British tourist dies after going home

Wednesday, Nov. 1, 2006 | 7:21 a.m.

British tourist Terry Brace, whose surgery and prolonged recovery at University Medical Center left more questions than answers for his family, has died after returning home - stoking a Las Vegas mystery that may be solved for the family by medical experts in England.

Brace, 63, underwent emergency gallbladder surgery Aug. 27 at UMC - a procedure that usually requires a day's recovery - and spent a month in the hospital before being discharged and flown home by medical aircraft. He died Monday at the Bristol Royal Infirmary, in his hometown of Bristol, England, his family said Tuesday.

Teresa Hudd, the wife of Brace's cousin, said Tuesday in a phone interview that an autopsy would be conducted today and that a coroner's inquest into Brace's death would follow.

"That is very unusual when there is a death at a hospital here, but they (British medical officials) do not know what happened to Terry when he was in the United States," Hudd said. "They want to find out what happened. We all want to find out what happened."

The family suspects that Brace's bile duct adjacent to his gallbladder may have been severed or mistakenly removed. Medical officials in Las Vegas have been tight-lipped on that subject.

The family has been told by British authorities that it could take months before findings are released.

Brace's plight was reported Sept. 28 in the Sun after members of his family said they were being stonewalled by the hospital and its application of federal laws designed to protect patients' privacy rights.

Those same laws may hobble the probe into Brace's death.

"There are directives for transferring information from one hospital to another and interstate, but there are not clear guidelines at the federal level for multiple jurisdictions between countries," said Larry Matheis, executive director of the Nevada State Medical Association.

Matheis said the coroner's inquest in England may have more to do with providing accurate forensic information for the death certificate than for laying blame for Brace's death.

Hudd and her husband, David, were vacationing with Brace when he fell ill. For weeks they butted heads with UMC officials, trying to get information about what happened during and after surgery.

The Hudds said Brace was never coherent enough to sign paperwork to give them power of attorney so that they could gain access to his medical records while they were in the United States. They accused UMC of using U.S. medical privacy laws that were enacted in 2003 to mask inadequacies and possible errors in Brace's care.

A UMC official said the Hudds were denied medical records because cousins are not high enough on the lineage ladder to receive such sensitive documents according to the federal standards that carry heavy penalties for violations, including potential imprisonment.

UMC spokeswoman Kristina Zemaitis said Tuesday that under federal patient privacy laws, which call for provider-to-provider release of such records, all of the required medical documents were sent to the Bristol hospital when Brace was released from UMC for his medical flight on Sept. 30.

At the British facility, Brace, an art teacher at the City of Bristol College, recovered sufficiently to be moved from intensive care to a ward. But in recent weeks his condition reversed. He died from an apparent liver ailment, his family said.

The family said they still want to know what happened on the night of Aug. 26, when Brace, after complaining about a stomachache, was taken by cab from the Plaza Hotel, where he was staying, to UMC.

"It would be difficult not to find some causal link between the treatment received under the knife in Vegas and his fatal decline in an English hospital a few short weeks later," Brace's friend Peter Allerhand wrote in an e-mail. "Whatever the outcome (of the autopsy), a perfectly sweet harmless guy has just been lost, and many of us old country folks back here in England feel pretty sore."

Brace's family said the veil of mystery over the incident initially led them to mistakenly believe that a student at the University of Nevada School of Medicine, which uses UMC as teaching grounds, did the operation, especially because it was the student who talked with them after the surgery.

Blain Claypool, chief operating officer for the University of Nevada School of Medicine, who looked into the incident following an inquiry from a Sun reporter, said that while a resident was present at the operation, Dr. James Tate, an adjunct professor at the school, "was the surgeon of record."

Claypool also said it is policy for the resident, not the doctor, to talk to the family after a surgery, apparently to get experience in that area.

Tate has practiced 18 years in Las Vegas, according to the Nevada State Board of Medical Examiners. A woman answering the phone at Tate's office said he declined to be interviewed for this story.