Lack of clinical notes angered UAE judge in Karabus case.

In an ironic twist, the absence of clinical notes sufficient to properly rule on manslaughter and forgery charges brought in the United Arab Emirates (UAE) against 77-year-old veteran Cape Town oncologist Professor Cyril Karabus may have led to his acquittal. On 6 December the prosecution failed for the second time to produce clinical notes made during the critical two weeks Karabus treated a 3-year-old leukaemia patient at the Sheikh Khalifa Medical Centre (SKMC) in Abu Dhabi in 2002. The veteran specialist, for the first time in the nearly four months since his shock airport arrest, took the stand, telling the judge that the prosecution's failure to produce the notes amounted to 'an insult to the ruling Sheikh (Khalifa bin Zayed bin Sultan Al Nahyan) and the court'. The judge reportedly agreed with him and expressed deep dissatisfaction at the ongoing impasse which prevented a court-ordered medical committee from properly reviewing the case. Karabus' legal team saw the medical file for the first time at the 20 November hearing. (The child failed to respond to chemotherapy and succumbed with fever to intracranial bleeding and a middle cerebral arterial obstruction on 19 October 2002.) Conspicuously absent were supportive notes (clinical records, laboratory blood count results, blood bank forms, nursing notes and infusion charts) to support Karabus' contention that he gave the child red cell and platelet transfusions. He is charged with manslaughter in that he allegedly failed to give platelets which led to her death, plus an additional count of forgery which claims he fraudulently wrote out instructions for the platelet administration after she died. His dramatic detention came on 18 August after Karabus, his wife, Jennifer, daughter Sarah and Sarah's two children overnighted in Dubai en route from Canada to Cape Town, having attended his son's wedding. Sarah told Izindaba that she just missed witnessing the arrest which came at passport control after they returned to the airport to board the home-bound flight the following morning. Her mother was given five minutes to say goodbye and told she must board her home-bound flight. 'When we saw her she was completely traumatised,' she added. Sarah, a paediatrician at the Chris Barnard Hospital in Cape Town, told Izindaba that while family spirits (Karabus senior has five children and his wife flew back to Abu Dhabi to support him) had flagged, they had pinned their hopes on one vital document their lawyers did have. …