Committee recommends doctor's transfer
Stabroek News
January 8, 2002

The commission appointed to conduct the investigation at the New Amsterdam Hospital in relation to two deaths has recommended transferal of a surgeon for a period to the Georgetown Public Hospital, where it is believed he will benefit from a busier and more structured service.

Additionally, the commission has expressed sadness that "the doctors did not write appropriate records when they wrote" and as such urged that "the service of the hospital be urgently improved" as it related to professional assets, medical personnel and laboratory services.

The five-man commission comprised surgeons Bud Lee and Deen Sharma of Woodlands Hospital, Dr Parlaparti Santosh of the Georgetown Public Hospital, Dr Gladstone Mitchell of Medical Arts Hospital and Dr Dennison Davis, director of Standards and Technical Services at the Ministry of Health.

They were appointed by Minister of Health, Dr Leslie Ramsammy to conduct an enquiry into the deaths of 25-year-old Shahabodeen Kassim and another patient identified as Chatterpaul.

Kassim was shot in his Vryheid, East Canje home by bandits and was rushed to the New Amsterdam Hospital where he died.

A release from the Government Information Agency (GINA) said that the report, which was submitted to Dr Ramsammy on December 27, indicated that doctors and essential staff ought to be provided with live-in or call-in accommodation within the hospital complex or nearby. It was found that in the case of Kassim "there were discrepancies between the times quoted by the father of the deceased and the professional staff," in relation to the events following his admission to the hospital after he was shot.

The report was released to GINA through a press release issued by Dr Ramsammy, who, according to the agency, said in the release that the report revealed that "some of these discrepancies could not be reconciled since the available records were incomplete."

"We received nurses' and doctors' verbal reports," the report stated.

According to Dr Ramsammy, because of this, the commission relied exclusively on the notes, since it had no way of reconciling the differences.

The investigation, the release said, was conducted on the basis that the sequence of events included a call to the orthopaedic surgeon at approximately 6:45 pm.

The surgeon had ordered that the patient be admitted to the ward and this was done 15 minutes later. He reportedly then requested the service of the general surgeon, who responded at 8:15 pm.

The patient was transferred to the operating theatre at 8:55 pm and died at 9:15 pm on November 24, 2001.

According to the report, "the patient's injury was so serious that a different outcome was unlikely, given the available service at the regional hospital."

It was noted that very major blood vessels were damaged, which caused blood loss so severe that the patient was in shock.

Additionally, the release said, both small and large bowels were injured, as revealed in the post mortem report.

However, it was found that there was a prolonged delay of over one hour at the Accident and Emergency Unit (A&E).

According to the commission's report, part of the delay was attributed to the family's wish to airlift the patient to Georgetown, with additional delay due to arrangements for helicopter transport and receiving team, among others, as well as being in the ward from 7:40 pm to 8:55 pm.

It took 40 minutes after the general surgeon's visit for the patient to be taken to the operating theatre.

After investigating the case, the five-man commission recommended that severely injured patients who need management in the operating theatre be transferred without need for admission to a surgical ward, as this process was seen as one that would accelerate the process of surgical care.

The report stated that the referring doctor should speak to the consultant on duty directly and provide likely diagnoses and details of the patients' key clinical status, as the present arrangement of the nurse contacting the consultant was unacceptable.

It was also recommended that A&E doctors be trained, at least in basic emergency life support and must be confident enough not only to manage the patient, but also to advise on possible outcomes, as well as the need of transfer to another institution.

It was also advised that arrangements should be put in place for senior professional staff to discuss outcomes with patients' relatives.

In the case of Chatterpaul, the committee expressed serious concerns pertaining to the clinical management of the 62-year-old man who was a patient at the hospital on October 31, but was readmitted and subsequently died.

The report pointed to the surgeon's "failure to treat the patient appropriately when he was presented in shock on readmission and his failure to ensure that the patient's consent form was completed before surgery."

The commission recommended that the particular surgeon be transferred to the city hospital. The report said that the patient was scheduled for surgery at the hospital during the first week of November, but was discharged by the general surgeon, presumably at the patient's request on October 31, after which he visited the doctor's private office on November 4, where day-case surgery was performed.

The patient was sent home, but was readmitted to the hospital in "shock" the following day and subsequently died.

The commission did not consider the question of "propriety of the public hospital/private clinic."