SCMP Thursday, November 16, 2000

Doctor tells of 'confusion' over epileptic


A doctor who allegedly told the husband of an epileptic woman under his care that he was not responsible for her shortly before she died said at her inquest yesterday there may have been a misunderstanding.
Dr Chan Tai-kin, a medical officer at Ruttonjee Hospital, said he had responsibility for Harinder Veriah, 33, on January 1 and 2 as he was the duty doctor on those days. "But when the patient was admitted to the hospital, she was in fact under the neurology department," said Dr Chan.
Veriah, an ethnic-Indian solicitor from England, had an epileptic fit and collapsed on January 1 while celebrating the millennium in Causeway Bay. She died the next day, shortly after suffering another fit at the hospital.
Veriah's husband, London journalist Martin Jacques, had earlier told the inquest he was angered by an exchange with Dr Chan. The doctor allegedly said Veriah was not his patient and did not say which doctor was responsible for her. Mr Jacques had also said his wife felt she was being discriminated against by the doctors because of her race.
Dr Chan told the inquest: "Normally from Monday to Friday at working hours, it was doctors from the neurology team who were to treat the patients. At weekends after 1pm, it would be the duty doctor who took care [of her].
"I cannot recall [if I had told Mr Jacques that Veriah was not my patient]. But it could be that there was misunderstanding in words because there were two meanings in [the phrase] 'doctor-in-charge'," he said.
Veriah, who had her first major epileptic attack in London in 1995, had been stable since entering the hospital, but at about 8.35am on January 2, she suffered a fit lasting for about five minutes.
Dr Chan ordered a nurse to inject her with a lower-than-normal dose of Valium as she was "of a smaller build". The mother-of-one stopped twitching about one minute later, the inquest heard.
The doctor said an insufficient dose could fail to stop a patient's convulsions. "But the size of an effective dose varies from person to person . . . The patient's consciousness showed obvious improvement after the injection," he said.
Dr Chan then noticed Veriah's blood oxygen level was 90 per cent, above which is considered normal for a physically fit woman. "But I considered her level to be acceptable given [that] her breathing was normal," he said. He had then left the patient as he was satisfied with her condition.
Dr Chan said he did not tell the nurses staying in the room what to do in case Veriah's blood oxygen level dropped. "But I trust the experienced nurses, they are reliable," he said.
Veriah's blood oxygen level later dropped even though a nurse had increased the oxygen input. Dr Chan was called to the room at about 9.05am to revive the patient, who later stopped breathing and had a heart attack.
The case continues today before Coroner Andrew Chan hing-wai.