Renal specialist says Dr Patel’s patient was too frail for surgery

Apr 12 2010

By Candy Lashkari

In the ongoing trial of Dr Jayant Patel, Dr Peter Miach, a renal specialist, gave evidence before the Supreme Court in Brisbane. Dr Miach said the patient James Phillips had too many other problems and he would not have recommended surgery for him in his frail state.

James Phillips was in the end stages of kidney failure, had heart problems and had also recently been diagnosed with oesophageal cancer. Dr Miach, who also treated Mr Phillips at the Bundaberg Base Hospital on a number of occasions, said that he would not have supported Dr Patel’s decision to operate at all.

Dr Miach remembered Mr Phillips as a “complex” patient, who had suffered heart attacks in 1999 and in early 2003. Mr Phillips was hypertensive and had repeated problems with his vascular access. He also needed to walk with the aid of a stick as a side effect to an anitibiotic that had damaged his balance.

Mr Phillips had gone through a failed renal transplant and due to his renal failure was receiving dialysis on a regular basis. In January 2003 Dr Miach mentioned that Mr Phillips had a potassium level up to 8.2 which is very high. This high level of potassium was brought down by treatment but was still dangerously high after dialysis which is why he was sent to Brisbane for further treatment.

Dr Jayant Patel performed an oesophagectomy on Mr Phillips which in Dr Miach’s opinion was unnecessary given his complicated case history. Mr Phillips died two days after the surgery was performed.

Dr Jayant Patel has pleaded not guilty to the manslaughter of Mervyn Morris, 75, Phillips, 46, and Geradus Wihelmus Gosewinus Kemps, 77, and causing grievous bodily harm to Rodney Vowles, 62, on various dates between March 2003 and April 2005. He was the head of surgery at the Bundaberg Base Hospital during that time.