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  1. #1
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    Australia - Jayant Patel Case

    Just a post regarding the Patel case, which is way off topic, I know, but which has been commented on in these threads as there is nowhere else on WS to comment. I posted this right at the end of the thread that has just closed, so if Marly will let me, I'll re-post it here in case anyone has more comments to make:

    Quote Originally Posted by KG1 View Post
    Having read a fair bit of the evidence, there were enough elements of doubt about the cause of the man's death in this case, to warrant this jury verdict. The jury found on the evidence presented, regardless of the accused Counsel's assertions in representation. MOO
    At the risk of straying way off topic, and regarding the Patel verdict - that was the ONLY verdict they could/should have brought down. I'm not commenting on whatever other charges he may or may not face, but I would respectfully disagree with the idea that they didn't understand the evidence. In fact I think the exact opposite - they were a good enough jury to demonstrate that the effects of social media and the media generally can be overcome by those who are able to weigh just the evidence.

    As probably the only one on here qualified to comment professionally, let me try to summarize the problem. The prosecution alleged that Patel shouldn't have operated on Mr Morris because he was sick and had heart disease etc. That description applies to most of my patients! But of course, they omitted the obvious fact that if he DIDN'T operate, then Mr Morris was going to die anyway from his bleeding.

    It is standard training and procedure, when faced with somebody bleeding heavily rectally, and with the cause unable to be determined (they don't have facilities in Bundaberg for selective angiography, for example, and the patient was far too sick to transfer, not to mention the delay), then you do exactly what Patel did - a laparotomy and if the sigmoid colon is full of blood (which it was) then you remove it. And 9 times out of 10 you will be right. And the bleeding did in fact cease.

    Now I know that Patel's mortality rate was within acceptable limits, and that the whole "Dr Death" thing is pure media hype. And he almost certainly had problems with judgment and insight - eg doing oesophagectomies in Bundaberg where the infrastructure just isn't there to look after them post-op. And his infection rate was a bit higher than average. But given the number of patients that he operated on, many of whom were very sick to start with, his record is nowhere near as bad as the media portrays. Or the "Patient Support Group". And THAT is where the problem lies - he has been made a scapegoat, and most of the opinion is driven by the very emotive desire for vengeance, rather than accepting the facts.

    As I said, I'm not commenting on the various other allegations - eg should he have been registered here. Different matter. But, based ONLY on the evidence in this case (and others, one of which in particular I'm very familiar with) he did NOT do anything wrong, let alone criminally wrong.

    One other point to consider (and I'm NOT protecting a colleague, by the way - if he did wrong, then he should be found to have done so): But, if he HAD been found guilty, then that would have ENORMOUS repercussions and implications for every surgeon in the future, when faced with a similar situation. Let's just say, for example, that I were to be faced with a patient in emergency (as I have been on countless occasions) with a presumptive diagnosis of a leaking aortic aneurysm.

    Now, if I operate, there is a 50-60% chance of survival. If I don't, the chance of survival is 0%. So what do I do? There is no time to faff about getting scans, or whatever. The patient with a hole in his aorta needs an operation, pronto. But now I have a problem - the patient has a 30-40% chance of dying even if I DO operate, and therefore I run the risk of being charged with manslaughter, despite trying to save him. So what do I do? The precedent would have been set by the Patel case.....

    The Crown stuffed it up big time. They brought the wrong case (not that any of the others would have been any different), and they didn't present it well enough to get a conviction (the correct decision IMHO). Several expert witnesses (colo-rectal specialists etc) testified that what Patel did was exactly the right thing to do in the circumstances, and they would have done the same. So would I - and have in the past. The patient had a problem which was going to be fatal if he did NOT get operated upon. Patel tried. And the patient died of complications - it happens. It goes with the territory.

    There has been WAY too much demonising by media and interest groups to enable most people see the facts from the hype, so I'm delighted that the jury, who were well-directed by the judge, were able to decide based purely on the evidence presented in court, and not be swayed by the hoopla!

    OK - way off topic, I know, but I know that several people in here are interested. And as far as comments about the jury not understanding the evidence - all I would say is that those people who think Patel should have been convicted simply don't understand the evidence, or the situation.

    Sorry for the long post - I hope it is allowed to stand, as it is off-topic. But WS doesn't have another thread where these points can be made.

    "Elementary, my dear Watson"

  2. #2
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    Thankyou Doc
    That was an eye opener
    Xxx

  3. #3
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    Thanks doc. Very timely. Was up last night reading about that case. Interesting and I appreciate you clarifying. Quite complex and critical when you put it that way. I wonder what will happen with the other cases.

  4. #4
    Agree re above SO informative DW.

  5. #5
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    Thanks DW. Very enlightening. Very much appreciated.

    Cheers.

  6. #6
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    Thank you Doc your explanation was very good in helping me understand the Patel case!

  7. #7
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    Quote Originally Posted by DrWatson View Post
    Just a post regarding the Patel case, which is way off topic, I know, but which has been commented on in these threads as there is nowhere else on WS to comment. I posted this right at the end of the thread that has just closed, so if Marly will let me, I'll re-post it here in case anyone has more comments to make:



    At the risk of straying way off topic, and regarding the Patel verdict - that was the ONLY verdict they could/should have brought down. I'm not commenting on whatever other charges he may or may not face, but I would respectfully disagree with the idea that they didn't understand the evidence. In fact I think the exact opposite - they were a good enough jury to demonstrate that the effects of social media and the media generally can be overcome by those who are able to weigh just the evidence.

    As probably the only one on here qualified to comment professionally, let me try to summarize the problem. The prosecution alleged that Patel shouldn't have operated on Mr Morris because he was sick and had heart disease etc. That description applies to most of my patients! But of course, they omitted the obvious fact that if he DIDN'T operate, then Mr Morris was going to die anyway from his bleeding.

    It is standard training and procedure, when faced with somebody bleeding heavily rectally, and with the cause unable to be determined (they don't have facilities in Bundaberg for selective angiography, for example, and the patient was far too sick to transfer, not to mention the delay), then you do exactly what Patel did - a laparotomy and if the sigmoid colon is full of blood (which it was) then you remove it. And 9 times out of 10 you will be right. And the bleeding did in fact cease.

    Now I know that Patel's mortality rate was within acceptable limits, and that the whole "Dr Death" thing is pure media hype. And he almost certainly had problems with judgment and insight - eg doing oesophagectomies in Bundaberg where the infrastructure just isn't there to look after them post-op. And his infection rate was a bit higher than average. But given the number of patients that he operated on, many of whom were very sick to start with, his record is nowhere near as bad as the media portrays. Or the "Patient Support Group". And THAT is where the problem lies - he has been made a scapegoat, and most of the opinion is driven by the very emotive desire for vengeance, rather than accepting the facts.

    As I said, I'm not commenting on the various other allegations - eg should he have been registered here. Different matter. But, based ONLY on the evidence in this case (and others, one of which in particular I'm very familiar with) he did NOT do anything wrong, let alone criminally wrong.

    One other point to consider (and I'm NOT protecting a colleague, by the way - if he did wrong, then he should be found to have done so): But, if he HAD been found guilty, then that would have ENORMOUS repercussions and implications for every surgeon in the future, when faced with a similar situation. Let's just say, for example, that I were to be faced with a patient in emergency (as I have been on countless occasions) with a presumptive diagnosis of a leaking aortic aneurysm.

    Now, if I operate, there is a 50-60% chance of survival. If I don't, the chance of survival is 0%. So what do I do? There is no time to faff about getting scans, or whatever. The patient with a hole in his aorta needs an operation, pronto. But now I have a problem - the patient has a 30-40% chance of dying even if I DO operate, and therefore I run the risk of being charged with manslaughter, despite trying to save him. So what do I do? The precedent would have been set by the Patel case.....

    The Crown stuffed it up big time. They brought the wrong case (not that any of the others would have been any different), and they didn't present it well enough to get a conviction (the correct decision IMHO). Several expert witnesses (colo-rectal specialists etc) testified that what Patel did was exactly the right thing to do in the circumstances, and they would have done the same. So would I - and have in the past. The patient had a problem which was going to be fatal if he did NOT get operated upon. Patel tried. And the patient died of complications - it happens. It goes with the territory.

    There has been WAY too much demonising by media and interest groups to enable most people see the facts from the hype, so I'm delighted that the jury, who were well-directed by the judge, were able to decide based purely on the evidence presented in court, and not be swayed by the hoopla!

    OK - way off topic, I know, but I know that several people in here are interested. And as far as comments about the jury not understanding the evidence - all I would say is that those people who think Patel should have been convicted simply don't understand the evidence, or the situation.

    Sorry for the long post - I hope it is allowed to stand, as it is off-topic. But WS doesn't have another thread where these points can be made.
    Very interesting post, my son tried to explain the same thing to me last night but didnt really get it, or stopped listening haha.

    I understand it more now but have to admit that after looking at him as Doctor Death for so long that there is no way I would let him near me. Mind you I have only been to a doctor two or three times in 16 years anyway.

    Btw I am guessing that will change now I am getting older...... cough lol.
    Shopping is a woman thing. It's a contact sport like football. Women enjoy the scrimmage, the noisy crowds, the danger of being trampled to death, and the ecstasy of the purchase.

  8. #8
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    [QUOTE=DrWatson;9035660]Just a post regarding the Patel case, which is way off topic, I know, but which has been commented on in these threads as there is nowhere else on WS to comment. I posted this right at the end of the thread that has just closed, so if Marly will let me, I'll re-post it here in case anyone has more comments to make:

    SORRY :-( but I think posting it ONCE was enough...just saying.

    I hope you are never operated on by an incompetent surgeon.

    Maybe if there were more competent surgeons like you out there the world would be a better place :-)

  9. #9
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    Quote Originally Posted by DrWatson View Post
    Just a post regarding the Patel case, which is way off topic, I know, but which has been commented on in these threads as there is nowhere else on WS to comment. I posted this right at the end of the thread that has just closed, so if Marly will let me, I'll re-post it here in case anyone has more comments to make:

    < respectfully snipped for brevity >

    Sorry for the long post - I hope it is allowed to stand, as it is off-topic. But WS doesn't have another thread where these points can be made.
    DrWatson. Thanks for taking the time to educate us. You are qualified to comment professionally and we have benefitted from this. This has increased my understanding. Appreciated.

  10. #10
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    Quote Originally Posted by BigApple View Post

    I hope you are never operated on by an incompetent surgeon.

    Maybe if there were more competent surgeons like you out there the world would be a better place :-)
    Thanks for the compliment. I also hope that I never need to be operated on by an incompetent surgeon.

    But that doesn't mean that I agree with your premise by inference - that Patel was incompetent. In fact, several expert witnesses have testified that he wasn't.

    The problem is, there are so many people with their minds already made up - mostly based on media, emotion, or rumour - that when actual, real facts are presented dispassionately, they find it difficult to change the mindset. And so it has become almost a "given" that incompetence is a fact in this case.

    I know quite a lot about the cases involved, as well as the audit that was done of his cases. And that is when the media started to tone down the whole "Dr Death" thing, and the number of alleged deaths came back down from 87 or thereabouts - all the way down to a mortality rate of about 8.

    The Patient Support Group have Patel prejudged, and want to see him swing. But their knowledge on which to base that judgment is non-existent. It is based almost completely on assumptions - which when they were looked into, were all found to be nonsense. I do understand how hard it is to lose a loved one, and for the medical team to be the focus of blame in some cases. But this is one that has just got completely out of control. Yes, there are other factors, such as his registration process (flawed) and his judgment and insight into his own capabilities (also probably flawed). But his surgical skills were at least OK, and in many cases, very good. Nobody talks about the hundreds of patients he operated on who had NO problems - and the lives he saved.

    There is one case in particular - which I won't post here for various reasons - with which I'm very familiar. It involves my own specialty and my own unit at our hospital in Brisbane. I can't and won't say any more about it - and that's not just to tease - but the allegations around that case are ridiculous! I would not have wanted to be in Patel's position when faced with the problems, although I have been in similar situations many, many times. And I would have, once again, done exactly what was done.

    Sorry to go on about this - but it is obviously something that is close to home for some, on both sides of the fence. And I know that justice was done by overturning Patel's original conviction, and by finding him not guilty on his re-trial. Let's wait and see how he goes with the fraud stuff to do with his registration process etc, and how others may have contributed to that...

    EDIT: OK - I think I should draw a line under this one, and not post any more about it. Other people's comments are always welcome, of course, but I won't post any more about the Patel case here. Thanks for being so tolerant, Marly

    "Elementary, my dear Watson"


  11. #11
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    Australia - Jayant Patel Case

    ...Queensland

    March 14, 2013

    Jayant Patel not guilty over patient death but more charges loom

    JAYANT Patel will be back in court tomorrow despite a stunning acquittal of unlawfully killing a patient.
    It has been a long road to vindication for the former director of surgery at Bundaberg Hospital, but a Supreme Court jury's decision to acquit him of manslaughter over the death of Mervyn John Morris, 75, is a major victory.

    http://www.couriermail.com.au/news/q...-1226596784793

  12. #12
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    Quote Originally Posted by DrWatson View Post
    Just a post regarding the Patel case, which is way off topic, I know, but which has been commented on in these threads as there is nowhere else on WS to comment. I posted this right at the end of the thread that has just closed, so if Marly will let me, I'll re-post it here in case anyone has more comments to make:



    At the risk of straying way off topic, and regarding the Patel verdict - that was the ONLY verdict they could/should have brought down. I'm not commenting on whatever other charges he may or may not face, but I would respectfully disagree with the idea that they didn't understand the evidence. In fact I think the exact opposite - they were a good enough jury to demonstrate that the effects of social media and the media generally can be overcome by those who are able to weigh just the evidence.

    As probably the only one on here qualified to comment professionally, let me try to summarize the problem. The prosecution alleged that Patel shouldn't have operated on Mr Morris because he was sick and had heart disease etc. That description applies to most of my patients! But of course, they omitted the obvious fact that if he DIDN'T operate, then Mr Morris was going to die anyway from his bleeding.

    It is standard training and procedure, when faced with somebody bleeding heavily rectally, and with the cause unable to be determined (they don't have facilities in Bundaberg for selective angiography, for example, and the patient was far too sick to transfer, not to mention the delay), then you do exactly what Patel did - a laparotomy and if the sigmoid colon is full of blood (which it was) then you remove it. And 9 times out of 10 you will be right. And the bleeding did in fact cease.

    Now I know that Patel's mortality rate was within acceptable limits, and that the whole "Dr Death" thing is pure media hype. And he almost certainly had problems with judgment and insight - eg doing oesophagectomies in Bundaberg where the infrastructure just isn't there to look after them post-op. And his infection rate was a bit higher than average. But given the number of patients that he operated on, many of whom were very sick to start with, his record is nowhere near as bad as the media portrays. Or the "Patient Support Group". And THAT is where the problem lies - he has been made a scapegoat, and most of the opinion is driven by the very emotive desire for vengeance, rather than accepting the facts.

    As I said, I'm not commenting on the various other allegations - eg should he have been registered here. Different matter. But, based ONLY on the evidence in this case (and others, one of which in particular I'm very familiar with) he did NOT do anything wrong, let alone criminally wrong.

    One other point to consider (and I'm NOT protecting a colleague, by the way - if he did wrong, then he should be found to have done so): But, if he HAD been found guilty, then that would have ENORMOUS repercussions and implications for every surgeon in the future, when faced with a similar situation. Let's just say, for example, that I were to be faced with a patient in emergency (as I have been on countless occasions) with a presumptive diagnosis of a leaking aortic aneurysm.

    Now, if I operate, there is a 50-60% chance of survival. If I don't, the chance of survival is 0%. So what do I do? There is no time to faff about getting scans, or whatever. The patient with a hole in his aorta needs an operation, pronto. But now I have a problem - the patient has a 30-40% chance of dying even if I DO operate, and therefore I run the risk of being charged with manslaughter, despite trying to save him. So what do I do? The precedent would have been set by the Patel case.....

    The Crown stuffed it up big time. They brought the wrong case (not that any of the others would have been any different), and they didn't present it well enough to get a conviction (the correct decision IMHO). Several expert witnesses (colo-rectal specialists etc) testified that what Patel did was exactly the right thing to do in the circumstances, and they would have done the same. So would I - and have in the past. The patient had a problem which was going to be fatal if he did NOT get operated upon. Patel tried. And the patient died of complications - it happens. It goes with the territory.

    There has been WAY too much demonising by media and interest groups to enable most people see the facts from the hype, so I'm delighted that the jury, who were well-directed by the judge, were able to decide based purely on the evidence presented in court, and not be swayed by the hoopla!

    OK - way off topic, I know, but I know that several people in here are interested. And as far as comments about the jury not understanding the evidence - all I would say is that those people who think Patel should have been convicted simply don't understand the evidence, or the situation.

    Sorry for the long post - I hope it is allowed to stand, as it is off-topic. But WS doesn't have another thread where these points can be made.
    Good post Doc, and clarifies the many elements of doubt in the causation of this patient's death. Seems that Patel was between a rock and a hard place with Mr Morris's situation. That is not to say that the other charges of manslaughter will have the same result, if the Crown proceeds with them. I agree that it is the ONLY proper verdict to bring down on this charge, and I believed that this would be the case before all the evidence was given. It was a very complex and difficult medical situation for any surgeon. MOO

  13. #13
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    I watched news tonight where a lady whose husband is one of the people who died and is the subject of the potential further charges, say she wants it withdrawn. Perhaps she has now seen the light as well. I agree with the comments made by Dr Watson but he has the expertise to say it correctly, for which I am very grateful.

  14. #14
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    Looks like they're going to waste yet more taxpayers' money....

    http://www.brisbanetimes.com.au/quee...315-2g4m7.html

    They really don't like to lose out to the facts, do they? And the lawyers will be rubbing their hands with anticipation again...

    "Elementary, my dear Watson"

  15. #15
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    Quote Originally Posted by DrWatson View Post
    Looks like they're going to waste yet more taxpayers' money....

    http://www.brisbanetimes.com.au/quee...315-2g4m7.html

    They really don't like to lose out to the facts, do they? And the lawyers will be rubbing their hands with anticipation again...
    Thats if they have actually BEEN paid for work done to date.

    I am sure you will guess that I am happy about this decision, and I know you 100% disagree with me DR W, but that is okay as we are all allowed our opinions for whatever reasons we have.

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