Can you respect the professionalism of a nurse? Argument with a nurse.. Patient dies, Indian doctor in Ireland apologizes in court and confesses

Dublin: Unlike in Ireland, when the doctor calls, nurses don't stand around waiting for you, If you call a nurse, they won't just walk with you and do things like in India, file...!! the medical facilities...!! yes everything, You will have to take your own.. what you need, and do it. No one needs to teach anyone, No one is great, don't waste your time, do your work and go home. That's the culture in Ireland, every job is respected. 

But the Indian doctor working in Ireland tried to make it all the same as in his homeland, and did not take into account the professionalism and knowledge of the nurse. He worked under the cover of his ego, saying, "I... I'm the only one." Not everyone, some, yes.. that's what happened here. That is, the doctor finally admitted that professional misconduct occurred in the patient's death following an argument with the nurse over the removal of the breathing tube.

Anaesthetist Ilangathir Sativel appeared before a medical inquest to face allegations relating to the treatment of a patient while working as a registrar anaesthetist at Connolly Hospital in Blanchardstown on 23-24 February 2019. The subsequent inquest found that the doctor admitted professional misconduct in an incident in which oxygen levels to the brain of a patient with meningitis fell fatally following an argument with nursing staff over whether to remove a breathing tube.

A hearing before the Medical Council's fitness-to-practice committee found that there were a number of complaints against Dr Sativel in relation to the care he provided to a 59-year-old man who was admitted to the hospital's intensive care unit following a diagnosis of bacterial meningitis.

The committee was told that Dr Sativel had accepted that it was professional misconduct to disregard the statement of Clinical Nurse Manager Rosanne Kenny that the patient’s breathing tube had become dislodged at around 3.58am on 24 February 2019. Written statements from several nursing staff at CHB show that Ms Kenny had twice raised concerns with the anaesthetist that the tube had become dislodged as ventilation alarms were sounding to indicate that the patient was experiencing a lack of oxygen.

However, Dr Sativel insisted that the tube had been inserted correctly and was not responsible for the patient's condition deteriorating. But Neesa Bird BL, a lawyer for the Medical Council, said the anaesthetist's disregard for the nurse's concerns was a serious failure to meet the standards expected of medical practitioners. 

Although Dr. Sativel responded immediately to the call for help, Ms Bird said that he had carried out an assessment of the patient's airway from the bedside. She claimed that he had observed the patient's chest rise and that the tube had not been removed from the stethoscope and that he had relied on his observation without performing a visual inspection of the equipment. The inquest found that he had delayed reintubating the patient and attempting to perform a laryngoscopy to assess the position of the tube. The inquest found that at 4.15am, Patient A suffered a 13-minute cardiac arrest due to lack of oxygen, which caused severe brain damage. Although meningitis was a contributing factor, a post-mortem examination found that he died on 2 March 2019 from lack of oxygen to the brain.

It was Dr Sativel’s first shift as an on-call registrar in the hospital’s ICU. However, she said the challenges of the role must be related to the anaesthetist’s competence. Ms Bird said it was clear from the views of two expert witnesses who reviewed the case that Dr Sativel’s failure to deal with the critical incident in a timely manner had led to an “adverse outcome”. The investigation was launched following a complaint to the Medical Council by the then general manager of CHB, Barbara Keogh Dunne. Ms Bird said an internal review by CHB into the serious incident had raised concerns that Dr Sativel’s competence could have put patient safety at risk.

Dr Sativel, an Indian national who qualified as a doctor in 2005, has been registered to practice in Ireland since 2012 and is currently working as a consultant anaesthetist at the Mater Private Hospital in Dublin. The anaesthetist admitted a number of other allegations relating to his treatment of the patient and accepted that they amounted to poor professional performance. He failed to adequately assess the patient’s airway in a timely manner and failed to adequately consider the man’s deteriorating condition after his skin turned blue and his heart rate slowed to a dangerous level.

Dr Sativel admitted that he had not written a medical note about the patient’s treatment in the emergency department for 12 hours and that he had failed to inform and provide information to the consultant anaesthetist at CHB in a timely manner about the serious incident. Expressing his condolences and apologising to the patient’s family, Dr Sativel’s lawyer, Cathal Murphy BL, accepted that the allegations against his client related to a serious and tragic incident. However, Mr Murphy said that what happened to Patient A was an “isolated incident” in the anaesthetist’s career and was not due to incompetence but to “human factors”.

Dr. Sativel has taken steps to improve his skills in the following years, has been a consultant since 2020, and there have been no further incidents regarding his performance and skills, his lawyer said. 

Mr Murphy claimed that the appropriate sentence for his client was a censure. However, Ms Bird asked the fitness-to-practise committee to take into account that the admission made by Dr Sativel related to a "serious matter". 

Based on the complaints, the fitness-to-practice committee will submit recommendations regarding approval to the Medical Council in due course, said Paul Harkin, the chair of the inquiry, but they have not yet been made public.

Credit: AP