Rhon­da Krys­tal Ram­bal­ly

The wid­ow of Ri­car­do McKen­zie (Smokey) plans to sue the Bri­an Lara Can­cer Treat­ment Cen­tre (BLCTC)/Med­corp Ltd and the Min­istry of Health (MoH) for ap­prox­i­mate­ly US$500,000 in spe­cial dam­ages for neg­li­gence aris­ing out of a pos­si­ble over­dose of ra­di­a­tion which she claimed may have led to her hus­band's death. McKen­zie, who was a can­cer pa­tient, re­ceived ex­ter­nal beam ra­di­a­tion ther­a­py at the BLCTC for six weeks in 2009. He died in De­cem­ber 2010.In a 21-page pre-ac­tion pro­to­col let­ter, filed in the High Court on Fri­day, McKen­zie's wife, Lisa, through her at­tor­ney Can­dace Preud­homme, in­struct­ed the BLCTC/Med­corp Ltd, the MoH and the At­tor­ney Gen­er­al to re­spond in 28 days or fail­ure to do so would re­sult in le­gal pro­ceed­ings.

A copy of the let­ter was ob­tained by the T&T Guardian.Let­ters were de­liv­ered by hand to Med­corp's cor­po­rate sec­re­tary Alyssa Achong Low and Health Min­is­ter Dr Fuad Khan.Sev­er­al at­tempts to con­tact deputy chair­man of the cen­tre and ex­ec­u­tive chair­man of Med­corp Ltd, Dr Kong­shiek Achong Low proved fu­tile.The let­ter stat­ed Lisa was tak­ing the nec­es­sary steps to ob­tain a grant of let­ters of ad­min­is­tra­tion for McKen­zie's es­tate.She was ad­vised by Preud­homme and her oth­er at­tor­neys, Ra­jiv Per­sad and Os­borne Charles SC, to file a claim in the High Court as the in­tend­ed ad­min­is­tra­trix and a de­pen­dent of the es­tate of McKen­zie against the par­ties for:

• Spe­cial dam­ages in the sum of US$412,817.61 at the pre­vail­ing US cur­ren­cy rate at the date of judg­ment with in­ter­est un­til the said sum is paid and the sum of TT$41,555.59;

• dam­ages un­der the Supreme Court of Ju­di­ca­ture Act, Chap­ter 4:01, for the ben­e­fit of McKen­zie's es­tate;

• dam­ages un­der the Com­pen­sa­tion for In­juries Act, Chap­ter 8:01 and Chap­ter 4:01, for the ben­e­fit of the es­tate and the de­pen­dent of McKen­zie;

• in­ter­est; and,

• any fur­ther or­der or re­lief that the court may deem just for their neg­li­gent acts that caused the death of McKen­zie.

Lisa Mc Ken­zie's pre-ac­tion let­ter claimed the BLCTC/Med­corp Ltd was li­able un­der the law of neg­li­gence, aris­ing out of the over-ra­di­a­tion of McKen­zie due to the mis­cal­i­bra­tion of the Linac ac­cel­er­a­tor dur­ing the pe­ri­od he was treat­ed and that the cen­tre failed to take rea­son­able steps to no­ti­fy McKen­zie or his fam­i­ly that there was a mis­cal­i­bra­tion and a pos­si­bil­i­ty that an over­dose of ra­di­a­tion may have oc­curred.

She al­so claims the Health Min­istry and the BLCTC failed to take rea­son­able steps af­ter they re­ceived the re­port from the Pan Amer­i­can Health Or­gan­i­sa­tion (PA­HO) that there was a mis­cal­i­bra­tion and a pos­si­bil­i­ty that an over­dose of ra­di­a­tion may have oc­curred.Ac­cord­ing to a writ­ten let­ter, dat­ed No­vem­ber 3 2010, by on­col­o­gist Dr Pe­ter Bovell at the BLCTC, Ri­car­do McKen­zie re­ceived treat­ment which be­gan on Sep­tem­ber 22 to No­vem­ber 3, 2009 from Mon­day to Fri­day, Preud­homme's let­ter stat­ed.Preud­homme stat­ed in May last year, Ri­car­do McKen­zie sud­den­ly col­lapsed and be­gan hav­ing seizures.

An MRI was sub­se­quent­ly per­formed and the find­ings in­di­cat­ed apart from ev­i­dence of a necrot­ic tu­mor, "ap­pear­ances can al­so be con­sis­tent with ra­di­a­tion necro­sis."The MRI re­port, elec­tron­i­cal­ly signed by Dr Al­lan Thomas, stat­ed: "Fea­tures at the re­sec­tion site are more like­ly to be re­cur­rent tu­mor, How­ev­er, it may be pos­si­ble that this could be ra­di­a­tion necro­sis."The Flori­da Cer­tifi­cate of Death, dat­ed De­cem­ber 23, list­ed McKen­zie's cause of death as res­pi­ra­to­ry ar­rest, ani­plas­tic as­tro­cy­tomz with cere­bral ede­ma and cere­bral ab­scess.

Preud­homme stat­ed that a let­ter by Pro­fes­sor Rober­to C Heros MD on Feb­ru­ary 10 2011 stat­ed:"It is my firm opin­ion that Mr McKen­zie was suf­fer­ing from se­vere, re­cal­ci­trant ra­di­a­tion necro­sis to the brain."It is clear that the necro­sis was due to ra­di­a­tion ther­a­py he had in Trinidad but I can­not com­ment with au­thor­i­ty on the amount of ra­di­a­tion that he had."What I can say is that this is the worst case of ra­di­a­tion necro­sis I have ever en­coun­tered."There is no ques­tion that his ra­di­a­tion necro­sis led to his death."McKen­zie was an in-pa­tient at the Jack­son Memo­r­i­al Hos­pi­tal from Ju­ly 27 to De­cem­ber 21 when he died.He was the joint own­er of the pop­u­lar St James sports bar, "Smokey and Bun­ty".

Flash­back

• Ju­ly 6-Khan an­nounced that there was the pos­si­bil­i­ty 223 pa­tients who sought treat­ment at the BLCTC could be ex­posed to po­ten­tial late ef­fects of ir­ra­di­a­tion which was based on the find­ings of a PA­HO in­ves­ti­ga­tion con­duct­ed in Sep­tem­ber last year af­ter dis­crep­an­cies over a pos­si­ble mis­cal­i­bra­tion.

Khan said the re­port in­di­cat­ed a mis­cal­i­bra­tion rang­ing from per cent to 20 per cent.

• Ju­ly 7-BLCTC said it was aware of a small mis­cal­i­bra­tion on its lin­ear ac­cel­er­a­tor but prompt­ly sought to have it ad­just­ed, checked and ver­i­fied at a cal­i­bra­tion lab­o­ra­to­ry in the Unit­ed States.

A state­ment said: "Each of the pa­tients treat­ed was called/fol­lowed up/seen by a BLCTC ra­di­a­tion on­col­o­gist and of those pa­tients, on­ly five pa­tients re­port­ed symp­toms that may have been at­trib­ut­able to side ef­fects of ra­di­a­tion."

• Ju­ly 14-Achong Low said the cen­tre was the on­ly one to have been au­dit­ed by PA­HO and giv­en a clean bill of health.

Achong Low said the max­i­mum cal­i­bra­tion at any giv­en time was 13.9 per cent. He al­so said the num­ber of pa­tients was 218 and not 223 as re­port­ed by the min­istry.

• Ju­ly 18-Khan said with as­sis­tance from the In­ter­na­tion­al Atom­ic En­er­gy Agency, the min­istry would launch an in­ves­ti­ga­tion in­to the BLCTC to de­ter­mine the cause for con­flict­ing mis­cal­i­bra­tion re­ports on a Var­i­an 23 iX lin­ear ac­cel­er­a­tor.