ATTORNEY ANAND RAMLOGAN is ready to shake things up in this country’s medical fraternity.
In a recent telephone interview with the Sunday Express, Ramlogan said, “There are too many people who have been the victims of medical negligence in this country and they are left to languish and suffer without any hope of remedy.”
Ramlogan, who wrote a new chapter in the nation’s history last year, when he won a rare medical negligence case, representing 25-year-old Rana Ramlal against the South West Regional Health Authority (SWRHA) over the death of Ramlal’s newborn baby, insists too many citizens continue to fall victim to medical negligence today.
Ramlogan identified the core of the problem as a lack of expert medical evidence to support medical negligence claims.
“You cannot win a medical negligence case unless you have expert medical evidence,” Ramlogan said.
He explained, however, that only the doctors themselves had the kind of expertise needed to win medical negligence cases.
Ramlogan described the conundrum as “virtually insurmountable,” and pointed out that in the last forty years, there have only been two High Court judgments concerning medical negligence.
“And that is not a reflection of the wonderful state of the medical practice in Trinidad and Tobago. It is, rather, a sad reflection of a deficiency on the part of our society,” Ramlogan said, underscoring that the lack of High Court judgments pointed to the more deep-seated issue of a kind of complicity among local doctors.
“The reason why we do not have any jurisprudence on medical negligence is that the medical fraternity, like the legal profession, is very close-knit,” Ramlogan stated.
“Because we live in such a small society, it is virtually impossible to find doctors from the local profession who are willing to testify against their colleagues.” Ramlogan described how doctors avoid “betraying” their colleagues.
“They escape it by two things, either calling astronomical fees or, alternatively, saying that they are willing to give advice behind the scenes. But they’re simply not willing to subject themselves to cross-examination in court. And the reason for that is that they’ll become ostracised and they’ll be looked upon with scorn, as if they’ve somehow betrayed their colleagues,” Ramlogan said.
He added that many victims of medical negligence chose to sign lucrative out-of-court settlements with binding confidentiality clauses before summarily condemning all these techniques used by doctors to protect their colleagues. That behaviour, Ramlogan insisted, is inconsistent with the fundamental principles outlined by the Hippocratic Oath.
“I think one implication of the Hippocratic Oath is that you will stand up and point out the bad eggs where there is gross malpractice and medical negligence,” Ramlogan said. To believe that the doctors’ behaviour would change, said Ramlogan, would be “wishful thinking.”
All the same, the lawyer announced that he has already filed about 25 cases of medical negligence, calling particular attention to a concentration in these cases in the areas of obstetrics, gynaecology and orthopedics. In addition, Ramlogan called for the establishment of a disciplinary authority to receive and assess medical complaints, suggesting that the current problem of medical negligence could be addressed by the establishment of a three-member panel comprising a non-Trinidadian chairman, a medical expert and a member of the legal profession.
“There are no doctors in Trinidad and Tobago who are willing to testify against their colleagues,” he repeated.
“The reason doctors are so flippant and casual about medical negligence is they know no-one can sue them. So a patient who complains about negligence, they just get a run-around and eventually they get frustrated.” Ramlogan spread the blame for the current problem, pointing a finger at the victims, who sometimes accept settlements, at members of the legal profession, at politicians and, ultimately, the doctors themselves.
“The time will come when we’ll start importing doctors,” Ramlogan said, sounding a battle cry against the medical fraternity, “And when they come to testify against you, the standard of care to which they are accustomed might be higher than the one to which you are accustomed. And they’ll be dragging you by the bootstraps.”
Ramlogan made a point to mention that he was already in the process of bringing in foreign doctors to testify in medical negligence cases.
The good doctors, he pointed out, have nothing to fear.