A report on the deaths of four patients treated by a Cuban doctor finds that the families have grounds to sue, reports Justin Arenstein
THE recent exoneration of a Cuban anaesthetist from responsiblity for the death of four patients at Pietersburg Hospital by the Northern Province health MEC, Joe Phaahla, flies in the face of an expert report he commissioned from the South African Society of Anaesthetists (Sasa).
The confidential report, extracts of which were leaked to the Mail & Guardian this week, expressed “alarm” at the attitude to the deaths by the Cuban doctor – identified for the first time as L de la Parte. It found that his degree of competence was far below the level where he could work without constant expert supervision.
The programme to bring Cuban doctors into the country was initiated by the Minister of Health, Dr Nkosazana Zuma, to plug gaps in health resources in some of the poorer provinces.
Phaahla claimed during television and press interviews that the Sasa report exonerated De La Parte. He accused the media of “picking on the deaths and sensationalising them to discredit the whole Cuban volunteer programme”. He refused to release the report for public debate.
The department insisted this week that the report was being kept confidential to protect the families of the deceased – so confidential that relatives have not been told that the report finds that any civil action by them would “probably be successful”.
The provincial health department director general, Dr Nicholas Crisp, was blunt: he said that “we don’t make a practice of telling people they can sue us. We definitely don’t see that as our obligation at all.”
Stressing that the leaked portions of the report dealing with the medical background of the patients were “severely paraphrased”, Crisp confirmed that the section dealing with Sasa’s peer review committee findings was accurate.
Referring to De La Parte, the report reads: “We were alarmed at his attitude. We found him to be arrogant, especially while making comments such as `I am not worried [about the deaths] as they were sick enough’ and `the surgeons were not well qualified’.”
The report says that all alternative treatment suggestions were “fobbed off as being our British training whereas in Cuba things are done differently”. A Medical and Dental Council disciplinary hearing would probably find De La Parte guilty of misconduct in all four cases, it says.
The report’s four core recommendations expressly state that De La Parte cannot be permitted to continue practising in South Africa without retraining and “complete supervision” at all times.
Acting on the recommendations, Crisp declined to renew De La Parte’s contract with the department and told the anaesthetist not to bother returning to South Africa from a holiday in Cuba.
Phaahla, however, told the media that De La Parte had returned to Cuba because of the stress created by sensationalistic press coverage and a subsequent nervous breakdown.
Phaahla’s representative, Tshepo Moshima, consistently refused to give the M&G access to the MEC on Wednesday to explain the discrepancies between his public comments and the report’s findings, but insisted that Phaahla stood by his previous public statements.
“Why would his views have changed? If you look carefully, there are actually no discrepancies between the statements and the report. The MEC is not available on this issue and I speak for him,” said Moshima.
He did, however, concede that there were “things that we need to still clarify on some points”.
Stressing that the department had commissioned the report to ascertain whether “the department is really taking care of lives”, Moshima said that it had never been intended for public debate or for the families of the deceased.
“That is just not the nature of the report – it is not meant for the families. It is true that we haven’t advised them that the report says any civil action would probably be successful but the document is confidential,” he added.
“And in any case, we don’t know whose duty it would have been to tell the families. Must administration or the MEC do this?”
Sasa’s president, Dr Leon du Preez, agreed that the report had been confidential to protect the families’ identities but stressed on Wednesday that they had to be informed that they had grounds for civil action.
“The whole case is now being investigated by the police to determine whether there are grounds for an inquest, as recommended in our report, but it is essential for the families to at least know that they could sue for damages,” he said.
Both Du Preez and Crisp repeatedly stressed that the issue that De La Parte was Cuban had focused undue attention on the incident and that it was “unfortunately discrediting the very good work being done here by brilliant Cuban surgeons and doctors”.
Confirming that there had been at least 12 anaesthestic deaths at Pietersburg Hospital during the same period as the four cases involving De La Parte, Crisp said that the department had instituted new strict monitoring procedures to review all future deaths immediately.
“If you saw the number of patients who are classified as dying `anaesthetic deaths’ in South Africa, you’d be surprised. It’s masses of people but there are often other factors involved. We all recognise that this is not a well-managed service but the new measures we have instituted and a new national study to determine exact figures and causes will give us a better handle on the situation,” he explained.
Police investigating the deaths of those at Pietersburg Hospital are still collecting affidavits for the attorney general but feel that there is sufficient evidence to justify a full Inquest.
According to Crisp, an agreement between Cuba and South Africa ensures that De La Parte will be brought back should he be required to “answer questions”. It is unclear whether this would also apply for a civil case by relatives. – African Eye News Service