Jayant Patel

Jayant Mukundray Patel (born 10 April 1950) is an Indian-born American surgeon who was accused of gross negligence whilst working at Bundaberg Base Hospital in Queensland, Australia. Deaths of some of Dr Patel's patients led to widespread publicity in 2005. In June 2010, Patel was convicted of three counts of manslaughter and one case of grievous bodily harm, and sentenced to seven years imprisonment. In August 2012, all convictions were quashed by the full bench of the High Court of Australia and a retrial was ordered due to 'highly emotive and prejudicial evidence that was irrelevant to the case' laid before the jury. A retrial for one of the manslaughter counts resulted in acquittal and led to a plea deal where Patel pleaded guilty to fraud and the remaining charges were dropped. On 15 May 2015, he was barred from practising medicine in Australia.

Patel was born in Jamnagar in the Indian state of Gujarat. Initially, he studied surgery at the M. P. Shah Medical College at the Saurashtra University, obtaining a master's degree. He then moved to the United States where he received further surgical training at the University of Rochester School of Medicine as a surgical intern and a resident in surgery.

Buffalo, New York

In 1984 in Buffalo, health officials cited Patel for failing to examine patients before surgery. He was fined US$5,000 and was placed on three years clinical probation. In April 2001, New York State health officials withdrew Patel's license.

Portland, Oregon

In 1989, Patel moved to the Kaiser Permanente Hospital in Portland, Oregon. In 1995, the hospital named him a "Distinguished Physician of the Year." By this time, he had been involved in a string of problem cases, eight of which had prompted or would later lead to malpractice or wrongful death lawsuits. Medical staff allege Patel performed surgery when not rostered to work, operated on other surgeons' patients, operated unnecessarily and caused serious injury and death. In 1998, Kaiser Permanente restricted Patel's practice; he was instructed not to operate on the liver or pancreas and to seek second opinions before performing other surgeries. In September 2000, after reviewing four cases involving the deaths of three patients, the Oregon Board of Medical Examiners made Patel's restriction statewide. Even though his medical license had been restricted, Patel still received glowing letters of recommendation from his colleagues at Kaiser Permanente.

Bundaberg, Queensland, Australia

In 2003, Patel moved to the position of Director of Surgery at the Bundaberg Base Hospital where he was employed by Queensland Health (the state government department of health in Queensland) under an "area of need" program where overseas trained doctors are employed in predominantly regional understaffed areas. He was appointed despite having no specialist surgical qualifications.

Inadequacies in Patel's practice were identified. His surgery was described as "antiquated" and "sloppy". Nurses claimed that they hid their patients from him when they knew that he was in the hospital. He showed poor regard for hygiene. He attracted the nickname "Dr. Death". It is alleged he altered medical records, including death certificates in order to hide his inadequacies.

Patel is linked to at least 87 deaths among the 1,202 patients he treated between 2003 and early 2005. 30 patients died while under his care in Bundaberg.

On 22 March 2005, Stuart Copeland, the Queensland Shadow Minister for Health, raised the issue of Patel's clinical practice during "Question Time" in the Queensland Parliament. Copeland had been alerted to Patel's inadequacies by Toni Hoffman, a nurse at the Bundaberg Base Hospital. Two days later, Rob Messenger, the National Party Member of Parliament for Burnett, also raised the matter in a speech to the Legislative Assembly. He called for Patel's suspension.

Hedley Thomas, a journalist at The Courier-Mail, who won a Walkley Award for his part in uncovering Patel's past, published reports about Patel. The newspaper and other media outlets were flooded with patient claims of injury and death caused by Patel's operations.

Patel departed Australia for Portland, Oregon, using a business-class airfare paid for by Queensland Health. His passport had not been withheld.

On 22 November 2006, a magistrate issued a warrant for Patel's arrest and extradition to Australia. He was charged with three charges of manslaughter, five charges of causing grievous bodily harm, four of negligent acts causing harm and eight charges of fraud. He was extradited to Australia on 21 July 2008.

In response to public discontent over Patel's performance at Bundaberg Base Hospital, the Beattie Government convened the "Bundaberg Hospital Commission of Inquiry". The Inquiry held similar judicial powers to a Royal Commission, and commenced hearings in Brisbane on 23 May 2005. It was led by Anthony Morris, a Queen's Counsel.

On 10 June, Morris released an interim report that was tabled on the same day in State Parliament by Premier Beattie. The report recommended, among other things, that Dr Patel be charged with murder or manslaughter in respect to one patient, with causing "a negligent act causing harm" to another patient, that he also be charged with fraud in relation to his registration at the Medical Board of Queensland to practice medicine and that extradition proceedings should begin. It also recommended changes to the Medical Practitioners Registration Act 2001.

The Morris Inquiry began hearings in Bundaberg on 20 June. Nurses, local Queensland Health administrators and former patients of Dr Patel were all expected to give evidence. Public hearings in Bundaberg concluded on 14 July. The Inquiry resumed public hearings in Brisbane on 25 July and also sat in Townsville from 2 to 4 August.

During the course of the Morris Inquiry, two senior Queensland Health bureaucrats in the Bundaberg region, Darren Keating and Peter Leck, filed an application in the Supreme Court of Queensland calling for the inquiry to be shut down, alleging that Morris had shown apprehended bias against them. On 1 September, Justice Martin Moynihan of the Supreme Court ruled in favor of the applicants, finding that the Commission of Inquiry was contaminated with ostensible bias against Keating and Leck, and that evidence gathered from other witnesses was entangled with the evidence given by Keating and Leck.

The new inquiry began on 8 September 2005 and was headed by former Supreme Court of Queensland judge Justice Geoffrey Davies QC. This inquiry, formally titled the Queensland Public Hospitals Commission of Inquiry, was widely known as the Davies Inquiry.

The report of the Davies Inquiry was handed down on 30 November 2005. It recommended that charges of manslaughter and other criminal offenses be prosecuted against Patel. The report also apportioned much of the blame to two former Health Ministers, Gordon Nuttall and Wendy Edmond, as well as senior Queensland Health bureaucrats for allowing the existence of an organizational culture of secrecy and ostracizing of whistleblowers that allowed Patel's misdeeds to go unpunished for two years.

An independent surgeon, Peter Woodruff, who was asked by Justice Davies to examine Patel's work believes that Patel negligently caused 13 deaths, and serious complications suffered by at least 31 others.

Extradition

Jayant Patel was arrested 11 March 2008 by FBI agents. He appeared in court that day with a court-appointed attorney, telling Federal Magistrate Dennis Hubel that he was unable to afford a lawyer, after incurring significant pre-trial legal fees. In response, the Magistrate ordered Patel, who lives in a $900,000 house, to fill out a financial affidavit before an upcoming detention hearing. Following his arrest, Toni Hoffman, the nurse who took her complaints about Patel to a member of the Parliament of Australia, said that "I am relieved he's been arrested, but there's still a lot to go." Patel denied the allegations. The extradition proceeding against Patel began April 2008. Patel was denied bail by Judge Hebel on 28 June 2008, with the judge warning Australian and US authorities that they must extradite Patel by 21 July 2008, or he would release Patel on bail.

Patel was extradited: US Marshals handed Patel over to two officers from the Queensland Police Service at Los Angeles Airport on 19 July, who then escorted him on board Qantas flight QF 176. The flight arrived at Brisbane Airport on the morning of 21 July. Patel was taken immediately to the Brisbane watch-house and was granted bail by the Roma Street Magistrates Court the same day.

Trial

Patel was tried in the Queensland Supreme Court for the unlawful killing of three patients, and grievous bodily harm to a fourth. He pleaded not guilty to all charges.

On 29 June 2010, Jayant Patel was found guilty of all four charges. On 1 July, he was sentenced to seven years' jail for his offences. Patel appealed his conviction and sentence to the Court of Appeal, and the prosecution also appealed sentence. Both appeals were dismissed.

Appeal to High Court

Patel then appealed the Court of Appeal's decision to the High Court of Australia, and was granted special leave to appeal. On 24 August 2012, the High Court unanimously allowed the appeal and quashed Patel's convictions on the ground that prejudicial evidence had likely influenced the jury. The Court also ordered a retrial.

Retrial

The following year, a retrial was held for one of the manslaughter charges, and Patel was acquitted by the jury. This resulted in calls to have the remaining charges against Patel dropped. The remaining manslaughter and grievous bodily harm charges were later dropped in exchange for Patel pleading guilty to two counts related to him dishonestly gaining registration and two counts related to dishonestly gaining employment in Queensland. Patel was sentenced to a two-year suspended sentence for those fraud charges.

In a television documentary on the case aired by CNN in November 2010 as part of its "World's Untold Stories" series and entitled "They Called Him 'Dr. Death'", several of Patel's medical co-workers in Australia testified to having repeatedly blown a whistle on him only to be ignored by medical superiors and other authorities. Questions were also raised about the lack of due diligence by those involved in his appointment.

In response to the case, Peter Beattie fired the Director General, Robert Stable and changes were made to funding, the operations of the medical board, and to how concerns raised by whistle blowers are handled.

On 15 May 2015, Patel was barred from "ever practising medicine again in Australia".