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Court favours doctor wrongly disciplined by Medical Council
By George Barclay www.guyanachronicle.com

A DECISION by the Medical Council of Guyana to conduct a second disciplinary hearing against Dr. Narine Datt Sooknanan, after declaring the first invalid, was contemptuous, Justice Jainarayan Singh ruled yesterday.

The litigation surrounded the removal of Sooknanan’s name from the Practitioners Register, allegedly for gross negligence.

But Justice Singh’s ruling is that orders nisi granted by another judge on August 3, 2007, be made absolute.

It had been reported to the Medical Council that Sooknanan was grossly negligent during an operation, at New Amsterdam Hospital in Berbice, causing the death of a woman.

Consequently, the statutory body took steps to remove his name from the registered listing. As a result, the doctor approached the Court for writs of certiorari, mandamus and prohibition to quash the move and he was granted a nisi order which was later made absolute with the consent of the Council.

However, the Council, subsequently, arranged for another hearing, resulting in the doctor again approaching the Court for redress.

Attorney-at-law, Ms. Jamela Ali, who represented Sooknanan at the other trial, submitted that it was contrary to the rules of natural justice and the principles of good administration. She also argued that what was done by the Council, among other things, amounted to an abuse of Court process.

Justice Singh noted it was being alleged that the woman died 11 months after the operation and Sooknanan denied any negligence.

After narrating other facts, the judge observed that, at the March 1, 2006 proceedings, Sooknanan was questioned on four specific medical issues to which he responded, despite the fact that he had no prior notice they would be raised.

Justice Singh said it would appear and a logical conclusion can be assumed that the Council, as constituted on that date, was unable to decide as to the negligence of the doctor and sought a review of the evidence by an independent obstetrician and gynaecologist, who was not present at the hearing, without the approval or consent of Sooknanan.

The judge said it was on this review that the Council reached its finding of gross negligence and communicated it to the doctor in August 2006, stating that his name would be expunged from the register.

Sooknanan moved for the reversal the same month and the Council was stopped from undertaking the removal but, although the statutory had ample opportunity to file an affidavit in answer, it did not do so and, on November 13, 2006, consented to nisi orders, Justice Singh said.

The judge said, some three months after, in February 2007, the Council informed Sooknanan it had decided to hold a second hearing and that was clearly a breach of the order of prohibition made on November 13, 2006 by a different judge.

Justice Singh said that, without going any further, he found that the Council is clearly in contempt of the prohibition edict to which it previously consented, by not doing or causing to be done any act, deed or thing, in furtherance of or reliance upon the August 4, 2006 decision to take Sooknanan’s name off the Register.

The proposed second hearing clearly was sought to be held for the exact purpose which the order prohibits and, in any event, to hold it almost five years after the alleged 2003 act of negligence would be contrary to the rules of natural justice and an abuse of the process, Justice Singh said. He agreed with the submission by Sooknanan’s lawyer that the matter was res judicata (a case already decided by judicial authority).

Declaring that the orders of November 13, 2006 are clear and unambiguous and were not appealed, Justice Singh also awarded $35,000 costs to Sooknanan, payable by the Council.

New Amsterdam hospital death. Doctor resigns after asked to proceed on leave

The New Amsterdam Hospital doctor Dr Narine Datt Sooknanan, at the heart of the investigation into the death of a 16-year-old, has resigned.

Kaieteur News understands that this decision was taken by the doctor, after he was asked by Health Minister Dr Leslie Ramsammy to proceed on extended leave to facilitate an in depth investigation into the incident surrounding the teen's death.

Recently, the Health Minister had said that a preliminary report, which was compiled by the hospital's investigating team, was being studied by the Health Ministry and the findings would determine whether there was need for a more in-depth probe.

The Committee on Questionable Deaths which was set up earlier this year by Minister Ramsammy, found last month, that death was not inevitable in the case of Michelle De Younge, and the lack of due diligence on the part of the staff of the New Amsterdam Hospital may have contributed to it.

Sitting on that Committee are Dr. Vivikenand Brijmohan, who is the Government Pathologist, Nursing Tutor Sister Javitri Eugene and Pastor Roy Thakurdyal.

De Younge died on February 7 last at the New Amsterdam Hospital , five days after being admitted.

An eclamptic patient, her condition at admission necessitated termination of pregnancy through caesarian section. This operation was done on February 2.

An eclamptic patient is one who suffers seizures and is almost comatose.

Among other things, the investigation also revealed that “professionalism, discipline, morale and consequently quality health care delivery are being compromised at the New Amsterdam hospital, in an environment of relational tensions, lack of protocol and absence of team work.”

The report also stated that there was evidence of some tensions between the two principal doctors involved in the case. This situation may have compromised the care given the patient, and contributed to the end result.

The committee's report indicates that over a 48-hour period, Dr Sooknandan, a senior doctor/consultant at the institution, failed to respond to numerous calls to attend to the seriously ill De Younge.

According to the report, another doctor, Dr Persaud ordered drips for the patient on February 4. However, Dr Sooknanan, changed the treatment from drips to bolus. Dr Persaud is adamant that the change was not necessary.

Two days later, on February 6, the patient became critical. Attempts to get Dr Sooknanan to attend to the patient on three occasions, 08.15 hrs.08.24, and 08.45 hrs were reportedly unsuccessful.

He finally came at 09:00hrs.

Dr Ganesh was summoned from the A&E unit at 17:05 hrs that same day to treat the patient.

He responded. Attempts were made to get Dr Sooknanan to attend to the patient at 21:35 hrs. The doctor responded that he was not on call. He advised that the patient's treatment be administered as per chart. The nurses' record book does not show this was carried out.

De Younge died the next day at 19:50 hrs.

Commenting on the findings of the committee, Minister Ramsammy reiterated that while the intention is not to point fingers, the safety of patients is first priority, and in any investigation where negligence is found, the appropriate action will be taken.

“We are not saying that every time such a death occurs, someone is to be blamed, but we look at the system and the kind of interventions to identify weaknesses, but once it is found that someone is responsible, as the Minister of Health, I can guarantee you that action will be taken,” he vowed.

Towards this end he told Kaieteur News yesterday that in addition to the changes recommended by the investigating team, a number of departmental changes and re-organisation within New Amsterdam Hospital has taken place.

He said that a doctor, who will be available for the maternity section, is now stationed at the New Amsterdam Hospital on a 24-hour basis, as was implemented at the Accident and Emergency Department.

Dr Ramsammy said he strongly feels that nurses should not have to call out a doctor and await his arrival. Instead the doctor would always be present to render immediate assistance to patients.

If the case requires the attention of a specialist, then that specialist would be called out. The Health Minister acknowledged that many deaths could be prevented, if quick action is taken.

He said patients' charts are also now being audited daily to ensure that the requisite entries are made by doctors, and that treatment is administered to patients as per schedule.

Commenting on the recent spate of reports of incompetence of doctors both in the private and public sector, the Minister noted that the Guyana Medical Council is in need of more enabling legislation that would allow them expanded leverage in which to execute their mandate.

He noted that such legislation would define the perimeters of operation, adding that at the moment, instances of ineptitude by doctors have got to be glaring, before the Medical Council can act on it.

The minister said the archaic Medical Practitioner's Act of 1924 which give birth to the Guyana Medical Council is in need of being updated.

“We need more enabling legislation to govern the Medical Council which would detail what kinds of misdemeanors by doctors' action could be taken against, how complaints are dealt with and overall to strengthen the way things are done in the Medical Council, from the ambiguous way they are done now.”

He said that the Council has begun preparation on such legislation, which once completed, it will be approved by him and then gazetted.

Minister Ramsammy reiterated that quality health care, in any country, cannot be administered only on good faith, but needs enabling rules and regulations in place to enforce it.

Council investigating doctor for alleged ‘incomplete’ surgery
By Stabroeknews.com staff | March 16, 2010


The Medical Council of Guyana is investigating the case of a West Coast Berbice man, who had his stomach cut open to remove a hernia but was stitched up almost ten hours later without the surgery.

“I coulda dead, I didn’t know nothing from 1 o’clock to 11 o’clock dah night and imagine he didn’t perform the surgery,” Duryodhan Jaikaran, 36, of D’Edward, West Coast Berbice told Stabroek News yesterday.

The father of two said he rued the day he visited the office of Dr Shiv Kumar Ganesh in November of last year, with the hope of undergoing what he was told was a simple surgical procedure.

Stabroek News yesterday confirmed that the council has launched an investigation into the incident. Efforts to contact Dr Ganesh, who is an Indian national and once worked with the government and the New Amsterdam Hospital, were unsuccessful.

Jaikaran said after he experienced what he called “dead and coming back,” he decided to complain to the council. He said he first approached Minister of Health Dr Leslie Ramsammy but was told that the man was no longer employed with the government and that he should take the matter up with the council.

The young father said he did so and while the council wrote him a letter and informed that it launched an investigation, he is concerned about the length of time it is taking to investigate the matter. The man said he has not been called to give further information to the council and he has only been told that the investigation is continuing.

Jaikaran, who said the incident has changed his life forever, explained that he first visited Dr Ganesh at his office in the Sigma Lab, New Amsterdam early November last year. He said the doctor diagnosed him as suffering from a hernia and told him that he would have had to undergo surgery. “I ask he. I say, ‘Doctor you could do the surgery?’ and he tell me how he could do it and I trust he,” the man said, adding that he paid out a $15,000 down payment after being told the procedure would cost $40,000.

The man said he later returned to the office, where the doctor administered anaesthesia around 1 pm. He said he was out of it for some ten hours, until around 11 pm the said day. While Jaikaran was unaware of what was happening, his wife and mother, who accompanied him, were forced to witness what his mother termed a “botched operation.”

Sita Jaikaran said she had already started to mourn her son, thinking he was going to die. The woman said when she accompanied her son into the room where the procedure was expected to be done she observed that it was only equipped with a bed and just a few instruments. “I start worry since before because I hear things and I tell meh son but he say he still going and when I just see deh bed alone I get frightened,” she said.

The woman said the doctor later cut her son but stitched him up without removing the hernia.

“He come and tell we dat he cut he and stitch he up back and he nah do deh surgery,” the woman said. She said the doctor nevertheless requested the remaining $25,000 that was owed to him. According to Sita Jaikaran, the doctor washed his hands and said he was going home to return while her son lay on the bed “like he dead, dead.” The doctor later returned but then around 4 pm informed them that he was closing his office and they should take the man home. “Now me son lie down like he dead and I had to ask de taxi driver dat come with we to help fetch he in de car and me son ent wake up or nothing,” the woman said. “He eye bin a close and he mouth open. When me meet home me a slap he on he face, kiss he up all kinda thing fuh he wake up. Imagine me son coulda dead. Why de doctor do dat to he?”

Jaikaran and his mother also said when they returned the following day for the doctor to “dress” the cut, he was told to return the next day. He did so and was told to return another day and “is den I get vex and tell he to give me de receipt and I went to another doctor to dress it and remove dem stitch.”

He later had the hernia removed at the Woodlands Hospital and the man said four hours after the procedure commenced he was awake and able to leave for home.

“I don’t know why deh doctor do something like a dah, is kill he wan kill me child,” his mother said.

Last evening, Jaikaran said he hoped to get some justice from the council but pointed out that while the investigation drags on the doctor continues to practice. “Somebody else life could be at risk. I don’t know why it taking dem so long,” the man said.

He said he contemplating moving to the courts against the man but lamented that he knows that would be another drawn-out procedure. “I just want de doctor to pay fuh wah he do and to mek sure he nah do it to anybody else,” the man said.

Taken from: http://www.stabroeknews.com/2010/stories/03/16/council-investigating-doctor-for-alleged-%E2%80%98incomplete%E2%80%99-surgery/comment-page-2/#comment-326289

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