Patel `ignored advice` as patient bled

Jayant Patel ignored a junior doctor's suggestion of a way to buy time to find
internal bleeding in a surgical patient who later died, a court has been told.
Former Bundaberg Base Hospital junior surgeon Dr Sanjeeva Kariyawasam told the
Brisbane Magistrates Court on Tuesday he advised Patel to pack surgical wadding into
the chest of Gerry Kemps during an emergency operation in December 2004.
He said Patel had re-opened Mr Kemps in an attempt to stop internal bleeding from an
oesophagectomy performed by the surgeon just hours earlier.
Dr Kariyawasam told the court "packing the chest" may have temporarily stemmed the
heavy bleeding, buying the surgical team time to locate the source.
However he said Patel ignored his suggestion.
Dr Kariyawasam said Patel sent the surgical team home before they had found the
source, telling them he would "sort out the rest".
"I had confidence in Dr Patel to sort out the patient and left it at that," Dr
Kariyawasam said.
However, the court was told Patel did not find the bleed and Mr Kemps later died.
Patel, 58, has been charged with the manslaughter of Mr Kemps and two other patients
relating to his time as director of surgery at the hospital between 2003 and 2005.
He also faces 10 other charges.
The court was told that Patel had performed the surgery on Mr Kemps even though
specialist physician Dr Dawid Smalberger wanted to transfer his patient to Brisbane
for treatment.
Dr Smalberger said he only became aware Patel had operated on Mr Kemps after he died.
He said he had asked Patel for a surgical opinion before the transfer.
However, Patel decided instead to operate without consulting Dr Smalberger, the
court was told.
Dr Smalberger told the court he was "surprised" to hear Patel had performed the
operation on his patient. He said the procedure would not have cured the patient's
cancer, which had already spread to other parts of the body.
"I only became aware about what happened to Mr Kemps ... after his death," Dr
Smalberger said.
"I was under the impression that he had been transferred to Brisbane, and I was
quite surprised when I eventually heard ... that the patient was re-admitted,
operated on and that he died."
The hearing continues on Wednesday.