Former colleagues at Kaiser Permanente gave surgeon branded “Dr. Death” glowing references

From Associated Press:

An Indian-trained surgeon linked to the deaths of at least 87 patients in Australia over two years had been given glowing references by six former colleagues in the United States, despite having been cited for negligence there earlier, according to copies of the references obtained by The Associated Press.

Jayant “Jay” Patel, 56, is now the subject of an official inquiry examining why the doctor was permitted to practice medicine in Queensland state in 2003 despite a nearly 20-year history of criticism and sanctions imposed by medical authorities in Oregon and New York as a result of his work practices.

Patel, who was educated in India and completed his residency in New York state, was first cited in 1984 by New York health officials for failing to examine patients prior to surgery.

He moved to Oregon in 1989, and began working for the Kaiser Permanente Hospital in Portland.

After reviewing 79 of his cases, Kaiser restricted Patel’s practice in 1998, banning him from doing certain types of operations _ such as liver and pancreatic surgeries _ and forcing him to seek a second opinion in complicated cases.

After reviewing four of those cases, in which three patients died, the Oregon Board of Medical Examiners made Patel’s restriction statewide in September 2000, and New York health officials forced Patel to surrender his license in that state in April 2001.

The Medical Board of Queensland alleges Patel — branded “Dr. Death” by Australian media — falsified his application to practice in Australia by removing his disciplinary history, but acknowledges that it failed to check his application against U.S. medical records.

But documents submitted to the inquiry by Queensland health officials and obtained by The AP show that Patel came highly recommended by six of his former colleagues in letters dated more than seven months after his license was restricted by the Oregon Board.

Four of the letters were written on Kaiser Permanente letterhead, one was a copy of an internal Kaiser memorandum and another was on private letterhead.

In one letter, dated June 4, 2001, a senior Kaiser anesthesiologist, Bhawar Singh, wrote of Patel: “His balanced judgment, surgical skills and decisive steps, especially in the management of high risk complex procedures, has always been appreciated.”

When contacted by The AP for comment on the letter, which was written on Kaiser letterhead, Singh said all questions relating to Patel had to be referred back to the organization.

Another physician, Joseph Leimert, the head of Kaiser’s Department of Hematology and Medical Oncology, also wrote a letter on June 4, 2001, saying aspects of Patel’s care were “unparalleled by any provider in any department at any time in my professional experience.”

“I profoundly regret Dr. Patel’s departure and recommend his services without reservation,” he wrote in the letter, which was also on Kaiser letterhead.

Leimert also refused to comment to the AP, saying he been instructed not to speak to the media.

Kaiser spokesman Jim Gersbach said the references were personal letters written on behalf of Patel by his colleagues.

“While some of the letters appear on our letterhead, Kaiser Permanente never approved or released these letters and did not then and does not now endorse the contents,” Gersbach said in a written statement e-mailed to The AP.

He said Kaiser was never approached for an official letter of reference and “our Human Resources Department, Medical Legal and Credentialing were never contacted by prospective employers about Dr. Patel.”

“While Kaiser Permanente cannot stop our physicians from writing personal letters of recommendations for their colleagues, we are reviewing our current process with our medical staff in an attempt to avoid situations like this in the future,” he added.

Another Kaiser surgeon who recommended Patel did not return a phone message seeking comment left by The AP. The other three could not immediately be reached for their views.

Gersbach said Kaiser had made no secret of Patel’s disciplinary history, having filed an “adverse action” report with the National Practitioners Data Bank when questions about his treatment first arose in June 1998.

“Our main position has been that we did review his practice, his license was restricted and we reported it (to authorities),” Gersbach said.

Patel has been linked by the Queensland state health department to the deaths of at least 87 of the 1,202 patients he treated during his two-year tenure at the rural Bundaberg Base Hospital. Several dozen other alleged malpractice cases are also under investigation.

He left Australia in April and his whereabouts are unknown. He has not commented on the allegations against him and has no legal representation at the inquiry.
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Associated Press reporter William McCall in Oregon contributed to this report.