Earlier this year, Surely Not published our analysis of the statistics presented by Dr Gordian Fulde, Head of Emergency at St Vincent’s. This data had been frequently referred to and used to justify the controversial lockout laws. Predictably, we found the data had been grossly manipulated and misrepresented to support the doctors own pro-lockout agenda. Over the last couple of months a far more disturbing story has been unfolding at St Vincent’s which has been brought to a head today with the release of an interim report from NSW Health.
It has been observed that St Vincent’s has potentially been negligent in their care and treatment over certain cancer patients over a number of years. Senior Oncologist Dr John Grygiel had allegedly been administering patients with incorrect doses of cancer drug carboplatin. Instead of the recommended amount, patients had been receiving roughly half and in some cases only one third of the prescribed dose.
St Vincent’s had been made aware of these allegations in 2015, but opted to not inform patients and allowed the process to continue as normal. In February 2016 when the reports became public knowledge St Vincent’s then opted to lie to the public and cover up what was actually going on. In response the the report airing on the 7.30 Report, a spokesman even went as far as to accuse the program of misleading the public.
“We are concerned the ABC story misleads [on this point] and implies that there has been an adverse impact. There simply hasn’t been.”
St Vincent’s Spokesman David Faktor – smh 19/2/16
Around this time the doctor at the centre of the scandal declared the whole thing to be a “beat up” and claimed no patients were harmed. When asked if he would apologise to affected patients his words were-
“I know that the patients weren’t harmed and they suffered no damage from the lower dose that was administered: so there’s nothing to apologise for”
Dr John Grygiel – Saturday Telegraph 20/2/16
By this stage it was being reported that 70 patients had been affected.
In March further documents revealed the number of patients affected by this case of gross misconduct was in fact 82 (later corrected to 78) What is most horrifying is it appeared this had been condoned by the hospital. It was aware of what was going on and had no intentions of altering their processes. This was despite concern expressed by junior nurses and doctors.
Greens NSW Legislative Council Member Jeremy Buckingham declared a cover up had been committed by St Vincent’s. This issue was extremely close to home for Mr Buckingham, with his own mother-in-law treated for neck cancer at St Vincent’s by Dr Grygiel for two years while the alleged negligence was taking place. Tragically, she passed away in 2013.
“There’s clearly an attempt by St Vincent’s to damage control this situation,” NSW Greens MLC Jeremy Buckingham told 7.30.
“They knew that there were more patients than they revealed. They knew this was happening for far longer than they revealed.
“And that’s of enormous concern.”
NSW Greens MP Jeremy Buckingham – abc 23/3/16
Shadow Health Minister, Walt Secord went even further, calling for a special commission of inquiry with the powers of a standing royal commission to investigate.
These new documents seemed to delight Dr Grygiel and his lawyer, Stephen Blanks, who remarked to 7.30 –
“It’s clear from the documents which have been tabled that St Vincent’s knew about this all through the whole process”
Stephen Blanks, Lawyer for Dr Grygiel – abc 23/13/16
One month later (April 5th) NSW Health released their explosive interim report.
It is a lengthy report and at the time of publishing this piece I’m yet to finish reading. You can read it in full for yourself here. For now I have chosen to highlight two key findings.
“Public statements by St Vincent’s Hospital about Dr Grygiel’s prescribing practices did not fully reflect the magnitude of the issue or its consequences. The initial statements contained important factual errors (reference to the prescribing being taken from an outdated eviQ protocol) as well as key omissions (recurrence or death rates). Further, there was a lack of acknowledgement of the potential distress caused to St Vincent’s cancer patients and their families.”
NSW Health St Vincent’s Interim Report pt 50 – Public Statements by St Vincent’s Hospital
St Vincent’s were dishonest about what they were doing and the impact it was having.
“The hospital’s public statement that “no patients appeared to have suffered any negative impact as a result of the dosage issue” is not accurate because the internal and external reviews did not examine any patient-level outcome data from this off-protocol prescribing. Reference to recurrence rates particularly should not have been made given that neither the internal nor external review quantified these rates. As such, St Vincent’s public statements were misleading. This motivated the external reviewer to send a further email of clarification to St Vincent’s Hospital indicating his concerns about how his response was being used.
NSW Health St Vincent’s Interim Report pt 51 – Public Statements by St Vincent’s Hospital
As discussed earlier in this article, St Vincent’s blatantly lied to the public, the patients, NSW Health, and indeed anyone who would listen. They have deliberately misled everyone to cover up wrongdoing. This conduct would be completely unacceptable for a used car salesman, let along a hospital that is treating cancer patients. The fact a hospital spokesman had the sheer audacity to accuse the ABC & 7.30 Report of misleading the public makes their deception even harder to stomach.
The most disturbing thing of all though is the tragic human cost, with as many as 30 patients negligently treated having passed away prematurely.
There has been extensive media coverage on this story so I’ve included links below to four mainstream media pieces that are well worth reading & viewing.
It appears there is a dangerous policy at St Vincent’s where senior department members run their unit like a small dictatorship, immune from scrutiny and not accountable to anyone. The NSW Health report suggests Dr Grygiel was allowed to continue incorrectly treating patients for an extended period of time. Junior staff members directly challenged this process and sought further explanations for why half and third doses of carboplatin were being administered instead of what was prescribed. They were given no explanation and I can only assume were put in their place. Intimidation and fear are two well known management styles at St Vincent’s.
Executive staff showed no urgency about external or internal reviews on the matter, choosing to ignore alarming information in favour of sticking with the off-protocol conduct of their leading expert.
Whilst this negligence has obviously been far more damaging for all involved, there are similarities to what Dr Fulde had been previously doing with his dodgy data. Once again, we had a single senior department member in total control with nobody to answer to. He has been allowed to manipulate statistics to further an agenda and wield considerable influence in policy discussion. Not to mention the damage to local business his figures are used to justify. One lesson learned from the Dr Grygiel scandal is just how dangerous it can be to allow one employee to have so much power and control.
Dr Fulde has had his statistical data thoroughly dissected and dismantled firstly by yours truly and then again by Matt Barrie in his latest LinkedIn essay. The bombshell dropped by NSW Health today along with evidence already published means only one thing. Dr Fulde and his alleged statistical fraud must immediately be the subject a formal investigation.
I call on Group CEO Mr Toby Hall, Sydney CEO Associate Professor Anthony Schemberi and the St Vincent’s Hospital Sydney Human Research Ethics Committee to investigate the conduct of Dr Fulde. You have already allowed one cowboy to to operate freely for years, how many more mavericks are currently practising unsupervised? How many more patients are at risk?
And I call on the Australian Medical Journal to remove Dr Fulde’s publication – “Presentations with alcohol-related serious injury to a major Sydney trauma hospital after 2014 changes to liquor laws” from their website and publish a retraction.
Certain individuals at St Vincent’s seem to believe the hospital is theirs to govern. They feel the hospital has a different set of laws to adhere to, much like the Vatican or the casino. Their conduct detracts from all the exceptional work done by the vast majority of doctors and nurses who work there. It’s time to put an attend to these blatant abuses of power.
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