The controversial limb-lengthening surgery set for Australia

I'm Ruby Jones and you're listening to seven AM. Limb lengthening surgery where bones in your leg are broken, a rod inserted and extended can be high risk and is

A defamation case against the nine newspapers. Today investigative reporter at the Age Charlotte Greeve on how she exposed Dr Munjed Al Madeiras and what she's learned about his plans for the Pale Institute.

It's Tuesday, December.

Two, Charlotte, thank you for speaking with me. You've been reporting on munded Amadeiras for a long time. So where did that start for you?

Yeah, so I first started looking into munjed Armadiras in twenty twenty two. The origin story for why I got there is kind of a personal story, and the basis of the books that I'm about to publish called Duty

This give an amputee a higher mechanical and functional capacity and a greater comfort compared to a combersome, archaic style off captain hook socket prosthesis.

Now, doctor Almaderris has performed the most of these surgeries than anyone on the planet, and our investigation ultimately revealed similar problems of over operating, unnecessary surgeries and risks being minimized. But yeah, that story really started with my dad's experience and an uneasy feeling that he got when he went for consultation back in twenty eighteen.

Right, So, your dad had what sounds like an uneasy experience which prompted you to look into this further. So how did you approach your reporting.

I started by reaching out to patients, to surgeons and really just taking a sort of light touch approach, asking open ended questions to people about their experience, what they thought, how the promises matched reality of this surgery, which you know, at its best, can be.

A very miraculous surgery.

It can help people walk who have been confined to a wheelchair for their life.

Five years down the track after being in a wheelchair, he walk his dog every day, He played golf that's in his backyard, by the way, and he has his life back.

But quickly, what I discovered is that there was this underclass of patients who didn't have the miracle experience, and for them, when the surgery fails, it can go horribly horribly wrong.

Is that good at talking that you think that he's going to be the one to fix all your problems? Well, no, it doesn't make them worse.

Actually for me, Doctor al Madeiras would say, well, these are just complications of surgery. The patient said, we were never warned about this.

I actually didn't know what to do. I was just dumbfounded that this was happening. I don't know what to do. Actually, for the first time in my life, I don't know how to fix this, and I sent the video to Mundid straight away and I never got a response from.

Him, And so it all boiled down to informed consent. And what we discovered is, in fact, no, they didn't know what they were signing up for, and behind that there was a major profit motive for the surgeon to keep prescribing this particular procedure.

And so how did Amadeiras respond to your reporting?

So he responded by suing for defamation.

In twenty twenty two, an investigation by sixty Minutes, The Age and The Sydney Morning Herald revealed the dark side of his booming practice, finding al Madeiras's care was not up to scratch, that he downplayed the risks and used high pressure sales tactics. Al Madeiras claimed nine was running a malicious campaign against him.

He denied all the allegations against him. He branded all of his patients as liars. He labeled the surgeons and experts who spoke out against him as biased or trying to tear him down for financial reasons or jealousy reasons.

And the end result was a three month trial.

So it was the third longest defamation trial in Australian history. There were thirty five patients and their family members who gave evidence for us. There were surgeons, experts, whistleblowers all took to the stand and gave evidence about the truth of the allegations. It was a year long wait for the judgment and when the results came in, we won on all counts.

So it was a good end.

It was a good result, but certainly took a long way to get there.

And tell me a bit more about that judgment. What did the Federal court decide?

So it was a very comprehensive judgment. It was seven hundred and seventy one pages long and essentially justice. Wendy Abraham found failures in munjed Almadeiras's surgical practice from the very beginning of his interaction with patients, So the types of people he decided were appropriate to operate on she found were often wrong. Then on the operating table itself she found he made mistakes. Then in the aftercare, the post operative care period, she found that he neglected patients

And so what does a finding like that mean for al Maderis's capacity to work as a surgeon.

Well, strangely enough, the regulators the h Triple Ce in New South Wales and are pro the National Healthcare Regulator. When the judgment first came out they said, you know, we're carefully reviewing this. But months later there's been no update from either of those parties. For now, it seems that yeah, there's no consequences for those findings in the Federal Court.

Coming up the cosmetic limb lengthening powerhouse set for Australian Shores Charlotte. Despite the court ruling in your favor, doctor Munjed Amadeiras is still allowed to practice in Australia. And you've discovered that he has ties to a Florida based medical tourism behemoth called the Pale Institute. So tell me about them. What do they do?

So? The Pale Institute are known for selling what they brand as innovative surgeries. The surgery that it's most well known for is limb lengthening, which is a surgery that, as the name suggests, lengthens your limbs for either medical reasons or cosmetic reasons.

On its website, it's found to draw.

Paley is described as a miracle man, a bone wizard, so he does the surgeries that many other surgeons refuse to do.

How cosmetic lim lengthening works.

Is you put rods into the bone and those rods can be operated externally using magnets or remote controllers to move over a series of months. And what that does is it breaks the bones from the inside, and so over a period of months your bones are sort of constantly breaking and healing to make it get longer. And the risks involved in that are that you can create nerve damage, there's always the ever present risk of infection, you can create problems later on in your life in

There are risks there.

But this is an irreversible and permanent surgery that can have serious consequences for people.

And you've uncovered some complaints about things that have potentially gone wrong in their US operations. Can you tell me a little about that.

What I found when I was investigating the Pale Institute is a couple of medical negligence claims that have been heard before the Florida courts this year. There three that I really honed in on. One was a ten year old girl who underwent surgery at the Pale Institute, and she alleged that she was left permanently disfigured, scarred.

And injured.

Another man died on the operating table during a complex spinal surgery. And the third was a thirty year old man who underwent limb lengthening surgery that went allegedly horribly wrong, and he had to have the surgery reverse, so he's sewing as well. So while medical negligence cases aren't necessarily rare, what was common throughout all three of those cases was these allegations or patterns of unnecessary surgery, high pressure sales tactics, and devastating consequences for patients.

Right And these cases they're still before the courts, so they're just claims at this point. But in the meantime, what have you found out about what exactly doctor Munjed Almadiras's plans are for the Pale Institute here in Australia.

Yeah.

So he wrote a letter to GPS earlier this year saying that his longer term plan is to bring the Pale Institute to Sydney, Australia. We don't know what that would entail or how it would work. McCrory Uni Hospital certainly said that they had never heard of the plans. When I went to doctor Almadeiras and Draw Paley for comment, they simply didn't respond. So we have no real details around how it would work or what it would look like.

So if he.

Does bring the Pale Institute to Australia, I'm sure we'll see a lot more of that surgery being offered to people of all ages.

But there is I suppose no legal reason that something like this couldn't go ahead or that Almoderis couldn't practice right, So how lackly does it seem that this is going to materialize exactly?

I mean, Australian health care has been open for business for foreign investment for a long time. We have major foreign companies owning large chunks of our private healthcare network. So there are very few checks and balances or roadblocks that would get in the way of something like this coming to Australia.

Well, Charlotte, thank you so much for your time.

Thanks Ruby.

Also in the news, Defense Minister Richard Miles has announced the largest reform to the Australian Defense Force in fifty years. Three groups within Defense, the Capability Acquisition and Sustainment Group, the Naval Shipbuilding and Sustainment Group, and the Guided Weapons and Explosive Ordinance Group, are set to be rolled into one organization. There will also be a dedicated agency to

Thanks for listening.