by A doctor who carried out a botched procedure that killed another senior consultant said ‘I didn’t think we would harm him in the way we sadly did’, as an inquest heard how the patient suffered a ‘catastrophic bleed over his be rare’.
Professor Amit Patel, ‘one of the UK’s most knowledgeable doctors’ at the world-renowned Christie cancer hospital, became seriously ill and rapidly deteriorating when he was admitted to Wythenshawe Hospital in August 2021.
Doctors were doing their best to understand and treat the 43-year-old’s rare illness. However, after a surgical test was recommended to try to diagnose his illness, the botched procedure ended up leaving Professor Patel with less than a 10 percent chance of survival, and he died more recently.
Professor Patel’s family will now have to wait another month for answers about the dad-of-two’s tragic death, after the inquest has already been adjourned for weeks due to the amount of evidence to be heard.
READ MORE: An expert was NOT given vital information before recommending surgery that killed a beloved doctor and dad-of-two
The family will have to wait for answers again
The inquest into the father-of-two’s untimely death began at Manchester Coroner’s Court on April 4 and was adjourned until Wednesday (May 1), under coroner Zak Golombek. The inquest was planned for two days but was adjourned due to the amount of evidence to be heard. It was planned to continue for two more days – ending yesterday (May 2) – but time to review all that evidence ran out.
The family will now have to wait another four weeks before they can hear the coroner’s conclusion about how Professor Patel died.
On Wednesday, the hearing heard that before the ultimately fatal procedure, test results showed that Professor Patel was also suffering from disseminated intravascular coagulation (DIC). DIC is a serious and rare blood clotting disorder that can cause uncontrolled bleeding.
The court was told that the procedure by which Professor Patel was killed is ‘low risk’. Dr Richard Booton, a respiratory consultant at Wythenshawe Hospital who was to carry out the procedure, told the court he was confident of going ahead with the test knowing the blood disorder, saying blood products had been ordered to the beds to ‘soothe’. ‘ any problems that the clotting disorder may cause.
But it is now understood that the procedure split and ruptured Professor Patel’s body and his lungs began to fill with blood. Having previously had a more than 75 percent chance of survival, Dr. Patel to just one to 10 percent, his wife and GP Dr Shivani Tanna told the court.
Dr Tanna rushed to the hospital to be by his side, finding him ‘coughing up blood’, and doctors told him to ‘lie back’. Dr Tanna said her husband told doctors ‘if you do, you’ll never get the blood out of my lungs’, while Prof Patel told doctors his blood was clotting so there was no need to lie back.
Dr Booton said he ‘didn’t see anything to do with him during the procedure’, and said it was odd that there was a delay in bleeding, as Professor Patel’s catastrophic bleeding increased around 30 to 50 minutes after the end of the operation. .
“We have never experienced extensive bleeding in this case,” Dr Booton said. “I didn’t think we would hurt him the way we did unfortunately.”
‘Extremely unusual circumstances’ which were devastating
Dr Adrian Draper, a respiratory consultant at St George’s Hospital in London, prepared a report for the coroner into the death as an independent expert. He declared the result an ‘extremely unusual complication’ and said that even with the ‘DIC status and the non-diagnostic test’, the procedure was worth the risk because the risk of bleeding is rare’.
Despite the rare illness Prof Patel was suffering from and his condition deteriorating, Dr Draper said ‘I don’t think I could have predicted he would have had a catastrophic bleed’, if it had been Prof Patel who was a medical doctor.
“An attempt was made to stop the catastrophic bleeding. With that management in place, I still think it was appropriate to continue,” he said.
Professor Patel was the first person in the country to qualify in stem cell transplantation and cellular therapy, and intensive care medicine, and was at the forefront of pioneering medicine at the Christie. He was also a national expert on the life-threatening condition he began to suffer from severe symptoms.
But the father-of-two’s condition deteriorated rapidly after being hospitalized in August and doctors – including Professor Patel himself – made a ‘working diagnosis’ that he might be suffering from Still’s disease. Disease is still an inflammatory disease, which can cause a potentially fatal immune reaction called HLH.
‘I would not have recommended the procedure if I had all the information’
During his career, Professor Patel was a ‘national guide’ to HLH and sat on the national multidisciplinary panel to which the most serious cases, including his own, were referred. His colleagues on that panel, including consultant rheumatologist Dr Jessica Manson, were drafted in to help after he was told that Prof Patel was in hospital and getting worse.
But the court heard how one doctor at Wythenshawe Hospital who treated Professor Patel said they had not treated anyone with the condition before, amid a backdrop of other clinicians who told his family they had ‘not heard of’ about the illness and ‘they will read about it’. as Professor Patel was becoming very ill.
That multidisciplinary national panel met, along with Wythenshawe Hospital doctors responsible for his round-the-clock treatment, to recommend a care plan for Professor Patel based on his presentation and test results. The panel, led by Dr Manson, recommended an endobronchial ultrasound-guided biopsy (EBUS), in which doctors look inside the lungs to diagnose lung disorders, including inflammation.
In court on Wednesday, Dr Manson said she would not have recommended the procedure if she had been given vital information about her condition, including her blood clotting problems and that the procedure was unlikely to lead to any diagnosis.
The panel met with local clinicians to review their information and help decide how he should be treated, including recommending the procedure that would end his life. She told the court: “I don’t think we would have recommended it [the procedure] to go on if someone had a DIC in that moment.”
Dr Manson also said she was not told by doctors at Wythenshawe Hospital that the procedure would only have a ‘low diagnostic yield’ – meaning there was a low likelihood that the test would provide the information needed to establish a diagnosis.
“If the person doing the procedure had said this will have a low diagnostic yield, I don’t think I would have recommended it at that point,” she said.
“The EBUS on September 2 does not happen without a recommendation from the MDT,” said coroner Zak Golombek. He then said: “The multidisciplinary team was not operating on full information, [Dr Manson] She would not have recommended EBUS if she had known that Professor Patel had DIC and that it was a low yield diagnosis.”
Following the procedure, Professor Patel underwent emergency treatment and was transferred to the Royal Manchester Infirmary, but his condition continued to deteriorate until his death in October 2021.
Going forward.
