Controversial Australian neurosurgeon Charlie Teo, whose futile surgeries left two patients in a vegetative state before they died, has been found guilty of unsatisfactory professional conduct and had conditions slapped on his practising certificate.
The damning findings and a formal reprimand were handed down last week by a professional standards committee, which said he lacked insight and judgment and failed to properly explain the risks of the operations, reports The Sydney Morning Herald.
The Health Care Complaints Commission said Teo’s decision to operate on Patient A, who had a brain stem glioma, was unethical and improper and that “there can be no doubt the operation was not one the majority of neurosurgeons in Australia would have supported”.
It also called his judgment in deciding to operate inappropriate because it was “high-risk …and by reason of the nature and location of the tumour, its genetic type, and that it was diffuse (over a wide area)”.
Teo did “not exercise appropriate judgment in proceeding to surgical resection” and “there is no directly relevant statistical data, medical literature and/or clinical guidelines to support the type of surgery”.
After her operation in October 2018, Patient A did not regain consciousness and died in April 2019.
An eight-day hearing earlier this year came after a joint investigation by Sydney Morning Herald and 60 Minutes revealed shocking outcomes of other futile surgeries performed by Teo for which vulnerable patients had been pressured into paying exorbitant fees.
The Health Care Complaints Commission raised extraordinary allegations against Teo after complaints were received following two disastrous brain surgeries. The outcomes for both female patients were catastrophic.
Patient B was a 61-year-old woman who was diagnosed with a diffuse stage 2 astrocytoma, IDH wild-type.
In her case, “the practitioner carried out surgery different from what was proposed to the patient, which led to unwarranted and excessive removal of normal functional brain”.
The operation was a disaster and Teo removed an excessive portion of normal brain.
Her husband lodged a complaint, and a further one was lodged by the chief medical officer of Epworth Hospital after a Mortality and Morbidity review into her treatment.
Neurosurgeon Elizabeth Lewis, who chaired the review, told the committee it was wrong for Teo to offer futile surgery “and then just send the patient back to a local hospital when things do not go well. It shows a complete lack of compassion and responsibility for appropriate care of people.”
Lewis also reported that this was not an isolated incident. “There have been a number of complaints re his management of patients, his lack of communication with the original treating doctor and his ‘I am the best attitude’.”
Teo was also criticised for conducting “experimental” surgery that was not done in a clinical trial setting.
“Of greater significance is his lack of reflection on his judgment in offering surgery without supporting statistical data or peer support which, in his own experience, may or may not be proved to have been in error in 10 years’ time.
“He does not express any remorse for offering surgery to Patient A or Patient B. This lack of insight into his judgment causes us concern.”
In August 2021, the NSW Medical Council deemed that the initial complaints against Teo were so serious that his surgeries could place the health and safety of the public at risk. After an urgent hearing, conditions were placed on his ability to operate.
The restrictions included that he was not allowed to perform any “recurrent malignant intracranial tumour and brain stem tumour surgical procedures” unless he obtained written approval from an independent neurosurgeon of 20 years’ standing who had to be approved by the Medical Council.
However, Teo could not find a neurosurgeon to approve his surgeries.
In the decision handed down last week, the committee said it had “endeavoured to appropriately balance the health and safety of the public while ensuring that the practitioner can continue to provide surgical services to patients”.
In doing so, the committee reduced the level of professional experience from an approved neurosurgeon to 15 years’ experience rather than 20.
Teo had submitted that the requirement of written approval from another neurosurgeon before surgery was a de facto “suspension” of his medical licence and that as a “pioneer in the field” he should not be restricted from performing surgery “which may not yet be recognised by peer-supported literature as being beneficial”.
However, the HCCC said the conditions were necessary to “protect the public having regard to the practitioner’s failure to properly weigh the risks and benefits of surgery, his understanding of obtaining informed consent, his understanding of patients’ right to privacy, bodily integrity and his use of inappropriate language”.
The committee also found “the practitioner has, for the most part, become isolated from the majority of his peers, and does not conform to a number of relevant accepted professional standards”.
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