Patel trial testimony by anesthetist: bleeding and kidney damage may have led to early death

By Dr. Ananya Mandal, MDApr 20 2010

The Patel case

In the Jayant Patel manslaughter case new testimony has surfaced. Dr. Patel has been accused of causing the deaths of three Queensland patients and permanently injuring another when he performed operations as director of surgery at the Bundaberg Base Hospital between 2003 and 2005. He had pleaded not guilty.

Testimony

Now a witness has told the court that Patel had nicked a vital vein in the neck of Mr. James Phillips’ (46) that had led to lot of bleeding and ultimately the death of the patient. Mr. Phillips had died in 2003 two days after Patel removed part of his oesophagus due to throat cancer. This testimony comes from key witness anesthetist Dr Alison McCready. According to her the jugular vein got nicked while Patel was trying to insert a central venous line, this then caused a lot of bleeding.

Argument

However she agreed with Patel's lawyer Michael Byrne that there are risks associated with any procedure and the patient is aware of the risk of death from any procedure and this was the best option to save his life. However there was no ultrasound equipment at the hospital, Patel had to try "blind" to insert the central venous line. This significantly increased the risk from the procedure.

Aftermath of the accident

Following the bleeding at least four bags of intravenous fluids and whole blood was transfused to the patient. The Queensland Supreme Court also heard the fact that Mr. Phillips was suffering from a chronically bad kidney and the high potassium content in the transfused blood may have damaged his kidney further to cause his death. “We always have to bear it in mind, but there didn't seem to be an alternative to replace red blood cells that he had lost," Dr McCready said. The inability to insert the central venous line was one of the reasons why monitoring the patient was incomplete. The excess build up of potassium that the patient’s kidney could not eliminate may have led to a fatal heart attack.

Earlier, Dr McCready told the court that she had taken over from anesthetist Dr Martin Carter during the operation because Dr Carter had to leave.