August was supposed to be a happy time for Cyril Karabus, a retired South African doctor who was in Canada for a family reunion and the wedding of his son, a Toronto lawyer.
On the way home, however, the 77-year-old pediatric cancer specialist was suddenly detained on a manslaughter charge he knew nothing about, during a stopover at Dubai International Airport in the United Arab Emirates.
“Dad’s been arrested. They won’t tell us why. Get hold of a lawyer,” his daughter Sarah, who was travelling with Dr. Karabus, managed to text to her brother before the rest of the family was forced to board a departing plane, leaving the elderly physician behind.
They later learned that, unbeknownst to Dr. Karabus, a court had sentenced him, in absentia, to 3 1/2years in prison in connection with the death of a patient he treated years ago while employed in Abu Dhabi by a Canadian health company.
What happened to Dr. Karabus underscores the perils of working overseas. Canadian employers with staff abroad often have professional liability insurance and indemnities to handle unforeseen legal hassles.
The Toronto firm that hired Dr. Karabus, however, told his family that it is not liable for his problems. The company told The Globe and Mail that it wasn’t aware of the charges and that, since it was a criminal matter, legal fees wouldn’t have been covered by the malpractice insurance it offers its staff.
Emirati authorities will try Dr. Karabus again now that they have him in custody. In the meantime, his passport has been seized and he is being held without bail. His next court date is Oct. 11.
“It’s difficult to fathom how someone like him can be caught in a situation like this,” said his son Matthew.
Dr. Karabus’s problems stem from a 2002 stint he did replacing a doctor at a hospital then managed by Toronto-based InterHealth Canada Ltd (ICL).
In statements e-mailed to The Globe and Mail Thursday, InterHealth said it ceased operating the hospital in 2003. “At no time was ICL informed of any complaint in relation to Dr Karabus’ performance of his clinical duties; no complaint was made against either ICL or [the hospital] and no claim was made under ICL’s medical malpractice policy.”
The company said it had difficulty establishing what happened at the time because it no longer manages the hospital and transferred records to UAE authorities.
InterHealth initially told Matthew Karabus that the doctor his father replaced should have warned him about the charges.
“We fully complied with our obligations towards your father and see no basis upon which we can be considered liable,” John Hyland, a lawyer for InterHealth, wrote in an e-mail seen by The Globe and Mail.
Dr. Karabus was filling in for five weeks for Lourens De Jager, another South African pediatric oncologist, at Sheikh Khalifa Medical City.
One patient they dealt with was a girl with a diagnosis of acute myeloblastic leukemia, a type of blood cancer, Dr. De Jager recalled in an interview from Pretoria.
The girl died, and Dr. Karabus returned to South Africa two weeks later.
According to Mr. Hyland’s e-mail, the girl’s father complained to police and Dr. Karabus was charged with manslaughter and also accused of forging a document ordering that the girl receive a transfusion of platelets.
“Wiel Al Mameed,” a cardiologist, heard about the charge and notified hospital officials, Mr. Hyland’s e-mail said.
“The department head advised Dr. De Jager, who by that time had returned from vacation, of the position and instructed that he advise your father not to return to or pass through the UAE,” the e-mail said.
In an e-mail to The Globe and Mail, the only SKMC cardiologist with a similar name, Wael Al Mahmeed, denied knowing about the court case until now.
Dr. De Jager also disputes InterHealth’s account. “That’s definitely not correct. I never knew anything about the sentence, otherwise I would have warned him.”
He recalled that there was an inquiry and that he and a hospital manager, John Morse, were questioned by police but they had no inkling that there would be charges. “InterHealth Canada was the employer at that stage,” he said. “Why would they ask me to inform [Dr. Karabus]?”
In statements e-mailed to the Globe and Mail, Mr. Hyland said no claims were made to the malpractice insurance InterHealth offered its employees.
“The charges which it seems were brought against Dr Karabus were brought under the criminal law; the costs of his defence against criminal charges would not have been covered by our or any other medical malpractice policy of which I am aware,” Mr. Hyland told the Globe and Mail.
There are about 27,000 Canadians living and working in the UAE. The Canadian government cautions that practices such as issuing a cheque without funds or failing to pay an invoice are considered by Emirati officials as serious offences that can result in jail. Non-residents are also not granted bail.