Fired for creating panic

The day before she was fired as Scarborough General Hospital's Medical Chief of Staff, Dr Rufaro Celestine sent a legal letter to the Tobago Regional Health Authority (TRHA), questioning the conduct of the authority's CEO Sheldon Cyrus in relation to an e-mail she had written, two weeks ago, expressing concern about the shortage of medical staff at the hospital.

In the e-mail which was leaked on social media, Celestine suggested the hospital should be placed in emergency mode as a result of the lack of specialist doctors.

The former medical chief of staff, through her attorneys, Martin George & Co, sent a letter on Thursday to TRHA Chairman Ingrid Melville and copied to Cyrus, complaining the latter had wrongfully accused her of professional misconduct in the discharge of her duties in two letters received on November 12 – but dated November 7 and November 12.

Celestine also accused Cyrus of acting in a "renegade" manner and breaching the principles of natural justice by allegedly not allowing her to respond to serious allegations made against her. Celestine said she had addressed the reasons for sending the e-mail in a meeting with the TRHA board of directors on November 7 and thought the matter resolved amicably. Cyrus did not attend that meeting.

As such, Celestine, through her attorneys, had requested a written response from Cyrus "that the allegations would be "immediately and unconditionally dismissed" and her professional integrity be restored.

The law firm had given the TRHA seven days to respond to her November 14 letter.

Celestine was fired as the hospital's Medical Chief of Staff with immediate effect the very next day, just ten months after she was appointed to the post. Her appointment took effect on January 2, 2019.

A release from the TRHA on November 15 stated: "The Board of Directors of the Tobago Regional Health Authority has terminated the services of Dr Rufaro Celestine as medical chief of staff of the Scarborough General Hospital effective immediately."

The authority said clinical oversight for the hospital would be undertaken by Dr Victor Wheeler, head of the department, Obstetrics and Gynaecology.

The TRHA said it remained committed to ensuring the delivery of the best quality health care for all.

The statement gave no explanation for Celestine's termination but Cyrus, when contacted, told Newsday it was prompted by an e-mail Celestine wrote, two weeks ago, complaining about the shortage of medical staff at the hospital.

"It created unnecessary panic and brought the organisation into disrepute," he said.

In the letter, however, Celestine said she took the necessary steps to address the situation at the hospital and said she was not to blame for the e-mail being leaked to the media.

The law firm noted that on November 1, while on duty at the hospital, Celestine learnt Dr Okeke, head of department, Internal Medicine, fell ill earlier that evening and was unable to provide specialist medical care to the patients.

Celestine also informed her attorneys that Dr Alfred-Demas, the senior medical officer was out on sick leave while two registrars and two assistant registrars were on vacation leave.

"Our client instructs us, therefore, that on that said evening a Locum House Officer....and an intern were the only doctors available to cover the Department of Internal Medicine at the said hospital."

The letter said Celestine quickly contacted Cyrus, who "instructed our client to make efforts to recruit a specialist who would be willing to cover the Department of Internal Medicine at the said hospital."

Celestine said she tried without success to contact a certain doctor but eventually got on to "Dr Madoo" who "unhesitatingly agreed" to provide the required services.

However, the firm said Cyrus informed her the board's chairman Ingrid Melville, was not in favour of the choice "without even providing our client with any reasons and/or explanations..."

The law firm said Celestine was advised by Melville to take on the responsibility of providing specialist cover at the hospital for that evening.

"We are informed that in response to that request our client promptly pointed out that she was not a specialist in internal medicine and that in light of same, she could not, from a medicolegal standpoint, accept responsibility for the patients at the said hospital."

The firm said Celestine received no further guidance from Cyrus in relation to her response.

"And so, in light of the fact that the hospital, despite her best efforts, remained without specialist medical cover, our client then issued a formal e-mail in her capacity as medical chief of staff to the doctors and nurses of the TRHA as well as the medical interns and also to the said Mr Sheldon Cyrus, informing them of the severe staff shortage and lack of specialist cover."

It added: "This was done in an effort to alert the medical team of the hospital's inability to function at its usual capacity and to also inform them that urgent assistance and co-operation was required from them in order to continue to provide patients with the best possible health care."

The firm said Celestine, in the e-mail, also suggested the hospital ought to be placed on emergency mode but advised the medical team that she would first obtain the advice of Cyrus, as her superior.

Celestine said Cyrus advised her the hospital would not be placed on emergency mode and no further instruction was given.

"Our client abided by and respected Mr Cyrus' decision in this regard."

On November 2, Cyrus told Celestine the e-mail, which was addressed to clinical staff and interns "was somehow leaked into the public domain and was broadcast on television stations and also circulated on a daily newspaper that weekend."

Five days later, on November 7, the firm said their client was called to a board meeting of the TRHA' s board of directors at which she was asked to provide an explanation.

Celestine attended the meeting without legal representation and detailed the events which led her to write the e-mail but made it clear she had no idea how it ended up on social media.

"We wish to inform that at no time during the said meeting or thereafter, was our client informed by the board, allegations, hints or suggestions of any misconduct or infraction of any rules or regulations of the TRHA against her in relation to the matter whatsoever."

However, the law firm said on November 12, "to our client's utter surprise and dismay," Celestine received two letters which were both issued by Cyrus, "who, despite the board having closed the matter, appeared to be off on a frolic of his own with these two letters."

The first, dated November 7, was a warning letter but in the one dated November 12 listed a series of allegations of misconduct against Celestine, namely that the e-mail in which she detailed the lack of specialist cover in the Department of Internal Medicine had resulted in "public panic and negative media coverage which has caused the TRHA reputational damage."

It also noted the e-mail was sent to "unauthorised persons who are not employees of the TRHA and interns."

The firm said at no time during her meeting with the board on November 7, was mention made of allegations of misconduct.

Further, the firm said Celestine was not in breach of the TRHA's Code of Conduct.

Celestine, who was born in Zimbabwe, is certified in paediatrics and dermatology. She has been a fully registered member of the Medical Board of TT since 1989.