I am Dr.Ranjima (wife of Dr.Rajesh Joseph and I happen to be house surgeon in Alappuzha TDMC Medical college, where Dr.Koshy had worked earlier). I witnessed the trauma and the terrible prolonged sufferings my husband had to undergo after Dr.Koshy’s surgery on my husband. Dr. Vinod Nair, being a member of Dr.Koshy George’s team can do nothing else but try and cover up Dr.Koshy’s team’s mistake.
However I want to clarify and tell the actual the actual truths about many Lies Dr.Vinod has written above against my husband..
Before I clarify, let me tell all those who happen to read this: the comment that the pioneer of Bariatric surgery in Kerala has told after reviewing Dr.Rajesh’s surgery by Dr.Koshy is that “ÏT WAS A TECHNICAL ERROR”.
LIE 1: Possibility of developing stricture following lap sleeve gastrectomy (LSG) is well documented and has well laid management guidelines (NIH Author Manuscript Curr Probl Surg. 2010 February; 47(2): 79–174. doi:10.1067/j.cpsurg.2009.11.003, discusses this in detail). A possibility of stricture following LSG is put at 0.7% and definite guidelines for its management are recommended.
ANSWER: By telling the above chances of DEVELOPING STRICTURE POSSIBILITY, he hopes absolve dr.koshy and their team from this. But Dr.Koshy himself had told me during the earlier days of the surgery failure: “”Since it was a familiar person, I put the mesenteric sutures tight, so that staples do not give way. I think that tightness led to stricture and if we remove that stitches he may become alright. Let Dr.Koshy tell with God as witness that he hasn’t told like that??. It is because we trusted him to relieve the problem, that we again took him to Dr.Koshy to operate him again and relieve the problem.
LIE 2: All possibilities of side effects were discussed with Dr Rajesh in detail as a preoperative routine””.
ANSWER: There was no explanation about anything. Why Dr.Vinod has confidently written this is because they have taken a written consent. Infact not even an ECG or Xray was taken before surgery. They were in a hurry to do the surgery.
LIE 3: “Dr Koshy George is one of the most experienced Bariatric Surgeons in India, and is one of the perhaps 2 or 3 surgeons doing Bariatirc Surgery in the state in high volumes. He has now done around 250 similar surgeries successfully. Dr Rajesh had consulted at least 3 gastro surgeons beforehand. His decision to undergo the surgery with Dr Koshy’s team at Meditrina hospital at Trivandrum by itself is an indication of Dr Koshy's credibility”:
ANSWER: Yes it is a fact that we trusted Dr.Koshy. Moreover the person who acted as agent in getting the case to Dr.Koshy lied to us that at Perinthalmanna it will cost 2.5 lakhs, where as Dr.Koshy will do with in 2 Lakhs. Actually we came to know later that at Perinthalmanna the charges were only 1.75 lakhs and genuine patient care is given. His canvassing was so good that we believed his words and we fell into the trap. The fact is that it is from this agent that we got Dr.Vinod’s number and my husband spoke to Dr.Vinod who said he is Dr.Koshy’s team member.
LIE 4: But patient refused to visit Dr Koshy despite repeated requests and preferred to self medicate and being managed at a hospital nearby home for an extensive period under self supervision.””
ANSWER: This is a very terrible Lie what is written. My husband kept on contacting Dr.Koshy and Dr.Harris due to the persistent vomiting..They were reassuring it is all due to your tension, soon it will change etc.. Later my husband being a Radiologist himself took the CT scan feeling that there is something wrong happening. It is at that time we called up, emailed pictures and informed Dr.Koshy and team that there has been some mistake in the surgery. But he and his team told him to take IV Fluids (Normal saline and RL) at home and take steroid injections, soon everything will be ok etc..But when he started vomiting blood, to convince him we took photo of the vomited blood and send him pictures, so that he will tell us what to do.. But they were busy celebrating Christmas and we could not reach his phone. So we traced his assistant/ junior surgeon Dr.Sudir’s number and informed him. We were doing everything as per instructions we got from him and Dr.Harris, not even a single medicine by ourselves..If he tells my husband took self treatment at home, it will be a really terrible klie to escape the mistake they have done..
LIE 5: Throughout this period he was in touch with Dr Koshy or members of his team on a day to day basis and consulted regarding his CT scan, medicines etc. Many a times he was requested to visit Meditrina hospital so that he can be attended in person which he declined as he felt it is unnecessary travel and he could manage things by self treatment. On the previous week prior to resurgery, Dr.Koshy had not been contacted at all leading to the assumption that things had settled.
ANSWER: He is trying to give assumption to the readers that Dr.Koshy called day-to-day and asked the patient to take CT scan, come to Meditrena etc… The facts are the opposite..It was a wrong attitude of theirs; if something they do mistake to a patient, develop a hostility with the patient, and tell that they were correct but everything went wrong because something patient did..
LIE 6: Even on Christmas day, Dr Koshi George had made himself available for consultation of this patient. For the single day he was unavailable, he did make arrangements so that he was accessible indirectly through his associate, Dr Sudhir.
ANSWER: It was we who managed to trace atleast Dr.Sudheer when DrKoshy who had gone to celebrate for a week was unavailable, not they asked Dr.Sudhir to contact us..Inspite of doing such a cruelty to a patient who was suffering due to their mistakes, they decide to post a lie here to cover up their mistakes.
LIE 7: After the re look surgery, Dr.Rajesh wasn’t willing to keep the Naso gastric tube for more than a couple of days and demanded its removal.
(I am witness to a similar patient operated elsewhere, for whom Dr.Koshy solved the issue by maintaining a Nasogastric tube as a stent for 3 weeks. That patient had been sent home on oral liquids and nasogastric tube for 3 weeks after which it was removed and patient hadn’t needed any intervention.) “”
ANSWER: There 2 LIEs side side in this careful statement. “1”st LIE. “”After the re look surgery: ÄNSWER: The second surgery was not a re-look surgery. Dr. Koshy told me that, he will remove some stitches he put around my husband’s stomach which are over-tight.. We even have video record of the surgery in which he is seen to remove that wrong stitches. But as we all know no human orgain can sustain for days if he has put an over-tight suture and cutting off the blood supply. 2ND LIE: Dr.Rajesh wasn’t willing to keep the Naso gastric tube for more than a couple of days and demanded its removal. ÄNSWER: The truth is that the tube was found to be curled up under the esophagus, it was not founf to be in position, that I why Dr.Koshy agreed to remove it.. We have the Xray films taken at Meditrena hospital showing the curled up tube. They are trying to somehow find some fault with the patient so that they can be relieved from the conscience prick for destroying a person’s life.
LIE 8: At Ernakulam too Dr Koshy suggested a senior gastroenterologist for consultation, and possible intervention (Dr.Mathew Philip) which he again refused.
ANSWER: “We went to Dr.Koshy again for the 2nd surgery thinking that he will correct the mistake he did in the 1st surgery.. We trusted him so much that is why even though our relatives told us not to go to the same person who did mistake. But inspite of him removing the tight stitches and we waiting for 1 week, my husband’s condition was worsening.. Dr.Koshy told my husband and his mother that ” My(Dr.Koshy’s) pulse is more by 10 beats when I see the condition of Dr.Rajesh.. Veere arrengilum aayirunnenkil enne thalliyeene””.
My mother in law is a witness this what he said.
Since all the tricks Dr.Koshy was doing had failed and my husband’s condition was becoming worse day by day, unable to swallow even his own saliva. They were puncturing all his veins for IV lines to give IV fluids..
But Dr.Koshy was telling they will take him to Neyyattinkara hospital in ambulance.. But by then if was about 30 days since we trusted Dr.Koshy’s words without any relief, it was not possible for us to trust Dr.koshy’s words anymore, we wanted to save him by taking him to an expert in this field.
LIE 9: Patient went home by train and visited Amrita hospital at a later date. Ultimately he underwent a possibly unnecessarily extensive surgery. There were guidlines regarding management of strictures following lap sleeve gastrectomy, which were not followed, like considering Laparoscopic seromyotomy or looking for Vit B12 deficiency which needed to be corrected.
ANSWER: Dr.Vinod seems to be saying that patient was healthy enough to travel by train.. It was with great difficulty that his parents and me took him by train to Amritha hospital.
Another thing to be noted is that Amritha hospital is one of the best hospitals in Kerala and it is not correct to tell that they are doing surgeries without following guidelines.. They did everything possible including multiple endoscopic dilatations.. But the surgery done by Dr.Koshy was so much of an error that they could not correct it.. Dr.Sudheer at Amritha hospital had told 4 mistakes done by Dr.Koshy (as mentioned in my husband’s experience above) so the only solution left was the extensive surgery”Roux-enY Gastric bypass. My husband has to bear the consequences of the mistake by Dr.Koshy..
LIE 10: Regarding the non removal of fundus, probably the dilatation of stomach proximal to the stricture might have mimicked the appearance of fundus.
Removal/non removal of fundus has got nothing to do with stricture formation as in this case.
Narrowing of upper stomach-if the fundus is not removed, how there will be narrowing of upper stomach, as the fundus itself is the upper part of stomach?!!!
ANSWER: My husbands’s notes above has mentioned the truths which doctors at Amritha told about the mistakes commited by Dr.Koshy.. The stricture was created because staples lost track and he didn’t visualize the fundus which was actually tilted posteriorly.
There is no point explain these to Dr.Koshy and team, they are adamant now that they will not accept their mistakes.. I myself had seen my husband’s abnormal looking removed part of the stomach and felt something wrong had happened..
During the period nobody contacted Dr Koshy regarding talking to Dr Sudheer O.V.
LIE 11: Later Dr Koshy was served a legal notice stating Dr Rajesh's experiences seeking a compensation of 1Cr 10 lakhs to which a reply was given through proper channel.
There was no further legal action from the patients' side after that.
ANSWER: It is true that Legal notice was served as Dr.Koshy had changed his words of self-acceptance of his mistakes.. We do not have to gain anything by tarnishing his image because he worked at the hospital where I did my MBBS. It is because I always used to tell Good about him that he came to know of the name (Dr.Koshy) even. Dr.Vinod seems to conclude that there was no further action from patient’s side because everything Dr.Koshy did was correct?
It is only because of the cordial relation we had with Dr.Koshy, we are still in double mind wheter to go for case against him.. My husband keeps telling: Änyway I had to suffer because of his mistake and now my life is difficult, what is the point of case etc..”But we keep reminding him that if somebody had done injustice against you, we have confront it, not to leave it and let others take advantage..
LIE 12: It can be easily seen the above stated complaint by Dr Rajesh was ill advised and aimed at tarnishing Dr Koshy's image, after realizing that he doesn’t hold any legal validity with the case.
ANSWER: They may try to cover up their mistake due to their influence or by telling the world that the patient was bad, that’s why all these happened to the patient..But our prayer is only this that “God let no other patients fall into these cheating and traps””
We do not have to gain anything by tarnishing Dr.Koshy’S image, especially because we trusted him, that’s why we even went to him..Atleast if he had confessed his mistake to me, like what he did earlier before the 2nd surgery, we would have forgiven him..but instead he decided to keep a hostile relation with us to escape his own conscience.. God Bless Him..