Doctor admits to mistakes during Medical Council meeting

Feb 01, 2010 News

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Tortured teen investigation…

By Michael Jordan

Police Physician, Dr. Mahendra Chand, admitted to several professional lapses during his examination of the teenage boy
who was tortured by police.
These include failing to examine the teen properly for other possible injuries, failing to take notes or keep a permanent record of the case; failing to solicit the patient’s age or any information from the patient as to how he sustained the injuries; and failing to make a written referral for the patient to be admitted to a hospital.
Dr. Chand made the admissions on November 20, 2009, when he was called before the Guyana Medical Council, to ascertain if he was guilty of professional misconduct.
In a subsequent letter, the Council informed Dr. Chand that based on his admission, his actions were “not consistent with the norms expected of a registered doctor in Guyana.”
The Medical Council subsequently found that Chand was guilty of professional misconduct and recommended that he be suspended for two months.
But Minister of Health, Dr. Leslie Ramsammy, is still to say whether the Council’s decision will stand.
The Health Minister recently told reporters that he has to verify whether the doctor may have breached certain rules.

“I need to make a decision and I’m not going to make it based on press reports. This is somebody’s life and I must understand the real issue.”
Records of the Guyana Medical Council meeting, obtained by
Kaieteur News, stated that on October, 2009, an officer from the Leonora Police Station went to the doctor’s residence, requesting
the examination of a patient after dark on the grounds they didn’t want unnecessary publicity.
He arrived at the station at 18:00 hrs, and a naked prisoner, with head covered and accompanied by two guards, was brought
outside.
He requested the removal of the bag but this was not done.
Upon examination there were superficial burns evident and the patient was in painful distress.
He stated that the police gave him the patient’s name, while he was writing out a prescription.
However, he was unaware of the prisoner’s age and the police did not provide him with any information as to how the
patient sustained the injuries. Nevertheless, from his experience, he was aware that they were first degree burns caused by fire.
Upon reflection, Dr. Chand stated that he should have demanded that the bag be removed, and if they didn’t, he should have done so.
He also stated that the other actions he took would remain the same.
However, he left with the assumption that the patient would have been taken to the hospital.
He did tell reporters from this newspaper that he had advised that the teen be taken to a hospital.
But in an interview with this newspaper shortly after the incident, Police Commissioner Henry Greene had said that the doctor did not recommend hospital treatment for the injured teenager.
Dr. Chand also told the Medical Council that this was the
first time he was faced with such a situation.
Dr. Chand stated that he has been a physician since 1993, and had been employed by the Georgetown Public Hospital Corporation and seconded to the Guyana Police Force to provide a service since 1997.
According to the Medical Council records, Dr. Chand explained that usually, a police
medical report is supplied for completion, which would require the examination of the patient from head to toe. However, in this case, no such form was given and he directed that the prisoner/patient be taken to the hospital.

“Do you have a record of the findings, and is it reasonable to see a patient and not record your findings?” one of the Council
members asked.
In response, Dr. Chand admitted he didn’t give a written referral, a practice he said was usually done at his office, but gave a verbal referral.
He conceded that this was not the right thing to do.
He added that because the patient was in “painful distress”, he prescribed ibuprofen and an antiseptic cream.
Asked if he would usually record his medical report in a ledger, Dr. Chand answered that the nurses would make a short note but he was unaware if this was done in the teen’s case.
The minutes of the Medical Council meeting showed that following the interview, Dr. Chand left and the Council members deliberated on the case.
One Council member stated that the members “must understand the mitigating circumstances, since at that moment in those
circumstances we can’t expect the doctor to follow protocol 100 percent.
“The doctor erred but I think he was intimidated, since there were mitigating circumstances.”
Another member sated that he could “understand what the doctor went through,” and that Dr. Chand, “wasn’t allowed to function as a doctor.”
However, a third member stated: “Is it ok to see a patient and not see his head and have no records? The doctor has admitted
he had done something wrong.
“The most important part is record keeping and that’s where I fault him. By his own admission, he stated he didn’t take any
record of the patient, in so doing performing less than a doctor.”
And yet another member said: “We are defending someone who has admitted he has done something wrong three weeks ago and during this time he is fighting in the press.”
“The fact that mention is made of intimidation and conditions operating under is never mentioned by Dr. Chand.”
At the end of the deliberations, all the nine members present agreed that Dr. Chand’s conduct fell short of the standard expected of a doctor, and that he had conducted an improper examination of the teen.

It was also recommended that “someone” should talk with Dr. Chand and the young doctors, informing them that “though something of this nature would not take you to jail; it makes the profession look very bad.”
It was also suggested that a letter be dispatched to Dr. Chand informing him of the Council’s observations and the measures that can be taken against him if found guilty of misconduct.
Section 17 (1) of the Medical Practitioners Act, 1991 states that Professional misconduct is conduct of a doctor connected with his profession which has fallen short, by omission or commission, of the standard of conduct expected of doctors.
Section 17 (3) of the medical Practitioners Act allows the Medical Council, upon a finding of professional misconduct to:
(a) Censure the medical practitioner.
(b) Suspend the registration of the medical practitioner for such period as may be determined by the Council and approved by the Minister.
(c) Direct the secretary to remove the name of the medical practitioner from the register of medical practitioners.

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