Vancouver resident Sandra Ickert cradles a picture of her parents, Marie and William Mesecher. Ickert wants answers from hospital officials and Dr. Jayant M. Patel after Patel operated on Marie Mesecher in 1997. Mesecher died after the procedure. (JANET L. MATHEWS/The Columbian)

Friday, March 10, 2006
By JONATHAN NELSON, Columbian staff writer

Sandra Ickert stood by her mother's bedside in 1997 and fought back tears as she peered at the near lifeless form of Marie Mesecher.

The room at Providence St. Vincent Medical Center's intensive care unit was quiet and felt like death, Ickert said. The machines and bed dwarfed the 73-year-old, 5-foot-2-inch Mesecher, who had lost weight as a result of pancreatic cancer. She had just spent approximately six hours in surgery where doctors worked to treat the Vancouver woman's cancer by removing a portion of her pancreas.

Ickert said her mother's doctor, Jayant M. Patel, described the surgery as a routine procedure.

But three hours after the first surgery, doctors rushed Mesecher into an operating room.

It takes two paragraphs to describe what happened. The final sentence reads, "After multiple attempts to resuscitate her, she died in the Operating Theater."

The 56-year-old Ickert, of Vancouver, said the lasting image of her mother is one she wants to forget. The loss of blood drained any color from Mesecher's skin and her swollen tongue protruded from her mouth.

Ickert wanted to pound on her mother's chest, to beat life back into her.

"You've got to work to get back to us," Ickert said.

The surgeries left Mesecher's body battered. One incision ran from her torso to breast line. Another was on her left wrist. Blood oozed from puncture holes that pocked her arms.

The Hamilton-Mylan Funeral Home in Vancouver wrote on its report that Mesecher's body arrived in "poor condition."

Grief engulfed Ickert. The family lost their matriarch, the woman who organized reunions, competed fiercely at even the simplest card game and loved to bowl. Ickert was most distressed that the unexpected and abrupt death didn't give the family a chance to say goodbye.

The years and routine of life softened the sadness. A phone call a year ago reopened that wound as if a bandage had been ripped away.

Images of Patel were being splashed across television news broadcasts and newspapers with reports that Australian authorities are investigating Patel in the deaths of 13 patients. Australian officials now want to extradite Patel.

Patel's Portland attorney, Stephen Houze, said Patel is not submitting to any media interviews. He also said in an Associated Press story that Patel could not get a fair trial in Australia because of the inflammatory press the cases had garnered.

Ickert is considering her own legal options, but her attorney, Stephen Giardini, said there are questions about whether the statute of limitations has expired.

"The greatest obstacle is the lapse between the act and the filing," he said.

Five cases settled

If Ickert sued, it wouldn't be the first time Patel's name was tied to legal action.

The Oregonian reported that Kaiser Permanente, the region's largest health maintenance organization, has settled five cases involving Patel and paid out $1.8 million in two of them.

Patel worked for Kaiser from 1989 until his resignation in 2001. He then went to a job in Australia. Patel left Australia in April and is now living in Portland, Houze said in the AP story.

Before coming to Oregon, Patel surrendered his medical license in New York.

Ickert would have appreciated knowing about Patel's past legal dealings and the fact that he surrendered his New York medical license. Instead, she said Mesecher was only given glowing accolades regarding Patel.

"Patel talked himself up like he was godly," she said.

It wasn't until Ickert saw Patel on the news that she questioned what happened on March 3, 1997, when Mesecher was wheeled into the operating room at Providence St. Vincent Medical Center in Portland. The medical reports Ickert gathered revealed a grisly story.

The four-page narrative is a concise, detached accounting of the procedure in which Patel performed a Whipple operation. The University of Southern California's Department of Surgery describes the procedure on its Web site as a method to remove the head of the pancreas, a portion of the bile duct, the gallbladder and the duodenum.

The site says studies show an experienced surgeon is important for good results.

Mesecher's operation turned fatal when a vein was torn. Doctors tried to sew the hole, but the surgery narrative said the vein "was the consistency ? of wet tissue and did not take suture well."

Massive bleeding followed. Doctors packed the wound and sent Mesecher to the intensive care unit. The bleeding, however, wouldn't stop and at one point seeped from the incision and pooled on the floor under Mesecher's bed.

About three hours after the initial surgery, Mesecher was rushed back into an operating room where she later died. Records show doctors used 82 units of blood in treating Mesecher.

"It was like a horror movie," Ickert said.

Ickert said whatever chance she has at a lawsuit isn't about the money.

"I've been without money my whole life," Ickert said. "I don't want to make money off my mother."

She wants someone to take responsibility.

Hard working, fun

Mesecher was born in Knob Noster, Mo., and eventually moved to Vancouver. She worked in the shipyards and cannery, sometimes coming home still wearing a hair net and rubber apron. Later, the family opened the Colonial Shake Shop, a business Mesecher oversaw.

The family of six children meant Ickert's father, William Mesecher, often worked two or three jobs. Dinners frequently meant pancakes slathered in hamburger gravy. Ickert said she didn't realize pancakes could be eaten with syrup or jam until she was an adult.

Payday meant a special meal, specifically big fat hot dogs and tomato or vegetable soup a tradition that continues today.

"I didn't know we were struggling," Ickert said.

It was Mesecher who also nurtured the family's passion for card games, specifically pinochle. It wasn't uncommon at family reunions to have up to three tables of games going at the same time.

But Ickert remembers her mother's competitive spirit was matched by an equally fierce temper when she lost. That meant guarding against mom and dad playing each other, Ickert said.

The family held its first reunion since Mesecher's death in August. Ickert took Mesecher's former role as organizer.

Any joy from bringing her sisters and relatives together was tempered by an anger toward Patel that still simmers.

"She was a lot of fun," Ickert said. "She wasn't ready to go."

Jonathan Nelson is a business reporter for The Columbian. He can be reached at 360-759-8013 or via e-mail at jonathan.nelson@columbian.com.