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June 10, 2005 Australia wants Patel charged. Officials say they'll pursue a homicide trial for the former Portland surgeon and suggest other cases are possible By SUSAN GOLDSMITH Australian state authorities said Thursday they plan to move swiftly to charge former Oregon surgeon Jayant Patel with murder in the death of a cancer patient, and suggested that additional charges of murder or manslaughter might be possible as evidence mounts before a royal commission of inquiry. Queensland Premier Peter Beattie said he would seek Patel's extradition to face charges in the aftermath of an interim report issued by the commission, which for two weeks heard charges of patient deaths and injuries involving Patel from doctors and nurses at remote Bundaberg Base Hospital in the northeast Australian province. Patel, 55, served as chief of surgery at Bundaberg after joining the staff in 2003, three years after being disciplined as a surgeon at Kaiser Permanente in Portland, where he maintains a home. He failed to disclose that he'd been disciplined when seeking a medical license in Queensland, the commission has established. Stephen Houze, a Portland criminal defense lawyer representing Patel, said he received the commission's report late Thursday and had no immediate comment. He has declined to reveal Patel's whereabouts. The 43-page interim report also recommends that Patel be prosecuted on a fraud charge for failing to disclose his medical past and for negligence in the care of a female patient whose leg he had amputated. Beattie said he had been in contact with Queensland police, and had urged them to "take immediate action" to charge Patel and move to extradite him. Beattie is the highest elected official in the province. Though the report recommended charging Patel with murder in the death of James Edward Phillips, whose cancer was terminal, it said the case could alternately be prosecuted as manslaughter, a lesser homicide. Dead five days later Phillips, in his 40s, had kidney failure and cancer of the esophagus. He died five days after Patel removed part of his esophagus in a surgery that Dr. Peter Miach, the Bundaberg hospital's director of medicine, told the commission was "fraught with danger" and probably would have killed the patient. Phillips was a poor candidate for surgery and had been told so by doctors at another hospital, Miach said. Even though Phillips had terminal cancer, a jury could conclude that Patel hastened his death and acted fraudulently because he had unlawfully misrepresented his medical record, the report said. Australian law defines felony murder as a death "caused by means of an act done in prosecution of an unlawful purpose," the report said. In the case of the amputee, Marilyn Daisy, 43, the report cited testimony alleging that Patel failed to follow up by removing stitches, or taking measures to prevent infection and gangrene. Other doctors became concerned that she might lose more of her leg, the report said. Media reports have said Patel is under investigation in 87 patient deaths at the state-run hospital. He left Australia in April and has not been represented during hearings before the commission, which lacks the authority to offer him immunity in return for testifying. The report said Houze has not responded to the commission's queries. Worked at Kaiser Patel worked for Kaiser Permanente in Portland as a general surgeon from 1989 to 2001 and ran the nonprofit health network's surgical residency program from 1992 through 1996. He was highly regarded enough to be honored by Kaiser in 1995 with the Distinguished Physician award. By 1998, however, Kaiser had concluded Patel had problems. After an internal peer review, Kaiser restricted him from performing three types of complex liver, colon and pancreas surgeries, which had been among Patel's specialties. The restrictions also required him to get second opinions from other doctors. As required by Oregon law, Kaiser reported Patel's practice restrictions to the Oregon Board of Medical Examiners and the National Practitioner Data Bank, which tracks physician discipline. The Oregon board extended the restrictions statewide in 2000, citing Patel for "gross or repeated acts of negligence" in four cases. A year later, Patel voluntarily left Kaiser. But his troubled record didn't stop six former Kaiser colleagues, including his boss, from writing glowing letters of recommendation. Doctor's endorsement Dr. Edward Ariniello, a Kaiser surgeon who was chief of surgery until 2000 and member of the board that restricted Patel's privileges, described "deep personal sorrow and regret" over his departure. "I feel that wherever he works or whomever he works for will be the beneficiary of his excellent skills and knowledge and will be all the better for it," Ariniello wrote. "I can recommend Dr. Patel without any reservations whatsoever." As to Patel's patients, Ariniello said, "They trust him, and he delivers the best care he can." Ariniello, who remains a surgeon at Kaiser, has declined repeated interview requests. Jim Gersbach, a Kaiser spokesman, said the references, although written on Kaiser letterhead, were not approved by Kaiser. Queensland officials said Patel failed to disclose either the Oregon disciplinary action or a 1984 decision by New York's medical board to put him on probation for negligence during his surgical residency in Rochester. Patel had filled out patient charts without examining them and harassed one patient to hinder investigators. It was unclear Thursday how quickly Patel could be extradited once charges are filed. Australian police must issue an arrest warrant and alert Interpol, the international police agency. Diplomats then would send an extradition request to the State Department. The FBI would be charged with arresting Patel, who would then face a detention hearing and extradition proceeding, which can be appealed. The process can take a full year, said Douglas McNabb, a nationally known extradition lawyer from [Houston], Texas. | |