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Australians will conduct Patel inquiry
As early as a month after Dr. Jayant Patel began, co-workers in Queensland voiced concerns
Wednesday, April 20, 2005
The premier of the Australian state of Queensland has ordered a royal inquiry into Dr. Jayant Patel's two-year tenure as director of surgery at a public hospital there, a rarely used power that involves appointing an investigating commission that can compel testimony and offer witnesses immunity from prosecution.
Patel, a general surgeon, spent 12 years working for Kaiser Permanente in Portland before landing at Queensland's Bundaberg Base Hospital, where co-workers said that a number of his patients died or were maimed because of botched surgeries and that Patel falsified medical records to cover his mistakes.
"The pain and suffering of the people of Bundaberg is such that we need to ensure that we get to the truth of what happened in every respect and ensure it doesn't happen again," Premier Peter Beattie, the equivalent of a governor in the northeast Australian state, said in a statement.
Patel, 55, returned to Portland recently but could not be reached despite repeated phone calls and visits to his home in the upscale Bronson Creek Estates community of Washington County just outside Portland.
Before taking the Bundaberg job two years ago, Australian officials have said, Patel hid the fact that the Oregon Board of Medical Examiners disciplined him in 2000 for "gross or repeated acts of negligence." Citing three patient deaths, the board restricted Patel's practice and prohibited him from performing some operations.
Queensland health officials have conceded that they erred by not thoroughly checking Patel's credentials. Now, the royal commission is expected to investigate whether hospital and state health officials failed to take seriously repeated staff complaints about Patel's surgical skills and patient injuries and deaths.
Toni Hoffman, head nurse of the hospital's intensive care unit, was one of those who complained.
"We noticed he was describing patients as stable when they were quite unstable," Hoffman told The Oregonian this week.
Other doctors and nurses also raised concerns after watching Patel cut, nick and perforate his patients' spleens and bowels, Hoffman said. The hospital's intensive care unit was filled with patients whose surgeries had been botched by Patel, she said.
"The wounds would completely break down and fall apart," said Hoffman, a nurse for 15 years.
Hoffman said she first went to supervisors a month after Patel arrived in spring of 2003. For the next two years, she and fellow nurses and doctors continued to tell hospital administrators, the director of nursing and officials from the state's health ministry that Patel was harming patients, she said.
At one point, Hoffman said, the hospital's director of nursing responded to her complaints about Patel by suggesting that she seek counseling, then handed her a book titled "How to Deal with Difficult People." One doctor refused to let Patel near his patients, she said.
Still, Queensland health officials took no action until Patel's Australian medical registration came up for renewal in February, according to a memorandum by the Medical Board of Queensland. At that point, the hospital launched an investigation that became public in March.
The investigation, while limited, substantiated some staff concerns, according to a hospital spokesman. It concluded that Patel had a higher-than-expected surgical complication rate and that he failed to refer seriously ill or injured patients to other facilities that were better suited to treat them.
"Appropriate checks and balances to deal with the concerns of staff and patients" were not in place, the spokesman told The Oregonian.
Dr. Bill Glasson, the president of the Australian Medical Association, said Tuesday that many staff members at the hospital had expressed concerns about Patel.
"This is a system that won't listen," said Glasson, who was scheduled to meet with Beattie to discuss the scope of the commission investigation. He said he planned to urge the premier to look into why staff complaints went unanswered for so long.
The commission also will attempt to determine exactly how many Bundaberg patients may have died or experienced problems after Patel operated on them. "We think (the number) is quite significant," Glasson said.
Beattie said the makeup of the commission had yet to be determined. Should the panel find evidence of criminal wrongdoing, it would be referred to prosecutors.
After being disciplined by the Oregon medical board, Patel remained at Kaiser until 2001.
Kaiser launched an internal review of Patel's work in 1998, reviewing 79 of his cases and restricting his privileges. The health maintenance organization turned its findings over to the Oregon board as required by law.
Prior to 1998, Kaiser was sued at least four times for negligence or malpractice involving surgeries performed by Patel.
Susan Goldsmith: 503-294-5131; email@example.com©2005 The Oregonian
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