Debarred gynaecologist had alcohol problem

Press, 17 June 1988, Page 8

Debarred gynaecologist had alcohol problem

PA Wellington Alcohol was the downfall of the recently-suspended Wanganui gynaecologist and obstetrician, Rajakumar Gulasekharam, according to a report made public by the Medical Council yesterday.

The report, which led to Dr Gulasekharam’s removal from the specialists’ register and foreshadowed his suspension from practice by the council last Thursday, was prepared by a threestrong committee of inquiry into the doctor’s competence. It details the complaints of eight women treated by Dr Gulasekharam at Wanganui Hospital between mid--1985 and March this year. In one, Dr Gulasekharam delivered a baby while under the influence of alcohol then sutured part of the mother’s vagina to her thigh, leaving the suture paper envelope inside her vagina. He was trying to repair an episiotomy — an incision sometimes made before childbirth in the vulva margin to enlarge the area through which

the baby’s head passes. Another specialist at the hospital later said the suture had to be removed and corrective surgery performed on the episiotomy, which had broken down and become infected.

Dr Gulasekharam’s technique in this case was seriously deficient, the committee said. "No obstetrician and gynaecologist could have stitched the episiotomy in such a fashion unless seriously impaired.”

Dr Gulasekharam denied he had been drinking before the birth when interviewed by the committee but it was known he had a drinking problem at the time and an independent witness supported the complainant’s claim that he smelt of alcohol. In June, 1985, Dr Gu-

lasekharam sought treatment for his alcohol problem at Queen Mary Hospital in Hanmer, the report said. But he continued to drink alcohol until at least as recently as early this year. The committee said three of the eight complaints against him did not give rise to any question relating to his competence. These allegations were: ® That a baby died shortly after birth because of his decision not to proceed to caesarean section. ® That he failed to correctly diagnose an infection in a woman’s pelvic cavity and abdominal wall after surgery. • That he did not follow correct procedure after an unsuccessful attempt to terminate a pregnancy.

Four of the other complaints related to: ® An allegation that a baby suffered brain damage" because of Dr Gulasekharam’s delivery procedures. • An allegation that his removal of a woman’s tube and ovary for an ovarian cyst resulted in damage to the left ureter and led to the formation of a uro cyst that required later surgery. • An allegation that he failed to evacuate a woman’s uterus after terminating her pregnancy. The woman expelled the foetus at home the next day. ® An allegation that he incorrectly performed an abortion leading to perforation of the woman’s uterus. The committee said those complaints were the result of an error of judg-

ment, medical misadventure, mistake resulting from undue caution, and medical misadventure, respectively. They were isolated incidents which, on their own, did not indicate incompetence, the committee said, but the cumulative effect raised a question of Dr Gulasekharam’s overall competence. It was the first complaint, and the related alcohol use, which concerned the committee most. Dr Gulasekharam was asked to obtain an up-to-date medical assessment of himself. The resulting reports, from doctors in Wellington and Wanganui, showed he was continuing to drink alcohol. The reports indicated he did not appear to appreciate the significance of what he was doing.