Dr. Jayant Patel is flying out of Australia as a free man. It is hard to reconcile this with the fact that few years ago he was painted as public enemy number one. It was alleged that large number of patients died or maimed due to his medical negligence. He was given a title of Dr. Death even before single sentence was spoken by his defense.

Medical/Surgical practice by their seer nature involves expected and unexpected death or complication. If a patient dies due to or in spite of treatment it does not make it manslaughter. Every society strives to minimize such occurrences.

The shock in case of Dr. Patel case comes from how we were lead to believe that Dr. Patel was some criminal on loses. He came to Australia to kill or maim innocent patients. He was society’s enemy number one. And all we need to do was to get him in Australia from US and throw him in justice system and he will be locked for life. It was supposed to be an open and shut case. Prosecution has so much evidence that they were having difficulty choosing which criminal act to try him to lock him away! Disbelief stems from the wide gap between the expectation and reality.

~2~

~2~ As it turns out the crown attempted four trials. In the very first trial they started prosecuting several manslaughter and grievous body harm based on allegation that Dr. Patel’s performed surgery incompetently. However, on 43rd day of 58-day trial they realized that they did not have ability to prove incompetence in Dr. Patel’s surgery. So in last 15 days they alleged that surgery was not indicated therefore performing the surgery was a criminal offense.

Of course jury heard too many allegations in first 43 days that would have never been allowed had the trial conducted to focus on indication. Also by bunching several charges prosecution was able to convince the jury that Dr. Patel was a bad surgeon.

During the first trial Dr. Patel was still recovering from massive public anger against him, even those who wanted to speak up for Dr. Patel, chose to remain quiet. Judge should have declared this a mistrial but he did not. Prosecution was able to get a guilty verdict and Dr. Patel was sentenced to seven years.

While there was no public outcry many in legal and medical profession were aghast. What if to morrow every physician who has few deaths or complication is called upon to defend himself or herself? This was the first time in recent history of Australia that a physician was charged with manslaughter for performing the operation that he believed was indicated after an informed consent.

Those of us who have been in clinical medicine know too well. Only person who never has unexpected mortality or complication is the physician who has never practiced medicine. Even with best of our efforts we do encounter death or complication. Who is going to decide if a given death is mortality?

Several attorneys agreed to help Dr. Patel (pro-bono if necessary) to get the justice. They were mindful of the prevailing strong sentiment against Dr. Patel and therefore the challenge of finding an impartial juror. Their first step was to challenge the first trial.

~3~
They succeeded in overturning the verdict in Aug 2012. High Court of Australia overturned the verdict stating, “there was miscarriage of justice when prosecution changed the statute under which they were charging Dr. Patel on the 43rd out of 58 day trial.” Judge also ordered that each charge be triad separately to avoid contamination of evidence that happened during the first trial.

This was the chance for DPP to accept the fact that they did not have enough evidence to prove their case in a criminal court. They had known it all along. That is why they switched the statute on 43rd day. Once again they chose to keep up the strong façade and Tony Moynihan declared, “ upon reviewing the evidence we are confident that we can get a conviction of Dr. Patel and new trials are in interest of justice.”

Upon reviewing all possible charges DPP decided to start with manslaughter charges for Mr. Morris. (This was their best hope) The case started cracking right at the beginning. They had to file a brief with the judge outlining the charges and the evidence and how it proved the guilt of Dr. Patel. It turns out that the judge could not make head and tail out of their argument and had to send it back three times for revision. He actually commented that he was embarrassed by the brief submitted.

March 2013 in the case of manslaughter of Mr. Morris, the jury gave a ‘not guilty verdict’ . Mr. Morris an elderly male had already had an episode of massive bleeding from his colon in past. He also sustained another massive bleeding before admission to Dr. Patel. Commonsense approach would have been to remove the colon rather than risk the third massive bleeding (it can cause heart attack). Dr. Patel rightly operated on the patient to save his life. Jury was able to understand that fact and rightly gave a not guilty verdict. You really do not want elderly patients bleeding repeatedly in your surgical ward while surgeon is running one test after the other

I am glad that I won't need to pay for his stay in prison from my tax-money.

Dear V. Mehta,

The law isn't about justice, it's about the law.
And J. Patel hasn't been vindicated or found to be
innocent, he's pleaded guilty to charges
of fraud.

His innocence or guilt is still under question.
This isn't a question of a doctor who's lost one
patient (for whatever reason). This is a doctor who's
lost 5 . And that kind of a loss warrants answers,
especially for the families. Seven counts of fraud
also brings into question the doctor's reputation.

Would you trust your family's health and well-being
to a doctor with this sort of record?

I know that I certainly wouldn't and I think that most
people would agree with me.

~4~
DPP had a chance to call it quits at this stage after losing their best case. However, Tony Moynihan pressed on charging Dr. Patel with Grievous body harm for operating on Mr. Vowel. This elderly man already had previous surgery for colon cancer and he came back with polyps in remainder of colon. Of course we can biopsy them repeatedly to look for cancer. But with his family history Mr. Vowel was at much higher risk developing colon cancer and that too much more aggressive type. Dr. Patel noted this and Mr. Vowel opted for never having to deal with colon cancer. Therefore, he underwent removal of total colon and ileostomy. Prosecution argued that he could have saved last portion of colon to avoid the ileostomy. However, most surgeons do not like to leave any colon because of the risk of cancer in remaining portion. As a matter of fact Mr. Vowel’s sister who was healthy at that time has passed away due to colon cancer since then. All the differences aside, Total colectomy for a hereditary cancer is one of the options.

Jury once again could not give guilty verdict. Majority of jurors were in favor of not guilty but 2-3 jurors refused to give in and after lengthy deliberation they came up with hung jury. Another blow to the prosecution. Of course Tony was not ready to concede the defeat. However, it was obvious that defense was not going to be bullied by the mighty machine of DPP.

3.6 million was the amount spent on the trial from June 2006 to June 2013. More bills are pending. They also have to pay for the amount spent by Dr. Patel during the first trial since it was a mistrial. 9.3 million to the compensation to the patients of Dr. Patel that were paid out to avoid litigation by Premier Beatty. Millions spent on Morris commission and Davis commission. The meter was running and Tony did not have any thing to show for or any hope of getting a conviction.

~5~

Finally, prosecution agreed to drop all medical negligence charges against Dr. Patel. He said that, “ we don’t have evidence to convince a jury in a criminal trial, so it would be in interest of justice to drop all the charges.” Of course, they needed something to save the face. Dr. Patel agreed to four counts of fraud.

These four counts of fraud stems from single act of omission or commission. At the time of application Dr. Patel faxed his medical license from Oregon that was current. But he had a restriction – namely if he were to perform surgery on esophagus or pancreas, he should seek a second opinion. On one page where it said any restriction on license it said, “see attached” however according to the hospital they never received the attachment. (If they had read original application and asked for it I am sure they would have received it) So this one act was multiplied four times since he worked two years and he was registered for two years!!

So there it is. After all these years and millions spent DPP successfully got a conviction on Patel for not attaching a page during his application.

Where is all the evidence of Medical negligence by Dr. Patel? If he was even 10% as bad as DPP was charging why is it that they have not been able to get a single conviction about his medical care?

I feel sorry for the families and patients of Bundaberg hospital, someone wanted to shift all the blame on Dr. Patel so you would not blame real culprit – your healthcare system. Political parties were posturing for benefit rather than look at the issue from every angle. Your journalist was too busy regurgitating whatever sensational information was fed to them. Thomas Headly (now retired) could not wait to write the book “Sick to death” but he did not bother to investigate the other side of the story

~6~

All surgeons have complications and deaths. More they operate more likely they are to have such events. More they perform complicated high risk procedure more they are likely to have adverse results. Just the fact that someone has more deaths and complication does not mean you have to drag him to the court. And the job of monitoring such adverse event should not be in hands of politicians or attorneys but Peers. A bad surgeon should be spotted by his peers.

Criminalizing a medical practice is a very slippery slope. Dr. Patel case has taught us an expensive lesson. DPP, do not act on your passion but on hardcore evidence. If you are trying in a criminal court make sure you have the evidence to meet that threshold. If the evidence does not exist let people know – they will get over it.
This case has embarrassed DPP on a world stage. Many international physicians who may be considering to come to Australia are now looking at other options.

It is time there is an open dialogue as to what went wrong and what could have prevented the whole tragedy

@ Foxy

It is the responsibility of Public Prosecutor to evaluate the evidence at hand. To determine that given evidence is good enough to convict the accused of the crime. As it stands right now the prosecution has admitted that they did not have strong enough proof to convict Dr Patel of a single charge of medical negligence. All the charges related to medical care were dropped by them.

So only thing they could charge Dr. Patel (so called four counts of fraud) consist of Dr Patel omiited to send one page from State board of Oregon. The page preceding this page was addressing 'do you have any restriction on your medical license' the board file stated " see attached" Apprantly, in the next page it was mentioned that He was required to get a second opinio (as to the necessicity of surgery) in case he were to perform esophageal or pancreatic surgery.

Now, the person who hired Dr. Patel never read this carefully to realize that a page was missing. Second, you do not ask the applicant to send you the license but directly to the Medical Board, Third all you had to do was to google his name. In US all medical board actions are matter of public knowledge. Remember Dr. Patel came as a surgeon and within few months he was promoted to Director of survey.

This one act has been multiplied four times for registration as well as getting the job and for two years.

He was given a suspended sentence, which means he does not have to serve any time and not get in any legal trouble for next two years. If this is all DPP had there was no point in international man hunt and millions of dollars of taxpayer's money.

DPP has a lot of explaining to do.

Dear V. Mehta,

J. Patel is the one who has a lot of explaining
to do not the DPP as you infer Sir.

1) The Court heard that J. Patel had been effectively
struck off by medical boards in the United States over
complaints about his competence, before applying for the
position of Senior Medical Officer at Bundaberg Hospital.

2) He failed to inform Queensland Health Authorities of the
restrictions upon him in the United States answering "NO"
when asked whether his registration had ever been subject to
cancellation, suspension, or disciplinary action.

3) J. Patel spent a total of 788 days behind bars after being
convicted in 2010 of unlawfully killing one patient and
causing grievous bodily harm to another. J. Patel had
served 131 days of pre-sentence custody.

4) Crown Presecutor Peter Davis, QC recommended J. Patel be
sentenced to 4 years imprisonment, wholly suspended allowing
the former surgeon to walk free from court and last week,
Queensland's Director of Public Prosecutions, Tony Moynihan,
QC decided not to proceed with further criminal negligence
charges possibly to allow J. Patel to leave this country
and thus get rid of the expense involved in further trials
and have this man continue to live in this country.

Your defence of this man to me is somewhat questionable.
Being a fellow American ( a Texan), and a retired thoracic surgeon,
are you perchance a friend of J. Patel's?

Just asking.

May I say both welcome to our author.
And thank you for a well put together thread, but too that we should not defend just because we share racial roots with the defendant.
History has a word to add to Doctor Death.
Words written before he came to this country, and they are unkind to him, and the QLD health system that employed him.
Racism? I doubt it! I am in the hands of the best Doctor in my life, a Gentle yet brilliant man from Iran.
Second to him was my previous a Doctor from India.

@ foxy
"The Court heard that J. Patel had been effectively
struck off "

There is misunderstanding. At the time of his application Dr. Patel had a license to practice surgery in Oregon. He was even allowed to do surgery on esophagus and pancreas with the restriction that he had to get a second opinion prior to operating. The word struck off implies he was not allowed legally to practice medicine that it is not correct.

As you may already know when you have multiple licenses anytime there is any question you have to go to each board and each board conducts hearing to decide the action they may take. Dr. Patel was holding New York license also and he chose not to go through hearing in New York and his NY license was not valid.

This is not uncommon to give up a license specially at the end of your career in the states that you are not likely to go.

Once again Dr. Patel had Oregon License that was valid and active.

It is duty of the employer to get such vital information directly from the board and not from the applicant or recruiting agency. The employer was required to read the application properly where it stated "see attached" and look for attachment - which was not done. As you probably know all medical board are a matter of public knowledge so going to the board's website will yeild you the information necessary

Dear V. Mehta,

I'm sorry but I don't really care to comment any
further on J. Patel.
I've had my say and suffice to say that I am relieved
that he's leaving our country.

Foxy, the responsibility lays squarely on those in charge of the medical board.

They, like so many in this new working world were quite simply incompetent.

You strike incompetence in so many government and non government departments it's scary.

Too much focus on RDO's, working conditions and trying to blend family time with work commitments, and not enough on the job at heand.

Our work ethics, on the whole, have slipped as we place too much importance on our personal wants than on the task at hand.

The DPP is just another example of incompetence.

I will bet their personal lives were well managed!

I too no longer wish to contribute to this thread.
While understanding our author has put together a good defense I am unsure it proves much.
Australia has no record of targeting Doctors.
And has many from all over the world fitting in with local community's and valued for not only medical skills but great contributions to those community's.
Know the great pain Nurses faced and family's of those unfortunates who became victims of this man?
I think the thread is a white wash and no matter what the evidence no agreement can be gained so? I leave without change to my view Doctor death is a true description of the mans actions.

Extension of Contract:

On the Christmas Eve 2004, after Dr. Patel already completely 21 of his 24 months contract at Bundaberg Hospital, he submitted a letter of intent not to renew the contract. He decided he was not going to stay beyond his contract till the end of March 2005.
Director of the Hospital offered him 4 (Four) years extension of contract and wrote a very complimentary letter praising his work at Bundaberg Hospital.

This is very important because this allows us to see Jayant Patel is he was seen by the Hospital administrators and his superiors. Mind you that these superiors had heard the complains from the Tony Moynihan and likes. They were the ones who saw the performance of Dr. Patel day in and day out. They are the ones who promoted him to the Director of surgery. The key is to understand their mindset to keep Dr. Patel working for 4 more years.

If he were as big a monster as the whistle blowers and prosecution contended there is not reason for his boss to favor Dr. Patel. Dr. Patel was not bribing them or was not related to them.

These senior physician and administrator had seen many surgeons in their life tile and each one of them have certain strengths and certain weakness. And based on the total picture they had seen they felt asking Dr. Patel to stay was in the interest of the hospital.

My point here is this. Dr. Patel was not a perfect or outstanding surgeon but he was not Dr. Death or he was not some criminal set out to harm the patients. His story was so embellished that people believed (and many will still continue to believe even after all the charges of medical negligence have been dropped) that he was an extremely bad surgeon.

Having been a surgeon for more than 35 years I can tell you that if you use Dr. Jayant Patel as an yardstick you will find a lot of surgeons who can be painted worse than him.

Dear V. Mehta,

Hospitals want to avoid lawsuits from family members.
And telling us that J. Patel is not as bad as some
other surgeons does not excuse him and is a lame
excuse. . As I stated
earlier, I am glad that he will be gone from our
shores. You haven't answered my earlier question -
are you a friend of J. Patel?

@ Foxy.

The answer is no I do not know Dr. Jayant Patel or not connected to him or related to him or ever met him. Only time I have ever talked to him is when he called after all his trials were over a week ago.

I first heard of Dr. Patel thru headlines on Internet news. As a Chief of Surgery it roused my curiosity. I started following the Morris commission right from the start.

My initial reaction was like everyone else - that he was a bad surgeon who killed hundreds of people. However, before soon I realized that something did not add up. All the allegations were so outrageous. How come someone from US land in small town (Pop 75,000) kills so many people over 24 months? Who were the people who hired him? Who promoted him? And more important who allowed him to carry on?

Being familiar with the function of hospital I found that the story being fed to people was not plausible. When Premier Beaty came to US and held a press conference saying that, "he was there to fish out Dr. Patel!" I wondered why does a Premier have to come to Portland to fish out so-called criminal? Don't we have treaties to deal with such issues? Thomas Hedley penned a book "Sick to Death" without ever trying to find out the Patel side of the story.

As the case evolved it became obvious to me (during the first trial) that prosecution did not have evidence to back up the charges of manslaughter or grievous body harm. And now, as the whole world knows Prosecution has admitted to that and dropped all the charges related to medical care by Dr. Patel.

This does not absolve the deception of not disclosing the license restriction by Dr. Patel. But you should not charge someone for manslaughter when your have evidence to charge deception

Dear V. Mehta,

Thank You for answering my earlier question.
There are still many unanswered questions regarding
J. Patel and I am
relieved that he shall not be practising
medicine in this country.