Dr Charlie Teo was accused of lying under oath during his interrogation by lawyers for the NSW health watchdog on Monday 20 July 2023, with questions raised over his estimation and communication of the risks involved with surgery.
The Health Care Complaints Commission’s (HCCC) Kate Richardson SC put it to Dr Teo that after proceeding with the high-risk surgery, he altered his evidence about the location of the tumour to deliberately mislead the Commission and reduce his liability – a claim which Dr Teo denied.
“I want to suggest to you that you deliberately gave untruthful evidence to the committee for that reason. Do you accept that?” Ms Richardson asked.
“No,” Dr Teo replied.
“I want to suggest to you that at no point did you suggest to them there was some ambiguity about where the tumour was,” Ms Richardson said.
“Absolutely disagree with that,” Dr Teo replied.
Dr Teo said that in hindsight he would perform both surgeries differently, and that he was potentially “too radical” with the amount of tissue that he took, telling the hearing it was plain from the outcome that he had removed too much of her brain.
“I did the wrong thing. I obviously did the wrong thing by the patient,” he said.
“Clearly, I have taken out a part of the right frontal lobe that has caused a deficit.
“Did I intend to hurt her? Absolutely not.”
When asked what he would do differently Teo replied, “pull my punches. Try to leave a little more tumour behind. Maybe a different approach.
“That is the $6m question. ‘What did you do wrong? What can you learn from it?’” he said.
Negligence was also strongly implied.
“The word negligent, I find that offensive,” Teo said.
“It was not negligent. Maybe ignorant on my behalf, but it was not negligence.”
Expert witnesses, Professor Bryant Stokes and Professor Andrew Morokoff, testified during the first week of the hearing that the risk of ‘profound neurological deficit’ from the surgery was 60%, yet after examining their brain scans, Dr Teo told the patient that the risk of death or paralysis was just 5%.
Differences in interpretation reflected the challenges in differentiating between a tumour and cerebral edema from a brain scan.
“There are just two different ways to look at it,” Dr Teo said.
Dr Teo told he had communicated his concerns by telling the patients that he was ‘hopeful’ that the tumour was in the tectal plate region of the brain, rather than the tegmental, but did not want to confuse patients by getting into the ‘finer neurosurgical details.’
“These people are emotionally charged. They have heard a lot of information. You do not want to confuse them,” he said.
“I’m not going to go into the finer surgical aspects with a patient. I think that’s inappropriate.”
Ms Richardson also raised the issue of comments that Dr Teo had made to the media suggesting that the source of the allegations made against him were ‘coerced’ out of patient’s family members by other doctors – particularly one West Australian doctor – who were jealous of his skill.
He said the WA doctor had “turned that into a complaint not about the system but a complaint about Dr Teo.”
Dr Teo said that he believed that the husband of one of the patients was ‘genuinely destroyed’ by the outcome of the surgery and had initially blamed himself and only decided to make an official complaint to the HCCC after being swayed by discussions with others.
“I think he has been hoodwinked into thinking my intentions were not honourable,” Dr Teo said.
“We had a good relationship and that seems to have soured. I made the assumption that he had been ‘got to’ by my enemies.
“He’s been suggested to that it’s Dr Teo’s fault, nobody else’s fault, not the tumour.
“So, I stand by those comments to the media.
“I think he has been suggested to by multiple doctors over this period of time.”
The hearing has run into overtime and will resume with a cross examination of Dr Teo in March but during that time, he will continue to operate on patients under additional oversight imposed by the HCCC in August 2021, including surgery on another malignant brain stem glioma.
“I am doing one next week. It is the same story and I hope I am going to get a good outcome by learning from all the past outcomes,” Dr Teo said.
Dr Teo was greeted outside the hearing every morning by a large group of supporters who said he had saved or improved their lives through surgery for conditions that had been deemed inoperable and was visibly overwhelmed with emotion on the Monday morning he was due to give evidence.
“What can I say? It is uh, it is overwhelming. It is crazy,” he said.
“Anyway, I’m here for them. That is why I am here. It’s not for me.”