Family of "Patient A" Welcome Decision to Erase Surgeon from Medical Register

The ruling has attracted significant attention in both local and national media. While details of the tribunal proceedings have already been widely reported, the family of the patient, who wish to remain anonymous, have agreed to share further information about the impact the events had on their loved one and the circumstances that led to their legal claim.

To protect the family's privacy, he will continue to be referred to as "Patient A".

Patient A was a graduate and financial services professional with what his family describe as a bright future ahead of him. He was a much-loved son, stepson, brother and uncle whose death has left a lasting impact on those closest to him.

In August 2020, Patient A underwent investigations after becoming unwell. A pre-operative CT scan identified a large abscess in the left flank area and a suspected perforated small bowel.

On 25 August 2020, he consented to undergo an exploratory laparotomy, small bowel resection and gastrojejunostomy at Royal Oldham Hospital. The procedure was performed by Dr Rahman.

Medical records show that when Dr Rahman reviewed Patient A on 27 August 2020, it was recorded that the intended surgical procedure had been successfully completed and that he would require chemotherapy treatment in the future.

Over the following weeks, Patient A's condition worsened.

On 12 September 2020, medical records noted that he was coughing up and regurgitating bilious fluid.

Just days later, on 16 September 2020, he underwent further major surgery. The procedure, carried out by another surgeon, Mr Rate, involved a laparotomy, small bowel resection, reversal of the gastrojejunostomy, transverse colectomy, proximal double-barrelled jejunostomy, small bowel anastomosis and right colonic mucus fistula.

According to the operation notes, surgeons discovered that the proximal jejunum, approximately 20cm from the duodenojejunal flexure, had been connected directly to the stomach, creating a continuous loop. The notes stated that this meant gastric contents could not travel through the gastrointestinal tract beyond that loop.

Histology samples taken during the operation confirmed that Patient A had large B-cell lymphoma.

Following the corrective surgery, Patient A was transferred to intensive care before later returning to a surgical ward on 23 September 2020.

The surgery left him with a high-output stoma, which he required for the remainder of his life. He also became dependent on long-term parenteral nutrition.

Despite these complications, treatment for his cancer progressed.

On 21 October 2020, Patient A commenced R-CHOP chemotherapy, a standard treatment used for large B-cell lymphoma.

He ultimately underwent six cycles of chemotherapy. However, expert evidence later obtained during the legal investigation concluded that the chemotherapy was delivered at a reduced dose intensity because of his condition following the initial surgery and the significant recovery period that followed.

As part of the family's legal claim, expert evidence was obtained from oncology specialists to assess the impact of the surgical treatment on Patient A's prognosis.

According to that evidence, had the initial surgery on 25 August 2020 been performed correctly, Patient A would likely have recovered within approximately three weeks and would have been assessed as having a performance status of one, rather than two.

The expert evidence further concluded that this difference was significant because it would likely have enabled him to receive R-CHOP chemotherapy at full dose intensity rather than at a reduced level.

The report stated that this would also have altered his prognostic risk category from a high-intermediate risk group to a low-intermediate risk group.

Evidence relied upon during the claim referenced published lymphoma survival data which indicated substantially better long-term outcomes for patients within the low-intermediate risk category compared with those in the high-intermediate group.

Tragically, Patient A died in May 2021. Mr Rate’s surgical intervention merely prolonged his life; it did not save ‘Patient A’.

His death was attributed to disseminated lymphoma, immunosuppressive therapy and complications arising from gastrointestinal surgery.

Medical experts instructed during the legal case accepted that it can never be known with certainty whether Patient A would ultimately have survived his illness had the initial surgery been performed correctly.

However, the evidence obtained on behalf of his family concluded that he lost the opportunity to undergo cancer treatment in the best possible condition and therefore lost a significant chance of achieving a better outcome.

The family's legal team say the MPTS decision marks an important moment in a long search for answers and accountability.

The tribunal heard evidence relating to Dr Rahman's conduct and clinical practice. The subsequent decision to erase him from the medical register means he can no longer practise medicine in the United Kingdom.

For Patient A's family, the outcome concludes a lengthy process that began with a desire to understand what happened to their loved one and whether anything could have been done differently.

Yunesh Yeeranah, lawyer at Slater and Gordon, who represented the family, said:

"Throughout this process, Patient A's family have shown remarkable courage, dignity and resilience. Their primary objective was always to obtain answers and accountability for what happened to their loved one.

"This has been an extremely lengthy and complex investigation, and while no outcome can ever undo the loss they have suffered, they hope the tribunal's decision provides some sense of closure.

"Patient A was a young man with a promising future ahead of him. He was deeply loved by his family, who now wish to focus on remembering him for the person he was rather than the circumstances surrounding his death."