A Foothill Ranch doctor with a history of insufficient record keeping is, again, facing reprimand by the state medical board. This time it's for doing an unsuccessful procedure and then not making a proper diagnosis.
Although the board could have revoked Dr. Bakulkumar Kantilal Patel's license, they gave him five years of probation, which takes effect today at 5 p.m.
Patel is accused of various causes of discipline stemming from an incident in 2005: gross negligence, repeated negligent acts, incompetence, and failure to maintain adequate, accurate records, according to the board's decision.
In November of 2005, a 62-year-old woman, who had recently returned from a trip to Turkey, came to Patel complaining of stomach pain and diarrhea.
A few days later she came back to the office for an endoscopy in hopes of finding what was causing the pain.
According to board documents, Patel didn't document his pre-operation exam. Then, he sedated the patient and started the procedure. He had some difficulties, though, and it ended up taking longer than expected -- about 45 minutes. The patient left around 10 a.m. and was asked to come back in a few days later to talk about the results.
By noon, she was in a lot of pain and her throat, neck and face started to swell. Around 2 p.m., she went back to Patel's office and he took some X-rays. He noted some gas in the neck, but interpreted the X-rays as "normal," the document states, although they weren't. Patel had perforated her esophagus during the procedure.
He thought the swelling might be an allergic reaction to the anesthesia from the procedure, so he gave her a steroid and painkiller and sent her home.
By 5 p.m., her chest hurt and the swelling had increased. She called Patel and he told her to take an over-the-counter pill for gas and use ice to ease the swelling. He didn't, however, document the conversation.
Still in pain, she called again and the on-call physician told her to go to the emergency room, where she was diagnosed with a perforated esophagus. She had emergency surgery and eventually another corrective surgery. She was hospitalized for three weeks. His "failure to diagnose the esophageal perforation and obtain prompt treatment jeopardized his patient's life, made repair of the perforation more complicated, and made her recovery more difficult," the board writes.
Patel didn't admit to the allegations, the document states, but agreed that at an administrative hearing there might be sufficient evidence of wrongdoing, so he agreed to the five-year probation term.
As part of his probation, Patel has to take a clinical training program and he can't do any gastroenterological procedures until that's complete and he gets the board's approval. In 2002, the board reprimanded Patel for "repeated negligent acts related to record-keeping," documents show.
Patel hasn't returned a call for comment.