Seven months before a Dunedin doctor stabbed a teenager to death, he turned up to a work meeting looking "a complete mess" and berated staff, documents reveal.
In the High Court at Dunedin on Wednesday, after a trial lasting nearly four weeks, Venod Skantha, 32, was found guilty of the murder of 16-year-old Amber-Rose Rush.
The jury heard from Southern District Health Board chief medical officer Dr Nigel Millar that, as a result of serious misconduct, Skantha was on a final warning at work when he committed the brutal killing on February 2 last year.
The basic details of the incident which put the doctor in hot water were aired during the trial, but the Otago Daily Times has obtained a report that shows the full extent of the man's erratic behaviour.
That included him reacting angrily to Dunedin Hospital staff, crying in front of a secretary and telling them he had been drinking "to numb the pain" of his mother's death.
Skantha's mother is not dead.
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The draft version of lawyer David Sim's independent review of the episode shows how the doctor called in sick to his Dunedin Hospital job three days in a row.
On July 5, 2017, he messaged his superior, Dr David Gow.
"Dr Gow I need your help. May I see you tomorrow please?" he sent.
Skantha said his absences had not been caused by a gastro-bug, as he earlier suggested, but by his mother's death the previous week.
The supervisor agreed to meet the following day and told him to take the rest of the week off.
Despite the plan being confirmed, Skantha showed up that same day with two teenage friends, to see Dr Gow.
When the trio arrived at the third floor, a medical secretary overheard their conversation.
"Are you looking for Mr Gow? I can direct you," she said.
Skantha's reaction, she said, was loud and aggressive.
"He is Dr, not Mr. He worked hard for his title and it cost him a lot of money, show him some respect, he's Dr Gow. Now hurry up and tell me where he is."
The secretary, who said she smelled alcohol during the exchange, was comforted by another doctor who told her Skantha had issues.
When interviewed by Sim for his report, the would-be killer told him it had simply been an example of "dark humour" and he had not intended the woman take him seriously.
The group was then directed to another reception where Skantha again had an unusual interaction with an administrative staff member.
While sitting with his head bowed, he began crying.
The woman asked whether he was feeling unwell. Skantha told her his mother had died.
"I've been drinking, you know, to numb the pain," he said.
She told the doctor he should know that consuming alcohol was inadvisable.
They left when it became clear Dr Gow was not there and was not expecting them.
Before leaving the hospital, however, Skantha took his young associates to the orthopaedic ward where he worked.
In a bed, recovering from a motor vehicle accident, was a woman.
While Skantha told her he had seen her the previous day, she said she could not recall that.
He introduced his female friend as a dental student, the report said, which she too thought strange.
Skantha said he had to flush the patient's cannula, which surprised the woman since it had not yet been used.
She was so concerned by the doctor's behaviour that she asked to check he was using saline solution.
Skantha then taped the cannula "very tightly" and annotated it with the previous day's date.
Bizarrely, he also taped down the woman's thumb so she could not move it and when she questioned him, he responded: "It won't matter."
In August that year, when he was interviewed about the episode, Skantha accepted it had been an error of judgement.
But before he left, he bumped into nurses with whom he had previously worked.
Skantha — who was wearing a tracksuit — "clearly looked a complete mess", one of his colleagues said.
Another asked him what was wrong.
"You look terrible," she added.
Skantha told them his mother had died.
The associate charge nurse manager asked him if he had been drinking.
"This is how I cope with grieving," Skantha said.
He asked the manager whether she thought he was a good doctor, and she replied that she had heard nothing to the contrary.
She later said the incident was concerning because, uncharacteristically, Skantha would not look her in the eye.
After consideration of the various witness statements, as well as the comments of the doctor and his friends, Sim released his report.
In it, he found all three allegations had been proven: that Skantha had come in smelling of alcohol, acting emotionally and had treated a patient.
All, he wrote, were potentially explicable by the man suffering a recent bereavement.
At trial, Millar told the court the serious misconduct had eroded his trust and confidence in the doctor.
His preliminary decision was to dismiss Skantha but a letter from the man's lawyer in November that year, asking the DHB to take into account the loss of his mother, earned him a reprieve.
Had he known the death of Skantha's mother had been a lie, Skantha would have been sacked, Millar said.
But the DHB did not think to check the validity of the doctor's claim and he continued working, his career teetering on the edge of decimation.
Then on the night of February 2 last year, Amber-Rose told Skantha she would inform his hospital bosses about him "touching up" young women, offering them money for sex and supplying alcohol to minors.
Just minutes later, the killer was in her Corstorphine bedroom stabbing her repeatedly with a kitchen knife, leaving her to bleed to death.
Skantha will be sentenced in March 2020.
July 3, 2017:
Skantha calls in sick to work.
Again takes the day off, claims he has a gastro-bug.
July 5, 7.56am:
Calls in sick for a third time, says he will get a doctor's note.
Skantha messages his supervisor, says his mum has died, asks to meet the following day. He agrees.
Skantha shows up to the hospital with two friends, a day early for the meeting.
Skantha berates staff, cries in front of a secretary, admits he has been drinking, treats patient.
Messages supervisor: "I can't afford to lose my job".
Lawyer David Sim speaks to witnesses, compiles report on the episode.
SDHB chief medical officer Dr Nigel Millar makes preliminary decision to fire Skantha.
DHB receives letter from Skantha's lawyer, stresses he was grieving his mother.
Millar amends his decision and gives the doctor a final warning.
February 2, 2018:
Skantha stabs Amber-Rose Rush to death when she threatens to derail his career.