Category: Coroners Inquests

Dr William Mooney ENT and Cosmetic Surgeon under investigation

UPDATE 02.07.19 – Media story about Dr Bill Mooney to air tonight on A Current Affair, Channel 9. William (Bill) Mooney is an ENT surgeon under investigation by the HCCC regarding the death of 2 patients, one at Strathfield Private Hospital and the other at East Sydney Private Hospital. Details regarding the cases (as reported in the media) can be found below. As it currently stands, the Medical Council has allowed Dr Mooney to continue to practise under supervision and with various restrictions, pending an investigation by the Health Care Complaints Commission.

EARLIER UPDATE: 03.06.19 – The Medical Council undertook a review of Dr Mooney’s suspension:

“The Council remains concerned about Dr Mooney’s ability to practice surgery safely while unsupervised.
Accordingly:
• Dr Mooney may not conduct most surgeries;
• Other surgeries which he is permitted to undertake may be performed only under the direct observation of a specialist supervisor approved by the Council• Dr Mooney must meet with his specialist surgical supervisor each fortnight who will report back to Council each month.
• Dr Mooney may conduct consultations, again under supervision by a specialist medical practitioner who will ensure Dr Mooney understands relevant professional obligations and report accordingly to the Council.”

Source: Media Release from Medical Council of NSW.

According to AHPRA’s website:

“The Medical Council of New South Wales has considered it appropriate to impose the following conditions on Dr William Wall Warner Mooney’s registration 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. The matter giving rise to the conditions will be referred to the Health Care Complaints Commission. These conditions will have effect until the matter about the practitioner is disposed of, or the conditions are removed by the Medical Council of NSW.

1. Not to perform any paranasal procedures including the following procedures:

• External fronto-nasal ethmoidectomy (MBS 41731)
• Radical fronto-ethmoidectomy (MBS 41734)
• Intranasal operation on the frontal sinus or ethmoidal sinuses (MBS 41737).
• Intranasal operation on sphenoidal sinus (MBS 41752)
• Catheterisation of frontal sinus (MBS 41740)
• Trephine of frontal sinus (MBS 41743)
• Radical obliteration of frontal sinus (MBS 41746)
• External operation on the ethmoidal sinuses (MBS 41749)
• Transorbital ligation of the ethmoidal artery or arteries (MBS 41725)
• Intranasal operation on or removal of foreign body from Antrum (MBS 41716)
• Removal of nasal polyp or polypi (MBS 41662 and 41668)
• Antrostomy (Radical) (MBS 41710)
• Antrostomy (Radical) with transantral ethmoidectomy or transantral vidian neurectomy (MBS 41713)
• Proof puncture and lavage of maxillary antrum (MBS 41698)
• Proof puncture and lavage of maxillary antrum, under general anaesthesia (requiring admission to hospital) (MBS 41701)
• Lavage of maxillary antrum (MBS 41704)

2. To practise under category A supervision when in the operating theatre in accordance with the Medical Council of NSW’s Compliance Policy – Supervision (as varied from time to time) and as subsequently determined by the appropriate review body.

a. The Council-approved supervisor must have Specialist Otolaryngology registration and directly observe the practitioner performing all procedure/s in the operating theatre.

b. The practitioner is to have review meetings with his Council-approved supervisor each fortnight for at least one hour and authorise the Council-approved supervisor to provide reports to the Council on monthly basis.

c. At each supervision meeting the practitioner is to review and discuss his operating practice with his approved supervisor with particular focus on:

i. Operative technique and outcomes
ii. Planned surgeries, including indications and patient selection
iii. Time management of procedures including concerns about the speed some surgeries have been conducted

d. To authorise the Medical Council of NSW to provide proposed and approved supervisors with a copy of the decision which imposed this condition.

e. Not to perform any procedures in the operating theatre until supervisor has been approved by the Council.

3. To practise under category C supervision for all other non-operating theatre practice in accordance with the Medical Council of NSW’s Compliance Policy – Supervision (as varied from time to time) and as subsequently determined by the appropriate review body.

a. The practitioner is to have review meetings with his Council-approved supervisor each month for at least one hour and to authorise the Council-approved supervisor to provide reports to the Council (in a Council approved format) on a 3 monthly basis.

b. At each supervision meeting the practitioner is to review and discuss his practice with his approved supervisor with a particular focus on:

i. Boundaries with patients
ii. Appropriate prescribing practices
iii. Clinical outcomes
iv. Medical record reviews
v. Work load and work related stress
vi. Overall patient care and management

c. To authorise the Medical Council of NSW to provide proposed and approved supervisors with a copy of the decision which imposed this condition.

4. Within 7 days of the end of each calendar month, the practitioner is to provide the Medical Council of NSW with a record of all procedures performed in the operating theatre in the last month. The record must include the following:

• the full name and date of birth of the patient
• the date and start and finish time of each procedure
• the name of the procedure
• Medicare item number
• the name and signature of the Council-approved Category A supervisor present throughout the procedure
• any complications arising during and/or as a result of the procedure (and specifically advising of any unplanned return to theatre and/or any post-operative infection).

5. To practise no more than a total of 35 hours per week.

6. Not to possess, supply, administer or prescribe:

a. Phentermine
b. Orlistat
c. Liraglutide
d. Topiramate
e. Phentermine/topiramate combination
f. Altrexone/bupropion combination
g. Lorcaserin

7. To submit to an audit of his medical practice, by a random selection of his medical records by a person or persons nominated by the Medical Council of NSW and:

a. The audit is to be held as required by the Council.

b. The auditor(s) is to examine and assess the following aspects of his practice including:

i. a general medical records audit of his practice
ii. an audit of operative procedure records, including the indications and compliance with conditions

c. To authorise the auditor(s) to provide the Council with a report on their findings.

d. To meet all costs associated with the audit and any subsequent audits and reports.

8. To authorise and consent to any exchange of information between the Medical Council of NSW and Medicare Australia for the purpose of monitoring compliance with these conditions.

This registration is also subject to other conditions. These conditions are not publicly available due to privacy considerations.”

EARLIER UPDATE: 13.11.18 – media reports that Dr Mooney has been suspended.

It has been reported in the media, that celebrity nose job doctor William Mooney is under investigation by the coroner in relation to the deaths of 2 patients.

Dr Mooney boasts on his website that not only is he “Australia’s leading ENT, specialising in Facial Plastic Surgery” but also  “Sydney’s Premiere Rhinoplasty Surgeon.” He has clinics in Bondi Junction and Bankstown, and founded Face Plus Medispa, on Bondi Beach, a day spa offering beauty treatments.

ABOUT THE CASES (AS REPORTED IN THE MEDIA)-

Patient Death: East Sydney Private Hospital

The Sydney Morning Herald reported on 2 March 2018, that Alex “Little Al” Taouil, a feared standover man and a close associate of bikies and Melbourne identity Mick Gatto, died after undergoing nasal surgery by Dr William Mooney at East Sydney Private. Dr Mooney says Mr Taouil had a post operative stroke that was not directly related to any trauma from the surgery. This case has  however been referred to the coroner.

Second Patient Death: Strathfield Private Hospital

On 15 February  2018, Pouya Pouladian underwent surgery by Dr William Mooney ENT for sinus problems/sleep apnoea at Strathfield Private Hospital. Dr Mooney allegedly nicked an artery during the surgery.

Nurses told the family that Dr Mooney would come to see them after the surgery. That night they waited until 8pm only to be told Dr Mooney had gone home. “He never came,” Mrs Pouladian said. The family said that, in the two days Pouya was in Strathfield Private, Dr Mooney did not see or speak to him or his family.

Pouya was discharged from hospital on 17 February, and within hours began vomiting. He collapsed and was taken to Canterbury Hospital by ambulance. He was then transferred to Concord hospital, where he subsequently went into cardiac arrest and died.

It was reported on 31/07/18 by media outlets that Pouya’s sister and mother died in a suicide pact on 30/07/18, and that Pouya’s sister was suffering from depression following her brother’s death.

Dr William Mooney and drug testing

Medical sources have confirmed that further restrictions have been placed on Dr William Mooney’s registration on top of the current conditions which require him to undergo random drug testing.

A search of AHPRAs database revealed that Dr William Mooney currently (22/03/18) has the following conditions imposed on his registration:

1. Not to perform the following frontal and ethmoidal sinus procedures:•

    • External fronto-nasal ethmoidectomy (MBS 41731)
    • Radical fronto-ethmoidectomy (MBS41734)
    • Intranasal operation on the frontal sinus or ethmoidal sinuses (MBS 41737)
    • Catheterisation of frontal sinus (MBS 41740)
    • Trephine of frontal sinus (MBS 41743)
    • Radical obliteration of frontal sinus (MBS 41746)
    • External operation on the ethmoidal sinuses (MBS 41749)
    • Transorbital ligation of the ethmoidal artery or arteries (MBS 41725)
    • Removal of nasal polyp or polypi (MBS 41662, 41665 and 41668)

2. To nominate an experienced ENT surgeon to act as his professional mentor for approval by Medical Council of NSW in accordance with the Medical Council of NSW’s Compliance Policy – Mentoring (as varied from time to time) and as subsequently determined by the appropriate review body.

(a) The first mentoring meeting is to occur within a week of being advised that his mentor is approved and thereafter at a frequency to be determined by the mentor.

At each mentoring meeting the practitioner is to include discussion of the following:

i) the personal and professional effect that the issues which brought the practitioner to the attention of the Council have had on the practitioner

ii) possible clinical concerns raised by the Council, such as his current heavy workload, patient and procedure selection, and time management of procedures including concerns regarding the speed of those procedures

iii) how the practitioner has reflected on his practice, and whether changes to his practice are required.

(b) To authorise the mentor to report, in an approved format, to the Council within one month of being advised that his mentor is approved and every three months thereafter about the fact of contact, and to inform the Council if there is any concern about his professional conduct, health or personal wellbeing.

(c) To authorise the Medical Council of NSW to provide proposed and approved mentors with a copy of the decision which imposed this condition.

3. To submit to an audit of his medical practice, by a random selection of his medical records by a person or persons nominated by the Medical Council of NSW and:

a) The audit is to be held within 3 months from 21 March 2018 and subsequently required by the Council.

b) The auditor(s) is to examine and assess the following aspects of his practice including:

i) a general medical records audit of his ENT practice

ii) an audit of operative procedure records, including the indications, compliance with conditions, and where possible, duration of such procedures against complexity and reasonably expected duration

c) To authorise the auditor(s) to provide the Council with a report on their findings.

d) To meet all costs associated with the audit and any subsequent audits and reports.

4. To authorise and consent to any exchange of information between the Medical Council of NSW and Medicare Australia for the purpose of monitoring compliance with these conditions.

This registration is also subject to other conditions. These conditions are not publicly available due to privacy considerations.

Sources:

Macquarie University Hospital Death of Patient Paul Lau

A coroner’s inquest has found that Mr Paul Lau died on 19 June 2015 as a result of prescribing error by an anaesthetist, which led to Mr Lau receiving medication intended for another patient whilst he was recovering from ACL reconstruction surgery. The error was not detected by Hospital staff before his death.

Dr Kim opened Paul’s TrakCare record to prescribe a small amount of fluids, which he had forgotten to prescribe during Paul’s surgery. Dr Kim then failed to close Paul’s TrakCare record and opened GS’s (another patient’s) TrakCare record before prescribing post-operative medications for GS at 1:55pm.

Mr Lau was prescribed a Fentanyl Patch and a Fentanyl PCA. He died of fentanyl toxicity.

According to the inquest findings:

It is clear that Dr Kim failed to exercise proper care, diligence and caution whilst prescribing medication erroneously in Paul’s TrakCare record from 1:55pm to 2:00pm. Dr Kim accepted that a patient’s name is displayed on screen in TrakCare at all times and that he overrode 22 alerts presented in three batches whilst prescribing, selecting “consultant’s decision” and entering his password each time. Dr Kim accepted that he bears primary responsibility for the error.

Criticism was made of the hospital’s pharmacist:

In the Pharmacy, Ms Bui, the dispensing pharmacist, failed to adequately assess the appropriateness of the Fentanyl patch for Paul, particularly having regard to the fact that an opioid naïve patient had been prescribed the strongest dose and the fact that Fentanyl patches were not regularly prescribed for postoperative pain.

Criticism was also made of the nursing staff:

A similar absence of critical thinking was displayed by the nursing staff. The Recovery nurses did not question the order for the Fentanyl PCA, despite the Fentanyl PCA not being discussed during handover. The Ward 1 nurses did not assess whether the Fentanyl patch was appropriate medication for a patient in Paul’s circumstances and did not adjust their practices to reflect the risks posed once the Fentanyl patch was administered.

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