Jayant Patel

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Dr. Jayant Patel
Head of an older Indian man, with short cropped hair, he has down cast eyes, and an unhappy facial expression.
Born Jayant Mukundray Patel
(1950-04-10) 10 April 1950 (age 64)
Jamnagar, Gujarat, India
Nationality American
Occupation surgeon
Conviction(s) manslaughter

Jayant Mukundray Patel (born 10 April 1950) is an Indian-born American surgeon who was accused of gross negligence whilst working at Bundaberg Base Hospital in Queensland, Australia. Deaths of some of Dr Patel's patients led to widespread publicity in 2005. In June 2010, Patel was convicted of 3 counts of manslaughter and one case of grievous bodily harm, and sentenced to seven years' imprisonment. In August 2012, all convictions were quashed by the full bench of the High Court of Australia and a retrial was ordered due to 'highly emotive and prejudicial evidence that was irrelevant to the case' led before the jury. A retrial for one of the manslaughter counts resulted in acquittal and led to a plea deal where Patel pleaded guilty to fraud and the remaining charges were dropped.

Early life and education[edit]

Patel was born in Jamnagar in the Indian state of Gujarat. Initially, he studied surgery at the M. P. Shah Medical College at the Saurashtra University, obtaining a master's degree.[1] He then moved to the United States where he received further surgical training at the University of Rochester School of Medicine as a surgical intern and a resident in surgery.

Career[edit]

Buffalo, New York[edit]

In 1984 in Buffalo, health officials cited Patel for failing to examine patients before surgery.[2] He was fined US$5,000 and was placed on three years' clinical probation. In April 2001, New York State health officials withdrew Patel's license.

Portland, Oregon[edit]

In 1989, Patel moved to the Kaiser Permanente Hospital in Portland, Oregon. In 1995, Kaiser Permanente in Portland, Oregon named Dr. Jayant Patel a "Distinguished Physician of the Year." By this time, the doctor had been involved in a string of problem cases, eight of which had prompted or would later lead to malpractice or wrongful death lawsuits.[3] Medical staff allege he performed surgery when not rostered to work, operated on other surgeons' patients, operated unnecessarily and caused serious injury and death. In 1998, Kaiser Permanente restricted Patel's practice. He was instructed not to operate on the liver or pancreas and to seek second opinions before performing other surgeries. In September 2000, after reviewing four cases involving the deaths of three patients, the Oregon Board of Medical Examiners made Patel's restriction statewide.[4] Even though his medical license had been restricted, Dr. Patel still received glowing letters of recommendation from his colleagues at Kaiser Permanente.[5]

Bundaberg, Queensland, Australia[edit]

In 2003, Patel moved to the position of Director of Surgery at the Bundaberg Base Hospital where he was employed by Queensland Health (the state government department of health in Queensland) under an "area of need" program where overseas trained doctors are employed in predominantly regional understaffed areas. He was appointed despite having no specialist surgical qualifications.[6]

Practice in Bundaberg[edit]

Inadequacies in Patel's practice were identified. His surgery was described as "antiquated" and "sloppy". Nurses claimed that they hid their patients from him when they knew that he was in the hospital. He showed poor regard for hygiene. He attracted the nickname "Dr. Death". It is alleged he altered medical records in order to hide his inadequacies.[7][8]

Numbers affected[edit]

Patel is linked to at least 87 deaths among the 1,202 patients he treated between 2003 and early 2005. 30 patients died while under his care in Bundaberg.[6]

Concerns made public[edit]

On 22 March 2005, Stuart Copeland, the Queensland Shadow Minister for Health, raised the issue of Patel's clinical practice during "Question Time" in the Queensland Parliament. Copeland had been alerted to Patel's inadequacies by Toni Hoffman, a nurse at the Bundaberg Base Hospital. Two days later, Rob Messenger, the National Party Member of Parliament for Burnett also raised the matter in a speech to the Legislative Assembly. He called for Patel's suspension.

Hedley Thomas, a journalist at The Courier-Mail, who won a Walkley Award for his part in uncovering Patel's past,[9] published reports about Patel. The newspaper and other media outlets were flooded with patient claims of injury and death caused by Patel's operations.

Patel leaves[edit]

Patel departed Australia for Portland, Oregon using a business-class air fare paid for by Queensland Health. His passport had not been withheld.[10]

In 2007, he was filmed in Oregon by the Nine Network's current affairs program, 60 Minutes in an investigation by reporter Paul Barry and producer Stephen Rice.

Extradition to Australia[edit]

On 22 November 2006, a magistrate issued a warrant for Patel's arrest and extradition to Australia.[11] He was charged with three charges of manslaughter, five charges of causing grievous bodily harm, four of negligent acts causing harm and eight charges of fraud. He was extradited to Australia on 21 July 2008.[12]

Consequences[edit]

Political[edit]

The scandal caused political problems for Queensland's Labor Party government, led by Peter Beattie. The state health minister, Gordon Nuttall (who was later convicted of corruption and perjury in unrelated matters) resigned from his cabinet position.[13] In spite of the political furore, the Beattie Government was re-elected in the 2006 Queensland elections.

Doctor registration[edit]

The Medical Board of Queensland was generally criticised for their registration of Patel but members of the board continued unaffected by the matter. Changes were, however, made to the process of doctor registration in Queensland and later the process was handed over to a national body. From 1 July 2010, registration and regulation responsibilities formerly held by state medical boards were transferred to The Australian Medical Board supported by the newly formed Australian Health Practitioner Regulation Agency.

Morris Inquiry[edit]

In response to public discontent over Patel's performance at Bundaberg Base Hospital, the Beattie Government convened the "Bundaberg Hospital Commission of Inquiry". The Inquiry held similar judicial powers to a Royal Commission, and commenced hearings in Brisbane on 23 May 2005. It was led by Anthony Morris, a Queen's Counsel.

On 10 June, Morris released an interim report that was tabled on the same day in State Parliament by Premier Beattie. The report recommended, among other things, that Dr Patel be charged with murder or manslaughter in respect to one patient, with causing "a negligent act causing harm" to another patient, that he also be charged with fraud in relation to his registration at the Medical Board of Queensland to practice medicine and that extradition proceedings should begin. It also recommended changes to the Medical Practitioners Registration Act 2001.

The Morris Inquiry began hearings in Bundaberg on 20 June. Nurses, local Queensland Health administrators and former patients of Dr Patel were all expected to give evidence. Public hearings in Bundaberg concluded on 14 July. The Inquiry resumed public hearings in Brisbane on 25 July and also sat in Townsville from 2 August to 4 August. Evidence was heard in Townsville about an alleged case of medical fraud in which a Russian with forged medical qualifications pretended to be a psychiatrist and practised for some time at Townsville Hospital.

During the course of the Morris Inquiry, two senior Queensland Health bureaucrats in the Bundaberg region, Darren Keating and Peter Leck, filed an application in the Supreme Court of Queensland calling for the inquiry to be shut down, alleging that Morris had shown apprehended bias against them. On 1 September, Justice Martin Moynihan of the Supreme Court ruled in favor of the applicants, finding that the Commission of Inquiry was contaminated with ostensible bias against Keating and Leck, and that evidence gathered from other witnesses was entangled with the evidence given by Keating and Leck.[14]

Davies Inquiry[edit]

The new inquiry began on 8 September 2005 and was headed by former Supreme Court of Queensland judge Justice Geoffrey Davies QC. This inquiry, formally titled the Queensland Public Hospitals Commission of Inquiry, was widely known as the Davies Inquiry.

The report of the Davies Inquiry was handed down on 30 November 2005. It recommended that charges of manslaughter and other criminal offenses be prosecuted against Patel.[6] The report also apportioned much of the blame to two former Health Ministers, Gordon Nuttall and Wendy Edmond, as well as senior Queensland Health bureaucrats for allowing the existence of an organizational culture of secrecy and ostracizing of whistleblowers that allowed Patel's misdeeds to go unpunished for two years.

An independent surgeon, Peter Woodruff, who was asked by Justice Davies to examine Patel's work believes that Patel negligently caused 13 deaths, and serious complications suffered by at least 31 others.[15]

Other inquiries[edit]

The Queensland Government commissioned two other inquiries in addition to the Morris and Davies Inquiries. These inquiries possessed few judicial powers or ability to summon witnesses.

The Forster Inquiry, headed by Peter Forster, concentrated on the administrative structure of the Queensland Health bureaucracy, and how administrative procedures could be improved to ensure that similar events to those at Bundaberg Base Hospital would not occur again.

The other inquiry was an internal audit of Dr Patel's clinical and surgical practices by Queensland Health. On 30 June 2005, The Courier-Mail newspaper published details of this audit before it was due for public release. The newspaper reported that there were seven patient deaths that were likely to have been caused by Patel and seven more that warrant further investigation. There has been some criticism that this audit relied too heavily on patient notes written by Patel himself, or by other Bundaberg Base Hospital staff who could have been interested in covering up Dr Patel's poor standards or minimising the hospital's liability for patient trauma and death.

The State of Oregon Medical Board is also investigating Patel a second time, this time for stating that he had retired, whilst working full-time as chief of surgery at Bundaberg Base Hospital, as well as lying to Kaiser Permanente about his previous disciplinary actions in New York state. Patel appeared before the state board in September 2005, but declined to answer questions, owing to possible criminal charges in Australia. On 6 October 2005, the Board voted unanimously to issue a formal complaint against Patel. Disciplinary action against the doctor can include a fine of up to US$ 5,000 and revocation of his medical license.

Legal proceedings[edit]

Extradition[edit]

Jayant Patel was arrested 11 March 2008 by FBI agents.[16] He appeared in court that day with a court-appointed attorney, telling Federal Magistrate Dennis Hubel that he was unable to afford a lawyer, after incurring significant pre-trial legal fees. In response, the Magistrate ordered Patel, who lives in a $900,000 house, to fill out a financial affidavit before an upcoming detention hearing. Following his arrest, Toni Hoffman, the nurse who took her complaints about Patel to a member of the Parliament of Australia, said that "I am relieved he's been arrested, but there's still a lot to go." Patel denied the allegations. The extradition proceeding against Patel began April 2008.[17] Patel was denied bail by Judge Hebel on 28 June 2008, with the judge warning Australian and US authorities that they must extradite Patel by 21 July 2008, or he would release Patel on bail.

Patel was extradited: US Marshals handed Patel over to two officers from the Queensland Police Service at Los Angeles Airport on 19 July, who then escorted him on board Qantas flight QF 176.[18] The flight arrived at Brisbane Airport on the morning of 21 July.[19] Patel was taken immediately to the Brisbane watch-house and was granted bail by the Roma Street Magistrates Court the same day.[20]

Trial[edit]

Patel was tried in the Queensland Supreme Court for the unlawful killing of three patients, and grievous bodily harm to a fourth.[21] He pleaded not guilty to all charges.[22]

On 29 June 2010, Jayant Patel was found guilty of all four charges.[23] On 1 July he was sentenced to seven years' jail for his offences.[24] Patel appealed his conviction and sentence to the Court of Appeal, and the prosecution also appealed sentence. Both appeals were dismissed.

Appeal to High Court[edit]

Patel then appealed the Court of Appeal's decision to the High Court of Australia, and was granted special leave to appeal.[25] On 24 August 2012, the High Court unanimously allowed the appeal and quashed Patel's convictions on the ground that prejudicial evidence had likely influenced the jury.[26] The Court also ordered a retrial.

Retrial[edit]

The following year, a retrial was held for one of the manslaughter charges, however Patel was acquitted by the jury.[24] This resulted in calls to have the remaining charges against Patel dropped.[27] The remaining manslaughter and grievous bodily harm charges were later dropped in exchange for Patel pleading guilty to two counts related to him dishonestly gaining registration and two counts related to dishonestly gaining employment in Queensland.[28] Patel was sentenced to a two year suspended sentence for those fraud charges.[28]

Aftermath[edit]

In a television documentary on the case aired by the CNN in November 2010 as part of its "World's Untold Stories" series and entitled "They Called Him 'Dr. Death'" several of Patel's medical co-workers in Australia testified to having repeatedly blown a whistle on him only to be ignored by medical superiors and other authorities. Questions were also raised about the lack of due diligence by those involved in his appointment.[29][30][31]

In response to the case, Peter Beattie fired the Director General, and changes were made to funding, the operations of the medical board, and to how concerns raised by whistle blowers are handled.[31]

See also[edit]

References[edit]

  1. ^ Bell, Rachael. "Australia's Dubious Dr. Jayant Patel". Crime Library. Retrieved 28 April 2014. 
  2. ^ "Australian officials to seek criminal charges against 'Dr. E. Coli'". CBC News (CBC). 21 November 2006. Retrieved 20 March 2013. 
  3. ^ Goldsmith, Susan. "Patel's disturbing record at Kaiser stayed hidden for years (First of two parts)". The Oregonian. Retrieved 16 July 2014. 
  4. ^ "JAYANT M. PATEL, MD Summary of Known Disciplinary Record". Oregon Board of Medical Examiners. Retrieved 28 July 2010. 
  5. ^ Bell, Rachael. "Australia's Dubious Dr. Jayant Patel". Crime Library. Retrieved 16 July 2014. 
  6. ^ a b c Healy, Judith (2011). Improving Health Care Safety and Quality: Reluctant Regulators. Ashgate Publishing. pp. 34–35. ISBN 0754676447. Retrieved 26 June 2012. 
  7. ^ "Queensland Public Hospitals Commission of Inquiry". Retrieved 28 June 2007.  Note: Temporarily Offline During Trial - 21 March 2010
  8. ^ Mancuso, Roberta (25 May 2005) "Queensland's 'Dr Death' linked to 80 deaths", The Age Retrieved 22 March 2010
  9. ^ Thomas, Hedley (2007). Sick to Death. Allen & Unwin. ISBN 978-1-74114-881-7. 
  10. ^ Chandler, Jo (28 May 2005). "The scandal of 'Dr Death'". The Age (Melbourne). Retrieved 28 June 2007. 
  11. ^ Tuck Thompson & Renee Viellaris (19 July 2008). US approves extradition of rogue doctor Jayant Patel. Courier Mail. Queensland Newspapers. Retrieved on 23 January 2012.
  12. ^ Patel arrives at Brisbane watch-house. ABC News. 21 July 2008.
  13. ^ "Qld health minister Nuttall resigns". Sydney Morning Herald. 22 July 2005. Retrieved 2009-07-20. 
  14. ^ "Supreme Court of Queensland: Keating v Morris & Ors; Leck v Morris & Ors [2005] QSC 243 (1 September 2005)". Australasian Legal Information Institute. Retrieved 6 June 2013. 
  15. ^ "Australia's Dr Death faces manslaughter charge". rediff.com. Retrieved 28 April 2014. 
  16. ^ "Doctor arrested in deaths of 3 patients in Australia". Archived from the original on 15 March 2008. Retrieved 11 March 2008. 
  17. ^ "Ex-surgeon's troubled career leads to jail cell". Retrieved 12 March 2008. 
  18. ^ Dick, Tim (2008-07-21). "Accused doctor returns for his day in court". The Sydney Morning Herald. Retrieved 2008-07-21. 
  19. ^ Australian Broadcasting Corporation (21 July 2008). "Patel arrives at Brisbane watch-house". Retrieved 2008-07-22. 
  20. ^ Lill, Jasmin; Matthew Fynes-Clinton (22 July 2008). "Jayant Patel bailed as emotions on a high at court hearing". The Courier-Mail. Retrieved 2008-07-22. 
  21. ^ Oberhardt, Mark (12 January 2010). "Supreme Court told Jayant Patel trial should take less than projected 12 weeks". The Courier-Mail. 
  22. ^ "Surgeon Patel to face trial on Monday". The Sydney Morning Herald. 19 March 2010. 
  23. ^ "Patel guilty on all charges". Australian Broadcasting Corporation. 29 June 2010. Retrieved 29 June 2010. 
  24. ^ a b Amelia Bentley (1 July 2010). "'Totally inadequate': verdict split on Patel sentence". Brisbane Times (Fairfax Media). Retrieved 22 January 2012. 
  25. ^ High Court of Australia (24 August 2012). "Patel v The Queen [2012] HCA 29 (24 August 2012)". Austlii. 
  26. ^ Jared Owens (24 August 2012). "Jayant Patel walks free after High Court quashes manslaughter convictions". The Australian. 
  27. ^ Sarah Elks & Roseanne Barrett (14 March 2013). "Jayant Call to drop remaining charges as Patel acquitted of manslaughter". The Australian. 
  28. ^ a b Francene Norton & Jason Rawlins (22 November 2013). "Former Bundaberg-based doctor Jayant Patel sentenced over fraud charges". Australian Broadcasting Corporation. 
  29. ^ "They Called Him 'Dr Death'". CNN. 2 November 2010. Retrieved 18 November 2010. 
  30. ^ "The Making of a Bad Surgeon". CNN. 2 November 2010. Retrieved 18 November 2010. 
  31. ^ a b "'Dr Death' Found Guilty". CNN. 2 November 2010. Retrieved 18 November 2010. 

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