An extraordinary doctor who should have been allowed to be an ordinary patient

-Credit: (Image: Family handout)
-Credit: (Image: Family handout)


Professor Amit Patel was not just an expert in his field. He was one of the best hopes the NHS had. He spent years becoming 'one of the best doctors in the UK', treating some of the most unwell cancer patients at the world-renowned Christie Hospital in Manchester.

But when Professor Patel was gravely sick with the life-threatening condition which he was a foremost authority in, the NHS did not come to save him. Instead, he lay on an understaffed ward, being told by doctors they had 'never heard of' the illness.

Despite weeks of fighting to stay alive in the face of conflicting medical opinions and chaos on wards, Prof Patel died following NHS 'failures to provide basic medical attention', a coroner found.

READ MORE: One of UK's best doctors killed by procedure 'that should never have been recommended' and he 'did not consent to'

The beloved doctor and dad-of-two met a tragic death, killed by a procedure 'that should never have been recommended' by colleagues in his field and that he 'was not given the opportunity to, and therefore did not, provide informed consent' to.

Three years on, his wife is fighting to make changes to the NHS after her husband died following years of service. Two young girls will grow up without their father. And patients with slim chances of survival have lost a brilliant defender.

Shivani Tanna, widow of Amit Patel at her home in Wilmslow -Credit:Manchester Evening News
Shivani Tanna, widow of Amit Patel at her home in Wilmslow -Credit:Manchester Evening News

Here, Helena Vesty looks back at the inquest into Prof Patel's death - and speaks to his heartbroken wife...

The chances of a highly-specialised doctor becoming afflicted with the rare condition on which they are a national expert might never be known. But there are some known numbers about Prof Patel's case.

Even though hemophagocytic lymphohistiocytosis (HLH) is life-threatening, Prof Patel's chance of survival stood at 75 per cent. After the procedure that preceded his death, his chances fell to 10pc, his inquest was told.

That surgical test was described as 'low risk'. Instead, Prof Patel ended up suffering a catastrophic haemorrhage after a blood vessel was 'transfected or ruptured' during the procedure. The chances of that happening, according to an independent expert giving evidence before the coroner, were only calculated because of this case. The witness said he'd never seen anything like it before.

The expert said the odds are estimated to be one in 10 to 15,000 cases. Prof Patel died as a result.

Professor Amit Patel, 43, who died on 28 October 2021, eight weeks after he underwent a lung procedure at Wythenshawe Hospital in south Manchester, pictured with his two daughters -Credit:MEN Media
Professor Amit Patel, 43, who died on 28 October 2021, eight weeks after he underwent a lung procedure at Wythenshawe Hospital in south Manchester, pictured with his two daughters -Credit:MEN Media

'I'm going to die here'

Prof Patel recognised he was suffering a potentially-deadly immune reaction, the long-running inquest at Manchester Coroners' Court was told. During his career, he had formed 'national guidance' on HLH and sat on a national multi-disciplinary panel to which the most serious cases were referred.

Prof Patel was the first person in the UK qualified in stem cell transplantation and cellular therapy and intensive care medicine. His abilities were ground-breaking and life-saving.

Yet when he was admitted to Wythenshawe Hospital in August 2021, staff were left scrambling to treat the professor, not knowing the seriousness of the condition. Staff even told Prof Patel he was actually the least unwell person on his ward and that he didn't qualify for intensive care – despite his warnings he was suffering from a life-threatening illness.

Professor Patel’s widow, GP Dr Shivani Tanna -Credit:MEN
Professor Patel’s widow, GP Dr Shivani Tanna -Credit:MEN

Despite his belief in the NHS; despite his reliance on fellow specialists who knew him for help; and despite his own wealth of knowledge about HLH, Prof Patel knew what was coming. Lying in a hospital bed, he told his wife: "I'm going to die here."

Following Prof Patel's inquest, his wife Dr Shivani Tanna - herself a GP - told the Manchester Evening News: "Sepsis is a big driver of HLH, a lot of people die of sepsis. I will admit I'm not an expert in HLH, I never knew it when I was training. The only reason I know so much about it is because of Amit.

"People say it's rare, I don't think it is that rare. But I guarantee had Amit not been him, his evolving picture of HLH would never have been picked up, that diagnosis would not have been made and he would have died within the first two weeks of admission.

"I think we should just be doing better in terms of education, training, medical school, specialist training in hospitals. We need to know more about things like HLH, which we should do because it was a big factor in why people died during Covid."

The procedure that should never have happened

A surgical test was recommended by that same national multi-disciplinary panel to try and diagnose the trigger for the HLH immune response, which could have been the result of tuberculosis (TB), lymphoma or, as Prof Patel suspected from an early stage, Still's disease. The endobronchial ultrasound guided biopsy (EBUS), where doctors look inside the lungs to diagnose lung disorders, could rule out TB or lymphoma – which medics decided needed to be done before giving a diagnosis of Still's, which is a rare type of inflammatory arthritis.

On Thursday (May 30), coroner Zak Golombek concluded that a recommendation for a procedure from that national panel – some of whom Prof Patel knew personally – should never have happened and led to his death on October 28, 2021, aged just 43.

Shivani Tanna holding a portrait of her late husband Amit Patel -Credit:Manchester Evening News
Shivani Tanna holding a portrait of her late husband Amit Patel -Credit:Manchester Evening News

The national multi-disciplinary panel met, along with Wythenshawe Hospital doctors responsible for his hour-by-hour treatment, to recommend a care plan for Professor Patel based on his presentation and test results.

The inquest heard that ahead of the ultimately fatal procedure, test results showed Prof Patel was also suffering from disseminated intravascular coagulation (DIC). DIC is a serious and rare blood clotting disorder and can cause uncontrollable bleeding.

But Dr Jessica Manson, the consultant rheumatologist who recommended the procedure - and leader of the national-level multi-disciplinary panel which worked with Wythenshawe Hospital doctors to advise on Professor Patel’s care - told the court she was never informed he was suffering from DIC – nor was Professor Patel aware he had the disorder.

Dr Manson also said she had not been informed by Wythenshawe medics there was only a small likelihood the test would provide the information needed to establish a cause for the HLH.

Professor Amit Patel was the first person in the UK qualified in stem cell transplantation and cellular therapy, and intensive care medicine -Credit:Family handout
Professor Amit Patel was the first person in the UK qualified in stem cell transplantation and cellular therapy, and intensive care medicine -Credit:Family handout

Dr Manson told the court she would never have recommended the EBUS procedure had she known about the DIC or the small chance of the test actually leading to a diagnosis. Coroner Mr Golombek informed the court that Dr Manson and the national panel were also not aware of the opinions of Wythenshawe doctors that, after assessing his symptoms, they felt it was unlikely Prof Patel was suffering from tuberculosis or lymphoma, potentially negating the need for the procedure.

Returning a narrative conclusion, the coroner said: "This recommendation [of an EBUS] was based on an incomplete presentation of the deceased's clinical case, and therefore should never have been made. Had the national HLH MDT had all relevant and readily available information presented to them, the EBUS procedure would not have gone ahead on September 2, 2021, and the deceased would not have died on October 28 2021.

"Moreover, the deceased was not given the opportunity to (and therefore did not) provide informed consent on September 2 2021 for his EBUS procedure."

Nevertheless, a 'recommendation' from the MDT in this case, where doctors in Wythenshawe had little experience of treating HLH, appeared to 'send out a clear message to the treating team that an EBUS was necessary, and this then presented the treating team with little option but to follow the MDT’s advice', the coroner added.

So, the EBUS went ahead – but that panel had 'reached their conclusion without all relevant information' after it had not been presented to them by the local treating clinicians. Following the conclusion, Dr Tanna said: "The irony here is that Amit was one of the most meticulous doctors. Sunday night was 'I need to get everything in order for the week ahead'.

"He would come home and had access to results, which we all now do from home. He would check everything thoroughly before doing any procedure – even a bone marrow [test]. He would be checking clotting and things like that.

"These are basic things."

Professor Amit Patel and his wife, GP Dr Shivani Tanna -Credit:Family handout
Professor Amit Patel and his wife, GP Dr Shivani Tanna -Credit:Family handout

An extraordinary doctor, who should have been allowed to be an ordinary patient

The coroner found that the consenting process for Profe Patel was 'sub-optimal' when he was asked to agree to the EBUS by respiratory consultant, Dr Richard Booton. The discussion 'did not include sufficient reference to his now established DIC, and the effects that this might have on the procedure itself', the coroner said.

"The consenting process was too proximate in time to the procedure starting. This did not allow Professor Patel to compute, digest, and discuss the evolving clinical picture and the procedure itself," he added.

Prof Patel was an extraordinary doctor, the coroner told the court, but should have been allowed to be an ordinary patient.

Mr Golombek added: "Professor Patel was not treated like an ordinary patient. In spite of his undoubted wealth of medical knowledge, he was primarily a husband and a father, and was not given the opportunity to consider the procedure itself, and its effects on his clinical course. I got the sense from hearing the evidence that Professor Booton did not intentionally rush through the process; however, his starting assumption was that Professor Patel was fluent in the language he was speaking, and therefore did not need to spend as much time as he should have done discussing what was, in my judgement, necessary.

"This goes to the heart of the issue - Professor Booton treated this more like an academic discussion between equals, rather than a formal consenting process between doctor and patient. Thus, I find that Professor Patel was not given the opportunity to provide informed consent for the EBUS procedure on 2nd September 2021."

“He was a brilliant dad, he always thought of me and the girls before his own needs," said Professor Patel's wife -Credit:Family handout
“He was a brilliant dad, he always thought of me and the girls before his own needs," said Professor Patel's wife -Credit:Family handout

Ultimately, the coroner found the lacking consent process and mistakes of the local treating team in not passing on all relevant and available information to the HLH national panel to be 'failures to provide basic medical attention to a person in a dependent position'.

"In spite of his professional achievements and medical knowledge, he was like any other patient in a hospital who entrusted specialists with his care," Mr Golombek added.

In another tragic turn in the case, the coroner also ruled that the driver of his HLH was, as Prof Patel had believed, adult-onset Still's disease. That moment brought bittersweet sighs of relief in court from his family.

For Amit's wife, it's a conflicting victory. Dr Tanna said: "I'm feeling a sense of relief. I am grateful and relieved again that Amit's diagnosis - that I've known was adult-onset Still's disease for the last two years - has been acknowledged, recognised and actually confirmed.

"Being in a position where you know something and people are refuting that so strongly is really upsetting when you're trying to grieve and move on. In hindsight, I'm happy it's taken two-and-a-half years."

What the trust says

Jane Eddleston, joint group chief medical officer for Manchester University NHS Foundation Trust, which operates Wythenshawe Hospital, said: "We wish again to extend our condolences and deepest sympathies to Professor Patel's family at this incredibly difficult time.

"The trust has undertaken a detailed investigation thoroughly examining the care Professor Patel received when he was with us and has since shared this investigation with Professor Patel's family and the coroner.

"We are committed to providing the best care possible for our patients and we must apply the lessons learned from this to our constant work to improve our patients’ safety, quality of care, and experience."

'We will find peace knowing that his death was avoidable'

For Dr Tanna, those condolences are cold comfort. She is fighting for that promised change to be borne out by Manchester University trust and the rest of the NHS.

Attending court for months, while carrying out her day job as a GP, and looking after the couple's two young daughters, Dr Tanna was fighting for the truth about why her husband died – and for other families failed by errors in treatment.

She is not alone. The family members and friends who showed up for every hearing were proof that Amit, and his tragic death, will not be forgotten.

Mr Golombek paid tribute to Prof Patel, saying: "The mutual love between Amit and all those who knew him has been palpable in court throughout these proceedings. He was clearly a brilliant man whose legacy will go beyond his academic and professional achievements."

Shivani with the couple's two daughters -Credit:Manchester Evening News
Shivani with the couple's two daughters -Credit:Manchester Evening News

"I know what happened because I was there every day with Amit during his hospital admission," Dr Tanna told the M.E.N. The coroner found failures to provide basic medical attention to a person in a dependent position. That is enough for me.

"From the outset, I just wanted the truth to be found. I owe that to Amit. The future for us is to rebuild. It's been a really difficult couple of years, and the focus is on my daughters, Amit's daughters. Throughout his hospital stay, all he could think about was them. I have to make peace with what's happened.

"The girls will carry in on his legacy and so will I, in many ways. I'm not giving up - I'm working within the NHS, I will continue to do what I need to do to stand my ground, speak up.

"I feel for all the whistleblowers who try their best to make change. I would like Amit's case to be the impetus for huge change in the NHS. He's always going to be remembered throughout.

"We will find peace knowing that his death was avoidable. I know he should have been here today. But we can't go back, we have to go forwards."