FBI arrests doctor wanted in Australia

Jayant Patel, a surgeon sought by the police in Queensland over allegations concerning his medical registration and his performance at a hospital in the state, has been arrested in Oregon by the Federal Bureau of Investigation.

Dr Pateloperated on about 1000 patients while he was at Bundaberg Base Hospital between April 2003 and April 2005. Australian authorities want Dr Patel extradited from the United States to face 16 charges, including three of manslaughter, two of causing injuries, and seven counts of fraud. US Department of Justice documents filed with the District Court for Oregon state that Dr Patel “faces up to two life terms plus over 100 years in prison” if convicted on all the charges.

A Department of Justice memorandum filed with the court states that in 1984 New York regulators had found Dr Patel guilty of gross negligence and incompetence, fined him, and placed him on probation.

Dr Patel subsequently gained a licence to practise in Oregon in 1989. In 1998 Dr Patel’s employer there, Northwest Permanente, placed restrictions on his licence and, in May 2001, initiated moves to fire him. Providence Portland Hospital, the documents state, revoked his surgical privileges in May 2001, and other hospitals “required that he have a second surgeon present for any surgery.”

The extradition complaint filed by lawyers acting for the Australian government states that Dr Patel, by not disclosing these restrictions when he went to work in Queensland, had “defrauded” Queensland officials “into hiring him as a surgeon” and that he “schemed to hide his history of professional misconduct from hospital and medical licensing officials.” Between April 2003 and April 2005 Dr Patel was paid more than $A400 000 (£185 000; €240 000; $376 000). The extradition complaint also alleges that Dr Patel “operated on one patient and concluded the surgery even though he knew that the patient was still bleeding internally,” removed a healthy gland from another patient while leaving a cancerous one intact, and “performed unnecessary surgeries on patients in poor health when there were less risky alternatives.”

A commission of inquiry into Dr Patel’s performance was set up after complaints by the nurses’ union (BMJ 2005;330:985; doi: 10.1136/bmj.330.7498.985), but on 1 April 2005, a month before the inquiry commenced, Dr Patel, a US citizen, left Australia for the US. Although the inquiry’s preliminary report recommended his extradition (BMJ 2005;330:1468; doi: 10.1136/bmj.330.7506.1468-b), the commission was terminated after a judge found that commissioner Tony Morris, who headed the inquiry, had displayed bias against several witnesses (BMJ 2005;331:536; doi: 10.1136/bmj.331.7516.536-b).

Although Queensland premier Anna Bligh has welcomed the arrest of Dr Patel, legal experts caution that comments by politicians on the case could be used as an argument by Dr Patel’s lawyers against the extradition application. Don Rothwell, professor of international law at the Australian National University, said that the US courts had the discretion to consider arguments as to whether Dr Patel could get a fair trial, given the publicity over the case since 2003.

The extradition application will be heard by the District Court of Oregon on 10 April. Dr Patel has been remanded in custody pending a hearing on whether he is to be granted bail.