'Toddler's cancer death not manslaughter', says UAE medical panel in Karabus case

Medical committee has found that a South African doctor, accused of manslaughter, was not negligent in his treatment of a three-year-old cancer patient who died in 2002.

ABU DHABI // A doctor on trial for the manslaughter of a three-year-old cancer patient who died in 2002 was not negligent in his care of the girl, a special panel of medical experts has found.
Treatment by Dr Cyril Karabus, 77, of the Yemeni girl Sarah Adel was necessary and appropriate and there was no other negligence in his conduct, according to a report by the Permanent Supreme Medical Committee presented to the Criminal Court yesterday.
The South African paediatric oncologist is accused of being responsible for the child's death by failing to give her a vital blood transfusion, and of tampering with a medical report so that it indicated that he had given the transfusion.
Shortly after the child's death Dr Karabus completed his five-week stint as a locum at Sheikh Khalifa Medical City in Abu Dhabi and returned to South Africa.
Two years later, in his absence, he was convicted of manslaughter and forgery, sentenced to three years in jail and ordered to pay blood money of Dh100,000.
He was arrested at Dubai Airport in August while travelling with his family, and is now being retried on the same charges.
Prosecutors claim that Dr Karabus altered the girl's medical records by adding a sentence saying he had ordered a blood transfusion.
His defence lawyer Khalfan Al Kaabi told the Criminal Court yesterday that a forensic examination accepted by the original trial had found the added sentence was written "with the same pen and handwriting of the person" who wrote the rest of the report, it did not specify whether this person was Dr Karabus.
Since the original document allegedly altered by Dr Karabus was now unavailable, the court had no way of determining whether Dr Karabus was guilty of forgery, the lawyer said.
He also argued that, as the medical committee had established, Dr Karabus had not been negligent in his treatment of the patient. and therefore had no reason to tamper with the records.
The lawyer pointed out that at the time of the girl's death hospital nurses had signed a statement saying Dr Karabus had not instructed them to administer a blood transfusion. However, medical evidence that the girl's blood platelets levels rose from 1,000 to 8,000 suggested a transfusion had taken place.
The way the law deals with accusations of medical negligence has changed since Dr Karabus's original conviction.
At that time, such cases were investigated by forensics team.
In 2008, the Medical Liability Act required charges involving alleged medical errors to be referred to the Permanent Supreme Medical Committee.
In Dr Karabus's retrial, because the alleged offences took place before the change in the law, the judge had a choice of applying the old procedure or the new one.
The Supreme Committee consists of nine doctors from different federal, local, semi-government and private medical institutions.
It has the expertise to provide a detailed analysis of whether a medical error has occurred, and can also advise on whether the case highlights a wider problem in the medical profession.
For Dr Karabus's retrial, the Supreme Committee had access to the dead girl's blood cells and tissue samples, which had been preserved by the judicial department.
A verdict is expected tomorrow.
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