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LETTERS TO Shadow Minister for Health WALES + related
4th December 2002
Dr Dai Lloyd
Member of Welsh Assembly (Plaid Cymru)
Dear Dr. Lloyd,
Following our recent telephone conversation, I feel I must draw your attention to an extremely worrying situation regarding a trainee doctor who is working in your local Hospital, having previously worked at ours. Dr Shane Gieowarsingh was promoted to the post of LAT in cardiology at the Heath University Hospital, Cardiff, from April 2002 to date.
Dr Gieowarsingh left the University Hospitals Coventry & Warwickshire, Coventry amidst controversy, including allegations of a fraudulent curriculum vitae. In February 2002, he provided copies of his CV to his supervisor, Dr R Mattu (consultant cardiologist), and to the longest serving consultant cardiologist, Dr Singh, and asked if they would be his referees. Neither provided Dr Gieowarsingh with a reference, even though they were the only consultants who had formally supervised and trained Dr Gieowarsingh during his attachment in the cardiology department with Dr Mattu.
Having declined to provide a reference, Dr Singh was so concerned about the suspected irregularities in Dr Gieowarsingh's CV, which allegedly included exaggerated claims of procedures he had undertaken and his clinical experience, that he formally raised this with the senior management at the Trust. The NHS Trust in Coventry were alerted to the dangers as long ago as March 2002, but they are still not known to have taken any action to protect the patients in Cardiff in the meantime. Neither do they respond to enquiries.
The disputed procedures are angiograms, where a catheter is inserted up the main artery in the body and into the arteries of the heart and dye injected into the heart blood vessels. This procedure is obviously dangerous in inexperienced or the wrong hands. It is unclear if Dr Gieowarsingh has been permitted to conduct these heart procedures on patients in Cardiff and whether the Heath Hospital has even been alerted to the potential fraudulent CV, and possible risks to their patients. I am very worried that Dr Gieowarsingh may not have been prevented from doing these procedures until the outcome of any inquiry had confirmed or refuted his alleged experience with this procedure.
I came across Dr Gieowarsingh over another matter, which had also raised serious concerns about his nature and integrity. I have established that Dr Gieowarsingh only received clinical training in general medicine and not cardiology in Coventry, and this has all been at the Senior House Officer grade. I understand that this is the most junior grade at which a doctor can hold a full medical practitioner's licence.
In March 2001, he joined Dr Mattu as an honorary research fellow, to pursue a higher degree in medicine. It is important to note that this was not a clinical training post. It was not until November 5th 2001 that Dr Gieowarsingh was converted to a non-honorary (substantive) research contract. Before this date Dr Gieowarsingh's Consultant did NOT allow him to undertake any angiograms because of safety issues. He was however allowed to observe the heart procedures, but was never expected or intended to gain any training in this procedure. Dr Mattu had a specialist registrar appointed specifically to gain clinical training, including angiograms. This person was definitely not Dr Gieowarsingh.
I am aware that he attended and observed about 10 of these procedures as an honorary fellow, when the angiograms were also explained to him. HE DID NOT UNDERTAKE OR GAIN TRAINING IN THIS PROCEDURE AT THESE ATTENDANCES. From November 2001 till the first week of February 2002, I understand that Dr Gieowarsingh observed about a further 20-25 procedures. He assisted in less than 10 of these. He has not been the primary operator at any of these procedures. You will understand from the above figures that it would therefore have been dangerous for him to be the primary operator after such little training and experience.
Despite this, Dr Gieowarsingh has claimed in his CV that he has undertaken about 75-80 procedures, at which he states that he has been the primary operator in over 25. This is strongly denied by both his consultant supervisors Dr Mattu and Dr Singh.
During the entire time that Dr Gieowarsingh was appointed with Dr Mattu only about 110 such angiograms were undertaken. He is certainly recognised as having been encouraged to talk to the patients before the procedure and consequently observing a number of these procedures, but it is strenuously contested that he has been physically involved with the vast majority of these procedures. He has at best been involved with a handful and even then his level of involvement has been limited and restricted as above.
Importantly, Dr Mattu only had a total of 25 patients on whom angiograms were performed, over the 13 weeks from November 2001 (start of Dr Gieowarsingh's substantive post) to when his CV was completed. It has therefore not been possible for Dr Gieowarsingh to have experience on more than 25 procedures, during which he also took holiday for at least four weeks and there was Christmas and new year also limiting his likely experience.
Consequently, the allegations about Dr Gieowarsingh's CV are probably founded, as he appears to have exaggerated his involvement, experience and training. This is of great concern because this would suggest that he has fraudulently gained his promotion at the Heath Hospital and that his colleagues will have been misled about his level of training and experience in this procedure. This will have endangered a number of vulnerable patients in Cardiff, because I understand that this procedure can cause strokes, heart attacks, kidney problems, and leakage and rupture of blood vessels. I believe that it is simply unacceptable to place those trusting patients at serious risk in this way.
Disappointingly a decision by the Coventry Trust on whether or not Dr Gieowarsingh's CV is fraudulent or not is still not forthcoming. I have been careful not to arouse unnecessary concern over this doctor in Cardiff and chosen not to contact you previously. Having waited patiently for about 8 months for the Trust report about his CV, and from my other experiences with the Trust, I suspect that there may be a worrying reason for the lack of openness and any formal response. I am therefore obliged to raise my concerns with you.
The reasons behind the Coventry Trust's apparent inaction remain unclear, but I hope you will agree that failing to protect the patients in Cardiff in the meantime is outrageous and unacceptable.
Yours sincerely,
MR BRIAN KING
6th March 2003
Dr Dai R Lloyd
Shadow Health Minister for Wales
Dear Dr. Lloyd,
Thank you for passing on the letters from Mr David Edwards (Chief Executive, Cardiff and Vale NHS Trust) dated January 7th 2003 and January 27th 2003, regarding Dr Shane Gieowarsingh.
I would emphasise that I raised only two specific points of concern with you, which were (a) the allegation that Dr Gieowarsingh had probably fraudulently secured promotion to Cardiff by using a falsified CV and (b) that Cardiff had not been warned of the potential danger to patients whilst this matter was being investigated and clarified.
You will therefore understand my intrigue at the claims expressed in Mr Edwards' correspondence, and what is rapidly emerging is a serious cover up, verging upon material breaches of our laws.
It is regrettable that Mr Edwards has chosen to cloud the specific issues that I had raised by drawing in some of the other controversies surrounding Dr Gieowarsingh. Although I would prefer to leave these other controversies surrounding Dr Gieowarsingh aside since they will be under investigation elsewhere, I am obliged to comment regarding the matter Mr Edwards has raised about Dr Mattu's suspension.
I should state that Dr Mattu has bravely spoken out on behalf of local patients regarding poor clinical care and that this has resulted in open hostility against him from the highest level of senior management, including Chairman, Chief Executive, Director of Personnel and Medical Director, which has included declarations to destroy his career and get rid of him from the Trust (along with four other consultants).
Consequently, Dr Mattu has faced about 20 complaints against him over the last 2 years, but none have been upheld. Dr Martin Been (Consultant Cardiologist) has made a number of these complaints against Dr Mattu, has been instrumental in others and approached a number of further people to encourage complaints against Dr Mattu.
I would emphasise that days after the financially troubled Dr Gieowarsingh had claimed that Dr Booth had promised him large sums of Trust monies Dr Gieowarsingh raised a statement against Dr Mattu, within 24 hours Dr Booth suspended Dr Mattu under cover of this statement, and then 5 weeks later Dr Gieowarsingh left Coventry for Cardiff.
I have raised the specific concern about Dr Gieowarsingh's CV and Coventry's obligations to the unsuspecting patients in Cardiff and it is still this to which I expect satisfactory and truthful responses. I stress that to date I have never raised any issues regarding NHS staff in Cardiff.
Responding to the specific points raised by Mr Edwards dated January 7th 2003 I have never questioned whether the "correct procedure" was carried out in Cardiff (para 3). However, I am concerned that Dr Booth and Dr Been may have supplied his references and I would be grateful if you could confirm this via Mr Edwards. The reason for my concern is that his supervisors Dr Mattu and Dr H Singh did not supply him references and that Drs Booth and Been are likely to have been the referees, yet they were responsible for the investigation of Dr Gieowarsingh's CV. This raises important and genuine concerns about the veracity of such an investigation and the likely conflict of interest.
I was puzzled by the comments Mr Edwards attributes to the Medical Director in Cardiff and a Clinical Director in Cardiology (para 5). There is no mention of "cross fire" on the web site and it is unclear as to which Clinical Director in Cardiology this refers to (Coventry or Cardiff?). This Clinical Director in Cardiology wrongly states that Dr Gieowarsingh "has become caught in the cross fire between the Coventry Trust management and one of the consultant cardiologists". Firstly, in his capacity as Dr Gieowarsingh's supervisor for cardiac catheterisation, it is Dr H Singh (not Dr Mattu) who has raised concerns about the CV. Therefore the dispute ("cross fire") between Dr Mattu and the Trust management has absolutely no bearing on Dr Singh's concerns about Dr Gieowarsingh's CV and his subsequent refusal to provide Dr Gieowarsingh a reference. Secondly, Dr Gieowarsingh directly involved himself in issues between Dr Mattu and the Trust management, and therefore he cannot now claim a peripheral involvement. In view of the very serious consequences of his allegations, of course a consideration of Dr Gieowarsingh's integrity is an appropriate and highly relevant issue.
Why does Mr Edwards inform you on January 7th 2003 that "An enquiry is at present being undertaken by the Walsgrave Hospital …" when it has emerged that the Trust inquiry into the CV by Drs Booth and Been had been completed by November 2002 (para 5)?
Dr Gieowarsingh only worked for Dr Mattu during his Cardiology appointment (para 6). Until November 2001 he held an honorary appointment that prevented him from any interventional contact with patients, therefore claiming to have undertaken all his catheterisation experience (approximately 80 cases) in under 40 working days. Dr Gieowarsingh cannot seriously claim to have received more training in cardiac catheterisation than the designated trainees in cardiology, when he was not even a clinical trainee himself but a researcher? When would he have performed his other research and clinical duties with Dr Mattu?
Dr Gieowarsingh admits that there is an irregularity in the number of catheterisations appearing in his CV and those possible in the time frame under Dr Mattu. However he then makes the claim that this has occurred due to his performing cardiac catheterisation on patients under the care of consultants other than Dr Mattu (para 6). His only two cardiology supervisors (Drs Mattu and Singh), strongly supported by the cardiac catheterisation log books, clearly contradict this claim and demonstrate that this is simply untrue. Consequently either Dr Gieowarsingh is being dishonest or his supervisors and the log-books are wrong. This is a very important and serious matter that must be clarified.
The remarks made in para 7 are irrelevant to my query.
You will understand my concern at having raised a genuine enquiry about a junior doctor's CV and the precautions taken by more senior staff to safeguard patient welfare whilst the matter was being clarified.
Yours sincerely,
MR BRIAN KING
13th December 2002
Mr Jim Gee
Director, Directorate of Counter Fraud Services
Dear Mr Gee,
I draw your attention to an extremely worrying situation regarding Dr Shane Gieowarsingh, who seems to have improperly secured a promotion in cardiology at the Heath University Hospital, Cardiff, from April 2002 to date, by utilising what appears to be a falsified CV
Dr Gieowarsingh left the University Hospitals Coventry & Warwickshire, Coventry amidst controversy, including allegations of a fraudulent curriculum vitae. In February 2002, he provided copies of his CV to his supervisor, Dr R Mattu (consultant cardiologist), and to the longest serving consultant cardiologist, Dr H Singh, and asked if they would be his referees. Neither provided Dr Gieowarsingh with a reference, even though they were the only consultants who had formally supervised and trained Dr Gieowarsingh during his attachment in the cardiology department with Dr Mattu.
Having declined to provide a reference, Dr Singh was so concerned about his suspected irregularities in Dr Gieowarsingh's CV, which allegedly included exaggerated claims of procedures he had undertaken and his clinical experience, that he formally raised this with the senior management at the Trust. The NHS Trust in Coventry was alerted to the dangers as long ago as March 2002, but they are still not known to have taken any action to protect the patients in Cardiff in the meantime. Neither do they respond to enquiries.
The disputed procedures are angiograms, where a catheter is inserted up the main artery in the body and into the arteries of the heart and dye injected into the heart blood vessels. This procedure is obviously dangerous in inexperienced or the wrong hands. It is unclear if Dr Gieowarsingh has been permitted to conduct these heart procedures on patients in Cardiff and whether the Heath Hospital has even been alerted to the potential fraudulent CV, and possible danger to their patients. I am very worried that Dr Gieowarsingh may not have been prevented from doing these procedures until the outcome of any inquiry had confirmed or refuted his alleged experience with this procedure.
I came across Dr Gieowarsingh over another matter, which had also raised serious concerns about his nature and integrity. I have established that Dr Gieowarsingh only received clinical training in general medicine and not cardiology in Coventry, and this has all been at the Senior House Officer grade. I understand that this is the most junior grade at which a doctor can hold a full medical practitioner's licence.
In March 2001, he joined Dr Mattu as an honorary research fellow, to pursue a higher degree in medicine. It is important to note that this was not a clinical training post. Dr Gieowarsingh was converted on November 5th 2001 to a substantive research contract. Before this date Dr Gieowarsingh's Consultant did NOT allow him to undertake any angiograms because of safety issues. He was however allowed to observe the heart procedures, but was never expected or intended to gain any training in this procedure. Dr Mattu had a specialist registrar appointed specifically to gain clinical training, including angiograms. This person was definitely not Dr Gieowarsingh or any researcher.
I am aware that he attended and observed about 10 of these procedures as an honorary fellow, when the angiograms were also explained to him. HE DID NOT UNDERTAKE OR GAIN TRAINING IN THIS PROCEDURE AT THESE ATTENDANCES. From November 2001 till the first week of February 2002, I understand that Dr Gieowarsingh observed a further 20-25 procedures, assisting in under 10. From the figures above it becomes clear it would have been dangerous for him to be the primary operator after such little training and experience. Indeed, he has not been the primary operator at any of these procedures.
Despite this, Dr Gieowarsingh has claimed in his CV that he has undertaken about 75-80 procedures, at which he states that he has been the primary operator in over 25. This is strongly denied by both his consultant supervisors Dr Mattu and Dr Singh.
During Dr Gieowarsingh's appointment with Dr Mattu only about 110 such angiograms were performed. From August 2001, he was encouraged to talk to patients before the procedure and consequently observed a number of these. It is strenuously contested that he has participated in the vast majority of these procedures. At best he has been involved with a handful, and even then his involvement has been limited and restricted as above.
Importantly, Dr Mattu only had a total of 25 patients on whom angiograms were performed, over the 13 weeks from November 2001 (start of Dr Gieowarsingh's substantive post) to when his CV was completed. It is therefore impossible for further experience on more than these 25 procedures, during which Dr Gieowarsingh also took holiday for at least four weeks and there was Christmas and new year also limiting his likely experience.
Consequently, the allegations about Dr Gieowarsingh's CV are probably founded, as he appears to have exaggerated his involvement, experience and training. This is of great concern because this would suggest that he has fraudulently gained his promotion at the Heath Hospital and that his colleagues will have been misled about his level of training and experience in this procedure. This will have endangered a number of vulnerable patients in Cardiff, because I understand that this procedure can cause strokes, heart attacks, kidney problems, and leakage and rupture of blood vessels. I believe that it is simply unacceptable to place those trusting patients at serious risk in this way.
I have been careful not to arouse unnecessary concern over this doctor in Cardiff and not to contacted them previously. Having patiently waited for about 8 months for the Coventry Trust report, and from my other experiences with the Trust, I suspect a worrying reason for their lack of openness and formal response. I therefore raise my concerns with you.
Earlier this week the Trust informed Karen Hambridge, Coventry Evening Telegraph, they had recently completed the inquiry and found no fault. I sincerely hope there is no 'cover-up' by the Trust, since Drs M Been and LJ Booth, who were tasked with investigating the alleged fraud, are strong supporters of Dr Gieowarsingh, and also provided him references to help secure this promotion.
The reasons behind the Coventry Trust's apparent inaction remain unclear, but I hope you will agree that failing to protect the patients in Cardiff in the meantime has been outrageous and unacceptable.
Yours sincerely,
MR BRIAN KING
24th July 2003
Dr Peter Mulrooney
Chairman Senior Medical Staff Committee
Walsgrave Hospital
Dear Dr Mulrooney,
The committee has advised me to formally ask you for a response regarding the outstanding issue of Dr Gieowarsingh's alleged fraudulent CV, which apparently misrepresented his clinical experience in order to secure his position in Cardiff.
I have now received further correspondence (enclosed) from Dr Dai Lloyd, Shadow Health Minister, Welsh National Assembly, containing claims made by the Coventry and Cardiff Trusts.
You will note that concerns about the alleged fraudulent CV have been categorically dismissed, and allegations are made about these being the consequence of a vindictive campaign by Walsgrave staff against Dr Gieowrsingh, apparently conveyed to them through the Medical Director, Dr Lionel Booth.
I would be grateful for your views about this correspondence and advice about whether there is any substance to the allegation that the CV produced by Dr Gieowarsingh, and endorsed by Drs Booth, Been and Shiu, is in fact fraudulent.
Yours sincerely,
Brian King
For The Dr Raj Mattu Reinstatement Committee
Cc: T Blair, I Duncan-Smith, C Kennedy, Dr J Reid, Dr Liam Fox, R Ainsworth, G Robinson, J Cunningham, A King, W Olner, M O'Brien, C Spellman, J Plaskitt, J Maples, Trust Board, Councillors, Parliamentary Business Unit, Sir Nigel Crisp, Dr RK Mattu, Dr H Singh
