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‘Incompetent’ doctor in New South Wales treating patient for pain management was banned from exercising after woman died when he injected inappropriate medication into her neck without getting x-rays , found a court.
Atef El-Sayed Mahmoud Sallam worked as a general practitioner at Medisense Health Care in Taree from 2008, was suspended in 2018 and did not apply to be re-enrolled.
Between 2014 and 2018, he performed improper procedures on 15 patients, one of whom died and another suffered from severe pain, according to the NSW Health Care Complaints Commission.
Sallam has administered corticosteroid injections to the spine or neck of patients where he could not know the injection site “with sufficient precision to properly avoid a serious or catastrophic complication”.
The Civil and Administrative Court found him guilty of professional misconduct on Monday and would have struck him off if he had still been registered.
He has been excluded from registration in the health profession for five years and can only reapply after this period.
“The respondent was not properly trained to perform injections of the type given to his patients,” the court said.
“Further, the Respondent’s failure to use X-ray imaging meant that his driving was unsafe when injecting his patients into the cervical region, including the neck region. The Respondent’s treatment of his patients was incompetent.
Following the patient’s death in 2018, the NSW Medical Council suspended Sallam after delegates discovered he posed a danger to the public.
They said her decision to inject a patient into the neck was wrong and, without additional tech or nursing support, reckless.
Sallam said he heard he was particularly interested in muscle and skeletal issues and chronic pain.
“During his testimony, it was evident that the Respondent had never been assisted by X-ray imaging before performing his injections,” the court said. “Further, it is of concern that the Respondent exhibited a lack of insight into the risks of the proceedings he was undertaking.”
His source of knowledge was “worrying” in that he was referring to “an American book, very small text on general medicine and it mentioned something about cortisone”.
Much of the patient’s information was missing from his clinical notes.
“However, the respondent stated that he had frequently given steroid injections,” the court said.
“He had not been trained to read ultrasound scans, but had previously administered neck injections to about 12 patients, with no unforeseen results. The Respondent stated that he reassured Patient A that he had performed such a procedure several times without adverse effects. The Respondent then administered two injections, one on top of the other, with no adverse effects.
“However, when he gave the third injection, Patient A complained of pain, moved her head and subsequently said she could not breathe. She became unconscious and an ambulance was called to take her to the hospital, where she later died.
The court concluded that Sallam had no idea of the risks he had taken and that he had not expressed remorse.
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