Shocking details of death of man, 74, only now revealed in 2014 Medical Council report

Feb 02, 2020 News

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– private hospital, doctors ordered to settle matter with family
– patient’s colon perforated accidentally; glaring breaches found

As concerns continue to mount over the operations of a number of private hospitals, one particular case has glaringly exposed breaches, one of which led to the death of Edward Subryan, a grandfather, 74.

The report of the Medical Council of Guyana which has been kept secret, until it was leaked, has blasted two prominent doctors, questioning the standards and quality of health-care they offer.
The private hospital in the city, and the two doctors have been ordered by the Medical Council to settle the matter with the family of the victim.
However, since 2014, the family of Edward Subryan has not been able to hear whether actions have been taken as a result of the damning report.
Yesterday made it six years since he died in what his family said was a botched surgical medical procedure. This led to complications and his eventual death on February 1, 2014.
According to the Medical Council report prepared by then Chair, Dr. Vivienne Mitchell, MBBS, DM, MPH, following the complaint by the family, there was a review of several documents, including from the city hospital, the Post Mortem report, Death Certificate, and responses from three doctors– two of them are general surgeons.
Subryan was admitted to the private hospital on January 21, 2014 with upper gastrointestinal bleed.
“After 11 days of investigations, procedures and treatment, he died with an abdomen full of pus and chest full of blood and clots.”
In her summary, Dr. Mitchell said that Subryan underwent a haemorrhoidectomy on January 4, 2014 at another

private hospital (name given).
He was brought to the private hospital in question on January 21 “with a three-day history of haematemesis and one week history of melaena. His doctors elicited no known comordidities, but his post mortem revealed severe emphysema, severe atherosclerosis and concentric left ventricular hypertrophy.”
According to the report, Subryan on admission to the private admission, showed a number of things, including gastric ulcers, but no active bleeding.
The next day, during a colonoscopy, the patient’s colon was “inadvertently” perforated.
Despite a repair, there was early clinical evidence of sepsis.
Over the next few days, the man’s condition deteriorated with suggestions of “overwhelming sepsis”.
According to the report, by January 29, there were obvious signs that Subryan had difficulty breathing.
A CT guided aspiration saw doctors draining him of almost one litre of pus.
“Post mortem performed the following day found one liter of blood and clots in the left thoracic cavity. His abdominal cavity was found to be filled with pus. His stomach had fecal material.”
The cause of death was given as peritonitis, acute pancreatitis, duodenal ulcer and COPD.
In her opinion, Dr. Mitchell was harsh. She said that the doctors should have been able to diagnose or at least suspect what the man was suffering from. This would have influenced the clinical management.
Shockingly, there was “no documentation by either Dr. X or Dr. Y (both named) of adequate history taking which must include past medical history, social history and review of systems. Further, there is no documented physical examination of all his systems. This is a breach of a basic standard of care taught at the undergraduate level.”
The Medical Council report questioned whether the correct tests were conducted.
“His colon was perforated by the surgeon. Was there adherence to standard safety practices?” The investigation found no documented evidence of pre-colonoscopy bowel preparation in either the physicians’ or nurses’ notes.
“The fact that he showed almost immediate features of sepsis suggested that the surgical repair of the colon was inadequate.”
Of major concern was the fact that none of the doctors recognised that there was a critically ill patient who required aggressive intervention and management in the Intensive Care Unit.
Subryan was not given enough oxygen despite the likely need and he “as never returned to theater for a possible life-saving peritoneal lavage.”
In her damning conclusions, Dr. Mitchell found that the two senior doctors “provided substandard care with respect to their inadequate history taking, incomplete diagnoses, scant documentation, failure to recognise a critically ill patient and failure to provide effective available life-saving interventions.”
In fact, the Chair of the Medical Council was emphatic: “These senior doctors did not meet the standard expected of a doctor.”
The report said that the private hospital cannot be absolved and has a duty to ensure that safety standards and protocols are inadequately implemented.
The report said that the private hospital, and the two doctors, should consider seeking an out-of-court settlement with Subryan’s family.
Disciplinary actions were recommended for the two doctors.
The surfacing of this report came as a number of patients made shocking claims of the mercenary-like treatment at private hospitals.
Among other things, patients were being sent for unnecessary tests and even forced to take operations they don’t need.
Kaieteur News has been flooded with a significant number of complaints.
Until now, there has largely been secrecy on how many doctors are being sanctioned.
In fact, the website of the Medical Council of Guyana is not working.
If you know of anyone who has a story to tell and has the evidence that he or she or a family member has suffered at a private hospital, please let us know by calling 225-8491 or email us at kaieteurnews@yahoo.com

 

 

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