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Sanctions for doctor predate job in Oregon
Sanctions for doctor predate job in Oregon
New York records show findings of negligence and incompetence by Jayant M. Patel, who now is under investigation in Australia
Friday, April 22, 2005
DON COLBURN and SUSAN GOLDSMITH
Five years before he was hired as a surgeon by Kaiser Permanente in Portland, Dr. Jayant M. Patel was disciplined by New York state for negligence, incompetence and unprofessional conduct.
Patel, who worked for Kaiser from 1989 to 2001, is at the center of a major investigation in Australia for allegedly botching surgeries and falsifying records during a two-year tenure at a public hospital in Queensland after he left Portland.
The Australian inquiry, which also involves a review of patient deaths at the hospital where Patel was chief surgeon, has focused new attention on disciplinary actions against him in both Oregon and New York.
Kaiser restricted Patel's surgical practice in 1998, and the Oregon Board of Medical Examiners, citing negligence in at least four cases, followed suit in 2000. But the New York disciplinary action shows that Patel's career troubles started long before he arrived in Oregon.
In New York, Patel was fined $5,000 and suspended for six months, records show. But New York authorities stayed the suspension and put Patel on probation for three years beginning in March 1984.
The charges against Patel in New York involved five patients he treated in Rochester. Investigators said he entered information in their charts without examining them and also harassed one of them to hinder a hospital investigation of his behavior.
Although the records were publicly available, Kaiser Permanente did not check Patel's disciplinary record in New York before hiring him as a surgeon in 1989.
Patel, 55, received his medical degree in 1973 in India and in 1977 moved to the United States. He trained as a surgeon in Rochester and Buffalo, N.Y., from 1978 to 1984, and worked in Buffalo until 1989.
"When Dr. Patel applied to work here in 1989, we confirmed he had completed his medical residency requirements to practice in the United States and held a valid, unrestricted Oregon medical license," said Jim Gersbach, a Kaiser spokesman.
He said Kaiser officials were unaware of Patel's record in New York record until being contacted Thursday by The Oregonian. Earlier, Kaiser said Patel had arrived with favorable reviews from prior employers.
Patel also brought "stellar recommendations," when he applied for an Oregon medical license in late 1988, said Kathleen Haley, executive director of the Oregon Board of Medical Examiners.
Glowing letters from Patel's supervisors in Rochester and Buffalo carried more weight for the Oregon board than his earlier probation, Haley said. The Oregonian obtained copies of the letters Thursday from the board.
While a surgical resident in Rochester from 1978 to 1982, Patel showed "technical and professional brilliance," Dr. J. Raymond Hinshaw, a prominent Rochester surgeon wrote the Oregon board in late 1988.
Aware of Patel's probation in New York, the Oregon board followed up, asking Hinshaw for more detail about Patel's dismissal from the University of Rochester's surgical residency program.
Hinshaw said a divided review committee had voted 5 to 3 to dismiss Patel in 1981 after two patients claimed he had added information to their medical charts without examining them.
But Hinshaw also described the proceedings against Patel as "harassment of a brilliant young surgeon" and said he would recommend Patel "without reservation."
After his dismissal from the Rochester residency program, Patel worked as a research assistant for Hinshaw before moving to Buffalo, where he completed his surgical training, according to Hinshaw's letter.
Hinshaw, a former president of the American College of Surgeons and chairman of the New York Society of Medicine's surgery section, died in 1993.
The chairman of the microbiology department at the State University of New York at Buffalo also recommended Patel to the Oregon board in March 1989. Thomas Flanagan described Patel's strengths as "curiosity, diligence, intellect," and rated his judgment "excellent" and his medical knowledge "extensive."
Patel joined the staff of Kaiser Permanente as a general surgeon in 1989. He performed operations at the now-closed Bess Kaiser Hospital in North Portland, as well as Providence St. Vincent Medical Center.
In 1998, after reviewing 79 surgical cases by Patel, Kaiser restricted his practice and alerted the Oregon medical board. Kaiser banned Patel from certain operations, such as pancreatic and liver surgery, and required him to seek a second opinion on all complicated cases.
An Oregon review
The Oregon medical board conducted its own review of the Kaiser cases, focusing on four patients, including three who died and a fourth who lost gastrointestinal function after Patel performed a colostomy backward. The board, citing "gross or repeated acts of negligence," made the Kaiser restrictions statewide in 2000 but did not revoke Patel's license.
Patel kept his New York medical license after moving to Oregon. But he surrendered it in April 2001, after New York authorities notified him that Oregon's disciplinary move could be grounds for revoking his New York license. Kaiser's Gersbach has said Patel left that same year but declined to discuss circumstances of his departure.
New York's action against Patel in 1984 was first reported this week by The Australian newspaper. The charges against Patel involved five patients, identified as A through E in the public record. State authorities acted on the basis of a fact-finding report by a committee of the New York Board for Professional Medical Conduct.
The report charged Patel with entering information into the patients' medical records without examining the patients themselves. For example, according to the report, he wrote "lungs clear" into the record of Patient B "without personally examining the patient's chest."
The report also charged Patel with "moral unfitness to practice" medicine under New York law. It accused him of false reporting, "abandoning or neglecting a patient in need of immediate professional care," and "harassing, abusing or intimidating a patient either physically or verbally" in an effort to "coerce her not to cooperate with an official hospital investigation of (Patel's) actions."