‘Thinks he’s Teflon’: Al Muderis goes to war with peak body, colleagues

Disgraced surgeon Dr Munjed Al Muderis is going to war with the Australian Orthopaedic Association, as leaked documents reveal concerns were raised about him threatening surgeons at a major hospital into silence.

This masthead reported last month the peak professional organisation expelled Al Muderis during a late night board meeting after the Federal Court found the former star surgeon had failed a significant cohort of his patients and used high-pressure sales tactics on vulnerable people.

Internal correspondence obtained by this masthead shows Al Muderis’ lawyers then “demanded” a general meeting be held after he was given “24 hours to show cause why he should be reinstated”.

The stoush comes as leaked minutes from a 2022 internal meeting involving Macquarie University Hospital’s vice chancellor of health Professor Patrick McNeil revealed the institution was warned about Al Muderis’ litigiousness towards surgical colleagues and a lack of transparency over complications arising from his surgeries.

The Australian Orthopaedic Association will now hold a meeting next week, where Al Muderis’ membership will be decided after he has an opportunity to appeal the decision and explain his conduct.

If two-thirds of members support the revocation, Al Muderis will be “expelled forthwith”, must return his fellowship certificate within seven days, remove all references to his AOA membership and pay the costs of holding the meeting, according to the AOA’s constitution.

A revocation is largely symbolic but would also restrict access to fellows and resources.

One surgeon, speaking on the condition of anonymity to discuss internal matters, was confident the expulsion would be supported by most members. “He thinks he’s Teflon-coated and can do what he likes,” said another. “He’s brought our profession into disrepute.”

Another surgeon echoed this statement, saying: “I suspect that there will be a few bumps along the way but reckon we will get there one way or the other.”

Al Muderis has also filed a lawsuit against the AOA in the Supreme Court of NSW. A hearing was scheduled in Sydney on Monday, but then adjourned until September 24. The court has not released any documents about the claim.

Al Muderis’ lawyers confirmed the surgeon had challenged his expulsion and was suing the AOA.

“The AOA self-evidently, and now admittedly, acted contrary to its constitution in its actions in relation to Dr Al Muderis. It has been unable to provide a coherent explanation for its conduct – which is now a matter before the court,” his lawyers said in a statement.

The dispute with the AOA comes as leaked minutes from a meeting on November 8, 2022, at Macquarie University Hospital show warnings about Al Muderis’ legal threats to surgical colleagues, a lack of transparency around his surgical complications, and concerns with patient selection.

The minutes, obtained by this masthead, show seven senior surgeons, including McNeil and Macquarie’s Clinical Leadership Council chair Professor Marcus Stoodley, discussed calls for Al Muderis to step down from leadership positions until an independent audit was completed.

Hospitals typically hold “morbidity and mortality” meetings where medical staff can freely discuss adverse outcomes with the aim to improve patient care and systems. However, the surgeons claimed Al Muderis’ clinic evaded this process, according to the minutes.

One surgeon described “dysfunction” where Al Muderis’ team had created a “hostile atmosphere where any case discussion was either shut down or unfairly contested with a refusal to provide further information”.

“There had been little or no open discussion about cases, case selection and/or complication rates arising from the limb reconstruction unit,” the minutes stated.

Another surgeon “drew the parallel between Prof Charlie [Teo], who similarly refused to submit his cases and numbers to open and transparent peer” review, according to the minutes.

The group discussed comments made by Professor Sumit Raniga that Al Muderis had created reputational risk for the hospital and made “other orthopaedic colleagues reluctant to consider joining” – after which Al Muderis “openly threatened” and “accused him of slander”.

“Prof Raniga received a few text messages from Prof Al Muderis and also had a phone conversation where he threatened to launch defamation proceedings against him unless he offered his unreserved apology and rectification,” the minutes stated.

“Prof Raniga provided an unreserved apology and resigned.”

One surgeon claimed “nothing that was said” by Raniga “was at all defamatory” and Stoodley would not accept his resignation “over this issue”, according to the minutes.

The surgeons called for McNeil and Stoodley to “conduct a detailed audit” of Al Muderis and his team’s “total clinical output over the last five years” by an independent expert.

“We also called for Prof Muderis to stand down from any committees/leadership roles at MQ Health pending this review,” the minutes stated.

“We reiterated our support for the institution, but all felt that there was a significant threat to the organisation and its reputation.

“We called for an immediate examination of the clinical data, outcomes and clear and transparent disclosure of any possible conflicts of interest.

“Professor McNeil asked for some time to reflect on this information and promised to return to us for a follow-up discussion and to outline a path forward.”

McNeil and Stoodley did not respond to requests for comment. Raniga declined to comment. Al Muderis’ lawyers denied the contents of the meeting minutes.

“Your information about what occurred at Macquarie University is demonstrably incorrect,” they said. “Attached for your information is a letter from Professor Raniga profusely apologising and resigning from his position because of his conduct.”

Macquarie University Hospital confirmed Al Muderis remained on leave and did not respond to questions about whether the five-year audit was completed, or what steps, if any, were taken to address concerns of the hostile and dysfunctional culture within the hospital.

“We have strong governance processes in place to monitor clinical services and to address any concerns raised by staff,” a spokesperson said in a statement.

The spokesperson said it would be inappropriate to comment on an individual case relating to “confidential personnel and clinical issues” but noted that all complaints were handled in line with its policies and with respect for due process and fairness.

Charlotte Grieve’s book Duty To Warn will be available in February. Pre-order here.

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