This is one of only two annual reports the Board has produced since it was created in 1998, although it is required by law to report to parliament every year. This report was produced after adverse publicity in the press. Although it was tabled in parliament in December 2008 it is currently unavailable to the public. This issue was discussed at length in the Tribune and on Bahama Pundit.
"In July 2004 Ms Leandra Esfakis complained in writing to the Board that there was contributory negligence in the death of her brother, Christopher Esfakis, a burns patient at Doctors Hospital. She continues to write letters to the Board and contributes articles to the newspapers demanding essentially the following:
•The Board must investigate the matter;
•The Board should cause the removal of Mr Barry Rassin as CEO (of Doctors Hospital) because he is not a fit and proper person to run the facility;
•The Board should remove Dr Kirkland Culmer, chairman, from any consideration in the matter because of his affiliation with Doctors Hosptial;
•The Board was illegally constituted;
•The Board at that time was acting beyond the expiratory date of its legal tenure;
•The Board was inefficient, and its members did not know what they were doing;
She also offered detailed suggestions as to how the Board should function.
Because of the gravity and legal implications of the complaint, the Board sought advice from the Attorney-General's Office and its own legal advisors. The Board's position is based on the following:
•It deserves the right to determine what matters it should investigate, and should not be pursued by badgering and personal inuendoes;
•Ms Esfakis sent a copy of the civil action filed against Doctors Hospital and staff reportedly involved;
•The qualifications of (Mr Barry Rassin) were submitted and accepted, and the hospital is duly licensed and has been found at annual inspections to have standards exceeding the scope of the Hospitals & Healthcare Facilities Act and regulations;
•The chairman, Dr Kirkland Culmer, recused himself ffrom consideration of the Esfakis matter at that time, and Dr Eugene Grey was appointed to handle it;
•Advice from the legal member of the Board at the onsetwas that the Board was not obligated to investigate. This opinion was verbally supported by the Ministry's legal advisor. A belated opinion came from the Attorney-General's Office suggesting that the Board should investigate. No guidelines were given, and there are no specific regulations for hospitals in the Act;
•A decision to investigate was made by the Board under the immediate previous chairman, Mr Jerome Gomez, and it was decided that an inspector was to be seconded from PAHO to do the investigation at Doctors Hospital. This did not materialise because it had to be arranged before the local head at PAHO was replaced. The present Board was not officially established before this change took place, and no further action was followed up.
•On the 29th of Februry, 2008 the Coroner's Court handed down a decision that neglect in the care of Christopher Esfakis was not necessarily the cause, but contributed to his death.
•Doctors Hospital has indicated in writing to the Board that from its own investigation and analysis of the Christophr Esfakis case, it recognised that there were two significant oppportunities in the process of care proviuded to Mr Christopher Esfakis to mitigate against such an incident occurring again. They were:
1. Clear terms of empowerment of a person, acting on behalf of the hospital, to intervene in the best interest of patient care and outcome; and
2. Provisions given to the attending registered nurses with a mandate to immediately withhold or defer and inform an agent of the hospital of any physician decision and/or order with which the nurse is uncomfortable or in the opinion of the nurse may prove detrimental to the patient.
In addition the hospital has contracted with an organisation to provide clinical oversight of the Intensive Care Unit and Intermediate Care Units, hired a hospitalist to attend all patients in these units, and has also engaged clinical directors for the various departments within the hospital.
It is obvious from the above that the named infractions involved facility and personnel, so the Board has a clearer picture of its role. A preliminary meeting between the chairman of this Board and the Medical Council was held. The legal committee of the Board is recommending that a medical inspector be appointed to investigate the facility to establish whether or not the matter has been properly addressed by the facility, and the Board and the Council will then decide on further steps to be taken."
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