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DOC DRILLED
Dr Viola Adele Bell leaving court after a previous appearance there to testify. (FP)
Published on: 9/22/2009.
by MARIA BRADSHAW
DR VIOLA ADELE BELL yesterday said she had no specialist training in anaesthesiology but administered the potent anaesthetic drug Propofol to about 30 patients.
The doctor was testifying at the coroner's inquest into the death of Anthea Burgess, 30, who died on the operating table of ENT specialist Denis Bailey, on April 25, 2007, when she went to have a polyp removed from her nose.
During an extensive examination by Queen's Counsel Sir Richard Cheltenham, the doctor of 40 years experience said apart from her medical degree training, she had also read books on anaesthesiology and honed her skills on the job.
She told coroner Faith Marshall-Harris she "deeply regretted" the Burgess' death but did not think she had done anything wrong and she was still puzzled as to why Burgess stopped breathing.
"This is the worst thing that has ever happened to me in medicine. No one wants to lose a patient," she said during two hours of questioning by attorneys.
Asked by Sir Richard if Burgess's blue lips suggested a lack of oxygen, Bell said a nasal pack had been inserted in only one of her nostrils and that it was not necessary to give oxygen in a 15 to 30-minute operation.
But Sir Richard suggested that because there was a nasal pack in one of the nostrils, it meant that it was important to find other ways to oxygenate the patient.
Bell responded she did not believe that oxygen would have helped the patient.
When Sir Richard put it to her that the manufacturers of Propofol wrote that the drug was very complicated and should be administered in a hospital setting, Bell said she was not aware of the direction.
On the painkiller, Voltarin, which she also administered to Burgess, Bell rejected reports by Bailey that she gave the drug undiluted and by IV push.
Referring to her medical chart, Bell said the drug was diluted with 10 ccs of saline and administered slowly over five minutes - between 10:20 a.m. and 10:25 a.m.
She said Bailey suggested they switch to Voltarin because some patients complained about the other painkiller.
Attorney-at-law Pilgrim produced a copy of the manufacturers' instructions which indicated that Voltarin should be given intravenously, must be diluted with saline or glucose, must be prepared with a buffer solution of bicarbonate soda, and 75 mg should be administered over a period of 30 minutes to two hours.
Bell said she did not follow these instructions.
Pilgrim suggested the doctor deliberately left out of her police report that she administered Voltarin, but Bell denied it was deliberate.
Coroner Faith Marshall-Harris asked Bell if she was aware that the manufacturer of Propofol suggested that it should only be given under hospital conditions.
Bell responded that some doctors did not always follow the manufacturers' specifications for some drugs.
"But you recognise that once you decide to go against it you are taking a risk?" the coroner asked.
The doctor told the court there was a time when she did not practise for three years because of a problem with paperwork arriving here from England after she had been ill, but stated that during those three years she continued to attend medical conferences.
She said she had never been debarred from practising medicine.
27 comment found!
Dying Art of Anesthesiology : 9/28/2009
Anesthesiology is a "Dying" art, no pun intended. Any physician can read books now and become an anesthesiologist!! The outcome of this case will be interesting to see. The facts are as clear as crystal.
Responsibility : 9/28/2009
If one entrusts a professional to take due care of their affairs, then, the ultimate responsibility must lie with that "professional". Even though those partnered professionals in carrying out their duty must share the responsiblity, the contracted professional must be accountable. Not rocket science!
Doc Drilled : 9/28/2009
For folks that have been saying that this has nothing to do with the Michael Jackson case, the similarity is that once again a physician that was not properly trained as an anesthesiologist was acting as one. Totally unacceptable in both cases! Even though Michael Jackson's demise occurred in his home and clearly did not have the appropriate controls and monitoring, Ms. Burgess' case is worse, since her death occurred in a medical setting. Barbados Association of Medical Practitioners (BAMP)needs to address this type of practice!!
Doc Drilled : 9/28/2009
Michael Jackson all over again. A doctor not trained in anesthesiology performing as one. NOT GOOD MEDICINE!! Only those physicians with the propoer qualifications and training should be allowed in the operating room.
Broken trust/Dr Dennis : 9/27/2009
We as trained professionals owe it to those persons entrusted to our care to provide them with the highest quality of care and professional practice. Anthea trusted her ENT specialist to act in her best interest and to work with professionals to act on her behalf. Dr. Dennis should have known that DR. Belle was not qualified to administer the medication and asked the hospital to provide someone who was qualified to do so.
Dr. Belle : 9/27/2009
Sincere condolences to the burgess family. Sympathy to Dr. Belle someone I knew more than 20 Yrs ago while working in Bdos. This case screams for some additional control on office surgery. This case appears to be a clear deviation from the acceptable norms of practice.
Doc Drilled - 9/22/09 : 9/24/2009
Dr. Bell, labels on all medications are placed there for very important reasons. If an unlearnt peasant like me, is aware of this, you should be. How can you say that "some doctors did not always follow the manufacturer's specifications for some drugs", and of all drugs Propofol, which should have been administered in a Hospital Setting. As a Doctor, you should have taken note of this rerquirement, and refuse to administer this drug outside of the required setting. This don't carish attitude is truely troubling, and I am praying that they are not many of your ilk practicing medicine in Barbados. May God be with you.
Not easy for anyone involved! : 9/24/2009
I am following this case with a very heavy heart. The death of Anthea Burgess truly pains me and I offer sincere condolences to her loved ones. I have had some interaction with both doctors involved and have found them to be wonderful competent people in the specific cases in which I was involved. I feel their pain and also wish them the very best in this situation. May this be resolved to the satisfaction of Anthea's family and may Drs. Bailey and Belle take heed of the very important lessons to be learnt here. May God bless all parties concerned.
Relevance : 9/23/2009
what is the relevance of honing in on the voltaren IV over 5 minutes???
Troubling : 9/23/2009
What could have been the hold up in paper work that 3 years elapsed, before the doctor could set up practice here? I am also wondering whether the 30 patients she administered the drug to were patients of her own, Dr. Bailey or other medical colleagues? I have to agree with another writer, that many of us take certification, qualifications and training for granted, and do not ask enough questions of people who are providing services in our community. Both of these individuals are culpable in my opinion, because if you are not an anesthesiologist, you could not be invited into my clinic to practice!!!
Why : 9/23/2009
Why is it that some blogs are removed from certain articles for whatever reason and articles with little or no substance remain. Please tell me why?
Doctors : 9/22/2009
What a coincidence. Speaking of Dr. Murray, MJ's doctor, if I am not mistaken, his father and I were very close friends in Grenada.
DR.QUESTION. : 9/22/2009
SORRY SORRY SORRY BUT PEOPLE IN BARBADOS ESPECIALLY PROFESSIONALS DO NOT LIKE ANYONE TO TELL THEM ANYTHING ABOUT ANYTHING.AND WHEN IT COMES TO DRS. YOU DEAR NOT SAY ANYTHING TO THEM MOST OF THEM THINK THEY ARE GODS SO SORRY SORRY SORRY.DR.SAY YOUR PRAYERS AND GOD HELP YOU THAT IT ALL I HAVE TO SAY.
: 9/22/2009
It seeems to me that this Dr. Bell seems to think she is a God. Either that or that her patients are sheep. I would not have an ingrown nail fixed in Barbados.
: 9/22/2009
Even if a patient is in surgery for a short space of time when powerful anestestics are administered the protocol is to have a licensed anesthesiologist or a registered nurse anestetist standing by with oxygen and a crash cart just in case the patient codes on the table. How is it that a doctor of 40 years believes that it is ok to study the administration of anesthesia by just reading books, or half ass reading drug labels and giving a patient an undiluted painkiller via IV push! This is what we call a God Complex! She said that she had never been debarred from practising medicine, well now is the time!
INQUIRY : 9/22/2009
While I agree with the comments of FR A BAJAN IN GA, I am inclined to inquire as to whether the practices employed in this particular case are isolated or systematic of the medical profession in Barbados. The reason for such inquiry is not to disparage the medical profession in Barbados but rather an expression of bewilderment as to why such experienced medical practitioners would seemingly take such pointless risks.
: 9/22/2009
Dr. Viola Adele Bell I pray that God be with you in these difficult times
: 9/22/2009
where is the third comment?
: 9/22/2009
Why are some comentators comparing this case to Michael Jackson, Anthea Burgess went in for local surgery I thought the inquest was being held to find out if the doctors involved were neglegent when administering the required medication or this was a tragedy that could not be avoided. Poor Michael Jackson was addicted to the different types of medication his doctor was giving him that it came to the stage whereby it was being increased constantly which eventually killed him here is a different type of neglegent therefore the two cases should be viewed differently
: 9/22/2009
This is a completely different situation from Michael Jackson. The only similarity is that propofol is involved. It is highly unlikely that the propofol is the cause of death in this instance and I think everyone, including the court of inquiry, is missing the real issue here if they are focussing on which drugs were used. These procedures need to be done in a monitored setting with access to supportive measures and qualified individuals. What I'm curious about is whether or not it was actually a simple polyp which was biopsied or something else.
Dr Death! : 9/22/2009
Do not class this young lady with Michael J, he was doing all kinks of drugs for years. While his family and friends stood by and watch,this Doctor just happen to be the last one that was treating him unfortunately.He had a problem with who he was it was just a matter of time before he fell apart. Annoyed!
DOC DRILLED : 9/22/2009
I HOPE THIS IS A WAKE-UP CALL TO ALL, TO TAKE AN ACTIVE ROLE IN THEIR MEDICAL CARE. KNOW WHAT YOUR DOCTOR IS QUALIFIED TO DO DON'T BE INTIMIDATED, ASK ABOUT THEIR EDUACATION AND TRAINING. ASK HOW MANY OF THE SURGERIES THEY HAVE PERFORMED AND THE LIST CAN GO ON. I'M LOOKING FORWARD TO SEE THE OUTCOME OF THIS CASE. FR A BAJAN IN GA.
: 9/22/2009
I am at a loss for a comment on this one. I would like to know if there was any answer to the last question posed by the coroner? To Bajan Yankee: It did not "happen again", this happened well before.
SAD CASE : 9/22/2009
I will be watching the progress of this case,quite interesting.My sympaty goes out the the family of Anthea Burgess .
IT HAPPEN AGAIN : 9/22/2009
After reading this it seem to me like the same thing that happen to Michael Jackson all that I have read about his death this case sound like it is heading the same way
: 9/22/2009
Dr. Bell. : 9/22/2009
The doctor that gave Micheal Jackson these same drugs is in big trouble as reported,so I`m looking to see what`s the outcome of this case and if the family will file a suit. BkNY.
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