‘Incompetent’ NSW doctor banned for five years after woman dies following pain relief injections
An “incompetent” New South Wales doctor treating a patient for pain management has been banned from practising after the woman died when he injected an inappropriate drug into her neck, without obtaining X-rays, a tribunal has found.
Atef El-Sayed Mahmoud Sallam worked as a GP at Medisense Health Care in Taree from 2008, was suspended in 2018 and has not applied to be re-registered.
Between 2014 and 2018 he performed inappropriate procedures on 15 patients, one of whom died and another suffered severe pain, according to the NSW Health Care Complaints Commission.
Sallam administered corticosteroid injections to the spinal or neck area of patients where he couldn’t have known the injection site “with sufficient accuracy to properly avoid a severe or catastrophic complication”.
The Civil and Administrative Tribunal on Monday found him guilty of professional misconduct and would have struck him off had he still been registered.
He was disqualified from being registered in the health profession for five years and cannot re-apply until after that period.
“The respondent was not properly trained to perform injections of the kind performed on his patients,” the tribunal said.
“Further, the failure of the respondent to use radiological imaging meant that his conduct was fraught with danger when injecting his patients in the cervical area, including the neck area. The respondent’s treatment of his patients was incompetent.”
After the female patient’s death in 2018, the Medical Council of NSW suspended Sallam after delegates found he posed a danger to the public.
They said his decision to inject a patient in the neck was wrong and, without additional technological or nursing support, reckless.
Sallam told that hearing he had a particular interest in muscular skeletal problems and chronic pain.
“During his evidence it was apparent that the respondent was never assisted by any radiological imaging before he performed his injections,” the tribunal said. “Further, it is concerning that the respondent displayed a lack of insight into the risks of the procedures which he was undertaking.”
His source of knowledge was “concerning” in that he referred to “an American book, very small text about general medicine and it mentioned something about the cortisone”.
Much of the information about the patient was absent from his clinical notes.
“However the respondent stated he had often given steroid injections,” the tribunal said.
“He had not been trained in reading ultrasounds but had given injections in the neck to approximately 12 patients in the past, with no unforeseen outcomes. The respondent stated that he had reassured patient A that he had carried out such procedure many times with no adverse effects. The respondent then provided two injections, one above the other, with no adverse effects.
“However, when he administered the third injection, patient A com
plained of pain, moved her head and thereafter stated she couldn’t breathe.
She became unresponsive and an ambulance was called to take her to hospital, where she later died.”
The tribunal found Sallam had no insight into the risks he took, nor had he expressed remorse.