The Tribune

By TANYA SMITH-CARTWRIGHT

ts-cartwright@tribunemedia.net

A ROW erupted in Princess Margaret Hospital’s Dialysis Unit recently, when, in what he says was a bid to prevent the spread of COVID-19, Dr Frederick Smith asked that all patients remove their shoes or not receive treatment.

Giavano Bowe, feels his father Marvin Johnson, a dialysis patient, was “ill-treated” by Dr Smith, director of nephrology at PMH, while at the hospital’s Dialysis Unit on April 24.

“My dad went for his routine dialysis treatment on April 24 to the Princess Margaret Hospital as per usual,” Mr Bowe recalled. “During treatment, Dr Smith told my dad that he needed to remove his shoes while on the dialysis machine due to the recent COVID-19 outbreak. My dad, being a forty-year diabetic patient with diabetic feet and severe nerve damage to his feet refused to take off his shoes and explained his reasoning to Dr Smith.

“Because my dad did not comply, angrily, Dr Smith then made a statement to the staff on the ward in a very audible voice, ‘from now on, if this patient or any others refuse to remove their shoes on this ward, do not allow them access to the dialysis machine.’ Well, needless to say my dad felt threatened and uncomfortable about the statement. He called me immediately and we discussed how we were going to handle this situation.

“I advised my dad to make a complaint to the police department for the record’s sake in the event that something were to happen to him as a result of a rule/law that was not yet in writing. In addition, my dad and I put together a letter of complaint which would then be given to the administrator of PMH and the head of PHA on Monday, April 27, 2020.”

According to Mr Bowe, the incident continued on the following Monday when his father went for dialysis treatment and was met again by Dr Smith asking him to remove his shoes.

“My dad asked for a shoe cover as he was not prepared to have his feet exposed to the ground due to his current condition,” said Mr Bowe. “Also, my dad had a copy of the letter for Dr Smith and handed him the same within moments of him making that statement. About an hour after handing Dr Smith the letter and being admitted to the dialysis ward, my dad calls me in a state of panic only to relay to me the worst – Dr Smith had instructed the dialysis ward staff to take my dad off the dialysis machine and deny him dialysis treatment effective immediately.

“A dialysis patient being denied access to the healthcare system is an indirect breach of the Hippocratic Oath and a signing of his/her death warrant, in my perspective. Furthermore, I am quite positive that Dr Frederick Smith nor anyone employed under the Public Hospital Authority working for a public healthcare facility has the right to deny a Bahamian tax paying citizen any form of health care treatment.”

The Tribune contacted Dr Smith and asked him about the incident. Dr Smith said for the past two weeks or so, he has made it his routine to go into the Dialysis Unit and remind everyone, including staff and patients, of what the rules are - to wear masks at all times, no eating or drinking, not to come to the unit more than an hour before treatment and to remove shoes when on the dialysis machines as the bottom of shoes can hold the COVID-19 virus and put patients and staff at risk.

“On the evening of April 24, I did not call any names. I stood in the front of the unit and I said, ‘Ladies and gentlemen can you all take off your shoes, please.’” Dr Smith said. “Some patients took them off others didn’t. Again I said, ‘Ladies and gentlemen can you all take off your shoes please. The reason I am asking this is to prevent COVID from being spread.’ Some people took off their shoes and one patient says, ‘I am not taking off my f*g shoes.’ And, I asked him again to take off his shoes. He said he was not taking off his shoes because I was making up rules. I told him those are the rules, we have to enforce them to keep us safe. I also told him if he doesn’t take off the shoes, we are in our right to deny him treatment and to disconnect him from the circuit because he was not abiding by the rules.”

Dr Smith said the patient then said, “I ain’t comin’ off this machine” and the doctor asked the nurse to take the patient off the machine. The nurse, he said, subsequently went to the patient and begged him to take his shoes off and told him she would give him booties to put on. The patient still refused, Dr Smith said.

“I called in the risk manager who told the gentleman we were well within our rights to discontinue the service to him because we have to make the environment safe for everyone and that everyone needs to abide by the rules,” said Dr Smith. “I then told the nurse going forward no one would be put on a dialysis machine unless they are following all of the rules. I then said, ‘ladies and gentlemen, dialysis is life saving and I want you to have your treatments, however, if you do not abide by the rules we cannot put you on the machine.’ His dialysis was continued for the evening.”

Dr Smith said the patient returned on the evening of April 27 and was again asked to remove his shoes. He said the patient refused and was told by a nurse that he could not be put on the machine with his shoes on.

“He then said, ‘That’s okay then I am not going to do the treatment. This ain’t gonna end like this, all of y’all trying to kill me.’ The reality is there are some people who are more difficult than others and this just happens to be one of the repeat offenders,” Dr Smith said.

He added that he never threatened Mr Johnson, but was enforcing the rules of the Dialysis Unit and trying to keep patients and staff from contracting COVID-19.

However, Mr Bowe said he wants this “type of behaviour” addressed immediately.