‘Brilliant’ dad and one of Britain’s best doctors, 43, died after ‘low risk’ surgery caused lungs to fill up with blood
A “BRILLIANT” dad-of-two died after “low-risk” surgery caused his lungs to fill up with blood.
Professor Amit Patel, described as one of Britain’s best doctors, was admitted to Wythenshawe Hospital in Manchester in August 2021.
The 43-year-old was suffering from a rare illness, which medics struggled to understand.
A usually-safe procedure was recommended but Prof Patel came out of it with his chances of survival at less than 10 per cent.
He died eight weeks later on October 28 from “an extremely rare catastrophic bleed”, MEN reports.
Dr Richard Booton, who performed the procedure, told an inquest: “I didn’t think we would harm him in the way we sadly did.”
Manchester Coroner’s Court heard how test results showed that Prof Patel was suffering from disseminated intravascular coagulation (DIC) – a serious and rare blood clotting disorder that can cause uncontrollable bleeding.
The procedure that led to his death was described as typically “low-risk”.
Dr Booton, a respiratory consultant, said he was confident in going ahead with the test while aware of the disorder, adding there had been blood products ordered to the bedside to “mitigate” any potential problems.
However, the operation is now understood to have severed and ruptured Prof Patel’s insides, causing his lungs to fill up with blood around 30 to 50 minutes later.
Having previously had a more than 75 per cent chance of survival, the likelihood fell to just 10 per cent, his wife Dr Shivani Tanna told the court.
Dr Booton insisted that although “delayed bleeding is an odd thing,” he “didn’t see anything during the procedure that concerned” him.
He added: “We’d never had experience of extensive bleeding in this situation.”
Dr Tanna, herself a GP, rushed to hospital to be by her husband’s side, where she found him “coughing up blood”.
“It was terrifying,” she said. “He looked liked a corpse, 70 per cent of his blood was in his lungs, he was freezing cold and he looked like he was dead.”
An independent expert, Dr Adrian Draper, a respiratory consultant at St George’s Hospital in London, prepared a report for the coroner.
He called the outcome an “extremely unusual complication” and said that even with the DIC status and the test being non-diagnostic, “the procedure would have been a risk worth taking as the risk of bleeding is rare”.
Despite Prof Patel’s rare illness and his worsening condition, Dr Draper said: “I don’t think I could have foreseen that he would have had a catastrophic haemorrhage”, had he been the medic treating him.
Dr Draper added: “Attempts were made to stop a catastrophic haemorrhage.
“With that management in place, I still think it was appropriate to proceed.”
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Prof Patel was “one of the UK’s most knowledgeable doctors” at The Christie – a leading cancer hospital in Manchester.
He was the first person in the UK to be qualified in stem cell transplantation and cellular therapy, and intensive care medicine.
And he was a national expert in the life-threatening condition that he himself started suffering symptoms of in August.
Doctors, including himself, made a “working diagnosis” of Still’s disease – a type of inflammatory arthritis marked by a fever, rash and joint pain which was causing a potentially deadly immune reaction known as hemophagocytic lymphohistiocytosis (HLH).
Prof Patel helped form national guidance on HLH during his career, and sat on a panel to which the most serious cases, including his own, were referred.
But many staff who treated him at Wythenshawe Hospital had never come across the condition before, while others had never even heard of it.
The panel and hospital staff recommended a care plan for the dad of two daughters, which involved an endobronchial ultrasound guided biopsy (EBUS) – a procedure to look inside the lungs.
But panel leader Dr Jessica Manson, a consultant rheumatologist, said she would not have advised an EBUS had she been told about his DIC and the fact it was unlikely to have led to a diagnosis.
He was an exceptionally brilliant doctor, an amazing human being, a wonderful teacher and a brilliant dad
Dr Shivani Tanna
“If the person carrying out the procedure said this will have low diagnostic yield, I think I would have not recommended it at that point,” Dr Manson added.
Coroner Zak Golombek, who adjourned the case after time ran out for him to review all the evidence, said: “The EBUS does not take place on September 2 without the recommendation of the multidisciplinary team.
“The multidisciplinary team was not operating on full information, [Dr Manson] would not have recommended an EBUS if she knew Professor Patel had DIC and it was a low yield diagnosis.”
After the procedure, Prof Patel underwent emergency treatment and was transferred to Manchester Royal Infirmary.
Sadly, his condition continued to deteriorate until his death on October 28.
Dr Tanna, who met her partner at medical school, said: “He was an exceptionally brilliant doctor, an amazing human being, a wonderful teacher and a brilliant dad”.
Senior doctors at Imperial College London praised him as “an intellectually daring clinician, researcher and teacher”.
The inquest continues.