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Australia Canberra obstetrician, gynaecologist and laparoscopic surgeon Omar Adham being investigated by AHPRA over complaints

22:54  20 july  2021
22:54  20 july  2021 Source:   abc.net.au

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These women hoped surgery would heal them. Instead, their treatment became a nightmare.

Kristy Stanford decided she'd had enough of the debilitating pain she suffered every month from endometriosis.

It was time to take more serious action.

In 2015, the mother-of-two had a consultation with Omar Adham, the lead gynaecologist at Canberra Hospital's Endometriosis Centre.

He told her he could perform keyhole surgery to remove the endometriosis.

It would be quick and non-invasive.

"The risks are very minimal — it's something he does all the time, easy surgery," Kristy says she was told.

The 37-year-old was warned there was a 1 per cent chance of injury to major organs.

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When Kristy woke up in recovery after the operation, she was told the surgery had taken longer than expected but had gone well.

But back at home in Cooma five days after the surgery, she knew there was a problem.

In excruciating pain, she was taken by ambulance back to Canberra Hospital.

"I just wanted to die," she says.

"It was horrific.

"I wouldn't wish it upon anyone."

Despite her pain, Canberra Hospital took two days before eventually performing emergency surgery.

By the time they did, she had developed a ruptured bowel and sepsis.

Kristy had part of her bowel removed and was fitted with a colostomy bag, which she needed for six months.

Kristy spent a week in intensive care on a ventilator.

It was another five weeks before she could be sent home.

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When Kristy had that first operation to treat her endometriosis, she had no idea she would end up undergoing numerous operations with other doctors, leading to a series of complications that would change her life forever, leaving her in pain and with PTSD.

She takes medication for both conditions.

"You know, it's been a few years now, and I'm still reliving [it] every day," she says.

At her post-op appointment with Dr Adham, Kristy asked him what had happened.

"All we wanted was an apology, and he wouldn't do it," she says.

"He would not do it and he was trying to explain it, but … couldn't really give us an answer as to how things could go so wrong."

Four months after the emergency surgery, Canberra Hospital called Kristy to a meeting to discuss possible compensation.

They told her that her colon may have been burned with an instrument during the keyhole surgery.

Instead of a scalpel, surgeons can perform surgery with instruments that use heat to cut and cauterise, but they carry a risk of damaging tissue and organs if too much heat is applied.

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"It should be relatively uncommon," says longtime Canberra gynaecologist Grahame Bates, who also treats one of Dr Adham's former patients.

"That one is a recognised complication but it's rare and with any complication, the important thing is to recognise that it's been done and treat it accordingly."

Kristy later sued Dr Adham and, because it was a public hospital, the ACT government.

Earlier this year, the case was settled with neither the hospital nor Dr Adham admitting liability.

From Iraq to Australia via New Zealand

Dr Adham has practised as an obstetrician and gynaecologist in Canberra for 11 years.

He consults in private rooms and operates at a number of private and public hospitals in the ACT and NSW.

His listing on his private practice website says he "grew up in New Zealand" and completed his specialist obstetrics and gynaecology training in New Zealand and Australia.

In fact, colleagues have told 7.30 that Dr Adham grew up in Iraq and obtained his undergraduate medical degree at Baghdad University.

This detail is not mentioned on his private practice listing, although it is noted on the website of the Australian Health Practitioner Regulation Agency.

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Dr Adham undertook specialist training at hospitals in Auckland and Sydney between May 2001 and January 2010, and was admitted to the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Dr Adham has declined a request to be interviewed.

He also did not respond to a series of written questions, including queries about his background and training.

'It was humiliating'

In February 2019, public servant and former police officer Julie Ashcroft consulted Dr Adham about a prolapsed bladder  — a common problem for women after childbirth.

Dr Adham told her he would perform a hysterectomy and fix the prolapse via keyhole surgery at private Canberra hospital, Calvary John James.

Julie's surgery went for two hours longer than expected but was described in Dr Adham's notes as "uncomplicated".

Twelve days later, however, problems began.

"I went to bed on Saturday night, woke up on a Sunday morning, drenched my whole bed, my pyjamas, everything drenched in urine," she says.

"It was horrible. It was humiliating. It was terrible."

Over the next nine days, the 49-year-old spoke to Dr Adham several times saying she couldn't hold any fluid.

He saw her in his offices and told her she was still healing and the issue might resolve itself.

At a second appointment, he removed her stitches and performed a test that didn't reveal a leak, however he called a urologist to assist with exploratory surgery.

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During the operation, it was discovered that the tube from her right kidney was leaking.

"Dr Adham said to me, 'Lucky you were so persistent, because there actually is an injury,'" Julie says.

"And I asked him what had gone wrong and he said he didn't know what had gone wrong."

Medical reports show there was a "thermal injury" to the right ureter.

Months later, another leak from the bladder was discovered and was also diagnosed as "more likely from a thermal injury which remained undetected".

Julie had developed a fistula — a rare complication where a hole in the bowel or the bladder means waste passes out of the vagina.

At one of her first appointments, Dr Adham had given Julie a brochure explaining her risk of developing a fistula was 2 in 1,000.

Fistulas are rare complications but extremely serious, according to Dr Bates.

"It's major surgery to rectify because you've got to fix the defect in the bowel then you have to fix the defect in the vagina," he says.

It was after more surgery to fix her problems that Julie says she first learned Dr Adham had used surgical mesh in the operation.

It was now eroding inside her and had to be removed.

The brochure Dr Adham had given her explained that up to 10 per cent of women have complications with mesh, and that it could include erosion into nearby organs requiring it to be removed.

However, there was no mention of mesh on the consent form Julie signed.

We asked Dr Adham about the use of mesh with Julie and the consent form, but he did not respond.

Two years on, Julie does regular hydrotherapy and receives nerve treatment for her bladder.

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She's had multiple operations by multiple doctors and further complications following those surgeries, including a stent in her kidney, a catheter for seven months and has had 40 per cent of her vagina removed.

"I barely work," she says.

"I've lost relationships.

"I probably stay home a lot because I don't want to be in positions where I might be embarrassed."

Dr Adham rises through the ranks

To become an obstetrician gynaecologist in Australia or New Zealand, doctors train for six years, with the final stages focussing on a particular area within the field.

Dr Adham's private listing on his website says he "obtained his general obstetrics and gynaecology training in Auckland" at Middlemore Hospital.

Middlemore Hospital confirmed that a Dr Omar Adahamm "completed some of his training in Obstetrics & Gynaecology" there over eight years from 2001 to 2009, as well as rotating through other New Zealand sites.

The hospital believes this is the same person as Omar Adham.

Dr Adham's website also said he "completed his fellowship in advanced laparoscopic surgery and urogynaecology" at the "renowned St Vincent's Hospital" in Sydney.

We contacted St Vincent's which said "Dr Adham was employed as a part-time (0.5 FTE) Fellow in Obstetrics and Gynaecology" training in laparoscopic gynaecology surgery for 12 months.

It said it was "not aware of any performance or clinical concerns during Dr Adham's brief time at St Vincent's".

We asked Middlemore Hospital in Auckland about Dr Adham's training in laparoscopic surgery prior to his move to St Vincent's, and were told that doctor training involved being "exposed to a range of clinical conditions and surgical opportunities which included laparoscopic surgery".

When asked how many laparoscopic and advanced procedures Dr Adham completed during training, neither St Vincent's nor Middlemore hospitals were able to answer, saying those details are held by the college, RANZCOG.

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However, RANZCOG could not tell 7.30, saying it does not comment on individual members due to privacy obligations.

Soon after completing his training, Dr Adham was appointed by Canberra Hospital to the relatively senior position of lead gynaecologist at the Endometriosis Centre.

That was how he came to operate on Kristy five years later.

We asked Canberra Hospital whether Dr Adham's training and experience was adequate to be appointed to that role, and were told that the hospital "does not make comments about individual patients or staff" and "we are confident in our credentialling and clinical review processes".

We sent Dr Adham detailed questions about his education, training and fellowship but he didn't respond.

A week after we approached him, the listing on his professional website was altered.

The reference to completing "his fellowship in advanced laparoscopic surgery and urogynaecology" has been removed.

The website now says he "completed 12 months training in advanced laparoscopic surgery and urogynaecology".

The website previously listed "complex endoscopic pelvic surgery" as one of his areas of specific interest and experience.

That reference has been removed from his current listing.

A life turned 'upside down'

These days, after a series of operations with numerous doctors, Jacqueline O'Brien can no longer tolerate solid food.

She needs regular vitamin infusions to help her get basic nutrients.

"It pretty much limits nearly your entire life," she says.

"It's also what stops you from going out and socialising as much as I used to because everything revolves around food.

"Going to parties even at work with people having morning teas and things like that…

"It can be quite tricky and difficult because people don't know what I'm going through.

"They can't see what I'm going through.

"It's very hard to accept, having a life that was incredibly social and active.

"It was a fun life, it was my life, to completely turning upside down."

Jacqueline went to Dr Adham in late 2019.

Eleven days earlier, she had been rushed to emergency after a massive vaginal bleed.

Doctors found a large tumour, which they told her needed to be removed.

With her usual gynaecologist away, she found Dr Adham online and checked his credentials at the website of the Australian Health Practitioner Regulation Agency (AHPRA).

"There were no red flags at all on AHPRA, which was my main concern," she says.

"It was a surgeon that I didn't know nor did my GP, so I certainly did my due diligence by researching."

Jacqueline made an appointment to see him.

Her usual gynaecologist had previously deemed her unsuitable for keyhole surgery because she'd had a hysterectomy, part of her bowel removed and her gall bladder taken out.

She says Dr Adham originally planned to remove her tumour via keyhole, but when she showed him her medical history, he changed his mind.

"And that's when he advised that he would need to, we'd need to have open surgery, not laparoscopic as originally thought, because of not knowing what the mass was and he would need to block out his entire morning because it was a delicate surgery," she says.

However, the consent form Jacqueline signed referred to both keyhole and possible open surgery — something she says she didn't notice at the time.

"When he came to visit me after the surgery, he advised that he had done keyhole surgery, which I was a bit worried about and questioned the change from open surgery to keyhole and he said everything was fine, everything would be okay, it went well," Jacqueline says.

But when the 50-year-old got out of bed the next day, she felt a gush of fluid.

She told Dr Adham.

"And he just turned and looked at me and said, 'We have a limited window of opportunity to have this fixed and we're just about to hit that limit, we need to get you into emergency surgery now,'" she says.

"So I was rushed in for close to seven hour's surgery where another surgeon was also brought in."

A scan done before the surgery found the right tube from Jacqueline's kidney had been "lacerated".

Records show Dr Adham apologised to Jacqueline and registered an "adverse outcome" with Calvary John James Hospital.

Jacqueline says Dr Adham offered a reason for the injury.

"Dr Adham said that it was probably his fault, that the instruments were too hot and I actually remember thinking, wow, a surgeon's just admitted that it's probably his fault," she says.

Jacqueline's sister and mother sat beside her hospital bed for two weeks following the emergency repair operation, as she was moved in and out of ICU, gravely ill with an infection.

Both confirmed to 7.30 that Dr Adham had separately told them he believed the cause of her injury was that his surgical instrument was too hot.

A scan five days after the repair surgery showed Jacqueline also suffered a bowel obstruction and adhesions.

While an earlier scan had shown there were no obstructions, there is no evidence that the later development of obstructions and adhesions were a result of Jacqueline's subsequent surgery.

After so many operations, including by other doctors, Jacqueline says eating food causes painful and dangerous obstructions in her bowel.

She's been told more surgery is not an option and now lives on a completely liquid diet.

She weighs less than 50 kilos.

Her life today is a far cry from the one she enjoyed before her treatment.

"Because I wasn't able to have children, I focused on having a different type of life of travel and career," Jacqueline says.

"And it was good. It was great.

"This new life is actually not my life, really … everything that made me who I was, has just simply disappeared.

Response to complaint 'deeply concerning', lawyer says

There was already an official complaint about Dr Adham when Jacqueline underwent surgery with him.

Julie had complained to the ACT's Health Services Commission — part of the ACT Human Rights Commission — in September 2019 following her complications.

However, the commission took more than four months before it notified the regulator, AHPRA, of the complaint and a further two months before formally referring it to AHPRA.

Since then, Julie and Jacqueline have engaged a lawyer.

"It's deeply concerning that the Health Services Commission would receive a complaint from a member of the public, and that that information would not be shared, or provided to the Medical Board of Australia and AHPRA who regulate the industry," says their Canberra solicitor, Sam Tierney.

The ABC asked the Health Services Commission about the delay and was told "we consider the matter was handled by the Commission in a timely and appropriate manner and in accordance with our legislative obligations".

Following the complaint being referred to AHPRA, it took another five months before a decision was made to investigate.

That investigation began in August last year, almost 12 months after the first complaint to the ACT's Health Services Commission.

Two more complaints have been filed since then.

AHPRA said it could not comment on its ongoing investigation due to strict confidentiality requirements but confirmed that complaints about the gynaecologist "were assessed by the Medical Board of Australia and AHPRA with clinical input and deemed serious enough to be investigated".

"Certainly there appears to be a common thread," Mr Tierney says.

"In circumstances where people suffer an injury during a surgery that requires further surgery, or very shortly after the reopening of wounds, that a range of different complications can arise."

Those who made the complaints can't understand why the medical regulator, AHPRA, is still investigating after almost a year.

AHPRA said its "investigations must be run in a systematic, thorough and fair way" and "accommodate reasonable requests for time extensions from practitioners to ensure procedural fairness".

'I just have to put up with what I've got'

We requested interviews with Dr Adham, the college and the hospitals, but they all declined.

In statements, Canberra Hospital said it "does not make comments about individual patients or staff" and Calvary John James Hospital said it "could not provide any … detail about Dr Adham".

The college said it "does not comment on individual members".

Dr Adham did not respond to emails with detailed questions.

The women we interviewed knew their procedures had risks but they're angry that they've endured so many more surgeries and still have problems.

They went to Dr Adham for help with very private health issues but are now going public because their lives have been changed forever following multiple operations with many different doctors.

They want other women to be aware of the problems which can arise following seemingly simple gynaecological procedures.

Both Kristy and Jacqueline say they've been told there's no further medical treatment that can help them.

"Seven surgeries later … I just can't do any more," says Kristy.

"I just have to put up with what I've got."

"It's a nightmare every morning that you wake up," Jacqueline says.

"You just think please God, get me through this day and don't let this be the last day."

Watch this story tonight on 7.30 on ABC TV and iview.

Credits:

Reporting: and

Photography and video: David Maguire and Gregory Nelson

Additional footage: YouTube: Amgad Mohammed

Main graphic:

Digital production:

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