Controversial Australian neurosurgeon Dr Charlie Teo has been back before the NSW Medical Council Professional Standards Committee for a week-long hearing into his performance.
After receiving a series of complaints from the families of two patients who died after undergoing brain surgery by Dr Teo, the NSW Health Care Complaints Commission has alleged that he should never have operated to begin with, while Dr Teo – who is currently under a temporary restriction on performing brain surgery in Australia – is seeking to have these conditions lifted.
The Committee heard that a brain tumour patient in her 60s was left in a vegetative state after the surgeon operated on her in January 2019, proceeding even though an oncologist and another surgeon in Geelong had previously advised the couple that the tumour was inoperable.
Her husband told the hearing that his wife, who had been given just 12 to 18 months to live, was a huge fan of Dr Teo’s, and believed that he could achieve almost anything, including curing her.
“We never had a discussion it could go badly. We never had that… [Dr Teo] said if she did not have the operation on Tuesday that she would be dead by Friday,” the man told the committee.
“He was not pulling any punches.”
Dr Christopher Profyris, a colleague of Dr Teo, disputed the husband’s evidence that he was not warned about the possible severe outcomes of surgery and told the hearing both he and Professor Teo explained it involved “complex” surgery.
Dr Profyris also spoke to the couple during their pre surgery consultation, and his witness statement said that he informed them that there were risks associated with all brain surgery, including death and coma.
Two fellow neurosurgeons, Dr Andrew Morokoff and Professor Bryant Stokes AO, were also called before the Council, with Professor Stokes, WA’s former Acting Director General of Health from 2013-15, testifying that Dr Teo’s rationale for performing the surgery was “nonsense.”
And despite acknowledging Dr Teo’s skill, Professor Stokes also queried the length of time that it took him to perform the operation.
“It was too quick is my view,” Professor Stokes said.
“It would have taken me at least 4 hours to do that operation as a minimum.”
However, when Dr Teo tried and failed to wake her after the unsuccessful operation, the woman’s daughter testified that she witnessed him telling a nearby nurse to “put her in the bloody chair, tie her there with sheets if you have to.”
The hearing also revealed on Wednesday that Dr Teo slapped the patient across the face as he attempted to wake her, which neurosurgeon Professor Paul D’Urso, who joined his colleagues as an expert for the hearing, described as culturally and socially insulting.
“Regardless of the family members it is entirely unacceptable to slap a patient across the face,” Professor D’Urso said.
Comments made to journalists before each day of hearings revealed much of Dr Teo’s state of mind, including that he would be the first to admit that the evidence against him did not look good, and that his peers were threatened by his skill.
“These aren’t good cases; they were bad outcomes – but I only do them because there are all these good outcomes and I just want to give people hope. Anyway, I am a little bit depressed today” he said, noting the next day that, “I think it is a whole lot easier to destroy someone than to upskill.”
On the website of his charity, the Charlie Teo Foundation, Dr Teo describes himself as someone who pushes himself to the edge – “radical brain surgery, riding a motorbike, never giving up fighting for people with brain cancer and what I believe in. Put simply, I never stop.”
“I continue to operate overseas on the world’s most difficult tumours and have been welcomed and celebrated by every country visited. I have recently been Visiting Professor to Johns Hopkins University, Cedars-Sinai Hospital, and the Mayo Clinic.
“I have been doing pro bono work in Africa, Asia and India and lecturing, teaching and advising on almost every continent.”
The temporary restrictions against him were applied in August 2021 under section 150(1)(b) of the Health Practitioner Regulation National Law (NSW) for “the protection of the health and safety of any person or persons, or because it is satisfied that action is otherwise in the public interest.”
They state that when proposing and before performing surgical procedures for recurrent malignant intracranial and brain stem tumours, Dr Teo must obtain a written statement of support from a council-approved neurosurgeon (a RACS fellow with 20 years’ experience).
The neurosurgeon must be satisfied that Dr Teo has explained both the costs and all the risks associated with the procedure and obtained consent, and if the written statement does not support the practitioner performing the procedure(s) the practitioner cannot perform the surgery.
Dr Teo must also maintain a log listing the details of all his patients and procedures, including any complications that arose, and submit a verified copy of this document each month to the Medical Council of NSW.
In addition, he is only allowed to practise under category C supervision in accordance with the NSW Medical Council’s compliance policy, must review and discuss his practice with that supervisor regularly, and submit to an audit assessing his management of interstate patients, record keeping and compliance with these conditions.
At the time it was applied, Dr Teo said that he believed that his treatment of patients, “who suffer from extremely rare, complicated and terminal brain cancers, had always been in line with local and inter-national standards of care and welcomes greater transparency of his office procedures.”
“I am often approached by patients suffering from brain cancer who have been told that there is nothing else to be done,” Dr Teo told The Daily Telegraph on 28 August 2021.
“Published manuscripts over the past 30 years show that my success rate with these so-called ‘inoperable’ tumours has been very successful in curing ‘incurable’ tumours, extending survival or improving quality of their lives.”
Whilst under temporary restrictions here in Australia, Dr Teo has continued to operate overseas, in Africa and Spain, with two Australian patients traveling to have him perform their procedure.
Dr Teo operated on 24-year-old Monica Lopresti in Madrid, Spain in August 2022, successfully removing a benign cystic tumour from her brain, and Ms Lopresti wrote to The Daily Mail Australia, about her experience, praising Dr Teo, on 30 October 2022.
Her father had died from brain cancer eight years earlier and by the time seven different neurosurgeons told her mother that they could not operate, she was already starting to lose her vision.
“I have heard the claims that Dr Teo demands $50,000 before a surgery. That never happened in our situation. He never even mentioned money in any consultation,” Ms Lopresti wrote.
“Of course, nothing is for free in life but this idea that Dr Teo gets a chunk of the money is just false.
“He was humble, down-to-earth, empathetic, and sweet – a man who listened far more than most doctors I have come across… I sat there and cried, and he just listened to me vent. I treated him like a therapist. And he listened to all of it. That is when he became like family to us.
“He was also straightforward about the risks. He is not a man that trades in false hope as I have heard.
“On the day of the surgery, he was there before, during and after and that was an amazing comfort… We had a pre-op appointment in which we went through everything again and met with some of his team.”
However, her mother had to raise $120,760 to fund the surgery, and the other recipient, a young man from Melbourne, Mr Billy Baldwin, had $70,000 raised by his father.
According to the Charlie Teo Foundation financial report for the year ended 30 June 2022, the charity received $3,104,739 in donations and bequests, $134,960 from fundraising (after expenses) and gave out grants to 13 organisations based in Australia, the US and Switzerland worth $2,057,270, leaving $9,541,227 in the bank. More than $220,000 was paid to executive management in 2022.
Dr Teo will appear before the Committee on Monday, 20 February.