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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. Read
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