Dear Editor,
As a medical intern, Dr. Madhu Singh was my supervising Consultant, thus I do have the greatest of respect for her. However, today, respect aside, I do have a few questions on a missive authored by her, pertaining to one Mrs. Wonder Kellman-Hall, published in two dailies:
1. Medical records by law are the property of the patient. As a result, if a patient request their medical records, it should be provided forthwith. However, Mrs. Hall alleges that she has requested her medical records which to date aren’t forthcoming. Thus, my question for Dr. Madhu Singh. Is the withholding of these medical records consistent with international medical standards? Would Dr. Singh concur that withholding these medical records is in itself a negative inference?
2. Barring an embryological abnormality, which is extremely rare, a woman would have two ovaries. If, as Dr. Singh alleges, she removed one, then what happened with the second? For an independent, ultrasound scan revealed that both ovaries were absent.
3. Considering the rarity of a woman having one ovary, the evidence is pointing towards the fact that both ovaries were removed by Dr. Madhu Singh. As Dr. Singh may be aware, barring minimal oestrogen from the paired adrenal glands, the ovaries are the predominant sources of female hormones. Further, as Dr. Singh may be aware, the abrupt removal of these oestrogen sources could’ve precipitated a catastrophic heart attack, in the absence of Hormone Replacement Therapy (HRT).Thus my question to Dr. Madhu Singh – why wasn’t this patient prescribed HRT or at least a discussion of it? Further, would Dr. Singh concur that not prescribing HRT placed Mrs. Hall life at risk? Furthermore, would Dr. Singh concur not prescribing HRT falls way below international standards?
4. The fact is, patients aren’t medical professionals, hence, they are likely to forget 99% of that told by their doctor. As a result, international standards dictates, all patients discharged are provided written documentation of all procedure and hospital interventions. Thus my question to Dr. Singh – would Dr. Singh agree by discharging this patient, who has had a complicated surgery, without any written documentation, falls way below international medical standards, which she so frequently alluded to?
Thus, for the following reasons I do believe the patient;
1. She wasn’t provided written documentation on discharge.
2. She wasn’t providing life-saving HRT on discharge.
3. She was forced to seek a second opinion.
4. Both ovaries were removed, despite Dr. Singh denials. For even if one buys the argument that one ovary was complicated with bleeding, what was the justification for removing the second?
As a result, with all things considered, I am inclined to believe Mrs. Hall.
Therefore, considering the available facts, Dr. Singh’s explanation makes no medical sense. In fact, being a consultant, the burden of proof is on her to prove that she only removed one ovary. Being a consultant she has to explain why she discharged the patient without lifesaving HRT. Being a consultant, she would have to explain why the patient was discharged without any written medical documentation. Being a consultant she’ll have to explain her post-operative ultrasound scan evidencing one ovary, whilst the independent ultrasound scan failed to identify an ovary.
The fact is, I have written ad nauseam of the need for regulation of hospital facilities and doctors. Unfortunately, many of the private hospitals and senior doctors are in bed with PPP. And for this reason, there are absent regulation of both doctors and private institutions. As a result, we will continue to read stories of many unexpected deaths, along with patients living with the consequences of malpractice and negligence.
Regards
Dr. M. A. Devonish MBBS MSc
MRCP(UK) FRCP(Edin) FRCP
Consultant Acute Medicine
Nottingham University Hospital
