Pliny the Elder, around 70BC, said doctors were able to get
away with murder, citing Cato the Elder two hundred and fifty years earlier[1].
Later, Galen had complained
Greek doctors fled to Roman cities to hide their incompetence.
Engelbrecht, Patel and Nicol are management with whom we communicated. The others were my mother's treating/attending doctors. Their current posts are unknown.
Complicating the charges, contrary legislation and ethics, Engelbrecht et al (and Dr Tunc Numanoglu) repeatedly refused to reveal who treated my mother at specific times. The police and DPP never requested the respondents' statements (no investigation was conducted).
In their packaged, rehearsed replies to the HPCSA (one attorney represented them), the attending hospital doctors (excluding Mayet; his name does not appear in my mother's medical record and thus not named as a respondent in our complaints although he was apparently in the unit at some stage) and Nicol claimed they had communicated with the family when they could not have done so (they did not know who we were until after we complained to WCHD). Or contradictory, they say they did not speak to the family.
According to them, Mayet spoke with us on the day. It's an old defence trick of blaming an unknown, mysterious third party who is not available to testify. Their claimed corroborating evidence is hearsay (re. Mayet) and fabricated. They offered as proof records I believe were inserted into my mother's hospital records after the fact.
The HPCSA accepted their responses, and didn't ask Mayet for a corroborating statement.
Formal complaints were not laid but we requested DPP and HPCSA investigate violations of National Health Act regulations, Health Professions Act and Inquests Act of Dr Gavin Kirk as part of their other investigations. There was no response.
Dr Gavin Kirk, state pathologist WCHD, forensic pathology UCT: Providing post-mortem findings to unauthorised parties and working beyond competence, unprofessional conduct, obstruction of justice.
Kirk gave Nicol (a WCHD and UCT colleague and respondent to charges mentioned here) post-mortem findings, and on request of DPP, an opinion on medical negligence. He had earlier stated in writing he was unable to do so by law.
About the negligence opinion, despite informing the DPP of Kirk's personal, irregular communications with a respondent to professional and possibly criminal charges and his earlier advice he was unable to provide one, the DPP ignored our request to obtain an independent opinion. It was partly based on this opinion they concluded there was no criminal offense.
Pliny’s tirade was against Greek doctors who undermined
Roman self-reliance. But he was right all the same.
Doctors (and chemists) have the technical skill to kill
without the cause of death being obvious, or they can be negligent without it
raising questions. It’s sometimes the plot of detective stories. But in these,
the doctor killer is always discovered.
In reality, it’s very hard to prosecute doctors for
malpractice or worse despite professional ethics and the law, in South Africa
the Health Professions Act and National Health Act, being clear about the
highest standards of professional and ethical conduct.
Traditionally, doctors are reluctant to testify against
colleagues even when the evidence of negligence is evident, although in a
litigious society that may be less of a problem than it used to be.
Over the years I’ve made three failed attempts to charge doctors on prima facie professional and/or criminal offences, two cases I wrote about in this blog. The
other concerned a former vet (perhaps I’ll write about that in future).
The last complaints concerned my mother’s suspicious death on 7 July 2017 at Groote Schuur Hospital's Trauma
Centre. Although her death was ruled
unnatural causes, that wasn’t due to the circumstances of her death and care,
but a legal technicality concerning what preceded it before she got to the hospital
(she fell at home).
However, because of our pressure, should it ever happen,
the inquest will include her hospital treatment and death. However, without investigating, separately Cape
Town’s director of public prosecutions (DPP) and Health Professions Council (HPCSA) ruled
there was no medical negligence, crime or unprofessional conduct by anyone – doctors, hospital, Western Cape Health Department[2].
Why an inquest is, therefore, required is something DPP and Cape Town Inquest Court have not explained despite my requests. We want my mother's death investigated, but the inquiry, especially after all this time, shall be a cover up rather than justice which we want no part of. Honore de Balzac wrote “Laws are spider webs through which the big flies pass and the little ones get caught”. And philosopher Herbert Marcuse said, “Law and order are everywhere – the law and order which protect the established hierarchy”.
Why an inquest is, therefore, required is something DPP and Cape Town Inquest Court have not explained despite my requests. We want my mother's death investigated, but the inquiry, especially after all this time, shall be a cover up rather than justice which we want no part of. Honore de Balzac wrote “Laws are spider webs through which the big flies pass and the little ones get caught”. And philosopher Herbert Marcuse said, “Law and order are everywhere – the law and order which protect the established hierarchy”.
Our 2019 complaint under the Prevention and Combating of Corrupt
Activities Act was dismissed or subsumed under the remit of the inquest. The DPP refuses to say.
Ironically, in The Guardian today director of the National Prosecuting Authority (NPA) Shamila Batohi writes now more than ever “prosecutors need to show empathy for the vulnerable and be vigilant against corruption and organised crime”.
Ironically, in The Guardian today director of the National Prosecuting Authority (NPA) Shamila Batohi writes now more than ever “prosecutors need to show empathy for the vulnerable and be vigilant against corruption and organised crime”.
The NPA, now as under Batohi's compromised predecessor Shaun Abrahams, is in thought if not deed corrupt and susceptible to political influence. It and her office are aware of my complaints against
those mentioned herein (and DPP). The DPP declined to prosecute or give reasons for not
doing so after they facilitated then premier Helen Zille's interference in the already non-investigation of my mother's case. And with the corruption allegations, they refused to initiate an investigation despite initially saying they shall look into it. They later washed their hands of it.
If this is not NPA malfeasance and indifference to victims and corruption, I don't know what is. Batohi is disingenuous and duplicitous. She knows how it is in her office. Perhaps that’s why she submitted her anodyne bromides to The Guardian. No South African believes her. And very few have hope in her and the wave of Panglossian Ramaphoria she was appointed on and still riding.
If this is not NPA malfeasance and indifference to victims and corruption, I don't know what is. Batohi is disingenuous and duplicitous. She knows how it is in her office. Perhaps that’s why she submitted her anodyne bromides to The Guardian. No South African believes her. And very few have hope in her and the wave of Panglossian Ramaphoria she was appointed on and still riding.
Here then, for the record – for that's all it shall remain – are the allegations against those implicated in my mother’s case made to the police, DPP and HPCSA. Unless stated
otherwise, the charges were under the National Health Act and Health Professions
Act and its Ethical Code of Conduct. Their posts indicated were as at the time of the event.
Dr Beth Engelbrecht, head of WCHD: Unprofessional conduct; refusal to investigate patient complaints; lack of supervision and oversight; failure to communicate; fraud and obstruction to prevent
health inquiries.
Unrelated to the above, ethics violation: Engelbrecht lied to/misled the public and Western Cape legislature about WCHD's finances. AfriForum laid charges against about WCHD's irregular spending. Her veracity was always in doubt. She was replaced as head of health from April 1.
Dr Bhavna Patel,
CEO Groote Schuur: Unprofessional conduct; refusal to investigate patient complaints; lack of supervision and oversight; failure to communicate; obstruction to prevent health inquiries.
Prof. Andrew Nicol,
head of department of trauma surgery, GSH and UCT: Unprofessional conduct; refusal to investigate patient complaints; obstruction to prevent health
inquiries; lack of supervision and oversight; failure to communicate; medical records fraud/misrepresentation.
Dr Marcelle Crowther,
anaesthetics registrar: Unprofessional and negligent conduct; failure to obtain
informed consent; failure to communicate; failure to provide follow-up care; lack
of supervision and oversight; working beyond competence; possible accessory to
assault and culpable homicide; medical records fraud/misrepresentation. Of them all, Crowther might be the least culpable.
Dr Ahmed Al Sayari,
trauma specialist/consultant: Unprofessional and negligent conduct; failure to
obtain informed consent; failure to communicate; failure to provide follow-up
care; lack of supervision and oversight; working beyond competence; possible
accessory to assault and culpable homicide; medical records fraud/misrepresentation.
Dr Mohammed Mayet,
emergency medicine registrar: Unprofessional and negligent conduct; failure to
obtain informed consent; failure to communicate; failure to provide follow-up
care; lack of supervision and oversight; working beyond competence; abuse and crimen injuria; possible accessory to assault and culpable homicide; medical records fraud/misrepresentation.
Dr Mikhail Botha,
junior medical officer: Unprofessional conduct; failure to obtain informed
consent; failure to communicate; failure to provide follow-up care; lack of
supervision and oversight; working beyond competence; assault
and culpable homicide; medical records fraud/misrepresentation.
Engelbrecht, Patel and Nicol are management with whom we communicated. The others were my mother's treating/attending doctors. Their current posts are unknown.
In their packaged, rehearsed replies to the HPCSA (one attorney represented them), the attending hospital doctors (excluding Mayet; his name does not appear in my mother's medical record and thus not named as a respondent in our complaints although he was apparently in the unit at some stage) and Nicol claimed they had communicated with the family when they could not have done so (they did not know who we were until after we complained to WCHD). Or contradictory, they say they did not speak to the family.
According to them, Mayet spoke with us on the day. It's an old defence trick of blaming an unknown, mysterious third party who is not available to testify. Their claimed corroborating evidence is hearsay (re. Mayet) and fabricated. They offered as proof records I believe were inserted into my mother's hospital records after the fact.
The HPCSA accepted their responses, and didn't ask Mayet for a corroborating statement.
In addition to the above laws, the following charges are
under the Prevention and Combating of Corrupt Activities Act.
Prof. Elmin Steyn,
head of department of surgery, Tygerberg Hospital and Stellenbosch University,
member of HPCSA Preliminary Committee of Inquiry: Corruption as defined in the Act; abuse of
authority; violation of Health Professions Act regulations; obstruction; unprofessional conduct.
Elmin Steyn, a writing partner of Nicol, didn't recuse herself from the HPCSA's inquiry into our complaints. It's also alleged, given their personal relationship and extraordinary leeway – up to a year – Nicol et al were allowed, his and their responses to our accusations were coached (Nicol was allowed a second response a year after his first, but most of our evidence wasn't reviewed). And there might have been contact between the two while the inquiry, which before it concluded I cautioned the HPCSA had problems, was still proceeding.
Elmin Steyn, a writing partner of Nicol, didn't recuse herself from the HPCSA's inquiry into our complaints. It's also alleged, given their personal relationship and extraordinary leeway – up to a year – Nicol et al were allowed, his and their responses to our accusations were coached (Nicol was allowed a second response a year after his first, but most of our evidence wasn't reviewed). And there might have been contact between the two while the inquiry, which before it concluded I cautioned the HPCSA had problems, was still proceeding.
Dr Raymond Billa,
CEO and registrar of HPCSA: Not reporting possible corruption, abuse of
authority, violation of Health Professions Act regulations, obstruction, unprofessional conduct.
Before the inquiry concluded I informed Billa of problems with it. He said he would investigate and respond within five days. He never did. Apart from Steyn's involvement, it was clear he and the committee had not adhered to the Health Professions Act's regulations for registering and investigating complaints and conducting inquiries.
Before the inquiry concluded I informed Billa of problems with it. He said he would investigate and respond within five days. He never did. Apart from Steyn's involvement, it was clear he and the committee had not adhered to the Health Professions Act's regulations for registering and investigating complaints and conducting inquiries.
Prof Kapil Satyapal,
chair HPCSA Preliminary Committee of Inquiry: Not reporting possible corruption,
violation of Health Professions Act regulations, obstruction, unprofessional
conduct. (His name is included as he ought to have known Steyn's connection to a respondent and for not conducting a proper inquiry.)
Formal complaints were not laid but we requested DPP and HPCSA investigate violations of National Health Act regulations, Health Professions Act and Inquests Act of Dr Gavin Kirk as part of their other investigations. There was no response.
Dr Gavin Kirk, state pathologist WCHD, forensic pathology UCT: Providing post-mortem findings to unauthorised parties and working beyond competence, unprofessional conduct, obstruction of justice.
Kirk gave Nicol (a WCHD and UCT colleague and respondent to charges mentioned here) post-mortem findings, and on request of DPP, an opinion on medical negligence. He had earlier stated in writing he was unable to do so by law.
About the negligence opinion, despite informing the DPP of Kirk's personal, irregular communications with a respondent to professional and possibly criminal charges and his earlier advice he was unable to provide one, the DPP ignored our request to obtain an independent opinion. It was partly based on this opinion they concluded there was no criminal offense.
Afterword
South Africa prides itself on a fine constitution and sophisticated legal system. But its criminal justice system and application of the law is failing the people and is threatened by systemic corruption and patronage. Our case represents all its deficits in one package that other citizens variously experience:- Police and prosecutors refuse to open and investigate criminal charges against politically connected and influential people and government officials. While that was the motive here, other times they're just lazy and incompetent to do so.
- Subject to influence and showing favouritism, they allow or facilitate interference from politicians and powerful people, and drop the investigation if one was opened.
- A senior state forensic officer (replace this with an officer in any deparment, e.g. HPCSA) shows favouritism and gives an accused, who is acquainted with and a colleague of his, details of the evidence knowing it's against the law to give it to any party except the police or court.
- The prosecutor instructs the same forensic officer to prepare a report of the accused's alleged actions and conduct despite it being a personal conflict of interest for him, over the objections of the complainant and contrary commonsense and professionalism. Unsurprisingly, the officer exculpates the accused which the prosecutor accepts (and finds nothing wrong).
- The police, prosecutor and court are aggressive toward victims and feel they have unreasonable demands for justice, but sympathetic to the accused, respectful and fearful of their position in society and that it's "unfair" to prosecute them.
- Cape Town inquest magistrate said there's a rumour at court about the case and didn't disagree it's a "mess". Wynberg Magistrate Court's chief prosecutor unusually rejects the inquest case because of problems with it after he said he had "no choice" and must accept cases the DPP refers. The DPP doesn't inform the family or respond to their questions about these extraordinary events. The DPP/NPA are irremediably compromised.
But the country's senior prosecutor, justice department, police and president hypocritically claim to empathise with victims and have no tolerance for crime, especially corruption.
Afterword added and minor edits 29/06/2020.
[1] Vivian Nutton, 2014, Galen: A Thinking Doctor in Imperial Rome; Allen E Jones, 2009, Social Mobility in Late Antique Gaul
[2] This was after former premier Helen Zille instructed
an underling to intervene with the DPP.
The CEO, Bhanvna Patel, in all honesty, is unethical in her dealings. She is, however, a protected figure and attempting to launch any inquiry into GSH that might uncover a glaring truth to anyone who pays attention is not good for the functioning of the well-oiled machine that is tertiary hospitals and the DA-led utopian ideal of Cape Town. The HPCSA only targets interns, to be precise- white male interns. Apparently, the likelihood of causing harm is taken more seriously than actually causing harm. Bhavna Patel is vague in all answers she provides. In my personal encounter with her, she is manipulative and a liar. a Proven liar. Contact me if you want the evidence.
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