High profile doctor cross examined for indecent assault charge
By Unumoe Esera
APIA: Thursday 5 July 2012: A well-known Physician, Obstetrician and Gynaecologist and founder of the private Medcen Hospital, Le Mamea Dr. Emosi Puni took the witness stand yesterday afternoon as he defended himself against one count of indecent assault brought by a former patient.
The retrial for the doctor began two days ago where his name suppression was lifted by the Court. The complainant still has her name suppressed.
The alleged incident occurred seven years ago on the 18th July 2005 and the doctors legal team had since managed to get a closed hearing and name suppression until the Court of Appeal ruled the case go to retrial.
Prosecution completed their evidence yesterday. The Prosecution’s last witness Papali’i Dr. Viopapa Annandale told the court that the victim had come to her for a consultation on the 22nd July 2005. This was some three days later after she was examined by Dr. Puni.
Dr. Annandale when asked to describe how she saw the victim said that from her perspective the victim wasn’t really experiencing any discomfort. But had told her during the consultation that she had a positive pregnancy test on the 14th July 2005 and she was experiencing low abdominal pain. She had also said that her last period had occurred on the 15th May 2005.
Dr. Annandale said however that during her examination at the Soifua Manuia Clinic, the victim had light bleeding and the victim had requested that the intra uterine device (IUD) be removed. She noticed in Dr. Puni’s notes that there was no indication to remove the IUD.
Dr. Annandale also told the court that the scan report for the victim showed that an ultrasound had been carried out and with two options upper and lower. The lower box was ticked. The results revealed that the position of the uterus was anteverted (tilted backwards) and no evidence of a gestational sack. She then seated the victim on an examination couch with a supporting part so she could sit up. The by-manual procedure was performed and the victim did not complain of any pain at all. From the procedure there were no masses and the uterus was normal.
Dr. Annandale said that the whole procedure took four to five minutes as it was a straight forward examination. The victim had the IUD inserted for a year and half and was recorded in the Dr. Annandale’s notes as the 15th October 2003.
Other Prosecution witnesses gave evidence yesterday. Afatia Palaamo, a nurse from Toamua told the court that when she had been present when the victim had come to see Le Mamea Dr. Emosi Puni.
She said the victim was not scheduled to see a specific doctor and also did not have an appointment but had requested to see a doctor for women which is why she had referred her to Dr. Puni.
After her appointment she said the victim came up to her and said she was not going to pay the bill.
“I told her sorry you have to, otherwise you will have to go back to the doctor and discuss this. I saw her crying. She said she didn’t want to go back to the doctor,” said Afatia.
Afatia said that the victim told her that she doesn’t like the doctor’s service and was not going to pay the doctor’s bill. She then walked down to where her husband was. Afatia relayed the message to Dr Puni.
“I told him the patient (victim) wasn’t going to pay the bill as she was not satisfied with his service. He said its ok wait till she comes for the follow up appointment,” said Afatia.
After that day she never saw the victim come to the hospital again.
Eseta Vaipou from Sinamoga, mother in-law of the victim gave evidence. She said that in 2005 she was living with her son, his wife and child but in separate houses. She was not aware of her son and wife’s visit to the hospital but they came in the afternoon.
“The car stopped and my daughter in-law walked to my house and she was crying. She came alone, my son was in the car. She asked whether I was going anywhere and said she had something to tell me. I told her I was not going anywhere and to tell me what happened,” said Eseta.
She said her daughter in-law told her that she had gone to the hospital and a scan was performed and Dr. Puni had told her to lie on the bed. The doctor carried out his examination and it took a while. Her daughter in-law told her she then sat up to see what was happening and saw the doctor’s body was shaking and his private part was hanging out and asked her whether she wanted him to put it in, her daughter in-law had told her she had responded no. He then asked her whether he should perform the procedure that she had come for and she also replied no.
He then wrote her the bill and she came out. Eseta’s daughter in-law told her that she did not tell her husband what had happened as she loves him.
Eseta told the court her daughter’s expression was one of sadness and she also looked worried. Eseta said she then called her son to come over and that they should report the matter to the police.
Dr. Emosi Puni’s evidence
Defense presented their first witness, late yesterday afternoon. Le Mamea Dr. Emosi Puni, a Physician, Obstetrician and Gynaecologist by profession from Tiapapata gave evidence.
The alleged incident took place on a Monday.
“What were Mondays usually like for you?” asked counsel for the Defendant, Belinda Sellars.
“Monday is usually a busy day for us. There are two to three doctors working simultaneously. Monday is fairly busy and a hectic day,” replied Dr. Puni.
He said the average number of patients he sees on Mondays is around 20 patients within an allocated time of 15-20 minutes with each patient. Some would take longer and others a shorter period of time.
Asked when he first saw the victim he said, “When I first saw her, I had just walked out of my office picked up a file from my pigeon hole next to the door and called out her name. She stood up and followed. She walked over and I indicated she can go inside the room.
“I might have said Talofa or malo and indicated the seat next to my desk to sit there. I then said malo, what brought you into the hospital and what problem brings you here? She said she has been referred to me for my opinion as she had a positive pregnancy test, intra uterine device (IUD) and also low abdominal pain for three or four days,” said Dr. Puni.
He said he then told the victim that the first thing they needed to establish is whether she was pregnant or not and that could only be confirmed by an ultrasound and it would also tell whether the IUD was in the right place (uterine cavity). He then filled in a form for the ultrasound for her to go to the sonographer Jesse. “I requested for her to have a pelvic scan,” he said.
After the scan, he took her file and called her name to come again. “I told her I have your ultrasound report. You are not pregnant,” said Dr Puni.
He said after reading the report he told her there was no evidence of pregnancy in the uterus and the IUD was in the right place (uterine cavity). He then discussed the report of the uterine cavity,
“I told her (victim) that the ultrasound showed no pregnancy and she might want to reconsider whether the IUD should be removed. Other contraceptive options available were the injection which would last three months or take tablets everyday,” he said.
Asked what he thought of the patient (victim). “She was not very communicative. I thought she must be thinking and considering her options. She said she had low abdominal pains and I would need to conduct a vaginal examination,” said Dr Puni.
He said he did not use the term ectopic pregnancy but used the words outside pregnancy meaning within the tubes.
“To find out what is causing her pain, I told her to make a decision of what kind of contraception she would use. I asked if she was with a friend she said no she was with her husband. I asked her whether she wanted him to be present during the examination she said no he was with their child,” he said.
He said he told the victim that as she had had the loop inserted before, the examination would be similar to that and he would be using his fingers. Dr. Puni said he told her to remove only her underwear behind the divider and not all her clothing. He also claims that he did not say she was big and only that the injection would make her gain weight.
“She is somewhat overweight as she weighs 95kgs,” he said.
He said she did not in any way indicate to him that she wanted the IUD to be removed or in place. He said the discussion between them lasted for five or six minutes.
“When she came for the first consultation before the ultrasound, I underlined problems, early pregnancy and IUCD inside you.”
He said before the second consultation, she had told him that her periods were delayed and may be partially due to her weight. When the examination was about to take place she was already seated on the bed with her legs hanging down the foot of the bed. He was still sitting at his desk at that time but had turned towards the bed.
“For me to examine her she would have to lie down and I pulled out the extendable part of the table to stretch out her legs. I then walked over and pulled the curtains closed.”
Asked why he had done this, Dr. Puni said it was because people were walking around outside could see as there was a service road beside the part of the clinic where the window was facing.
After he shut the curtains he told her he was going to examine her vaginally and told her to move down so that her buttocks were at the edge of the bed without the extendable portion of the bed. He said she was still fully clothed at this point, wearing a puletasi on a lavalava.
From the extendable part of the bed he pulled out two stirrups, at that stage he was still standing.
“I asked her to please put her feet on the stirrups with the heel of her foot on the stirrups then pushed back halfway the extendable portion of the bed to be pushed in to be at the same level as the doorstep. I then turned on the examination light, brought speculums and forceps then placed on extendable portion now forming a little table or tray.
“I was sitting down on my chair facing patient with her legs apart. I started sitting when I pushed back the extendable portion of bed. I adjusted the examination light to light it up a little bit more. After pulling out the stirrups I opened the draw and unwrapped the instruments and placed them on tray,” he said.
He said he then opened a packet of gloves and put it on. He put on the right hand glove first with the left hand lubricating jelly on the long portion of the speculum. At that time he was holding speculum with right hand and said, “O le mea lea o le a tu’u totonu o ‘oe e va’ai ai lou itutino sa. It’s going to be a bit cold,” said Dr. Puni.
He said he then told her he was going to insert the speculum inside and would gently push the speculum in at an angle and slowly turn it so that the angle of the speculum was facing down.
The doctor’s evidence continues today.
Prosecutors Leinafo Taimalelagi and Rexona Titi represent the victim and Belinda Sellars and former Judge Tagaloa Enoka Puni for the Defense Counsel. The hearing continues.