‘I lost everything’: How denouncing surgeon Al Muderis landed biggest critic in prison

Amputee Fred Hernandez spent 16 months in jail after disgraced surgeon Munjed Al Muderis pursued multiple lawsuits against his former patient turned business partner.

What started with a series of Facebook posts alleging the doctor was involved in a “major cover-up” ended with Hernandez, an above-the-knee amputee, serving an indefinite sentence alongside hardened criminals in a US prison in Nevada for contempt of court.

There, he said, he was manhandled by guards, was denied access to treatment for severe nerve pain and was injured after he was shackled at the legs and waist without appropriate disability support and fell.

“The medical [treatment] in there was severely lacking on just about every level,” he said. “I spent a good 15 months in a wheelchair, which has caused me to start from scratch for my walking. I started with a walker, and that went to two crutches, one crutch and I’m still on a cane.”

The lawsuits filed by Al Muderis against Hernandez in America were sparked by social media posts from Hernandez in 2018 warning patients about Al Muderis’ unethical conduct and raising awareness of other surgeons who perform osseointegration, which involves inserting a titanium rod into an amputee’s residual bone to enable a prosthetic limb to be attached.

Hernandez’s claims, like those of many victims of the once celebrated surgeon, were vindicated this month in a devastating defamation case judgment in the Federal Court of Australia which lashed Al Muderis over his negligent treatment of patients.

But by that point Hernandez had already paid a heavy price for his criticisms of Al Muderis going back to 2018.

“Over the years I became aware of situations that I frankly did not agree with; unethical on some levels and downright wrong on others,” Hernandez posted on December 20, 2018.

“This is not the forum to air anyone’s dirty laundry in detail but what the patient population and general public sees is not what actually goes on ... I smell a major cover-up.”

This spurred years of litigation leaving Hernandez broke, unemployed and struggling to piece his life back together as Al Muderis still blocks his ability to work in osseointegration. Despite the heavy toll, Hernandez has no regrets.

“I literally lost everything,” he said. “Patients had a right to know. Given my role in building this fake persona that is Al Muderis, I feel like I had a responsibility. If I have to lose everything over that, so be it. It’s been hard, don’t get me wrong.”

In Al Muderis’ failed defamation case against this masthead and 60 Minutes, his barrister, Sue Chrysanthou, SC, falsely claimed Hernandez was the “primary source” for the media outlets’ investigation and successfully opposed Hernandez giving evidence from prison via video link.

Hernandez believes Al Muderis’ ongoing pursuit of him has been designed to silence him, and maintain a monopoly on the lucrative surgery in America.

“If you work for him, he owns you. His cult following will deny it, but they’ve never seen it. They’ve never worked on that level with him, so they have no clue,” Hernandez said in an interview.

‘Whatever it takes’

Hernandez first approached Al Muderis with a business pitch in 2012, attracted by the surgeon’s passion for osseointegration.

“Osseointegration technology is a life changer and once amputees see the implant for themselves, they will do whatever it takes to obtain it,” Hernandez wrote.

The cigar-smoking, whiskey-drinking Las Vegas resident became an above-the-knee amputee in 1985 at the age of 17 after he was crushed by a truck in an accident. Like many above-the-knee amputees, Hernandez always had trouble with traditional sockets that were uncomfortable and made it difficult to walk.

In the early 2000s, he discovered osseointegration online and became transfixed by the novel procedure.

For the right people, osseointegration alleviates the blisters and discomfort of traditional socket prosthetics and enables greater mobility. But it also carries immense risks, from worsening pain to infections and the need for further amputations.

The Federal Court judgment ruled Al Muderis deliberately downplays or fails to explain risks to vulnerable patients and uses high-pressure sales tactics to sign them up to invasive and experimental operations without informed consent.

Enthralled by the potential of osseointegration, Hernandez started a website dedicated to the procedure, and tracked the clusters of surgeons performing it around the world.

He couldn’t afford the surgery so, in 2012, he emailed every osseointegration surgeon, asking for a free procedure in exchange for his promotion of their work in the US, a country with an enormous number of amputees. Al Muderis was the only one who was interested.

By March 2013, Hernandez was on a flight from Las Vegas to Sydney for the operation to be performed at Macquarie University Hospital. It was a success, though he has experienced worsened pain and several infections.

Hernandez held up his end of the bargain – giving glowing media interviews in America, and promoting the procedure and Al Muderis through roadshows aimed at prospective patients who flew to Australia for surgery.

What these patients did not know was that, for a period, Hernandez was paid cash commissions of $US1000 for each patient he sent Al Muderis’ way who went ahead with surgery. These commissions were detailed in a contract that included confidentiality and exclusivity clauses, forbidding the patients from knowing Hernandez’s advice was conflicted.

In the Federal Court ruling, Justice Wendy Abraham found this arrangement to be unethical, as it altered the advice Hernandez gave to prospective patients, many of whom considered him a “friend”.

By 2018, Al Muderis stopped paying Hernandez’s commissions, the tipping point behind a bitter falling out between the two. They parted ways, and Hernandez turned to social media to expose what he saw as unethical conduct by Al Muderis.

“I chose Australia at the time, because they had the beginnings of a proper team but that has significantly changed over the year,” Hernandez wrote. “If you look at what they have now, it looks nothing like what they started with and I think that is sad; because it really doesn’t have to be that way.”

Al Muderis responded by filing a defamation suit in the US. Hernandez said a combination of poor legal representation and US competition laws led to a default judgment being filed against him — and he was ordered to pay Al Muderis $US2.7 million.

The court documents in that case revealed the once lucrative nature of their partnership, with each American patient flying to Australia for osseointegration surgery with Al Muderis delivering the surgeon a profit of $US75,000.

While Hernandez tried to overturn the judgment, Al Muderis’ lawyers were conducting surveillance on Hernandez and his business partners before launching a second lawsuit – this time alleging he was shuffling money between businesses to avoid paying the money.

Hernandez tried to file for bankruptcy, but every step he took was blocked. Eventually, during one hearing, on November 29, 2023, the judge found him in contempt of court over his failure to pay and sent Hernandez to prison, with an indefinite sentence.

In jail, he said, he was denied access to proper healthcare, and was terrified of his osseointegrated leg becoming infected. He tripped, and fell, putting him in a wheelchair while he awaited treatment.

“I was constantly complaining in writing,” he said. “Trying to get somebody’s attention to help me in there.”

Hernandez was due to give evidence in Al Muderis’ failed defamation case about everything from the secret cash commissions to recruit patients, to Al Muderis’ illegal US hotel room “clinics”, to his bullying of staff and failure to care for his patients.

“I always saw Dr Al Muderis’ motivation as related more to status, and that Dr Al Muderis wanted to be known as the king of osseointegration, and as ‘the guy’ for osseointegration,” Hernandez’s affidavit stated.

He did not end up testifying, but watched some of Al Muderis’ cross-examination on Youtube. “I kept shaking my head when I was listening to him talk about things I knew weren’t true, and I … thought to myself, don’t they have laws in Australia about giving false testimony?”

Under cross-examination, Al Muderis denied any knowledge of the cash commission paid to Hernandez. Abraham ruled he made “disingenuous attempts to distance himself from the arrangement” and “denied the obvious”.

“Al Muderis’ cross-examination in relation to the contract was not just evasive, it was false,” she ruled. “Given the evidence, it is apparent he denied it in the interview because it reflected adversely on him.”

Hernandez said that since his release in April, Al Muderis had continued to block his ability, through court orders, to work in osseointegration, an area he has spent 13 years building a career in.

His family and friends launched a petition to raise funds to pay for lawyers to keep fighting these battles, titled “Help Amputee Advocate in Legal Battles for Whistleblowing”.

In the landmark Federal Court judgment, Justice Abraham found that it was clear Hernandez “holds strong views against” Al Muderis and sent “unpleasant” messages about him to friends, but cited other messages in which Hernandez said, “it’s all about the truth anyway”.

Chrysanthou alleged Hernandez was one of the driving forces behind a “concoction” of fake complaints designed to destroy Al Muderis.

Abraham was searing in her criticism of this submission.

“This reflects the preparedness of the applicant to make such serious allegations blaming others, where it appears there is no basis,” she found.

Al Muderis was last week asked to respond to Hernandez’s claim that he aggressively used litigation to silence concerns about his practice. He did not respond.