would be
Speaker 1: bad by management. In a showdown, as Patel often boasted
Speaker 1: of his influence over Darren keating.
Speaker 4: I can get what I want from Darren as I've
Speaker 4: just made this hospital five hundred thousand dollars.
Speaker 1: Patel stormed into doctor Martin Carter's office and denounced doctor Joyner.
Speaker 1: He pressured Carter to end Robin Turton's life and free
Speaker 1: up a bed for the esophagectomy. Nurse Vivian Tapiolus witnessed
Speaker 1: Betel's insistence on the withdrawal of life support for Turton,
Speaker 1: whose children were in the waiting room at the ICU,
Speaker 1: as Pateel pressed doctor Carter to make a decision. After
Speaker 1: a review of the charts, Tapiolus and the two doctors
Speaker 1: spoke to the family about ending Turton's life. Patel walked
Speaker 1: back into the ICU with a spring in his step.
Speaker 4: Now I can perform the esophagectomy.
Speaker 1: Doctor Carter switched off life support at eight fifty five
Speaker 1: am on Monday, despite the absence of the formal brain
Speaker 1: death tests. Carter decided that there was sufficient clinical evidence
Speaker 1: to show Turton had suffered massive and irreparable brain damage.
Speaker 1: He wrote, in view of the dreadful prognosis this lady
Speaker 1: has and following discussion with family, ventilator support is to
Speaker 1: be withdrawn. Importantly, for Patel, he now had a spare bed.
Speaker 1: At nine to fifty two am on Monday, twenty December,
Speaker 1: less than an hour after the death of Robin Turton,
Speaker 1: the operation on Jerry Kemp's began. Patel was flanked in
Speaker 1: theater by the anesthetis doctor Dieter Behrens, two principal House officers,
Speaker 1: doctor Sanjeeva carr Owasam and doctor Anthony Athanasiov and the nurses.
Speaker 1: Doctor Karyoasam had spent much of his time at the
Speaker 1: hospital as Patel's shadow. They got along well. Patel was
Speaker 1: only too happy to explain the complexities of surgery to
Speaker 1: his eager apprentice. Together they used to undertake what Patel
Speaker 1: would call a blitz. In one week, there would be
Speaker 1: a swag of colonoscopy procedures. In another week there would
Speaker 1: be a run of gallbladder operations. It was part of
Speaker 1: Patel's ongoing assault on the waiting lists, and it kept
Speaker 1: him in management's good books. Korea Withsam often heard Patel
Speaker 1: boasting about how successful he had been in reducing the
Speaker 1: lists and establishing rapport with Keating. The esophagectomy appeared to
Speaker 1: go well at first. Jerry Kemps's abdomen needed to be
Speaker 1: opened to permit access to the esophagus and the stomach. Suddenly, however,
Speaker 1: he became unstable with plunging blood pressure and a rising
Speaker 1: pulse rate. Kemp's was turned onto his side for the
Speaker 1: thorochotomy part the opening of the chest cavity. As Patel
Speaker 1: resected the tumor in the chest. The blood continued to
Speaker 1: pour freely into the drain. The heavy bleeding in the
Speaker 1: abdominal cavity was obvious to everyone. Doctor Barons was worried.
Speaker 1: Apart from the blood loss, he could see that the
Speaker 1: director of surgery lacked the skill to be attempting such
Speaker 1: an operation. Patel's roughness around the heart and the vessels
Speaker 1: was all too obvious, nor did he appear interested in
Speaker 1: the monitoring being done by doctor Barons of blood pressure
Speaker 1: and other vital signs. Barons was shocked. It was as
Speaker 1: if Patel could not acknowledge a major problem. Unless the
Speaker 1: blood stopped flowing, Kemps would surely die. Nurse Damien Gas
Speaker 1: raised the alarm. Dr Patel, the Bellovac draine is over
Speaker 1: half full with no vacuum and is still draining freely.
Speaker 4: That's what dreams are forward Demian.
Speaker 1: To the amazement of doctor Barons and the theater nurses,
Speaker 1: who were alarmed by the obvious and heavy bleeding, Patel
Speaker 1: gave instructions for Kemps to go to the ICU. From
Speaker 1: that moment it was inevitable that he would not survive.
Speaker 1: At two PM, Patel called Judy at her home. He
Speaker 1: told her it was a great success. We've got it all.
Speaker 1: There's a little bit of bleeding there, but that's nothing.
Speaker 1: When Judy went to the intensive care unit soon afterwards,
Speaker 1: she saw a nurse frantically pumping blood into her husband's body.
Speaker 1: Jerry Kemps received more than thirty bags of blood altogether.
Speaker 1: His abdomen was distended as bright blood drained away. Three
Speaker 1: nurses were needed at his bedside for fluid management, and
Speaker 1: one ran back and forth from the blood bank for
Speaker 1: products and to page the doctors. Doctor Barons was using
Speaker 1: large quantities of a drug to maintain blood pressure and
Speaker 1: support the heart. Another nurse took Judy aside and told
Speaker 1: her Jerry is a very sick man and he is
Speaker 1: on life support. Judy, joined by her son John, went
Speaker 1: over to his bedside and gave Jerry a kiss. I
Speaker 1: love you, she said. He tried to sit up. At
Speaker 1: five pm, Judy was told of the need for another operation.
Speaker 4: I have to take him back into theater again. It
Speaker 4: can only be the spleen. I'll dig it out because
Speaker 4: he doesn't need it anyway.
Speaker 1: But Patel had begun another operation on a different patient,
Speaker 1: which led to another complication. Kemps was not taken back
Speaker 1: into theatre until after six thirty pm. The situation was
Speaker 1: critical when doctor David Risson, who had not been involved
Speaker 1: in the esophagectomy, came to theatre to help. Doctor Risson
Speaker 1: was surprised to see doctor Sanjeeva Carrio asam a junior doctor,
Speaker 1: identifying problems and tactfully pointing them out to Patel, who
Speaker 1: seemed out of his depth and at a loss to
Speaker 1: pinpoint the torrential bleeding. Patel reopened Jerry's abdominal cavity and
Speaker 1: the chess cavity. As scout nurse Janelle Law's tasks included
Speaker 1: finding sutures, sponges, and anything else that might be needed
Speaker 1: for the operation. Janelle lost track of the amount of
Speaker 1: blood spilling from Kemps on the operating table, but she
Speaker 1: counted seventy five large sponges and fifteen gauze squares to
Speaker 1: absorb the blood. It was everywhere. As the nurses moved
Speaker 1: around theater, they left footsteps of blood on the floor.
Speaker 4: This man's going to die. He's going to die on
Speaker 4: the deva. I can't do anything. Get the family, Get
Speaker 4: the family.
Speaker 1: Janelle Law watched Patel becoming more agitated, defending his surgery
Speaker 1: and saying that the bleeding had nothing to do with him.
Speaker 4: This isn't my fault. This has nothing to do with
Speaker 4: my surgery. This isn't my fault.
Speaker 1: But Patel also had a rare moment of insight. He
Speaker 1: was shaken by the demise of Jerry Kemp's He said
Speaker 1: in the operating theater.
Speaker 4: Maybe they're right. Maybe we shouldn't be doing aesophagectamies. Maybe
Speaker 4: I should start thinking about not doing these type of
Speaker 4: procedures anymore.
Speaker 1: Janelle Law opened the theater door for Patel to go outside
Speaker 1: to talk to Judy and her two sons. Patel was
Speaker 1: covered in his patient's blood.
Speaker 4: I've taken the spleen out, but it was all right.
Speaker 4: I had a look at the lungs and they were
Speaker 4: all right. So the bleeding must have come from the
Speaker 4: hot I can't do anything about it, but he will
Speaker 4: be lucky to last the.
Speaker 1: Night, Patel repeatedly told the shocked Kemp's family that his
Speaker 1: surgery was perfect. The longest night in Judy's life was
Speaker 1: spent with her dying husband in Tony Hoffman's intensive care unit.
Speaker 1: Jerry's demise was inevitable. The equipment supporting him was gradually removed.
Speaker 1: Judy noticed something else. The nursing staff seemed strangely uncomfortable
Speaker 1: around her. Their body language was defensive, they avoided eye contact.
Speaker 1: Jerry Camps died at nine to twenty am on twenty
Speaker 1: one December two thousand and four. Doctor Patel had notched
Speaker 1: up another lucrative procedure for Bunderberg based hospital, which received
Speaker 1: its financial bonus irrespective of whether the patient survived the operation,
Speaker 1: and the intensive care unit bed was vacant again already.
Speaker 1: Doctor Athanasiov, given the task of filling in the death certificate,
Speaker 1: was discouraged by Patel from referring the case to the coroner.
Speaker 4: We know the cause of death. It was due to
Speaker 4: a bleed in the aoder.
Speaker 1: The theater staff were furious with Patel. Doctor Barons was alarmed.
Speaker 1: He could not understand why Patel would send a bleeding
Speaker 1: patient to the intensive care unit, nor could he understand
Speaker 1: Patel's inability hours later to discover the source of the bleeding.
Speaker 1: Doctor Barons and doctor Martin Carter agreed the death should
Speaker 1: be reported for formal autopsy. The Coroner's act referred to
Speaker 1: a death being reportable where it was not reasonably expected
Speaker 1: to be the outcome of a health procedure. But by
Speaker 1: the time the two anisthetis had come to this view
Speaker 1: it was too late. A notice in the Bunderberg news
Speaker 1: mail showed that Kemp's was being buried in a few hours.
Speaker 1: Doctor Barons was struck by the lack of interest from
Speaker 1: doctor Darren Keating when it came to investigating. Even when
Speaker 1: doctor Carter explained his concerns about the survival rates of
Speaker 1: Ptel's patients, Nurses Janelle Law and Damien Gadds decided to
Speaker 1: make a formal complaint they believed doctor Petel had killed Kemps.
Speaker 1: In the afternoon after Kemps's death, Peter Lex saw a
Speaker 1: note blandly advising the outcome of the complex procedure performed
Speaker 1: by the director of surgery. Leck asked doctor Keating a question.
Speaker 7: The esophagectomy concerns me somewhat. Have any of these patients survived.
Speaker 1: Chapter twenty six, Life and Limb Late December two thousand
Speaker 1: and four to January two thousand and five, Shannon Mobs
Speaker 1: fell spectacularly from his friend's trailbike at ten am on
Speaker 1: twenty three December the day duty Kemp's farewelled her husband
Speaker 1: at his funeral in Bunderberg. The teenager had struck a
Speaker 1: tree stump hidden by long grass on a winding track
Speaker 1: at Woodgate south of Bunderberg. The fifteen year old was
Speaker 1: flown by helicopter to Bunderberg Hospital after his friend sped
Speaker 1: ten kilometers along the track to raise the alarm. By
Speaker 1: the time he was in the operating theater for life
Speaker 1: saving surgery by Jayon Patel, the boy had lost a
Speaker 1: massive amount of blood from a deep slash in his
Speaker 1: groin an lacerated femeral vein in his thigh. His condition
Speaker 1: was so perilous that the boy was initially transfused with
Speaker 1: blood that did not match his type, but at least
Speaker 1: it kept him alive. After the first operation, Patella merged
Speaker 1: from theater to reassure Mobs's mother, Karen Oriole. The surgeon
Speaker 1: talked about himself for the first ten minutes, falsely claiming
Speaker 1: that he had been in charge of the trauma and
Speaker 1: emergency ward of a New York hospital for a decade.
Speaker 1: Karen Oriole was relieved when the director of surgery told
Speaker 1: her he had stopped the bleeding. He assured her that
Speaker 1: her son was fine and would make a complete recovery,
Speaker 1: all thanks to Patel's vascular surgery. Over the next twelve hours,
Speaker 1: Dr Pittell performed another two operations on Shannon Mobs. Despite
Speaker 1: the initial life saving surgery and then serious complications demanding
Speaker 1: more major surgery. Dr Pittell told the other doctors and
Speaker 1: Karen Oriole that there was no need to transfer the
Speaker 1: boy to Brisbane. Pettell left the hospital on Boxing Day
Speaker 1: to fly to the United States for annual leave, but
Speaker 1: not before instructing the medical staff to keep the boy
Speaker 1: in the surgical ward. He had extracted something from Darren
Speaker 1: Keating on Christmas Eve. It was another Dear j letter.
Speaker 1: It set out the terms of a four year extension
Speaker 1: of his current contract. Keating wrote, I.
Speaker 2: Would like to offer my congrettions on your ongoing appointment
Speaker 2: and hope that you'll work with the Bunderberg Health Service
Speaker 2: District will continue to be both beneficial and rewarding.
Speaker 1: The many serious issues raised by Tony Hoffman were yet
Speaker 1: to be formally investigated. She was at home mourning the
Speaker 1: death of her grandmother at ninety eight, preparing for the
Speaker 1: funeral in Sydney and worrying about the condition of young
Speaker 1: Shannon Mobs. Although Tony was supposed to be on annual
Speaker 1: leave and entertaining her parents, her sister Marie and husband Matthew,
Speaker 1: and their two kids, she could not let go of
Speaker 1: the problems with Patel. She stayed in touch with the
Speaker 1: hospital by telephone and repeatedly urged the nurses in the
Speaker 1: intensive care unit to do what they could to influence
Speaker 1: the transfer of Shannon.
Speaker 3: You've got to get that boy to Brisbane.
Speaker 1: Tony's brother in law, Matthew, was also worried. He could
Speaker 1: see the high levels of stress that she was under
Speaker 1: when she was supposed to be on holidays. Tony showed
Speaker 1: him the lengthy letter of complaints she had written and
Speaker 1: spoke to him about her pleas for a clinical audit.
Speaker 1: He told her that at least you will be able
Speaker 1: to sleep at night, but Hoffmann was finding sleep difficult
Speaker 1: For most of the nine days Shannon Mobs remained in
Speaker 1: the hospital. There was no pulse in his left foot.
Speaker 1: The foot was dying. Contrary to the claims Patel had
Speaker 1: made in the notes about repairing Mobs's femeral vein, he
Speaker 1: had simply tied it off after doctor Pateell went on holidays,
Speaker 1: handing over to doctor Jim Gaffield. The boy was in
Speaker 1: excruciating pain, with a fractured pelvis, huge muscle tears in
Speaker 1: his thigh, raging temperatures, sepsis and gangrene. It took until
Speaker 1: one January and a snap decision by and appalled Dr
Speaker 1: David Risson on his return from leave, for Mobs to
Speaker 1: be airlifted to the Royal Brisbane Hospital. There, doctor Mark
Speaker 1: Ray diagnosed him on New Year's Day as the sickest
Speaker 1: fifteen year old he had ever seen. Doctor Ray could
Speaker 1: smell the septic and grossly infected leg from the other
Speaker 1: side of the emergency department. He did not expect Mobs
Speaker 1: to survive the night. If he did survive, he would
Speaker 1: need more surgery to amputate his leg through the knee.
Speaker 1: The operation by doctor Jason Jenkins and doctor Ray showed
Speaker 1: that both ends of the femoral vein had been suture
Speaker 1: legated instead of being reconstructed. Blood had been going to
Speaker 1: Shannon's limb through the femoral artery, but it could not
Speaker 1: drain away through the femoral vein. This had led to
Speaker 1: gross swelling and a range of serious life threatening implications.
Speaker 1: Steve Rashford, who organized the emergency airlift, and the two
Speaker 1: Brisbane surgeons Jenkins and Ray, were disgusted by the care
Speaker 1: Mobs had received in Bunderberg. There was no excuse for
Speaker 1: the failure to send him to Brisbane after the initial surgery.
Speaker 1: They believed that the athletic two meter tall boy who
Speaker 1: wanted to be a professional basketballer might have kept his
Speaker 1: leg if he had been transferred immediately after the major operation.
Speaker 1: On four January, Michelle Hunter, the nurse who had alerted
Speaker 1: the doctors to Shannon's shocking condition on New Year's Eve,
Speaker 1: resolved to do something. She had come to the conclusion
Speaker 1: that Patel was a serial danger. She had never seen
Speaker 1: so many instances of woundehesince, and the Internet search she
Speaker 1: had done months earlier was still on her mind. Patel's
Speaker 1: treatment of Shannon Mobs, the eyeing off of his feneral vein,
Speaker 1: which effectively destroyed his leg, persuaded Michelle Hunter to act.
Speaker 1: She went to see Tony Hoffman, who was back from
Speaker 1: Christmas leave, but the nurse in charge of the ICU
Speaker 1: had still not heard anything from Peter Leck or Darren
Speaker 1: Keating about an investigation. Despite her increasingly detailed and grave
Speaker 1: complaints made during two thousand and four, Hunter decided to
Speaker 1: make her own complaint. She considered going directly to the
Speaker 1: Health Rights Commission. First, she sent a MIMO to Linda
Speaker 1: Mulligan setting out her concerns over the Mob's case.
Speaker 8: My concerns are with the surgeon that performed his initial
Speaker 8: three operations. I'm concerned that if the patient had been
Speaker 8: transferred to Brisbane initially, he may not have lost his
Speaker 8: leg or be in such a grave condition. I would
Speaker 8: like his treatment the hospital investigated, as I fear his
Speaker 8: health and well being has now been compromised by inadequate
Speaker 8: substandard treatment by the medical team.
Speaker 1: There was a similar expression of concern from doctor Rashford
Speaker 1: in Brisbane, who wrote to the most senior administrators in
Speaker 1: Queensland Health and he copied his memo to Peter Leck
Speaker 1: and Darren Keating. Pressure was mounting, but doctor Keating, who
Speaker 1: wanted Patel to return from holidays to a new four
Speaker 1: year contract, produced a report stating that no external probe
Speaker 1: was necessary. Linda Mulligan was now starting to worry. From
Speaker 1: the beginning, she had downplayed Tony Hoffman's concerns. She believed
Speaker 1: that the nurse and the top surgeons simply loathed each
Speaker 1: other and that Hoffman's complaints were motivated by emotional rather
Speaker 1: than clinical issues. But on seven January, three distraught nurses
Speaker 1: from the operating Things Katrina's Wolak, Damien Gadd's a Janelle
Speaker 1: Law had decided to unite in an unprecedented complaint. They
Speaker 1: went to Mulligan and they told her that Patel was
Speaker 1: a shocking surgeon whose patients were dying unnecessarily. Katrina and
Speaker 1: Janelle were weeping as they told of the falsification of patients'
Speaker 1: records by Patel and of how staff had felt powerless
Speaker 1: because of his claims to have management in his pocket.
Speaker 1: Linda Mulligan immediately tipped lek Off about this dramatic new development.
Speaker 8: She told him they displayed different degrees of emotion to
Speaker 8: the point of one stating that the whole issue was
Speaker 8: keeping them from sleeping.
Speaker 1: All of Tony Hoffman's claims were being corroborated, and still
Speaker 1: a clinical audit of Patel's work was not begun. Chapter
Speaker 1: twenty seven Executive Decisions thirteen to fourteen January two thousand
Speaker 1: and five. Peter Leck was showing the first signs of
Speaker 1: acute panic by the time J. N. Patel had returned
Speaker 1: to work in early January. Leck worried about his own
Speaker 1: failure to conduct any sort of review of Patel, despite
Speaker 1: a trial of dead and maimed patients and a string
Speaker 1: of complaints. He had broken his own promise to Hoffman
Speaker 1: to have the concerns properly checked. He had not even
Speaker 1: told her what he was doing. Peter Leck had dithered.
Speaker 1: He had been indecisive, weak, and interminably slow. On thirteen January,
Speaker 1: Lek raised the concerns for the first time with the
Speaker 1: Acting Director General of Health, doctor John Scott.
Speaker 7: I was just wanting to flag that I actually do
Speaker 7: have some concerns the outcomes of some of doctor Pateell's surgery.
Speaker 1: He also told Scott about the nurses fears over injuries
Speaker 1: and deaths, adding that doctor Darren Keating believed that the concerns.
Speaker 7: Were completely driven by the personality conflict. However, he has
Speaker 7: now expressed some concern although he still believes most of
Speaker 7: the issues are personality driven.
Speaker 1: He was silent about the backing of Hoffman's concerns by
Speaker 1: the three doctors. Doctor Martin Carter, doctor David Risson, and
Speaker 1: doctor Dieter Behrens, who had been interviewed. Keating was angry
Speaker 1: that it had come to this. He did not like
Speaker 1: confrontations with Patel, particularly as he had exceeded the surgery
Speaker 1: targets and made Keating and the hospital look good, but
Speaker 1: the ICU and theatre staff were close to rebellion. Something
Speaker 1: had to give. Keating told Leck.
Speaker 2: Look, we need to make sure that doctor Patel is
Speaker 2: aware of the investigtion and give him as much information
Speaker 2: as possible.
Speaker 1: In a meeting in Lex's office on thirteen January, Patel
Speaker 1: was told for the first time about the complaints concerning
Speaker 1: his handling of Shannon Mobs as well as other patients.
Speaker 1: Patel was told that there would be an investigation and
Speaker 1: that in the meantime he could continue doing surgery, just
Speaker 1: not cases requiring admission to the ICU. Patel scoffed at
Speaker 1: the notion that his surgery was below standard, but for
Speaker 1: the third time in his career he faced a thorough
Speaker 1: investigation with potentially grave findings. He was indignant.
Speaker 4: I will be considering my position.
Speaker 1: The next day, Patel told doctor Keating that he would
Speaker 1: not be taking up the four year contract after one April,
Speaker 1: but he had no plans to leave Australia. Patel still
Speaker 1: believed that he could remain as a surgeon on a
Speaker 1: special contract, despite the trouble he would be in if
Speaker 1: the easily discovered details of his past came to light.
Speaker 1: He chose not to flee, at least not yet.
Speaker 4: He told Keating, I would like to thank you for
Speaker 4: your support over the past two years. My sted Bunderberg
Speaker 4: has been challenging at times, but mostly enjoyable and roareding.
Speaker 1: Keating replied with a glowing appraisal of Patel's troubled time
Speaker 1: at the hospital, thanking him for.
Speaker 2: His sustained commitment, ongoing enthusiasm and strong work ethic. I
Speaker 2: have greatly valued your advice, inside and support over the
Speaker 2: last two years, and I wish you well in the
Speaker 2: future in whatever endeavors you may take.
Speaker 1: Patel kept Keating's note for his curriculum vitae. It was
Speaker 1: the sort of adulation not dissimilar to the praise bestowed
Speaker 1: by his peers in New York State and Oregon when
Speaker 1: he had been in trouble. Seeking further reassurance and comfort,
Speaker 1: Patel turned to the junior surgeons, doctor Anthony Athanasiov and
Speaker 1: doctor Sanjeeva Carrio Asam. They were upset at the story
Speaker 1: told by their mentor, the man who had bought their
Speaker 1: meals and passed on his surgical prowess. They teamed up
Speaker 1: with three other junior doctors to lobby on Patel's behalf.
Speaker 1: In a note to doctor Keating, they wrote.
Speaker 9: Doctor Patel is now in a position whereby he feels
Speaker 9: it is not in his best interest to stay at Bunderberg,
Speaker 9: and we believe the hospital should consider this very carefully.
Speaker 9: Doctor Petel's approach to his work is nothing short of admirable.
Speaker 9: He is dedicated, hard working, efficient and knowledgeable. His efforts
Speaker 9: to ensure his patients received the best care go above
Speaker 9: and beyond the call of his duties. He consistently goes
Speaker 9: out of his way to provide timely expert management for
Speaker 9: a wide variety of surgical problems. In summary, we are
Speaker 9: concerned about the circumstances surrounding Dr Patel's departure and we
Speaker 9: believe his leading would be a great loss for the
Speaker 9: hospital and also for the Bunderberg community.
Speaker 1: By the end of January, Keating had hatched a devious plan.
Speaker 1: He was annoyed that impertinent nursing staff had dashed his
Speaker 1: hopes of retaining Jon Patel as the director of surgery
Speaker 1: until two thousand and nine, Doctor Keating decided to flex
Speaker 1: his management muscle, panned to Patel and put the nurses
Speaker 1: back in their place, all with one big decision. In
Speaker 1: early February, he offered Patel a senior surgical role with
Speaker 1: a daily rate of one thousand, one hundred and fifty dollars,
Speaker 1: a significant enhancement on his existing two hundred thousand dollars
Speaker 1: a year package. Keating had also given the medical Board
Speaker 1: another glowing appraisal of Patel's work.
Speaker 2: Dr. Patel is a very committed and enthusiastically who has
Speaker 2: continued to be a very effective member of staff and
Speaker 2: director of surgery. He has a very strong work ethic,
Speaker 2: which is a model for others.
Speaker 1: Keating told the board that there were nil significant areas
Speaker 1: for improvement in Pateel's performance, and he rated the surgeon's
Speaker 1: performance as excellent. Keating had paved the way for the
Speaker 1: four year extension offered previously. He wrote to the Department
Speaker 1: of Immigration and confirmed that the hospital planned to employ
Speaker 1: Patel until two thousand and nine, Patel was elated as
Speaker 1: he boasted to Nurse Janelle Law in the operating theater
Speaker 1: during an endoscopy procedure.
Speaker 4: They're going to be me as much for three months
Speaker 4: as what I get in a year.
Speaker 1: The nurse was appalled. She had been looking forward to
Speaker 1: seeing the back of Patel and all the problems he
Speaker 1: brought to the hospital. Now it seemed he was to
Speaker 1: be showered with money and kept on Chapter twenty eight
Speaker 1: the Investigation. February to March two thousand and five, Jerry
Speaker 1: Fitzgerald spread the email printouts, memos, reports and letters across
Speaker 1: his desk at Queensland Health Headquarters in Charlotte Street, Brisbane.
Speaker 1: The Chief Health Officer of Queensland had given himself an
Speaker 1: unenviable assignment a clinical audit of Jon Patel's surgical outcomes.
Speaker 1: The documentary material was the first part of the puzzle.
Speaker 1: Doctor Fitzgerald had already been advised by Peter Leck that
Speaker 1: there were personality differences between Patel and his principal accuser,
Speaker 1: Tony Hoffman. Fitzgerald also knew how valuable Patel was too
Speaker 1: Burg hospital. The surgeon's role in slicing through the waiting
Speaker 1: lists had been repeatedly stressed by Leck. Mindful of the
Speaker 1: sensitivities of the people involved, Fitzgerald made plans to visit
Speaker 1: Bunderberg to interview Patel as well as the nursing and
Speaker 1: medical staff. He wrote to Peter Leck.
Speaker 10: At this point, we will be simply collecting information and
Speaker 10: not seeking to validate or evaluate any particular concerns raised.
Speaker 10: Would you mind asking Dr Patel if he can spare
Speaker 10: some time to meet with me to discuss any concern
Speaker 10: he may have. Dr Patel is definitely entitled under the
Speaker 10: principles of natural justice to be confronted with the details
Speaker 10: of the complaints made against him. He may decline to
Speaker 10: meet with me until he has had the opportunity to
Speaker 10: respond to the complaints. I hope he does not do so.
Speaker 10: Our main intent is to find the facts and to
Speaker 10: seek a resolution asap.
Speaker 1: Anyone else who risked being exposed as a clinical fraud
Speaker 1: would have skipped overseas on the eve of an investigation
Speaker 1: by the Chief Health Officer, but not Jaunt. Patel, his
Speaker 1: ego and self belief, refuse to entertain the idea that
Speaker 1: he might be found out. Patel also knew that the
Speaker 1: hospital still desperately needed him. On eight February, Keating had
Speaker 1: all but pleaded for Patel and other staff to work
Speaker 1: harder on those waiting lists. The hospital was ninety two
Speaker 1: operations behind its target. Kidding wrote a memo to senior staff.
Speaker 2: Should the target not be achieved, Bunderberg Health Service District
Speaker 2: will not get another chance to upgrade the target and
Speaker 2: hence lose flexibility and significant dollars. Therefore, it is imperished
Speaker 2: that everyone continue to pull together and maximize elective surgery
Speaker 2: throughput until thirty June. All cancelations should be minimal, with
Speaker 2: these cases pushed through as much as possible.
Speaker 1: In the executive meeting room on fourteen February, Fitzgerald and
Speaker 1: Brisbane colleague Sue Jenkins began working their way through a
Speaker 1: list of about thirty nurses and doctors. Some of the
Speaker 1: interviews lasted just fifteen minutes, others went for over an hour.
Speaker 1: The nurse Karen Jenna wondered how seriously the investigation was
Speaker 1: being taken.
Speaker 3: This is not an investigation of doctor Patel.
Speaker 1: This is US.
Speaker 6: Gathering information to find out whether or not it is
Speaker 6: important to have an investigation into doctor Patel.
Speaker 1: When Patel strolled in, he acted as if he did
Speaker 1: not have a care in the world. He had spared
Speaker 1: about twenty five minutes for the chief health officer, who
Speaker 1: immediately identified and arrogance bordering on megalomania. Patel's self confidence
Speaker 1: was almost pathological. It was a personality that Fitzgerald, a
Speaker 1: naturally shy and disarming man, could not easily understand. Patel
Speaker 1: proceeded to boast about how much surgical experience he had
Speaker 1: in the United States. He repeatedly spoke of his expertise
Speaker 1: in complex procedures. He was clearly agitated at the scrutiny
Speaker 1: being applied to his work, but he brushed it off
Speaker 1: as the product of flaws in other people.
Speaker 4: He told Fitzgerald, nurses have been complaining about doctors for centuries.
Speaker 4: Some of them are lazy. They don't want to work hard.
Speaker 1: Patel offered an olive branch.
Speaker 4: Well, if you don't want to do these procedures anymore,
Speaker 4: we won't do them here.
Speaker 1: After hearing from doctor Peter Meak and several mercers about
Speaker 1: the Catholic problems and the lack of hygiene, Gerald too
Speaker 1: was doubting the competence of the director of surgery at
Speaker 1: the Bunderberg Base Hospital, but was the hospital better off
Speaker 1: with Patel than with no senior surgeon at all. When
Speaker 1: Fitzgerald asked Tony Hoffman this question, she was certain of
Speaker 1: the answer. She told him that the patients would be
Speaker 1: much better off if Patel were immediately suspended. As she
Speaker 1: told the chief health officer, we.
Speaker 3: Don't like this guy, but that's not the issue. The
Speaker 3: issue is he's doing these things here and it's harming people.
Speaker 10: He replied, well, we can't do anything because nothing's been
Speaker 10: proved at this stage.
Speaker 1: Hoffman was chres fallen. She wondered, what on earth can
Speaker 1: we possibly do to stop this man. Fitzgerald asked Darren Keating,
Speaker 1: what do the patients feel?
Speaker 10: What's the level of patient satisfaction? Have there been any
Speaker 10: complaints against doctor pateell by patients.
Speaker 1: Keating had a folder of complaints, but he assured Fitzgerald
Speaker 1: that there were none. Patel had given an undertaking to
Speaker 1: stop doing the esophagectamies and other complex surgery needing intensive
Speaker 1: care unit support, but he was still causing serious damage.
Speaker 1: Three days before Fitzgerald's arrival at the hospital, Jenny White
Speaker 1: was the scrub nurse for a procedure to remove part
Speaker 1: of the cancerous bowel of a patient Jean Stuart Sutherland.
Speaker 1: Patel cut the healthy part of her bowl. If he
Speaker 1: noticed his error, he did not acknowledge it until a
Speaker 1: junior doctor pointed it out. Nurse White shook her head
Speaker 1: in disbelief. How Patel could have overlooked the four centimeter
Speaker 1: cut was unfathomable. When the patient returned to theater in
Speaker 1: late February because of the inevitable complications from the earlier incompetence,
Speaker 1: Jenny White saw the terrible state of the bowl. It
Speaker 1: was leaking. More than one liter of bile stained fluid
Speaker 1: needed to be drained. There was also a gross infection.
Speaker 1: The blood from the carotid artery of Harry petra Helos
Speaker 1: spurted in a fine but steady stream. It happened suddenly
Speaker 1: when one of the doctors in the coronary unit tried
Speaker 1: to put a central line into his neck, missing the
Speaker 1: vein but piercing the artery. Because arterial pressure is greater
Speaker 1: than venus pressure, petra Helos began losing blood fast. He
Speaker 1: was already in poor shape. He had suffered a heart
Speaker 1: attack and was also battling severe kidney failure, which made
Speaker 1: him anemic, He took blood thinning substances for a condition
Speaker 1: called atrial fibrillation and irregularity of the heart. He had
Speaker 1: one more disadvantage. Petra Helos was a Jehovah's Witness, which
Speaker 1: meant he would not be a candidate for blood transfusion.
Speaker 1: His delicate condition and complications meant he had to be
Speaker 1: handled with extreme care. Any operation was a grave danger
Speaker 1: because of the potential for petra Helos to bleed to death.
Speaker 1: When Jayon Patel saw the commotion on for March and
Speaker 1: asked what was going on, a nurse explained that Petra
Speaker 1: Helos was one of doctor Peter Meak's patients. Patel replied, okay,
Speaker 1: I won't touch him. Then. The rift between doctor Miak
Speaker 1: and doctor Patel had only widened in the years since
Speaker 1: the Director of Medicine banned the Director of Surgery from
Speaker 1: handling certain patients. Doctor Miak had made it clear in
Speaker 1: his interview with doctor Jerry Fitzgerald in February that Patel
Speaker 1: was dangerous and incompetent. Miak had even taken the un
Speaker 1: usual step several months earlier of asking to see Patel's
Speaker 1: personnel file and CV. He flicked through it in a
Speaker 1: couple of minutes, expecting to find a red flag pointing
Speaker 1: to the incompetence of the man, but it seemed in order.
Speaker 1: Peter Miak had walked back to the ward perplexed, but
Speaker 1: Patel could not walk away. He told the theater nurses
Speaker 1: to prepare for an operation. Patel wanted to operate on
Speaker 1: the punctured artery of Petra Helos. The nursing and junior
Speaker 1: medical staff were immediately alarmed. Someone called Dtor Miak and
Speaker 1: asked him to come to the ICU urgently. He walked
Speaker 1: into a bizarre and tense situation. Dr Patel, all scrubbed
Speaker 1: up in his surgical gear, was intent on taking Petro
Speaker 1: Helos into theater. The nurses were pleading with their eyes
Speaker 1: and body language to prevent another death. Miak gave an
Speaker 1: instruction to one of the.
Speaker 11: Doctors, just put pressure on it.
Speaker 1: Patel loudly insisted on an operation to put a couple
Speaker 1: of stitches in the carotid artery. It was a delicate
Speaker 1: procedure under ideal conditions, but in the hands of Patel
Speaker 1: it promised to be a disaster. Doctor Meak refused to budge.
Speaker 1: He believed that there was absolutely no chance the man
Speaker 1: would survive the operation that Patel seemed determined to perform.
Speaker 1: He told Patel, look, the corota doesn't need fixing. His
Speaker 1: priorities are his heart, his anemia, everything else. Miak knew
Speaker 1: that by maintaining pressure on the small hole in the carotid,
Speaker 1: the bleeding would eventually stop. He gave firm instructions to
Speaker 1: a junior doctor, but he still had to silence Patel,
Speaker 1: who was angry and embarrassed.
Speaker 11: Look, this man is not going to theater and that's
Speaker 11: the end of it. He's going to Brisbane.
Speaker 1: Tony Hoffman watched the drama with mounting alarm. Why had
Speaker 1: it come to this? She had prayed that an investigation
Speaker 1: by the Chief Health Officer would result in decisive and
Speaker 1: immediate action, but instead Patel was still wreaking havoc, still
Speaker 1: boasting about the renewal of his contract and his massive
Speaker 1: salary boost. Miac constructed Hoffman.
Speaker 11: Whatever you do, don't leave this patient's bedside, and if
Speaker 11: doctor Patel goes near him, telephone me immediately.
Speaker 1: As Hoffman stayed by Petro Helos to await the Royal
Speaker 1: Flying Doctor for an emergency flight to Brisbane, a leader
Speaker 1: of the Jehovah's Witness church in Bunderberg, came to the
Speaker 1: intensive care unit. Tony Hoffman already knew from contacts close
Speaker 1: to the church that Patel had ingratiated himself with the flock.
Speaker 1: She had been suspicious when first told of the charm offensive.
Speaker 1: Now one of the men who knew petro Helos as
Speaker 1: well as Patel, was in the intensive care unit. He
Speaker 1: asked if doctor Patel was available. Hoffman was in a panic.
Speaker 1: If she put a call through to Patel, the patient's
Speaker 1: fate would be sealed. Hoffman knew how persuasive Patel could be.
Speaker 1: He would tell the church elder that an operation to
Speaker 1: repair Petrohelos's carotid artery was absolutely imperative, and he would
Speaker 1: prevail upon the elder to demand that the operation by
Speaker 1: Patel should go ahead. Tony Hoffman decided that she could
Speaker 1: not let that happen.
Speaker 3: She told the elder, doctor Pateel isn't here at the moment,
Speaker 3: but the patient is going to be fine.
Speaker 1: Ten days later, doctor Martin Strawn decided to use an
Speaker 1: endoscope to examine the stomach of Joan Cameron, who had
Speaker 1: been admitted to the medical ward with vomiting and bleeding,
Speaker 1: Strawn discovered an obstruction in the second part of her duodenum.
Speaker 1: He strongly suspected it was a secondary which would require
Speaker 1: further investigation and possibly surgery in Brisbane. In the corridor
Speaker 1: outside the theater, Patel asked Strawn about the finding. Patel
Speaker 1: told him.
Speaker 4: Oh, well, that will be a primary toma in the
Speaker 4: duo Dunham. The patient needs an operation to remove it,
Speaker 4: and I'll put the patient in the surgical ward and
Speaker 4: I'll do it early next week.
Speaker 1: Doctor Strawn suspected that Patel was wrong and would attempt
Speaker 1: more complex surgery after opening the patient up. He was
Speaker 1: determined to prevent Patel from operating, but how When Joan
Speaker 1: Cameron developed a chest infection a few days later, Strawn
Speaker 1: seized the opportunity to remove the patient from Patel's grasp.
Speaker 1: He spoke to Dr Miak, Doctor Martin Carter, and Tony
Speaker 1: Hoffman about a plan to hide the patient in the ICU,
Speaker 1: a safe refuge. Since Petel no longer ventured there. From
Speaker 1: the ICU, Joan Ca could be quietly transferred to Brisbane.
Speaker 1: They were all in agreement behind Patel's back. At the
Speaker 1: time Strawn regarded it as outrageous behavior to have to
Speaker 1: resort to a ruse to keep an ill patient away
Speaker 1: from the director of surgery. He was also worried about
Speaker 1: how Patel might retaliate when he found out, But the
Speaker 1: bizarre episode had made a more profound impression on Tony Hoffman.
Speaker 1: Her mind was made up. Now she had to fully
Speaker 1: expose Patel and worry about the consequences later. Sick to
Speaker 1: Death is written and presented by me Headley Thomas, the
Speaker 1: Australian's National Chief correspondent. Claire Harvey is The Australian's editorial director.
Speaker 1: Audio editing, production and music have been done by Jasper Leik,
Speaker 1: with assistance from Leah Sammaglu and Neil Sutherland. Our producer
Speaker 1: is Christin Amias. Production management by Stephanie Coombs. Artwork by
Speaker 1: Sean Callanan. Thanks to Ryan Osland, Matthew Condon, Karina Berger,
Speaker 1: Ellie Dudley, David Murray, Dominique McDermott, Zach Sculander and all
Speaker 1: our family, friends and colleagues who helped in this series
Speaker 1: and contributed voice acting and special thanks to Tony Hoffman
Speaker 1: and Rob Messenger. Subscribers to the Australian here. New episodes
Speaker 1: of Sick to Death first at Sick to Death podcast
Speaker 1: dot com and on Apple Podcasts. You can get exclusive
Speaker 1: access to photographs, videos, timelines and more at the website