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- [00:00]
A
This is Australian True Crime with Michelle Laurie and our guest this week is the one and only Hedley Thomas. He's back with us to talk about his latest podcast, which comes from his first book, Sick to Death. It's the result of his investigations into the Queensland health system in the early 2000s for the Courier Mail newspaper. Headley was writing in real time about the frightening state of affairs, including the many botched surgeries taking place in Bundaberg under Dr. Jayant Patel joins us to talk about it. This is Australian True Crime. We acknowledge the traditional owners of the land on which this podcast is created, the Wurundjeri Woi Wurrung People of the Kulin Nation and a warning. This episode of the podcast contains graphic descriptions of violence.
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B
What we learned is that if you are a doctor who is so bad that you're hurting or potentially killing patients with your appalling surgical technique, the effort that an investigative authority needs to take to prove that is quite large and costly.
- [01:11]
A
So he goes to Bundaberg Hospital, Jayant Patel. That's where he ends up. And they are thrilled, thrilled beyond thrilled to have him, because he presents as a very experienced, very well trained surgeon. He's come from two American hospitals and as we mentioned, he's brought glowing references with him. However, by the time he gets to Bundaberg, for reasons that he doesn't really disclose, doesn't talk about, he hasn't actually performed surgery in a couple of years at all. And he walks in there and he's just charging around like a bull in a china shop organizing surgeries.
- [01:43]
B
That's right. The Bundaberg Hospital was, you know, relatively well equipped until very complex surgery or serious complications developed. And then there would be the retrieval team coming in and taking the patient to tertiary hospitals, the Royal Brisbane Hospital, Princess Alexandra and the Prince Charles. And those hospitals in Brisbane had better trained surgeons and doctors. They had more of them and they had facilities that could look after those complex patients and give them a better chance. But Dr. Patel was determined to do the complex operations in Bundaberg, procedures like esophagectomies. And because of the way the system was geared, if those kinds of complex surgeries were undertaken in the regional hospitals, the budget for those hospitals would be bettered. So if you're the administrator running that hospital and you've got a surgeon who's very keen to do complex surgeries and to do a lot of surgery to increase the volume, then the amount of money that that hospital can be provided by the Queensland health hierarchy is larger. So it takes the pressure off an administrator when there's more money coming in. So all of a sudden, you have a terrible scenario. A surgeon who shouldn't have been I holding a scalpel, who was told he shouldn't practice, he couldn't practice. He was barred from surgery in the US after very serious findings against him and detailed forensic investigation into the outcomes for his patients. He turns up. He then wants to perform all these very complex surgeries. He isn't vetted before they make him the director of surgery because he wasn't originally appointed to be the director of surgery. But someone made a very poor decision that they'd just give him that title and give him all of the responsibility that went with it. And then he just set about operating on as many people as he could. He was a workaholic. He was prolific. And then the terrible outcome started to occur. Now, it continued for two years. And in that two years, the hospital was in chaos. The nursing staff were traumatized because they were dealing with the aftermath of these operations.
- [04:28]
A
I remember a part of Sick to Death where Tony Hoffman, she. For me, and for a lot of people listening to her, hers is the face that pops into our mind because she became the face of this.
- [04:40]
B
Yes.
- [04:41]
A
She said, I thought this was breathtaking. She said, it got to the point where we nurses were virtually throwing ourselves over the top of pain to keep him off them. She said that when he walked into the hospital, she felt sick because she thought, who is he gonna kill today? Because by that stage, she had tried through every proper channel to bring attention to the fact that just statistically, his numbers were through the roof. Suddenly, the number of fatalities they had in the hospital, the number of patients who weren't making it out of the hospital and out of surgery warranted someone to look at it, even if they didn't believe, even if they thought it was a personality clash. And she and he just didn't like each other. The data was the data. The numbers were the numbers, you know, and no one would agree.
- [05:30]
B
That's right. The nurses were actively scheming to try to keep patients away from Dr. Patel.
- [05:41]
A
The mistakes that he made were just so sloppy. He's doing things like flushing someone's bowel backwards so the contents of their bowel ends up in their mouth. He's constantly nicking people's nicking the wrong organs, basically. Bowels and everything else. Is he. So he's clumsy while he's performing surgery? What about his hygiene? Oh, these poor nurses saying he would go from patient to patient, touching Their wounds, no gloves and not washing his hands in between patients. This is just rudimentary stuff.
- [06:15]
B
I know and it's a horror story in that regard.
- [06:19]
A
By the way. The Department of Health in Queensland was really not very subtle in its threats against whistleblowers, wasn't it? It was made very clear to them that complaining, certainly complaining outside of the hospital and the department, as you've mentioned earlier, was possibly a sackable offence, if not illegal.
- [06:41]
B
Jailable. Jailable, yeah, yeah, yeah. They tried to put great fear into the nurses and they repeated that when it was obvious that the nurses were becoming highly anxious about Patel's conduct and to try to discourage further disclosures, the nurses were read the riot act again about, you know, speaking out again. This is so much about bureaucrats and politicians acting in their own interests rather than the interests of public safety. I had been contacted by Toni Hoffman by email. She'd written to me, you know, very privately as a response to the stories that I'd done on Elise Neville and her tragic death and how the health system had failed Elise's parents and failed Elise. And Tony was deeply moved by that story. I'd written a very lengthy feature article and she'd written to me about Dr. Patel. She hadn't named him, she just talked about a surgeon in Bundaberg who was causing a huge amount of concern. And I'd had a bit of a follow up with her and I said, look, I want to look at this when I get back into reporting on health. I'll be back in touch with you. And then other stories came up and there are other interruptions. And then I read about the nurses have gone outside the system, they're making formal complaints about him and they've even gone to their local member of Parliament who stood up in the Queensland Parliament in Brisbane and named Dr. Patel as the person who's become a public menace in this major regional hospital. And I thought, well, this is what this is about. This is what Tony Hoffman emailed me about not too long ago. I contacted Tony and could she come and see me. And it turned out she was going to be in Brisbane on a. A course at the hospital down the road, the Royal Brisbane. I could see it from my desk in the old Queensland newspapers building in Bowen Hills. And so she came in with her friend and they both signed in, they're both nurses and they signed into the visitors book that we had in the old foyer there under false names because they were paranoid about going outside the system. And I led them through to the cafe that we had and sat down and took many pages of notes. And I realized that I needed to go to Bundaberg next, that I couldn't write the story without seeing more nurses trying to meet some patients, trying to get a better feel for it. Some several days later, I made arrangements to fly to Bundaberg, and I did a bit of work through the day, trying to talk to patients and just scoping out the hospital. And then I made an appointment for Tony to meet me with some of the other nurses at Tony's house in Bundaberg. It was a secret meeting and it was going to be after everyone had finished work. So in the evening, I feel like I had one of the most important penny drop moments of my career. And it was right near the end when the takeaway containers were being packed up and thrown away, and I was soon going to be driving the hire car back to this awful motel in Borbong Street. And one of the nurses just kind of randomly said, of course he didn't become a bad surgeon overnight. And you know when you hear something but you haven't quite understood the underlying significance of it, but you know there's something there, you just have to tease it out. I just stopped and said, well, right, what do you mean exactly like, he didn't become a bad surgeon overnight? And of course, what she meant, which is what she explained, was that he's a surgeon in his 50s, he's been practicing surgery for many years, he's always been a bad surgeon. And so I then talked to her about how, therefore there must be a trail of patient wreckage where he's word previously. And she said, yeah, there will be. Absolutely there will be. And that was like an epiphany that meant it wasn't just because of the crummy motel room and the bad bed. I couldn't sleep properly that night. I was tossing and turning because all I could think about was rushing back to Brisbane to try to research Dr. Patel's background before he came to Australia. I. I wanted to work out where he had worked before and what had happened in those places where he had practiced surgery. And back then, 2005, I must have had one of those pretty cheap Nokias. Smartphones were not a thing, and I didn't have Internet on my laptop, if I even took a laptop. I probably just took notebooks to Bundaberg. So I had to go back to Brisbane and either go straight home from the airport or to the office and get on a desktop computer to use Google to start that process. So I went to the office. And I started just googling Dr. Jayant Patel, disciplinary, using keywords like that. And it became obvious with the first. The first search that he had this terrible disciplinary history that had always been online and should have been discovered when he first applied two years earlier. And there it was on the screen. And then you had this terrible fear that something so obvious can't be true. This must be another Patel. How could they have failed to check this and discovered this? But what I didn't discover until months later, when it came out, as a result of the excellent investigative work by the public inquiry and the subpoenas that were issued, that one of the senior doctors who was running the hospital in Bundaberg, Darren Keating, and who had been defending Patel and not responding to Tony Hoffman's concerns for the two years he had himself, days earlier, days before my search, he had done the similar search and had a oh, shit moment and discovered it.
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A
Wow. I can't imagine the size of that oh, shit moment. That is terr. I almost feel sorry for him. That's such an awful scenario.
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B
God.
- [13:46]
A
So it seemed. I just remember I was working in radio in Brisbane at the time, and so I just remember suddenly Jayant Patel was just everything, every story, everything and more and more cases, people, victims coming out, talking about, as I say, Tony Hoffman in the media everywhere. So when did it end? How did it end? Was it. It felt sudden to me.
- [14:08]
B
Yeah. So he, by the time that Google search was done and everyone realized this is what we're dealing with, he had left Australia and he was back in Portland, Oregon. And he must have, you know, pretty soon realized that in Australia, journalists in the media were onto him. So we had this period where the health system came under intense scrutiny over months of public hearings. And Patel stayed away from the inquiry. He was invited back and he refused to return. And then the inquiry recommended he be charged over the deaths of, I think about 15 or 16 patients and injuries to many more. He was charged over the deaths of several of his patients, so manslaughter charges, and there were some other charges relating to that. He was also charged with fraud because you shouldn't have been practicing here in the first place. He lied to get the job and the financial rewards that came with it. And he was convicted by a Supreme Court jury over the manslaughter and these other matters. The fraud was left to another, I think, the district court to deal with. So that wasn't part of the Supreme Court case. And then he appealed the convictions and the Queensland Court of Appeal rejected his appeal and said, no, the convictions stand. Then he appealed to the High Court. The High Court said, well, we're going to quash these convictions because suffered a miscarriage of justice when the prosecution changed direction very abruptly during your manslaughter trial. And so the High Court being the final arbiter of the law in Australia and cases, its ruling meant that the Queensland DPP had to sort of go back to square one and start again with possibly a retrial. At the same time, you had patients who were frail or. And dying witnesses who were dropping off. And the upshot was that Patel left Australia with his manslaughter convictions having been quashed, but he pleaded guilty to the fraud. And then, you know, because of the time served, because he had been in prison for several years after the original conviction, he was then told, leave and you won't be able to return. And I don't believe he's ever going to practice again. He wouldn't have practiced afterwards because the Oregonian authority said, you can't practice. One of my colleagues, Ellie Dudley, who was on second in the United States, she went and saw him. He's still in the same home in Portland, Oregon. And he said, oh, it's history. I've forgotten all about it. I don't want to, you know, revisit that. You know, you sort of think, how. How do you sort of reconcile, if you're Jayaan Patel, the things you've done and the outcomes and the infamy and the shame that you brought upon your own family and, you know, in his village in the town in. In Jamnagar, he must still be person with a high degree of notoriety. You know, it's not something you easily walk away from. It would have brought shame upon that place.
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A
Thanks for joining us on Australian True Crime. If you would like any more information about anything you've heard on the show today, or support numbers, just check out the show notes.
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The producers of this podcast recognise the traditional owners of the land on which it's recorded. They pay respect to the Aboriginal elders, past, present and those emerging.