Patient was not warned about maggot risk, surgeon tells court

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High-profile surgeon Munjed Al Muderis has told the Federal Court he did not warn a patient about the potential risk of maggots in a skin opening, as he faced a tense day of questioning in his defamation case against Nine newspapers and 60 Minutes.

The court has heard that one of Al Muderis’ former patients, Mark Urquhart, complained to the surgeon about maggots in his stoma, a skin opening created during osseointegration surgery to insert titanium pins in an amputee’s residual bone to connect to prosthetic limbs.

Surgeon Munjed Al Muderis arrives with barrister Sue Chrysanthou SC for the defamation case against Nine at the Federal Court in Sydney on September 4.Credit: Steven Siewert

Al Muderis, clinical professor at Macquarie University, is suing The Sydney Morning Herald, The Age 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, the owner of the media outlets, is seeking to rely on a range of defences, including a new public interest defence, truth, and honest opinion.

“I recall Mr Urquhart [being] concerned about maggots, yes,” Al Muderis told the court on Friday after being asked about a message in April 2018.

“From memory, I think Mark was maybe one of the early patients that had maggots.” He agreed that “a few” patients had experienced this problem over time.

“You accept, don’t you, that from the patient’s perspective this is a distressing phenomenon?” Matt Collins, KC, acting for the media outlets, said. “Yes,” Al Muderis replied.

“You accept … that you hadn’t alerted Mr Urquhart at the time of his surgery to this being a risk?” Collins said. “Correct,” Al Muderis replied.

He agreed with Collins that a patient’s distress about maggots in their stoma required an urgent response.

The court has heard Al Muderis provided Urquhart with a document in May 2018 entitled “maggot protocol” after Urquhart complained of the incident in April 2018.

“You know, don’t you, that Mr Urquhart didn’t see the maggot protocol until he came to see you in your rooms seven days after he had complained?” Collins asked.

“That may be the case,” Al Muderis replied.

Asked if he accepted that this was “just not acceptable … as a matter of follow up”, Al Muderis said he may have called Urquhart in the meantime.

“You’ve made up that phone call because you accept that it was not acceptable to wait a week before providing guidance to Mr Urquhart?” Collins suggested.

“I’m not making up anything; I’m just saying I may have called him. I don’t recall,” Al Muderis replied.

Earlier on Friday, Al Muderis broke down in tears in the witness box as he insisted his former patient Lisa Calan suffered “intolerable pain” because of the “bastards that blew her [legs] off” in an Islamic State bomb blast, and not because of his surgery.

“I tried to help her and I try to help every patient I deal with,” Al Muderis said. “It’s unfair that I get accused of causing the pain that I never did.”

He apologised for being emotional but said he was “very passionate about what I do”.

He said his work was “the future for amputees” and “Channel Nine has took it back 20 years at least”.

“People deserve to have better treatment than a socket prosthesis that is 600 years old. People deserve to have better mobility. What Channel Nine has done has destroyed that dream for hundreds and hundreds of thousands of people.”

Justice Wendy Abraham reminded Al Muderis that he was in court to answer questions rather than to deliver speeches, prompting the surgeon to apologise.

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