Jayant Patel

Dr. Jayant Patel
Born	10 April 1950 (1950-04-10) (age 61) Jamnagar, Gujarat, India
Alias(es)	Dr. Death
Conviction(s)	manslaughter, grievous bodily harm
Penalty	Seven years jail
Occupation	surgeon

Jayant Mukundray Patel (born 10 April 1950), referred to as Doctor Death is a surgeon who is at the centre of a 2005 scandal in which he was accused of gross incompetence while working at Bundaberg Base Hospital in Queensland, Australia. In June 2010, Patel was convicted of 3 counts of manslaughter and one case of grievous bodily harm, and sentenced to seven years in jail.

Career

Patel was born in Jamnagar in Gujarat, India. He had undertaken his initial surgical studies at the M.P. Shah Medical College in Saurashtra University, and obtained a master's degree in surgery. After graduation he moved to the United States where he received further surgical training at the University of Rochester School of Medicine as a surgical intern and resident of surgery. Whilst Patel was working at a hospital in the city of Buffalo in 1984, New York health officials cited Patel for failing to examine patients before surgery. Patel was fined US$5,000 and was placed on three years' clinical probation. In 1989, Patel moved to Oregon and began working for Kaiser Permanente Hospital in Portland, Oregon. Medical staff alleged that he would often turn up, even on his days off, and perform surgery on patients that were not even his responsibility. In some cases, surgery was not even required, and caused serious injuries or death to the patient.

After a review, Kaiser restricted Patel's practice in 1998, banning him from doing liver and pancreatic surgeries and requiring him to seek second opinions before performing other surgeries. Further, after reviewing four cases in which three patients died, the Oregon Board of Medical Examiners made Patel's restriction statewide in September 2000,^[1] and New York State health officials required him to surrender his license in April 2001.

After this, Patel decided to leave Oregon for Queensland. The Queensland Health Department employed him without conducting due diligence regarding his qualifications and experience; and it allowed him to become director of surgery at Bundaberg Base Hospital in 2003, under the "area of need" program, which hires overseas trained doctors for regional areas. He continued to practice in a similar manner to which he did in New York, with his surgical work being described as "antiquated" and "sloppy", and some nurses even claimed that they hid their patients from him when they knew that he was in the hospital. He attracted the nickname "Dr. Death" as a result of these actions.^[2][3]

Patel is also alleged to have shown a poor regard for hygiene with claims that he responded to a nurse's concern over his unwashed hands with "doctors don't have germs". Patel is linked to at least 87 deaths out of the 1,202 patients he treated between 2003 to early 2005, 30 of whom died while under his care in Bundaberg. Hospital staff have also accused Patel of altering medical records to hide mistakes.

On 22 March 2005 Stuart Copeland, the Queensland Shadow Minister for Health, first raised the issue of Patel's clinical practices during Question Time in the Queensland Parliament. Two days later, Rob Messenger, the National Party Member of Parliament for Burnett also raised the matter of Patel's alleged incompetence in a speech to the Legislative Assembly and called for his suspension.

Journalist Hedley Thomas of The Courier-Mail, who won a Walkley Award for his part in uncovering Patel's past,^[4] gave attention to these allegations, and soon the newspaper and other media outlets were flooded with patient claims of injury and death caused by Patel's operations.

Patel soon left Australia using a business-class air fare paid for by Queensland Health^[5] and returned to his home in Portland, Oregon, where he was filmed in 2007 by the Nine Network's current affairs program, 60 Minutes in an investigation by reporter Paul Barry and producer Stephen Rice.

A warrant for Patel's extradition was sought after he returned to the United States^[6] (his passport was never taken) and a magistrate was asked on November 22, 2006 to issue a warrant for his arrest. 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.^[7]

Political fallout

The scandal caused political problems for Queensland's Labor Party government, formerly led by Peter Beattie. State health minister Gordon Nuttall resigned from his cabinet position.^[8]

Some of those treated by Patel have proposed to take the Queensland Government to court for not detecting his poor job performance earlier. However, with changes to state law originally intended to limit payouts to patients who sue their doctors on health matters, which were passed before the scandal broke, it is unlikely that they would receive significant compensation^{[citation needed]}.

Queensland Health has arranged corrective surgery to those affected by Patel's surgical practices. Over one hundred patients have been said to have undergone corrective procedures since Patel fled Australia.^{[citation needed]}

The Medical Board of Queensland introduced extensive measures for registration of overseas doctors, including receiving a certificate of good standing from each and every jurisdiction where a doctor has practised and getting the primary medical degree, registration and transcripts of applicants verified by the Educational Commission for Foreign Medical Graduates International Credentialing Service.

The Dr Jayant Patel bungle was one of many factors that influenced the Council of Australian Governments in 2006 to effectively disband state-based medical regulation practices in favour of a new National Registration and Accreditation scheme. From 1 July 2010, registration and regulation responsibilities formerly held by the state-based Medical Boards are now the responsibilities of The Australian Medical Board supported by the newly-formed Australian Health Practitioner Regulation Agency.

Morris Inquiry

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, and was widely referred to as the Morris Inquiry.

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 are 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 practiced 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 a suit in the Supreme Court of Queensland calling for the inquiry to be shut down. Keating and Leck alleged that Morris had shown apprehended bias against them when they were giving evidence and therefore the inquiry did not have the necessary impartiality. On 1 September, Justice Martin Moynihan of the Supreme Court ruled in favor of the plaintiffs, 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. On the morning of 2 September, Justice Moynihan ordered that the Morris Inquiry be shut down.

Radio station 612 ABC Brisbane announced on 6 September that Premier Beattie has called for a full examination of the evidence given to the Morris Inquiry by a prominent former judge. Mr Beattie stated that this review would "in essence" be a new inquiry. He also issued a "six-point action plan" to deal with evidence gathered by the Morris Inquiry that may be biased.

Davies Inquiry

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. 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 possibly up to 17.

Other inquiries

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.

The cases

The Davies Inquiry found that he had caused 13 deaths, and perhaps up to 17. Since the publication of this report, an additional four patients that he negligently treated have died.

He performed four oesophagectomies while at the hospital. Three of the four patients died as a direct result.^{[citation needed]}

He removed a patient's large bowel after he was diagnosed with a hyperplastic (non-malignant) polyp.^{[citation needed]}

Arrest and Trial

Extradition

Jayant Patel was arrested 11 March 2008 by FBI agents.^[9] 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 dollar 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 out of Australia." The extradition proceeding against Patel began April 2008.^[10] 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.^[11] The flight arrived at Brisbane Airport on the morning of 21 July.^[12] Patel was taken immediately to the Brisbane watch-house and was granted bail by the Roma Street Magistrates Court the same day.^[13]

Trial

See main page: The Queen v Patel.

Patel was tried in the Queensland Supreme Court for the unlawful killing of three patients, and grievous bodily harm to a fourth.^[14] He pleaded not guilty to all charges.^[15]

On 29 June 2010, Jayant Patel was found guilty of the four charges and was remanded in custody pending sentencing.^[16] On 1 July he was sentenced to seven years jail for his offences.^[17] Much controversy over the sentence has ensued, with many speculating that term imposed was too lenient considering the gravity of the charges and the lack of remorse shown by the defendant. Calls have been made for the sentence to be challenged by Queensland Attorney-General Cameron Dick, and a harsher penalty be imposed.^[18]

Aftermath

In a TV 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.^[19][20][21]

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.^[21]

References

1. ^ "JAYANT M. PATEL, MD Summary of Known Disciplinary Record". Oregon Board of Medical Examiners. http://www.oregon.gov/OMB/PDFforms/Patel.pdf. Retrieved 28 July 2010. 
2. ^ "Queensland Public Hospitals Commission of Inquiry". http://www.qphci.qld.gov.au/transcripts.htm. Retrieved 28 June 2007.  Note: Temporarily Offline During Trial-March 21, 2010
3. ^ Mancuso, Roberta (May 25, 2005) "Queensland's 'Dr Death' linked to 80 deaths", The Age Retrieved 22 March 2010
4. ^ Thomas, Hedley (2007). Sick to Death. Allen & Unwin. ISBN 9781741148817 
5. ^ Chandler, Jo (28 May 2005). "The scandal of 'Dr Death'". The Age (Melbourne). http://www.theage.com.au/news/General/The-scandal-of-Dr-Death/2005/05/27/1117129900672.html. Retrieved 28 June 2007. 
6. ^ [1] Courier Mail
7. ^ "Patel arrives at Brisbane watch-house" ABC News, 21 July 2008
8. ^ "Qld health minister Nuttall resigns". Sydney Morning Herald. 2005-07-22. http://www.smh.com.au/news/National/Qld-health-minister-Nuttall-quits/2005/07/22/1121539132175.html. Retrieved 2009-07-20. 
9. ^ "Doctor arrested in deaths of 3 patients in Australia". Archived from the original on 15 March 2008. http://web.archive.org/web/20080315033512/http://edition.cnn.com/2008/WORLD/asiapcf/03/11/patel.arrest.ap/index.html. Retrieved 11 March 2008. 
10. ^ "Ex-surgeon's troubled career leads to jail cell". http://www.oregonlive.com/news/oregonian/index.ssf?/base/news/120529410566270.xml&coll=7. Retrieved 12 March 2008. 
11. ^ Dick, Tim (2008-07-21). "Accused doctor returns for his day in court". The Sydney Morning Herald. http://www.smh.com.au/news/national/patel-returns-for-his-day-in-court/2008/07/20/1216492255414.html. Retrieved 2008-07-21. 
12. ^ Australian Broadcasting Corporation (2008-07-21). "Patel arrives at Brisbane watch-house". http://www.abc.net.au/news/stories/2008/07/21/2309149.htm. Retrieved 2008-07-22. 
13. ^ Lill, Jasmin; Matthew Fynes-Clinton (2008-07-22). "Jayant Patel bailed as emotions on a high at court hearing". The Courier-Mail. http://www.news.com.au/couriermail/story/0,23739,24056924-952,00.html. Retrieved 2008-07-22. 
14. ^ Oberhardt, Mark (12 January 2010). "Supreme Court told Jayant Patel trial should take less than projected 12 weeks". The Courier-Mail. http://www.news.com.au/couriermail/story/0,,26579695-5003402,00.html. 
15. ^ "Surgeon Patel to face trial on Monday". The Sydney Morning Herald. 19 March 2010. http://news.smh.com.au/breaking-news-national/surgeon-patel-to-face-trial-on-monday-20100319-qjia.html. 
16. ^ "Patel guilty on all charges". Australian Broadcasting Corporation. 29 June 2010. http://www.abc.net.au/news/stories/2010/06/29/2940352.htm. Retrieved 29 June 2010. 
17. ^ http://www.brisbanetimes.com.au/queensland/patel-gets-seven-years-20100701-zph9.html?rand=1277963935139
18. ^ Agius, Kym (1 July 2010). "LNP says Patel sentence inadequate". Sydney Morning Herald. http://news.smh.com.au/breaking-news-national/lnp-says-patel-sentence-inadequate-20100701-zpwq.html. Retrieved 1 July 2010. 
19. ^ "They Called Him 'Dr Death'". CNN. 2 November 2010. http://edition.cnn.com/video/#/video/international/2010/11/02/wus.dr.death.bk.a.cnn. Retrieved 18 November 2010. 
20. ^ "The Making of a Bad Surgeon". CNN. 2 November 2010. http://edition.cnn.com/video/#/video/international/2010/11/02/wus.dr.death.bk.b.cnn. Retrieved 18 November 2010. 
21. ^ ^{a b} "'Dr Death' Found Guilty". CNN. 2 November 2010. http://edition.cnn.com/video/#/video/international/2010/11/02/wus.dr.death.bk.c.cnn. Retrieved 18 November 2010. 

External links

• 'Six-Point Action Plan' to deal with biased evidence gathered by Morris Inquiry
• Portland Oregonian coverage (includes copies of documents
• Australia's 'Doctor Death'
• Davies Inquiry website - includes terms of reference and transcripts of public sittings (temporary disabled due to current legal proceedings)
• Article in 'The Courier-Mail'^{[dead link]}
• The Kaiser Papers^{[dead link]}
• Queensland Government press release announcing Davies Inquiry^{[dead link]}
• Open letter from Peter Beattie

Persondata
Name	Patel, Jayant
Alternative names
Short description
Date of birth	10 April 1950
Place of birth	Jamnagar, Gujarat, India
Date of death
Place of death