A COMPETENT surgeon should have known the reason for Heidi Clarke-Lewis' massive blood loss and been able to do something about it, an inquest into her death was told yesterday.
Professor Andrew Korda told the inquest a sharp medical tool known as a trocar had struck the 29-year-old's spine during an operation to remove an ectopic pregnancy, causing the fit, healthy patient to bleed to death.
Giving expert evidence yesterday, Professor Korda said it would have been "like hitting a nail into a wooden table" and should have alerted surgeon Dr Samy Nassief to the possibility of damage to major vessels.
Professor Korda agreed with assisting counsel Peggy Dwyer that he would have expected a "competent general surgeon" to identify the source of the bleeding, clamp major arteries and call for assistance if needed. "Most general surgeons should have enough rudimentary knowledge to repair a vascular injury," Professor Korda said.
Ms Clarke-Lewis died during the surgery for the ectopic pregnancy at Wagga Wagga Base Hospital on April 30, 2009.
A post-mortem examination found she died from an intra-abdominal haemorrhage, after injuries to her right common iliac artery and vein. Professor Korda said the trocar caused the damage to the artery, after entering her body about 2-3cm off target, and resulted in Ms Clarke-Lewis losing more than four litres of blood.
Dr Nassief should have made a larger incision to look for the site of the bleeding about 10-15 minutes into the surgery, he said.
"The appropriate response would have been to extend the incision and try and find out where the bleeding was coming from," Professor Korda said.
A second doctor called in to assist Dr Nassief made that larger incision after arriving in theatre about 90 minutes later but was not able to find the direct source of the bleeding in the time.
Nurse Cherie Anderson has previously told the inquest that she believed the trocar's safety mechanism failed, meaning that a sharp blade had been exposed within the stomach of Ms Clarke-Lewis.
Professor Korda said: "If a trocar is inserted in a manner in which it hits the fifth lumbar vertebra, no safety mechanism will protect the patient."
But he was not critical of Dr Nassief's decision to operate on Ms Clarke-Lewis because he said ectopic pregnancies were unpredictable.
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My name is Dr Rob North. I am an Australian trained surgeon and I would like to make the following comment please. Professor Andrew Korda your honesty and courage in exposing an incompetent surgeon is admired by the long mistreated Australian people. It's time for the federal government having established AHPRA to weed out these dangerous surgeons and to never again allow Australian patients to be exposed to dangerous overseas trained doctors. Dr Samy Nassief has now moved to Bathurst to expose further patients to incompetence. He was trained in Egypt and falls well below Australian standards.
ReplyDeleteFor the record, I would like to say that I was a patient of Dr Samy Nassiefs in 2007 & 2008 in Bathurst. I saw him before and during my pregnancy with my 1st child. He also delivered my son via c-section.
ReplyDeleteAs a patient of Dr Nassiefs I found him to be very caring, understanding, professional, helpful, and very experienced.
My care was 1st rate and I trusted him.
I have not heard that he has moved back to Bathurst, but I really hope that he has as he has been missed.
I'm a professor of surgery and I trained in Sydney. This is a very sad story. The inquest found that the doctor was at fault. However, I'm confident that no doctor would deliberately compromise patient care regardless of where they trained. I know that Dr Rob North has probably never done a laparoscopic procedure in his life. I wonder if has actually ever met Dr Nassieff or whatever the doctor's name was. I believe the anaesthetist was also trained in the Middle East. The doctor showed remorse as a father and a doctor. He said the tragic loss of Heidi is not any easier and will remain on his conscience forever.
ReplyDeleteTo sit in a court room and to be told lies there was no remorse or truth to anything that Dr Sami Nassief said ....a healthy 29year old passsed away at the hands of a Qualified surgeon Would you send your family member to Dr Nassief now that your aware of Heidi's case. I would NOT.
ReplyDeleteI had Samy Nassief for the delivery of my third child ten years ago, he also preformed surgery for unrelated problems. You would not find a more caring,thoughtful or thorough doctor whose main concern was always for the safety and well being of his patients. I know that Sammy Nassief's heart would be breaking over this horrific loss beacause unlike most Doctors he genuinely cares for his patience
ReplyDeleteDr North, stop your b*s*. I am a doctor, and know how 'competent' Aussie doctors are! Anyway, Dr Nassief is a FRANZCOG, regardless of where he has trained (for your information he worked in the UK, and is an FRCOG). If you think overseas doctors are not at par with Aussie doctors, and yet RANZCOG grants them Specialist status, something must be terribly wrong with your system and your ROYAL College. And the very fact that you still have to rely on doctors whom you call 'incompetent', shows Australia in poor light. Stop calling yourselves 'first world', 'developed' etc, because you cannot even produce enough doctors!
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