VijayUncle.com - Desi Life the Good the Bad and the Ugly!
« Dr. Priya Ramnath »

Welcome Guest. Please Login or Register.
Jan 21st, 2018, 11:36pm



« Previous Topic | Next Topic »
Pages: 1 2 3 4  ...  6 Notify Send Topic Print
 veryhotthread  Author  Topic: Dr. Priya Ramnath  (Read 12675 times)
solicitor
Guest
xx Re: Dr. Priya Ramnath
« Reply #15 on: Jan 20th, 2009, 4:05pm »

also, it is clear that within seconds of the injection being given, mrs leighton suffered a reaction to the adrenalin and collapsed. coincidence? maybe. but inferences can be drawn from the timings of the injection to the reaction. and of her conduct in the immediate moments once the patien had collapsed.

furthermore, inferences can be drawn of dr ramnath's resignation and departure within days of mrs leighton's death.

personally, my feellings as a legal practitioner are that she did act negligently and that as a result the patient died. i even feel that it was so negligent that it could be classed as gross negligence, and that therefore it is possible that the Judge will direct the jury to convict her.

however, i understand the notion that, politically, there may be reservations about doing so, thereby potentially criminalising drs actions.

but the point to distinguish is that, in an emergency situation, people make calls and can make mistakes. but was this a mistake, or was it something more than that? a mistake so terrible and negligent that criminal sanctions are necessary?

i think both medical and legal practitioners everywhere are watching this case with interest.
User IP Logged

Vijay Mehta
Administrator
ImageImageImageImageImage


member is offline

Avatar



YIM YIM AIM
Homepage PM

Gender: Male
Posts: 2702
xx To the solicitor
« Reply #16 on: Jan 20th, 2009, 6:03pm »

Well there are problems with the scenario those witness are trying to create. Suppose the patient was sitting up and had blood pressure and Dr. Ramnath asks for adrenaline the nurse did not have to give it to Dr. Ramnath. She could have simply called the attending. Also why would Dr. Ramnath give adrenaline to the patient who is sitting up and talking - did she want to hurt the patient?

It is also possible that someone very powerful wanted to cover up his/her mistake and found Dr. Ramnath to be an easy scapegoat.

Do not discount several white people testifying against one brown doctor. Racism can also play a part.

Her leaving the country was a logical thing to do. A doctor feels horrible when a patient dies specially immediately after administering the medicine. Once patient died they needed someone to pin the blame on and the witness easily change their story.

If the patient dies due to error in judgment, that calls for professional discipline and not a jail term.

If you were to place all the physicians in the jail who prescribe or administer some medication and patient either suffers grave consequences or dies, you will have to build many jails. As they say 20/20 hindsight. Once such event occurs in majority of events we the medical profession are able to come up with, what could have been done to prevent such occurrences.

To me the whole story just does not make sense. And it will come down to who the jury believes. But in criminal case the bar of proving guilt is much higher on the prosecution. Let us see what happens.
« Last Edit: Jan 20th, 2009, 6:19pm by Vijay Mehta » User IP Logged

Greatest threat to Hindu religion comes from Dhongi Baba - Dada - Didi - Swami etc.
solicitor
Guest
xx Re: Dr. Priya Ramnath
« Reply #17 on: Jan 21st, 2009, 12:04pm »

whilst i agree that the matter is now in the hands of the jury, i believe that your comments are unhelpful and misguided.

you talking of racism and dr ramnath being a scapegoat, which is absurd. her actions are the cause of her being on trial, no one elses. and racism is not a part of this case, as a black doctor nd a chinese doctor gave evidence on behalf of the crown. there is no evidence of these issues being evident and have certainly not been raised in court.

you also discuss possibilities - what if, if she did this, etc... when these are not the case. the evidence is clear - she gave an injection of indrenalin against her colleagues advice. this is what she will be tried for, and nothing else.

i understand why, as a practitioner of medicine, you would feel strongly about this case. but you have to set aside all feelings and emotions when considering this - did her actions amount, in UK law, to gross negligent manslaughter (which is a different standard to UK manslaughter, and completely different to the US's crime of involuntary manslaughter)? a coroner concluded that mrs leighton was unlawfully killed. that indicates the seriousness of dr ramnath's actions. now she is being tested by the UK legal system to see whether she should be accountable for her actions.

thanks for listening.
User IP Logged

Vijay Mehta
Administrator
ImageImageImageImageImage


member is offline

Avatar



YIM YIM AIM
Homepage PM

Gender: Male
Posts: 2702
xx 783,936 deaths may be iartogenic in US per year!
« Reply #18 on: Jan 21st, 2009, 8:35pm »

Death and injury due to medical errors are not as uncommon as non-medical public think and they are not as criminal as legal minds would think.
http://www.chiro.org/LINKS/FULL/Death_By_Medicine.html

You can check out the detailed article but here are some noteworthy quotes.
"As shown in the following table, the estimated total number of iatrogenic deaths–that is, deaths induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures– in the US annually is 783,936. It is evident that the American medical system is itself the leading cause of death and injury in the US . By comparison, approximately 699,697 Americans died of heart in 2001, while 553,251 died of cancer. [5]"

If we charge one out of a thousands physicians for homicide that would be 783 physicians per year!
Criminalizing medical errors could have profound effect on honest reporting and solving the errors. It is estimated that vast majority of errors are not reported due to fear of adverse action or malpractice litigation.



You have not paid attention to the other important fact, which is this. The hospital could have charged her with a civil offense but for that the statute of limitation had expired. So they had to elevate it to a criminal charge.
4/26/2007 Extradition treaty between US and England became effective - this was signed earlier in 2003.
9/18/2007 Extradition was requested by England.
11/30/2007 She was arrested.
« Last Edit: Jan 21st, 2009, 10:02pm by Vijay Mehta » User IP Logged

Greatest threat to Hindu religion comes from Dhongi Baba - Dada - Didi - Swami etc.
solicitor
Guest
xx Re: Dr. Priya Ramnath
« Reply #19 on: Jan 22nd, 2009, 01:41am »

you are incorrect.

under uk, the family alone can bring a civil case against her, not the hospital. the family potentially may still be able to bring a case, outside of limitation, but it will be at a court's discretion whether to allow it.

also, the hospital nor the General Medical Council could not bring disciplinary procedures against her because she resigned following the patient's death and fled to America.

the cps sought to extradite dr ramnath but were prevented due to an administrative error which meant that the extradition timelimit had elapsed. once the extradition treaty legislation was amended, the cps submitted the extradtion papers and dr ramnath was arrested and processed.

with respect, you do not understand how uk law operates, and seek to muddy the waters by using arguments that are not based either on uk law or the relevant facts of the case. whilst you are entitled to your opinion which I respect, you should only seek to comment on elements of the case which have been raised in court, and keep theories such as racism and scapegoat-ism out of any discussion.

sorry for the rant - i need coffee! smiley



User IP Logged

satishd
Guest
xx Re: Dr. Priya Ramnath
« Reply #20 on: Jan 23rd, 2009, 05:15am »

I am confident Dr. Ramnath would not have given adrenaline if patient were talking and sitting in chair.
Why would she? our solicitor friend has no idea about what runs through physician's mind when there is an emergency. you don't have luxury to call consultant. and yes, you may disagree with your colleagues. that is not a crime. She acted in good faith, she truely believed adrenaline had to be given under circumstances. It was unforunate that outcome was fatal. I am sure dr. Ramnath was sorry for patient's loss. we all feel for patient's family., but fact is Mrs Leighton was suffering from septic shock, and Dr. Ramnath gave adrenaline in patient's best interest.
One thing I don't understand is that if patient was alraedy sitting in chair and talking, why they are saying that after she received injection sat bolt upright in her bed and shouted.
I hope jury will use common sense-physician did act in good faith, her intention was to save life, never to take one, if we all could look in future, we would never do thousands of things we did.
i feel sorry for solicitor, he will never be able to think from physicians perspective, no matter what.
let us just pray for Mrs Leighton's soul.
but also dr. ramnath has suffered enough for past year. may be that is her punishment. but she should be acquitted at this point and her two young children finally should meet their mom.
User IP Logged

solictor
Guest
xx Dr. Priya Ramnath
« Reply #21 on: Jan 23rd, 2009, 06:49am »

satishd

the evidence of 4 individuals is that she gave the patient adrenaline when she was sitting and talking in bed. those are the facts of the case. the jury must consider whether they agree with those testimonys.

your personal confidence that dr ramnath would not have administered adrenaline is based upon a premise that you or a reasonable doctor would not have done so.

the crown's case is that ramnath's actions were in conflict with other colleagues, and those actions had consequences so dire that criminal charges were brought.

i agree that i have no comparable knowledge about what a physician may consider at any given moment. but, from an evidential perspective, 4 other doctors and nurses who were there deemed it unnescessary to give adrenalin, and tried to prevent dr ramnath from administer it. she may have acted in "good faith" but her more senior colleagues attempted to warn her off from acting.

with regards to the sitting query you raise, the patient was lying on a bed in a raised position ie: not flat and not sitting upright at 90 degrees. she then surged forwards. hope that clears that up. I was in court when evidence was given.

with respect, your sympathy for me being unable to "think from physicians perspective, no matter what" is not not necessary. you are unable to objectively look at the evidence and weigh that up, which is what must be done in any legal proceedings, whether in the US or UK.

personally, i dont believe she intended to kill mrs leighton. dr ramnath is not a murderer. but it is clear that her actions went against the opinions of everyone else in that room. it is also clear from the witness evidence in court that dr ramnath was a very arrogant doctor who did not take well to being told what to do.

from a legal perspective, i honestly dont know which way it will turn. i agree that common sense could prevail and dr ramnath could be acquitted. but ultimately there IS a triable case and dr ramnath needs to be tested by the courts.

mrs leighton and her family deserve that.

thank you.

Solicitor thank you very much for providing the information. We are unable to find detailed information about the testimonies etc. Is there anyway for us to get it? The testimonies are supposed to be a public knowledge, do they post it on the web? Please keep us posted with details of proceedings. Thank you. -Vijay Mehta
« Last Edit: Jan 23rd, 2009, 07:39am by Vijay Mehta » User IP Logged

Vijay Mehta
Administrator
ImageImageImageImageImage


member is offline

Avatar



YIM YIM AIM
Homepage PM

Gender: Male
Posts: 2702
xx Let us look from other point of view
« Reply #22 on: Jan 23rd, 2009, 08:22am »

Let us look the incidence from Dr. Ramnath's point of view:

You are a registrar in charge of the patient with Septic shock and you feel that patient is sinking, her blood pressure is falling and in your best judgment adrenaline injection can save her life. You have two colleagues and a nurse who tells you that adrenaline is not indicated. You being a Crown's loyal physician do not give her adrenaline. The patient proceeds to die. Now can you live with your self for rest of the life saying that I felt that patient could be saved but my colleagues and one smart nurse told me not to do it. The patient died what else can I do? Can you stand in front of jury and tell them, "ladies and gentlemen, I felt that patient needed but I had to go by the advise of two colleagues and one smart nurse, so I did not give her the adrenaline. Too bad patient died. I am not culpable!! I am sure solicitor & company would be happily defend her as long as she listened to her colleagues.

If the judge and Jury do decide to convict her may be they need to guide us as to how to manage patient in times of crisis. Do we call the meeting to order and get a vote?

It is darned if you do and darned if you don't situation. Let us hope the Judge and Jury has common sense to figure this out. She is a physician and she has dedicated her life to serve the humanity. She had no ill intentions. She did what at that point in time she felt was in the best interest of her patient. I urge British Medical Association and physicians to speak up. May be to day it is Dr. Ramnath's turn, to morrow it could be yours.
« Last Edit: Jan 23rd, 2009, 08:24am by Vijay Mehta » User IP Logged

Greatest threat to Hindu religion comes from Dhongi Baba - Dada - Didi - Swami etc.
solicitor
Guest
xx Civil vs criminal neglience
« Reply #23 on: Jan 23rd, 2009, 10:38am »

I understand the "d**n
ed if you do/don't" view. Under the UK civil standard of medical negligence, the Bolam test would apply - would three reasonable doctors have done the same actions. It is an objective test. It is not a subjective one - ie: "I was acting in the best interests of the patient." If the three reasonable doctors disagree with those actions, the doctor is liable.

True, they weren't all doctors there at the scene, but the prinicple applies, and that is what is being tested effectively, albeit in a criminal context where the burden of proof is higher.

I will do my best to report as much as I can from the court for you smiley

Thanks.
Well in that case, based on the outcome, no one is going to argue that reasonable doctors would not have given the adrenaline. However, what legal test in UK law makes it criminal offense, rather than medical negligence? -Vijay Mehta
« Last Edit: Jan 23rd, 2009, 12:43pm by Vijay Mehta » User IP Logged

Vijay Mehta
Administrator
ImageImageImageImageImage


member is offline

Avatar



YIM YIM AIM
Homepage PM

Gender: Male
Posts: 2702
xx Expert testifies that patient died of septic shock
« Reply #24 on: Jan 27th, 2009, 7:36pm »

http://www.birminghampost.net/news/west-midlands-news/2009/01/28/doctor-on-trial-over-death-of-patient-opts-out-of-giving-evidence-65233-22793363/

Doctor on trial over death of patient opts out of giving evidence

Jan 28 2009 Birmingham Post

A hospital registrar accused of killing a patient by injecting her with adrenaline opted not to give evidence at her trial.

A jury at Birmingham Crown Court was told by counsel acting for Dr Priya Ramnath, who is accused of killing Patricia Leighton in 1998, that she would not be called as a witness.

Ramnath, 40, is alleged to have gone against the advice of three colleagues at Stafford District General Hospital before injecting adrenaline into Mrs Leighton.

The defendant, who returned from the United States to the UK to face trial last year, denies the manslaughter of Mrs Leighton by gross negligence.

Jonathan Caplan QC, began Ramnath’s defence case by informing the trial judge that his client would not be called as a witness.

The lawyer then called Dr John Coakley, an expert in intensive care medicine who works at London’s Homerton Hospital, to give evidence.

Dr Coakley told the court that he believed Mrs Leighton died as a result of septic shock rather than the injection of adrenaline. He told the jury Mrs Leighton’s condition was critical when she was admitted to Stafford District General in July 1998 and that she had about a 50 per cent chance of survival.

Dr Coakley said: “I don’t envy any of the doctors that were present - this was a critically ill patient. If you believe that the situation is becoming out of control then you have to do something.”

Mr Caplan asked the witness what he believed the cause of Mrs Leighton’s death to be.

Dr Coakley, who said he himself had used adrenaline to “buy time” for other treatments, replied: “I think she died of septic shock.”

The expert also said that although adrenaline was dangerous, he would not have expected the dose given to Mrs Leighton to have resulted in death.

Ramnath is alleged to have acted against the express instructions and advice of colleagues when she administered the adrenaline.

The court has heard that moments after the injection Mrs Leighton lost consciousness and her heart stopped.

Jurors have been told that she suffered from arthritis and had been admitted to hospital in Cannock on July 20 after a wound on a bunion on her left foot became infected.

She then suffered side-effects from antibiotics and was transferred to Stafford, where she was admitted to intensive care with septic shock.

Ramnath, whose address cannot be published for legal reasons, came back to Britain in February last year after dropping her opposition to extradition proceedings.

The case continue


The crown had to prove the cause and effect relationship between the injection of adrenaline and the death of the patient. It seems that they have failed to do it so far. How do they know that patient did not die of septic shock as testified by the expert witness for the defense. Where is the evidence beyond a reasonable doubt that Dr. Ramnath killed the patient? How do we know that patient died due to Adrenaline instead of in spite of Adrenaline?
- Vijay Mehta
« Last Edit: Jan 27th, 2009, 7:49pm by Vijay Mehta » User IP Logged

Greatest threat to Hindu religion comes from Dhongi Baba - Dada - Didi - Swami etc.
solicitor
Guest
xx Re: Dr. Priya Ramnath
« Reply #25 on: Jan 28th, 2009, 1:05pm »

because a coroner ruled that she was unlawfully killed by an overdose of adrenaline, not by septic shock

from a legal perspective, please remember that the defence expert witnesses CHARGE and are PAID fees to give their evidence in support of the defence, whereas the crown will only reimburse their expert witnesses for travel expenses.

as regards proof, it was seconds between the dose being given and mrs leighton collapsing and dying. the evidence of the crown paints a completely different picture that mrs leighton was ill and not critically ill, as indicated by the defence.

finally, inferences can and will be drawn by the jury upon dr ramnath chosing not to give evidence.

the case continues...
User IP Logged

Vijay Mehta
Administrator
ImageImageImageImageImage


member is offline

Avatar



YIM YIM AIM
Homepage PM

Gender: Male
Posts: 2702
xx Coroner may be over his head
« Reply #26 on: Jan 28th, 2009, 3:45pm »

Thank you solicitor.

With all due respect to the coroner the fact is that no one can testify with certainty if a person died of overdose of adrenaline. Adrenaline is destroyed by the body.

Adrenaline might have killed by induction of ventricular fibrillation - a condition where the heart beats at 300-400 times per minute in stead of 80 per minute. In process the heart is not able to pump any blood resulting in the death. The process could have been reversed with proper defibrillation. The effect of adrenaline is very short lived so the patient need to be resuccited for few minutes.

If the adrenaline was the only culprit heart would have come back in few minutes but if toxicity for sepsis had made the heart too weak to return to normal, she could not come back, as it happened in this case.

Scientifically no one can be certain that it was the adrenaline.
Sepsis also makes heart more vulnerable to fibrillation - so a coroner can not be hundred person sure that sepsis did not play a part in her death.

The amount of Adrenaline was not a fatal dose. We generally give 1 cc and repeat two to three times.
Why would anyone give her 3 cc of adrenaline in the first place? All emergency cardiac drugs come on single does to prevent such errors. So hospital can also be liable.

I am much more positive now than when he case started. Let us see what jury decides.

where can I find the testimony of the coroner?
« Last Edit: Jan 28th, 2009, 3:45pm by Vijay Mehta » User IP Logged

Greatest threat to Hindu religion comes from Dhongi Baba - Dada - Didi - Swami etc.
solicitor
Guest
xx Re: Dr. Priya Ramnath
« Reply #27 on: Jan 29th, 2009, 07:02am »

Thank you Vijay

The coroner's verdict is a matter of public record and im certain that audio recordings of the hearing were taken, but these are not "public documents" if you will - requests can be made to obtain them via the courts, but at a price. also, because this happened over 10 years ago, i think they have probably been destroyed by now. I could be wrong though! smiley

I do not profess to understand the medical side of things so I will not comment on them. However, I do not believe that ventricular fibrillation played a part in mrs leighton's death as there is no evidence of the same.

Your comments are interesting -"The amount of Adrenaline was not a fatal dose. We generally give 1 cc and repeat two to three times. Why would anyone give her 3 cc of adrenaline in the first place? All emergency cardiac drugs come on single does to prevent such errors. So hospital can also be liable." The crowns case, I understand, is that a 3cc dose is fatal when delivered in that quantity and undiluted. If it is infused with saline over hours, then it would not be lethal. This is what the crowns experts and witnesses testified. Clearly, I am not a doctor so do not know whether this is accurate, but this is the evidence before the court.

Interestingly, the Judge commented during arguments with the barristers and experts that she was satisfied that the quantity given was a lethal dose. unfortunately this has not been accurately reported in the press. we are being fed mere snippets from what they deem to be relevant, which is a shame.

All emergency drugs may nowadays come in 1cc doses, but this may not have happened at the time of the incident. Again, I am only hypothocising on that point.

If you are questioning why she would give that quantity of drug, then do you personally consider her actions to be incorrect? Especially if senior colleagues and nurses are all telling her not to? Would you personally have done the same in an identical situation? Or would you have been one of those trying to stop the injection?

Thanks for your time.
User IP Logged

GUEST
Guest
xx Re: Dr. Priya Ramnath
« Reply #28 on: Feb 3rd, 2009, 10:10am »

What about the septic shock that the patient was admitted with and the low WBC count. Could it have any connection with the experimental drug that she was on. Nobody seems to be discussing the reason why she went into septic shock in the first place which does have high mortality rate of almost 50%
User IP Logged

Vijay Mehta
Administrator
ImageImageImageImageImage


member is offline

Avatar



YIM YIM AIM
Homepage PM

Gender: Male
Posts: 2702
xx Professional Neglience vs Homicide
« Reply #29 on: Feb 3rd, 2009, 10:21am »

Guest,
You are correct. It is the job of prosecution to prove that the patient died only due to Adrenaline. And the Adrenaline was given with criminal neglect. There is a higher bar for the proof in criminal charges compared to civil ones.

So far I have seen so many accusation but nothing that would amount to justify anything more than professional negligence.
User IP Logged

Greatest threat to Hindu religion comes from Dhongi Baba - Dada - Didi - Swami etc.
Pages: 1 2 3 4  ...  6 Notify Send Topic Print
« Previous Topic | Next Topic »

Donate $6.99 for 50,000 Ad-Free Pageviews!

| Conforums Support |

This forum powered for FREE by Conforums ©
Sign up for your own Free Message Board today!
Terms of Service | Privacy Policy | Conforums Support | Parental Controls