2 Nov 2015

Screwing (with) the dead

This morning, I was rather taken aback when I saw this article:

DOCTORS REFUSE TO TESTIFY

A $2 million lawsuit, filed by a man whose wife died following a C-section delivery at the San Fernando General Hospital almost five years ago, is in danger of collapsing because the woman’s husband is unable to find a specialist doctor who is willing to provide expert medical evidence for the Judge to determine whether three doctors were negligent.

Unable to secure the testimony of one, Lorne Ramsoomair filed an application in the High Court requesting Justice Frank Seepersad to have the Court appoint a specialist obstetrician/gynaecologist, to assess the expert medical evidence tendered by the three doctors who are all contending that they were not negligent.

During a hearing of the case recently, Seepersad sounded a stern warning to Ramsoomair, that if an expert gynaecologist cannot be found by the court and he (Ramsoomair) in unable to file his expert evidence to support his claim against the doctors and the South-West Regional Health Authority (SWRHA), the Court would proceed and “the chips would have to lay where they fall”.

Ramsoomair’s wife, Chrystal Boodoo-Ramsoomair, 28, of Couva, died on March 4, 2011, at the Labour Ward of the San Fernando General Hospital (SFGH).

Her death attracted national attention when, after a C-section performed by doctors at the SFGH’s Maternity Ward to deliver her baby, she bled to death after two attempts to surgically stop internal bleeding failed. She had given birth to a girl, her third child. A post-mortem revealed that two blood vessels in the womb were not ligated (tied off).

Five doctors and six nurses were suspended, after which Government appointed a three-member team, headed by University of the West Indies lecturer in Obstetrics and Gynaecology, Dr Bharat Basaw, to investigate her death. The suspension of the doctors and nurses led to the firing of the then Acting CEO of SWRHA, Paula Chester-Cumberbatch, for failing to issue suspension letters to the doctors upon the direction of the then minister of health.

Ramsoomair filed a lawsuit against SWRHA claiming approximately $6 million for death of his wife. His claim was reduced to $3 million and then $2 million.

While the lawsuit was pending before Seepersad, during which time attorneys for Ramsoomair and SWRHA tried to negotiate a settlement, SWRHA offered Ramsoomair $300,000. However, Ramsoomair is yet to accept the money and instead, his attorneys went on to pursue a High Court claim against the doctors who are named as defendants in the lawsuit - Drs Mondira Seenath, Deepavali Ramballack and consultant gynaecologist Ashmeed Mohammed.

The doctors are challenging the lawsuit and have since filed medical expert evidence in court to support their claim that they did not act negligently. University of the West Indies lecturer in obstetrics and gynaecology, Dr Gordon Narayansingh and senior forensic pathologist Dr Valery Alexandrov, have filed witness statements on behalf of Drs Seenath, Ramballack and Mohammed.

It has been ten months now since that case has been pending for want of expert medical evidence on behalf of Ramsoomair, to assess Narayansingh and Alexandrov’s medical evidence. Senior Counsel Alvin Fitzpatrick, Jagdeo Singh, instructed by Saira Lakhan, are representing the doctors. Senior Counsel Israel Khan, attorneys Ravi Rajcoomar and Allister Khan are representing Ramsoomair.

Before the next date of hearing in December, Seepersad needs the expert medical evidence to be filed on behalf of Ramsoomair, in order to proceed with the trial. In July 2013, Ramsoomair went to the San Fernando Magistrates’ Court and filed private criminal charges against Seenath, Ramballack and Mohammed.

That case is pending, but recently when Ramsoomair’s $3 million claim against the three doctors came up for hearing before Seepersad, his attorneys petitioned the judge with an application.

The application filed on behalf of Ramsoomair by attorney Khan, states that pursuant to Part 33 of the Civil Proceedings Rules 1998, the Court should appoint a specialist obstetrician/gynaecologist as an expert witness. Khan stated that Ramsoomair has tried unsuccessfully over the past ten months, to obtain an obstetrician/ gynaecologist to give expert testimony, in order to analyse the various evidence of the Narayansingh and Alexandrov filed on behalf of the doctors.

Khan further stated in his application that he approached former Head of the Department of Obstetrics/ Gynaecology at SFGH, Dr Jehan Ali, but was told that he could not.

“I approached five specialist obstetrician/gynaecologists, but was refused by all,” Khan stated and added, “the claimant (Ramsoomair) applies to the Honourable Court for the Court to appoint a specialist obstetrician/ gynaecologist; that an expert to be appointed from the following - Dr Karen Sohan, Dr Sunil Persad and Dr Prakashbhan Persad.” Last week when the matter came up, Seepersad granted a final extension to Ramsoomair’s attorneys and fixed hearing for December.

In granting a final extension, the Judge said: “The court has an obligation to balance the rights of the parties and to also ensure that there is a proportionate use of the Court’s resources.” Recently, Ramsoomair suffered another set-back when his instructing attorney, Khan, withdrew as one of his attorneys in the private criminal manslaughter charges.

This matter has been on-going for a number of years, and has raised a whole minefield of legal and ethical questions on the medical fraternity… and fraternity it is, if this article is right. While I am in sympathy with the claimant, I feel quite a bit of nausea at the way the medical brotherhood has obviously banded together to protect their own.

Let’s start with my thoughts on Dr Jehan Ali.

“Dr Jehan Ali is on record saying that he was present on the ward seeing Mrs Ramsoomair pale and wan due to the excessive bleeding. He drew it to the attention of the nurses and doctor on duty who did nothing until it was too late.”

He was very vociferous about the medical negligence committed at the hospital, even going so far as to put his opinion on record in a video (which has mysteriously disappeared from the ‘net’). Suddenly, he has ‘boiled dong like bhagi’ and is unwilling to testify on behalf of Mr Ramsumair. What remains though, are opinions he has expressed and which were published:

The question now remains, “Why the about face of Ali?” I can only surmise that it is pressure from his colleagues in the medical sector. Being blackballed will certainly put an end to any further medical practice, as he could not rely on any cooperation through referrals or follow-up treatment at State institutions.

My thought also run on Dr Valery Alexandrov… how is he involved when the pathologist on record for the autopsy was Dr Hubert Daisley? Why is there no report on any documentation or statements from Daisley? Dr Gordon Narayansingh has supported the doctors who are “named as defendants in the lawsuit - Drs Mondira Seenath, Deepavali Ramballack and consultant gynaecologist Ashmeed Mohammed”. I wonder how his involvement came about when he was nowhere in the original matter?

I wonder too that Dr Basaw, from the investigation panel cannot be served a subpoena, as can Drs Ali and Daisley, to testify in this matter? Is the judicature afraid to summon doctors?

The SWRHA and apparently the Ministry of Health are also to get their share of blame… it is obvious that these institutions have rallied around the doctors. Earlier questions which I have asked have never been answered and appear to have been swept under the carpet. Or Crystal’s shroud.

Was the consultant doing a private C-section at the time of the incident where Crystal lost her life? I want readers to understand something… A doctor is put on a rota to be on-call for a period. His name appears on that rota and he is paid for being ‘on-call’ but… as you can probably see and guess, he does not have to be anywhere near the hospital premises to be paid. So, it is quite possible, and I dare say, likely, the consultant was not at work as claimed but in private practice as inside sources have revealed. The rota is not proof that he was on the job.

Advice to Mr Ramsumair. Hire an independent Ob-Gyn from the UK, let them examine the evidence and testify on your behalf. I wonder that your lawyers have not yet suggested this to you. Are they incompetent? Consider this: lawyers do have friends in the medical fraternity, and taking action against doctors can be taken personally by said doctors, so even lawyers are unwilling to cross that bridge.

I do foresee a sad end to this issue.

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