May 19, 2005
Allegations of Negligence Follow Doctor
SYDNEY, Australia (AP) -- After Des Bramich's sternum was crushed when a camper he was working under fell on him, his family thought the worst was over when he recovered enough to make jokes after being rushed to a hospital emergency room.
But complications soon set in, and the director of surgery at the rural Australian hospital decided that it was necessary to drain excess fluid from Bramich's chest using a procedure that required a large needle to be pushed into a sac surrounding his heart.Bramich died the day after the treatment. His son, Mark, said he later learned from hospital staff that the surgeon, Jayant Patel, had to thrust in the needle up to 50 times before finally getting the procedure right.
It's not clear if the procedure contributed directly to Bramich's death, but his family is among about 100 former patients or their relatives who have filed lawsuits or criminal complaints against Patel for alleged negligence. Homicide detectives are investigating some of the claims.
Medical reports and interviews by The Associated Press with the families of former patients and Patel's co-workers indicate a pattern of alleged malpractice that has trailed the Indian-born doctor for years - from the United States to Australia and now into hiding, and earned him the media sobriquet "Dr. Death."
The scandal has triggered reviews of medical licensing procedures in Australia and Oregon, where Patel was disciplined for gross negligence in 2000 and forced to surrender his medical license issued by New York State, according to officials and documents.
On Monday, officials in Queensland state will open an inquiry into Patel's record at the Bundaberg Base Hospital, where former colleagues have linked him to the death or serious injury of at least 14 patients, including Bramich.
An initial investigation indicated the scandal could be much broader. A report by the state health department, Queensland Health, found this week that 110 of 1,202 patients Patel treated in two years either died or had to be transferred elsewhere for further treatment - a much higher ratio than normal, doctors say.
The Queensland inquiry will try to determine why Patel was allowed to practice in Australia despite a history of botched operations.
Bramich was helping a friend do some repairs on the camper last July when it fell, his son Mark told the AP by telephone from his home near Bundaberg, about 186 miles north of Queensland's capital, Brisbane.
He was rushed to the hospital in critical condition, though he was quickly stabilized and moved from intensive care to a regular ward. Nurses arranged for him to be transferred to a Brisbane hospital with a cardio-thoracic surgeon, said Mark Bramich and a nurse who spoke on condition of anonymity.
But Patel slowed the transfer and insisted on performing the fluid draining procedure first, said the nurse, who is to testify to the inquiry.
It was then that Bramich's family noticed signals that something was wrong, Mark Bramich said.
"The nurses were distressed, upset. They were sort of crying," he said. "I think they must have known things were going downhill. We sort of had a hint then."
Australian authorities say Patel left the country after the allegations against him were aired in March, in a letter from a senior nurse at the hospital, Toni Hoffman, that was tabled in the Queensland Parliament. His whereabouts are unknown.
He has a home in Portland, Oregon, but has not returned phone calls there from the AP.
Some reports have suggested he has returned to India. But Patel's mother Mridulaben Patel, 89, said she hasn't heard from him in some time.
"I understand that he is a very famous doctor in America and Australia, but about the charges against him that you are telling me now, I am in the dark," she said, sitting in the bedroom of the family's palatial home in the western province of Gujarat.
Patel, 55, comes from a wealthy family and attend the state-run M.P. Shah Medical College at Saurashtra University in Jamnagar city, earning a medical degree in 1973 and a master's in surgery in 1976, university records show.
"In spite of the fact that he belonged to a powerful and rich family, Jayant was always modest and keen to work with the poor," said Dr. R.U. Mehta, who oversaw some of Patel's studies. "I cannot understand what exactly has gone wrong with him."
Patel practiced in India before moving to the U.S, where he took up an internship and residency at the Rochester University School of Medicine in New York in 1979, a Medical Board of Queensland report says. He moved to Portland in 1989 and began working for Kaiser Permanente hospital.
In 1998, Kaiser banned Patel from conducting certain operations, including liver and pancreatic surgeries, and required him to seek a second opinion in complicated cases.
Kaiser spokesman Jim Gersbach said the hospital confirmed Patel had an unrestricted license before hiring him, and that he was well recommended by previous employers.
The Oregon Board of Medical Examiners made Patel's restriction statewide in 2000, prompting New York authorities to ask Patel to voluntarily surrender his license for that state, documents from New York show.
The documents cited "gross ... negligence on more than one occasion."
Patel surrendered his New York license in 2001.
Despite the U.S. bans, Patel twice answered "no" when asked in applications to practice in Australia if he had ever been the subject of disciplinary action in another state or country, the Medical Board of Queensland said.
He gained an Australian license in 2003.
Co-workers at Bundaberg soon noticed disturbing signs.
Hoffman, the nurse who worked with Patel, told the AP he regularly failed to wash his hands between patients, was belligerent toward nursing staff and often resisted transferring patients.
In her letter tabled in parliament, she wrote: "Every time I see him walk into the unit ... I feel sick because I just think 'who's he going to kill now, what's he going to do now?'"
Mark Bramich believes bravado on Patel's part contributed to his father's death.
"I think he just kept having to do it himself, fix it up," Mark said. "He was way out of his depth."
Associated Press reporters Rupak Sanyal in India and William McCall in Oregon contributed to this report.