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BRISBANE: Indian-origin doctor Jayant Patel, who caused the deaths of three patients and left a man impaired after performing on him a "careless" surgery, was reluctant to transfer his patients to a bigger city hospital despite describing his hospital as a "third world country", an Australian court was told on Tuesday.
A nurse - Karen Stumer - gave evidence in the Supreme Court in Brisbane on Tuesday and said she had overheard Patel on a number of occasions in 2004 discussing his reluctance to send his patients to a bigger hospital in Brisbane.
However, she said Patel was critical of the intensive care unit (ICU) at the Bundaberg Base Hospital.
"A couple of times he said that the Bundaberg ICU was a third world country," Stumer was quoted as saying by Australian agency AAP.
Earlier on Tuesday, specialist physician David Smalberger told the court he believed one of the patients, Gerry Kemps, should have been sent to Brisbane. Kemps died in December 2004 after Patel performed an oesophagectomy on him at the Bundaberg hospital.
Patel, 60, has pleaded not guilty to manslaughter of Kemps, and of two other patients - Mervyn John Morris and James Edward Phillips. He has also pleaded not guilty to causing grievous bodily harm to a fourth man, Ian Rodney Vowles.
The charges relate to his time as director of surgery at the hospital between 2003 and 2005.
Smalberger said he assessed Kemps in 2004 after the 77-year-old complained of difficulty in swallowing. He said when he discovered a cancerous growth on Kemps' oesophagus, he recommended the patient be sent to Brisbane, where major tertiary hospitals could provide a higher level of care.
"My advice at the time was that we should transfer him down to Brisbane for further assessment and multi-disciplinary treatment," he was quoted as saying.
He said radiation therapy or insertion of an oesophageal stent would have been a good treatment approach for Kemps.
However, the court heard evidence that Patel encouraged Kemps to instead have an oesophagectomy in Bundaberg.
Smalberger told the court on Tuesday that Bundaberg Hospital did not have sufficient resources to deal with this sort of major surgery.
"It could deal with certain levels of complexities but I think in this case, with it being an elderly patient who was a high risk for surgery ... probably Bundaberg wasn't quite the correct place to do that surgery," he said.
Kemps died a day after the operation from severe internal bleeding
A nurse - Karen Stumer - gave evidence in the Supreme Court in Brisbane on Tuesday and said she had overheard Patel on a number of occasions in 2004 discussing his reluctance to send his patients to a bigger hospital in Brisbane.
However, she said Patel was critical of the intensive care unit (ICU) at the Bundaberg Base Hospital.
"A couple of times he said that the Bundaberg ICU was a third world country," Stumer was quoted as saying by Australian agency AAP.
Earlier on Tuesday, specialist physician David Smalberger told the court he believed one of the patients, Gerry Kemps, should have been sent to Brisbane. Kemps died in December 2004 after Patel performed an oesophagectomy on him at the Bundaberg hospital.
Patel, 60, has pleaded not guilty to manslaughter of Kemps, and of two other patients - Mervyn John Morris and James Edward Phillips. He has also pleaded not guilty to causing grievous bodily harm to a fourth man, Ian Rodney Vowles.
The charges relate to his time as director of surgery at the hospital between 2003 and 2005.
Smalberger said he assessed Kemps in 2004 after the 77-year-old complained of difficulty in swallowing. He said when he discovered a cancerous growth on Kemps' oesophagus, he recommended the patient be sent to Brisbane, where major tertiary hospitals could provide a higher level of care.
"My advice at the time was that we should transfer him down to Brisbane for further assessment and multi-disciplinary treatment," he was quoted as saying.
He said radiation therapy or insertion of an oesophageal stent would have been a good treatment approach for Kemps.
However, the court heard evidence that Patel encouraged Kemps to instead have an oesophagectomy in Bundaberg.
Smalberger told the court on Tuesday that Bundaberg Hospital did not have sufficient resources to deal with this sort of major surgery.
"It could deal with certain levels of complexities but I think in this case, with it being an elderly patient who was a high risk for surgery ... probably Bundaberg wasn't quite the correct place to do that surgery," he said.
Kemps died a day after the operation from severe internal bleeding
