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April 09. 2014 2:17PM

Keene doctor reprimanded after patient's death

A Keene physician was reprimanded by the state Board of Medicine after a patient he cared for died last year in the emergency room at Cheshire Medical Center.

As a result of the reprimand, Dr. Adnan S. Khan is required to take 15 hours of advanced cardiac life support education. He agreed to the discipline in a settlement with the board, but neither admitted nor denied his actions in the case constituted professional misconduct.

Khan was licensed to practice medicine in New Hampshire on Feb. 7 , 2007, and practices emergency medicine in Keene.

According to the seven-page agreement dated April 4, Cheshire Medical Center revoked Dr. Khan's privileges after the patient died. The state board opened an investigation into the incident after it was notified on June 4, 2013, of the hospital's actions.

The patient was brought to the emergency room by ambulance the night of Feb. 6, 2013, in respiratory distress, with a fever and elevated heart rate as high as 278. A normal heart rate is 60 to 100 beats per minute at rest.

Emergency medical services (EMS) personnel performed a pre-hospital EKG because ventricular tachycardia "VTach" was a concern.

Ventricular tachycardia is a pulse rate of more than 100 beats per minute, with at least three irregular heartbeats in a row, according to the National Institutes of Health. The condition can develop as an early or late complication of a heart attack.

EMS contacted the hospital to report the patient's vital signs and their impression of VTach. The patient arrived at 11:29 p.m. and was triaged at 11:42 p.m. with a pulse of 245, blood pressure of 53/39 and a temperature of 101.02. An EKG was done at 11:43 p.m. and Dr. Khan was shown the results four minutes later.

He examined the patient at 12:13 a.m. and suspected VTach, but "no therapy was administered," according to the agreement.

Khan then contacted the on-call cardiologist, who advised him to treat the patient for probable sepsis with fluids and Tylenol.
Khan ordered IV antibiotics and spoke to a Dartmouth-Hitchcock critical care physician about transferring the patient.

At 12:29 a.m. - an hour after the patient arrived - he suffered a "ventricular fibrillation cardiac arrest" - a heart attack. He was treated with various medications but "no shock was given," according to the board. He was pronounced dead at 12:45 a.m.

Sandra Phipps, senior director of development and communications for Cheshire Medical Center, said Khan’s privileges to practice at Cheshire Medical Center were revoked on July 17, 2013. However, Dr. Khan did not provide patient care at Cheshire Medical Center after Feb. 7, 2013, she said.


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