Indian-Trained American Surgeon Facing Manslaughter Charges

Dr Jayant Patel an Indian-trained American surgeon is facing 14 charges, including manslaughter, grievous bodily harm as well as fraud

Brisbane Magistrates Court was told by Dr Peter Miach, director of medicine at Bundaberg Base Hospital that had he been asked he would have advised Jayant Patel against operating on James Phillip. He said Phillips was a frail patient suffering from kidney failure and had a history of post-operative complications when it was discovered he had oesophageal cancer. James Phillip died two days after Dr Patel performed an oesophagectomy on him in May 2003 and Dr Patel is charged with the manslaughter of Phillips. The charges of fraud are in connection with his tenure as director of surgery at the Bundaberg Base Hospital between 2003 and 2005. He is accused of falsifying his resume to cover up a lengthy period of unemployment, as well as a history of medical misconduct and negligence in the US.

Dr Miach was the 40th witness to give evidence at Dr Patel's hearing where he said he disagreed with a decision to perform complex procedures on two frail patients at Bundaberg, both of whom later died. He added that Dr Patel did not consult him before operating on Phillips, but if he had been consulted, he would have advised against it.

He said James Phillip was emaciated and had suffered two heart attacks, the latest being just five months prior to the surgery and it was possible that Phillips suffered his third heart attack immediately after the procedure. He concluded the decision to removed part of Phillips's oesophagus in a difficult procedure known as an oesophagectomy by Patel had resulted in his death.

"(Mr. Phillips) was a man (who) was wasted. He had numerous complications; he'd had two heart attacks, one in 1999 and one in 2003. He was malnourished," Dr Miach said. "I'm not surprised ... he got into trouble. It's well accepted in medical circles that if you operate on someone after a heart attack, it's very dangerous."

He told Crown prosecutor David Meredith he had some concerns with the fitting of catheters by Patel on his renal patients and "took steps" to have the procedure moved to another hospital in Bundaberg. "I'm not a surgeon, but I don't think oesophagectomies should be performed at Bundaberg."

Meredith asked Dr Miach whether he could connect the surgery and the heart attack to which re replied, "In people with known coronary artery disease, there is no doubt surgery can precipitate the incidence," he said.

Prosecutors for the Crown have alleged that the same procedure also caused the death of patient Gerry Kemps, who suffered a post-operative bleed.

The hearing continues on Monday.

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