Prominent surgeon Munjed Al Muderis has told the Federal Court he considered operating on a morbidly obese man with vascular dementia, uncontrolled diabetes and ulcers that would not heal, against the advice of two fellow medical professionals.
Al Muderis is a specialist in osseointegration surgery, which involves inserting titanium pins into the residual bone of an amputee, allowing prosthetic limbs to be connected.
Surgeon Munjed Al Muderis outside court in Sydney this week.Credit: Dion Georgopoulos
A clinical professor at Macquarie University, he is suing The Age, The Sydney Morning Herald and 60 Minutes over reports published and aired in September 2022. He alleges the reports convey a range of defamatory meanings, including that he negligently performed osseointegration surgery and provided inadequate aftercare.
Nine, owner of the media outlets, is seeking to rely on a range of defences including a new public interest defence, truth and honest opinion.
Documents tendered to the Federal Court on Thursday show clinical psychologist Dr Chris Basten met with Kerry Ford, an elderly man seeking Al Muderis’ treatment. Basten later told Al Muderis that Ford had hoped to obtain a statement that he did not have dementia, before surgery. Basten declined, and believed Ford was unsuitable for osseointegration surgery.
Al Muderis is pursuing a defamation case over reports from 2022.Credit: Dion Georgopoulos
“Mr Ford is clearly a very ill man with a limited life experience,” Basten wrote in a letter to Al Muderis.
“His comorbidities ... are very significant. He has marked cognitive decline on the basis of his vascular dementia. He has poorly controlled insulin-dependent diabetes, obesity and very little insight into his own care.”
Al Muderis told the court he disagreed with Basten’s professional opinion and had still been considering taking Ford on as a patient before Ford’s death.
“He can comment on a psychological aspect of the patient, not on the rehabilitation aspect or the physical aspect of the patient. So I disagree with this statement.”
Al Muderis also rejected the professional opinion of Associate Professor Paul Stalley, an orthopaedic surgeon who similarly believed Ford was unsuitable for surgery.
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“Dr Stalley has never done a single osseointegration surgery, so he doesn’t, to my knowledge, know anything about osseointegration surgery or what it involves,” Al Muderis told the court.
“In my opinion, as clinicians, as medical practitioners, we are here to service people. We’re not here to make decisions about their future and their life. My understanding is that I’m here to provide a service for people and if I can give them a better [life], an improvement in their life, I would do my best to do so.”
Matt Collins, KC, acting for the news outlets, said: “What you’re doing in this case is suggesting that all of the patients who have complaints about their service at your hands are wrong, and disputing every aspect of what they say.”
Al Muderis said: “People have feelings and I can’t control that. The vast majority of my 27,000 patients are extremely happy.”
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The court was told that the net profit for each of Al Muderis’ patients in the United States in 2021 was $75,000. This masthead is not suggesting Al Muderis operated on patients for financial gain.
Collins said one former patient developed an infection after her surgery, later telling Al Muderis she had never suffered an infection before.
The patient alleged Al Muderis replied, jokingly: “Maybe I didn’t wash my hands properly.” Al Muderis denied this.
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In court, Al Muderis also rejected the findings of a team from The Alfred hospital’s osteointegration clinic, which examined another former patient, Shane Mortimer.
Collins read from a letter the clinicians wrote to Al Muderis, in which they said Mortimer’s stoma (the site where the implant exits the body) had produced a significant amount of discharge, which the doctors observed dripping onto the floor during his examination. They believed this indicated an infection.
“That doesn’t mean that there was an infection; that’s their opinion,” Al Muderis replied. “It’s a matter of their opinion.”
The team also examined Mortimer’s CT scan results, finding the implant “fixture [had] breached the head of [Mortimer’s] humerus, into the shoulder joint”.
Al Muderis replied: “That is not true.”
The hearing continues.
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