Licensed for Life: A stroke finally moves the Medical Board to take decisive action

(Read Part 1 here.)

An autopsy revealed the damage Dr. Madhusudhan T. Gupta had done.

The patient identified only as E.T. in Medical Board documents had entered the hospital alive, with a slow heart rate. She died a few hours later after Gupta had tried to insert a pacemaker into her artery instead of her vein.

The autopsy found multiple puncture wounds in her left subclavian artery and bruising, too. The cause of death was declared to be “hemorrhagic shock resulting from exsanguination due to complications associated with placement of the pacemaker,” according to Medical Board documents. In simpler terms, the pacemaker was poorly inserted, tore up her insides, and caused her to bleed to death.

The Medical Board of California called that gross negligence. The board also noted that Gupta should have known that E.T. was on anticoagulant medication and would have badly needed a platelet transfusion because of her internal bleeding. Gupta didn’t give her the transfusion. The board described this as repeated acts of negligence.

E.T.’s daughter sued Gupta. And in December 2010, he was deposed. He was asked whether he had confirmed that he was inserting the pacemaker into the subclavian vein and not the subclavian artery. Gupta said under oath that he had checked the blood flow and the color to confirm that he was in the right place.

The Medical Board would later call that dishonesty. Board documents state:

Patient E.T. had normal oxygen saturation and high blood pressure at the start of the procedure, making it impossible for a competent, experienced cardiologist to confuse the flow and color of arterial blood as venous blood. In truth and fact, [Gupta] told Dr. B.N. upon Dr. B.N.’s arrival at the catheterization laboratory, that he had entered patient E.T.’s artery, and [Gupta] stated in his operative report that ‘[i]nitially, left subclavian artery was entered by Sedlinger technique.’

When the Medical Board asked Gupta about the same thing, he repeated the same claim. He knew what he was doing. He confirmed that he was inserting the pacemaker into the vein, not the artery.

The board filed an accusation against Gupta, on April 23, 2013. The accusation stemmed from a complaint filed with the Medical Board in 2011. (The year in the accusation number filed by the board is based on the date a complaint was filed.) This is, in all likelihood, when the Medical Board became aware of the lawsuit against Gupta.

The Board followed up with an amended accusation on June 15, 2015.

The new accusation provided new clues as to what might have been leading to some of Gupta’s decision-making. His health had been deteriorating. And in April 2014, he suffered an “intracranial hemorrhage,” according to Medical Board documents. The documents said that, as a result, Gupta was left with:

Muscular weakness or partial paralysis restricted to one side of the body.

Loss of the ability to produce language

A common form of dementia caused by an impaired supply of blood to the brain, such as may be caused by a series of small strokes.

Shrinking of the brain caused by the loss of its cells, called neurons.

The board declared that Gupta’s “condition is considered permanent and unlikely to change in the future.”

On Sept. 29, 2015, Gupta’s license was finally taken away by the Medical Board. One could declare it a victory for the Medical Board, but consider the circumstances. Gupta had suffered a stroke that, according to Medical Board documents, “has rendered him unable to make decisions on his own behalf.”

Note the dates. Gupta suffered a life-altering stroke in April 2014. The Board took his license away in September 2015.

So for 18 months, Gupta maintained a valid medical license, even though he was unable to communicate.  

The Medical Board had to negotiate with Gupta’s attorney. The attorney waived all rights for Gupta to contest the charges but, as is usually the case with stipulated disciplinary agreements with the Medical Board, the attorney also only agreed to a few specific items in the accusation.

Medical Board documents show that Gupta “admits the complete truth and accuracy of the cause of action … as alleged in Paragraph 8 in First Amended Accusation No. 09-2011-217440 and agrees that cause exists for action” under state code. That’s the part about Gupta having a stroke, a fact that would be hard to argue against.

He also conceded in the documents that the Medical Board could make a good case against him in regard to “the charges and allegations in Paragraph 10 of the First Amended Accusation No. 09-2011-217440 and that he has thereby subjected his Physician’s and Surgeon’s Certificate No. A38511 to disciplinary action.” That’s the part about the repeated negligent acts.

As for the rest, Gupta’s attorney does not say.

Does it really matter that the Medical Board took so long to remove the license of a physician whose health had deteriorated so badly that he had lost the ability to use one half of his body and to speak?

Ask the patients who were seen by Gupta. Wouldn’t they want to know that a debilitating stroke was enough to retire his license for good?

It might seem like a minor error by the Medical Board of California, but it is worth noting in a case this serious that the board couldn’t even spell the accused physician’s name right. Two years after it filed charges against the doctor, it filed an amendment to correct the spelling of his name.

Related post

Licensed for Life: Pacemaker procedure gone wrong leaves patient dead

File photo by Phalinn Ooi via Flickr.