WEBVTT - The controversial limb-lengthening surgery set for Australia 0:00:01.320 --> 0:00:08.760 I'm Ruby Jones and you're listening to seven AM. Limb 0:00:08.840 --> 0:00:12.280 lengthening surgery where bones in your leg are broken, a 0:00:12.400 --> 0:00:16.200 rod inserted and extended can be high risk and is 0:00:16.280 --> 0:00:20.599 especially controversial when it's done for cosmetic reasons. The procedure 0:00:20.720 --> 0:00:24.119 is a specialty of the Florida based Pale Institute, which 0:00:24.160 --> 0:00:27.960 now plans on opening an Australian arm The center is 0:00:28.000 --> 0:00:30.520 no stranger to controversy, and neither is the man they're 0:00:30.560 --> 0:00:34.520 partnering up with, the once celebrated surgeon, doctor Munjed Almadeiras, 0:00:34.720 --> 0:00:36.000 who recently lost. 0:00:35.760 --> 0:00:40.680 A defamation case against the nine newspapers. Today investigative reporter 0:00:40.760 --> 0:00:43.600 at the Age Charlotte Greeve on how she exposed Dr 0:00:43.640 --> 0:00:47.040 Munjed Al Madeiras and what she's learned about his plans 0:00:47.080 --> 0:00:51.880 for the Pale Institute. 0:00:54.240 --> 0:00:55.920 It's Tuesday, December. 0:00:55.560 --> 0:01:04.120 Two, Charlotte, thank you for speaking with me. You've been 0:01:04.160 --> 0:01:07.920 reporting on munded Amadeiras for a long time. So where 0:01:07.920 --> 0:01:09.039 did that start for you? 0:01:09.920 --> 0:01:15.640 Yeah, so I first started looking into munjed Armadiras in 0:01:15.800 --> 0:01:20.319 twenty twenty two. The origin story for why I got 0:01:20.319 --> 0:01:23.480 there is kind of a personal story, and the basis 0:01:23.520 --> 0:01:26.400 of the books that I'm about to publish called Duty 0:01:26.480 --> 0:01:31.680 to Warn. So my father is an amputee and he 0:01:31.800 --> 0:01:37.280 went to a consultation with doctor Almadias in twenty eighteen, 0:01:38.000 --> 0:01:41.520 and doctor Amadurras is famous for a particular type of 0:01:41.520 --> 0:01:46.959 surgery called ossio integration, which is for amputees and basically 0:01:46.959 --> 0:01:52.040 involves putting a titanium rod into the bone of the 0:01:52.080 --> 0:01:56.320 residual limb, which protrudes through the skin and connects to 0:01:56.360 --> 0:01:57.320 a prosthetic limb. 0:01:57.960 --> 0:02:04.200 This give an amputee a higher mechanical and functional capacity 0:02:04.560 --> 0:02:11.880 and a greater comfort compared to a combersome, archaic style 0:02:12.480 --> 0:02:16.600 off captain hook socket prosthesis. 0:02:17.320 --> 0:02:21.760 Now, doctor Almaderris has performed the most of these surgeries 0:02:21.760 --> 0:02:26.880 than anyone on the planet, and our investigation ultimately revealed 0:02:27.400 --> 0:02:33.160 similar problems of over operating, unnecessary surgeries and risks being minimized. 0:02:34.160 --> 0:02:37.480 But yeah, that story really started with my dad's experience 0:02:37.760 --> 0:02:40.639 and an uneasy feeling that he got when he went 0:02:40.680 --> 0:02:42.560 for consultation back in twenty eighteen. 0:02:43.280 --> 0:02:45.800 Right, So, your dad had what sounds like an uneasy 0:02:45.919 --> 0:02:49.680 experience which prompted you to look into this further. So 0:02:49.760 --> 0:02:51.440 how did you approach your reporting. 0:02:51.760 --> 0:02:56.359 I started by reaching out to patients, to surgeons and 0:02:56.480 --> 0:03:00.840 really just taking a sort of light touch approach, asking 0:03:00.960 --> 0:03:06.080 open ended questions to people about their experience, what they thought, 0:03:06.720 --> 0:03:10.960 how the promises matched reality of this surgery, which you know, 0:03:11.040 --> 0:03:13.120 at its best, can be. 0:03:12.919 --> 0:03:14.760 A very miraculous surgery. 0:03:14.800 --> 0:03:17.640 It can help people walk who have been confined to 0:03:17.680 --> 0:03:19.040 a wheelchair for their life. 0:03:19.560 --> 0:03:22.720 Five years down the track after being in a wheelchair, 0:03:23.360 --> 0:03:26.760 he walk his dog every day, He played golf that's 0:03:26.800 --> 0:03:29.639 in his backyard, by the way, and he has his 0:03:29.680 --> 0:03:30.320 life back. 0:03:31.000 --> 0:03:34.239 But quickly, what I discovered is that there was this 0:03:34.639 --> 0:03:41.160 underclass of patients who didn't have the miracle experience, and 0:03:41.560 --> 0:03:46.320 for them, when the surgery fails, it can go horribly 0:03:46.360 --> 0:03:47.160 horribly wrong. 0:03:48.720 --> 0:03:51.680 Is that good at talking that you think that he's 0:03:51.720 --> 0:03:56.320 going to be the one to fix all your problems? Well, no, 0:03:56.400 --> 0:03:58.360 it doesn't make them worse. 0:03:59.000 --> 0:04:03.280 Actually for me, Doctor al Madeiras would say, well, these 0:04:03.280 --> 0:04:07.680 are just complications of surgery. The patient said, we were 0:04:07.720 --> 0:04:09.000 never warned about this. 0:04:09.520 --> 0:04:12.360 I actually didn't know what to do. I was just 0:04:12.400 --> 0:04:17.360 dumbfounded that this was happening. I don't know what to do. Actually, 0:04:17.400 --> 0:04:19.520 for the first time in my life, I don't know 0:04:19.560 --> 0:04:22.680 how to fix this, and I sent the video to 0:04:22.800 --> 0:04:27.560 Mundid straight away and I never got a response from. 0:04:27.480 --> 0:04:31.920 Him, And so it all boiled down to informed consent. 0:04:32.240 --> 0:04:35.440 And what we discovered is, in fact, no, they didn't 0:04:35.440 --> 0:04:38.360 know what they were signing up for, and behind that 0:04:38.400 --> 0:04:41.719 there was a major profit motive for the surgeon to 0:04:41.880 --> 0:04:44.600 keep prescribing this particular procedure. 0:04:48.279 --> 0:04:50.800 And so how did Amadeiras respond to your reporting? 0:04:51.560 --> 0:04:55.400 So he responded by suing for defamation. 0:04:55.839 --> 0:04:59.359 In twenty twenty two, an investigation by sixty Minutes, The 0:04:59.480 --> 0:05:02.599 Age and The Sydney Morning Herald revealed the dark side 0:05:02.600 --> 0:05:06.120 of his booming practice, finding al Madeiras's care was not 0:05:06.240 --> 0:05:09.080 up to scratch, that he downplayed the risks and used 0:05:09.200 --> 0:05:13.520 high pressure sales tactics. Al Madeiras claimed nine was running 0:05:13.560 --> 0:05:15.279 a malicious campaign against him. 0:05:15.640 --> 0:05:20.720 He denied all the allegations against him. He branded all 0:05:20.760 --> 0:05:27.120 of his patients as liars. He labeled the surgeons and 0:05:27.400 --> 0:05:32.680 experts who spoke out against him as biased or trying 0:05:32.720 --> 0:05:37.320 to tear him down for financial reasons or jealousy reasons. 0:05:37.800 --> 0:05:40.360 And the end result was a three month trial. 0:05:40.560 --> 0:05:45.479 So it was the third longest defamation trial in Australian history. 0:05:46.200 --> 0:05:49.320 There were thirty five patients and their family members who 0:05:49.560 --> 0:05:55.119 gave evidence for us. There were surgeons, experts, whistleblowers all 0:05:55.560 --> 0:05:59.080 took to the stand and gave evidence about the truth 0:05:59.279 --> 0:06:02.599 of the allegations. It was a year long wait for 0:06:02.680 --> 0:06:06.400 the judgment and when the results came in, we won 0:06:06.600 --> 0:06:07.760 on all counts. 0:06:08.200 --> 0:06:10.440 So it was a good end. 0:06:10.560 --> 0:06:13.600 It was a good result, but certainly took a long 0:06:13.640 --> 0:06:14.279 way to get there. 0:06:14.839 --> 0:06:16.920 And tell me a bit more about that judgment. What 0:06:16.960 --> 0:06:19.440 did the Federal court decide? 0:06:19.800 --> 0:06:23.440 So it was a very comprehensive judgment. It was seven 0:06:23.520 --> 0:06:28.280 hundred and seventy one pages long and essentially justice. Wendy 0:06:28.320 --> 0:06:34.440 Abraham found failures in munjed Almadeiras's surgical practice from the 0:06:34.600 --> 0:06:39.480 very beginning of his interaction with patients, So the types 0:06:39.520 --> 0:06:42.279 of people he decided were appropriate to operate on she 0:06:42.400 --> 0:06:46.680 found were often wrong. Then on the operating table itself 0:06:46.960 --> 0:06:50.800 she found he made mistakes. Then in the aftercare, the 0:06:50.839 --> 0:06:55.320 post operative care period, she found that he neglected patients 0:06:55.360 --> 0:06:58.800 when they needed him. So right across the full spectrum 0:06:58.960 --> 0:07:03.520 of his practic does she found he was negligent, unethical 0:07:03.800 --> 0:07:07.200 and placed profits before people. 0:07:08.240 --> 0:07:11.800 And so what does a finding like that mean for 0:07:12.080 --> 0:07:15.360 al Maderis's capacity to work as a surgeon. 0:07:16.280 --> 0:07:20.320 Well, strangely enough, the regulators the h Triple Ce in 0:07:20.400 --> 0:07:23.600 New South Wales and are pro the National Healthcare Regulator. 0:07:23.800 --> 0:07:26.280 When the judgment first came out they said, you know, 0:07:26.360 --> 0:07:31.080 we're carefully reviewing this. But months later there's been no 0:07:31.440 --> 0:07:35.160 update from either of those parties. For now, it seems 0:07:35.200 --> 0:07:39.160 that yeah, there's no consequences for those findings in the 0:07:39.200 --> 0:07:40.160 Federal Court. 0:07:43.400 --> 0:07:47.000 Coming up the cosmetic limb lengthening powerhouse set for Australian 0:07:47.040 --> 0:07:55.520 Shores Charlotte. Despite the court ruling in your favor, doctor 0:07:55.640 --> 0:07:59.760 Munjed Amadeiras is still allowed to practice in Australia. And 0:08:00.040 --> 0:08:02.840 you've discovered that he has ties to a Florida based 0:08:02.960 --> 0:08:07.080 medical tourism behemoth called the Pale Institute. So tell me 0:08:07.120 --> 0:08:08.360 about them. What do they do? 0:08:09.120 --> 0:08:12.960 So? The Pale Institute are known for selling what they 0:08:13.040 --> 0:08:17.960 brand as innovative surgeries. The surgery that it's most well 0:08:18.000 --> 0:08:22.600 known for is limb lengthening, which is a surgery that, 0:08:22.760 --> 0:08:26.920 as the name suggests, lengthens your limbs for either medical 0:08:26.960 --> 0:08:29.000 reasons or cosmetic reasons. 0:08:29.320 --> 0:08:31.040 On its website, it's found to draw. 0:08:31.120 --> 0:08:34.640 Paley is described as a miracle man, a bone wizard, 0:08:34.760 --> 0:08:38.439 so he does the surgeries that many other surgeons refuse 0:08:38.520 --> 0:08:38.880 to do. 0:08:39.559 --> 0:08:41.559 How cosmetic lim lengthening works. 0:08:41.320 --> 0:08:47.559 Is you put rods into the bone and those rods 0:08:47.640 --> 0:08:52.480 can be operated externally using magnets or remote controllers to 0:08:53.040 --> 0:08:56.440 move over a series of months. And what that does 0:08:56.520 --> 0:09:00.520 is it breaks the bones from the inside, and so 0:09:00.880 --> 0:09:03.000 over a period of months your bones are sort of 0:09:03.280 --> 0:09:08.960 constantly breaking and healing to make it get longer. And 0:09:09.040 --> 0:09:12.000 the risks involved in that are that you can create 0:09:12.080 --> 0:09:15.040 nerve damage, there's always the ever present risk of infection, 0:09:15.640 --> 0:09:18.080 you can create problems later on in your life in 0:09:18.160 --> 0:09:21.800 terms of arthritis. There's a full gamut of reasons. And 0:09:21.840 --> 0:09:25.280 I guess it's like any kind of cosmetic surgery. You know, 0:09:25.640 --> 0:09:28.160 there are risks whenever you're going under the knife, or 0:09:28.440 --> 0:09:30.760 whenever you're putting a foreign body into your body. 0:09:30.920 --> 0:09:31.960 There are risks there. 0:09:32.400 --> 0:09:36.880 But this is an irreversible and permanent surgery that can 0:09:36.920 --> 0:09:38.560 have serious consequences for people. 0:09:39.520 --> 0:09:43.400 And you've uncovered some complaints about things that have potentially 0:09:43.440 --> 0:09:46.640 gone wrong in their US operations. Can you tell me 0:09:46.880 --> 0:09:47.680 a little about that. 0:09:48.160 --> 0:09:51.359 What I found when I was investigating the Pale Institute 0:09:51.800 --> 0:09:55.600 is a couple of medical negligence claims that have been 0:09:55.760 --> 0:10:00.560 heard before the Florida courts this year. There three that 0:10:00.640 --> 0:10:03.559 I really honed in on. One was a ten year 0:10:03.600 --> 0:10:07.800 old girl who underwent surgery at the Pale Institute, and 0:10:08.040 --> 0:10:12.880 she alleged that she was left permanently disfigured, scarred. 0:10:12.880 --> 0:10:13.720 And injured. 0:10:14.120 --> 0:10:19.000 Another man died on the operating table during a complex 0:10:19.040 --> 0:10:22.960 spinal surgery. And the third was a thirty year old 0:10:23.000 --> 0:10:28.800 man who underwent limb lengthening surgery that went allegedly horribly wrong, 0:10:29.280 --> 0:10:32.600 and he had to have the surgery reverse, so he's 0:10:32.640 --> 0:10:37.480 sewing as well. So while medical negligence cases aren't necessarily rare, 0:10:38.160 --> 0:10:41.520 what was common throughout all three of those cases was 0:10:41.920 --> 0:10:47.320 these allegations or patterns of unnecessary surgery, high pressure sales tactics, 0:10:47.520 --> 0:10:50.160 and devastating consequences for patients. 0:10:50.559 --> 0:10:52.880 Right And these cases they're still before the courts, so 0:10:53.320 --> 0:10:56.040 they're just claims at this point. But in the meantime, 0:10:56.360 --> 0:11:00.480 what have you found out about what exactly doctor Munjed 0:11:00.559 --> 0:11:04.640 Almadiras's plans are for the Pale Institute here in Australia. 0:11:04.760 --> 0:11:04.960 Yeah. 0:11:05.080 --> 0:11:08.920 So he wrote a letter to GPS earlier this year 0:11:09.120 --> 0:11:12.320 saying that his longer term plan is to bring the 0:11:12.360 --> 0:11:17.360 Pale Institute to Sydney, Australia. We don't know what that 0:11:17.400 --> 0:11:21.280 would entail or how it would work. McCrory Uni Hospital 0:11:21.320 --> 0:11:23.400 certainly said that they had never heard of the plans. 0:11:23.480 --> 0:11:27.320 When I went to doctor Almadeiras and Draw Paley for comment, 0:11:27.400 --> 0:11:30.920 they simply didn't respond. So we have no real details 0:11:31.559 --> 0:11:34.280 around how it would work or what it would look like. 0:11:34.760 --> 0:11:38.800 But one thing I have noticed is that doctor Almadeiras 0:11:38.840 --> 0:11:44.800 earlier this year was promoting cosmetic limb lengthening in the media. 0:11:44.840 --> 0:11:47.880 There was a Mumma mea article where he gave an 0:11:47.920 --> 0:11:52.200 interview and he said, cosmetic limb lengthening is really popular 0:11:52.400 --> 0:11:56.960 among women these days because giving examples such as, you know, 0:11:57.480 --> 0:12:00.840 people who were shorter get bullied and women need to 0:12:00.920 --> 0:12:04.480 be taller for you know, jobs and to be considered 0:12:04.480 --> 0:12:08.120 for certain roles. So he was really taking a promotional 0:12:08.559 --> 0:12:11.680 approach earlier in the year, sort of which seemed to 0:12:11.760 --> 0:12:14.840 me to be laying the groundwork for he wants to 0:12:14.880 --> 0:12:18.760 expand this practice in Australia, and all the surgeons I 0:12:18.840 --> 0:12:23.080 speak to have said cosmetic limb lengthening is way beyond 0:12:23.320 --> 0:12:29.040 their risk profile, and it's a high risk operation and 0:12:29.080 --> 0:12:33.080 it's a cosmetic procedure. And you know, the dominant thinking 0:12:33.160 --> 0:12:36.720 in Australia has been the risks outweigh the benefits. 0:12:36.800 --> 0:12:38.120 So if he. 0:12:38.080 --> 0:12:41.120 Does bring the Pale Institute to Australia, I'm sure we'll 0:12:41.160 --> 0:12:43.840 see a lot more of that surgery being offered to 0:12:44.440 --> 0:12:45.720 people of all ages. 0:12:46.280 --> 0:12:50.240 But there is I suppose no legal reason that something 0:12:50.280 --> 0:12:53.800 like this couldn't go ahead or that Almoderis couldn't practice right, 0:12:54.000 --> 0:12:56.560 So how lackly does it seem that this is going 0:12:56.559 --> 0:12:58.079 to materialize exactly? 0:12:58.160 --> 0:13:02.800 I mean, Australian health care has been open for business 0:13:02.840 --> 0:13:05.839 for foreign investment for a long time. We have major 0:13:05.920 --> 0:13:09.760 foreign companies owning large chunks of our private healthcare network. 0:13:09.880 --> 0:13:13.920 So there are very few checks and balances or roadblocks 0:13:13.960 --> 0:13:15.760 that would get in the way of something like this 0:13:15.960 --> 0:13:19.439 coming to Australia. 0:13:20.679 --> 0:13:22.920 Well, Charlotte, thank you so much for your time. 0:13:23.559 --> 0:13:30.360 Thanks Ruby. 0:13:39.720 --> 0:13:42.760 Also in the news, Defense Minister Richard Miles has announced 0:13:42.760 --> 0:13:46.200 the largest reform to the Australian Defense Force in fifty years. 0:13:46.800 --> 0:13:50.600 Three groups within Defense, the Capability Acquisition and Sustainment Group, 0:13:50.920 --> 0:13:54.120 the Naval Shipbuilding and Sustainment Group, and the Guided Weapons 0:13:54.120 --> 0:13:57.200 and Explosive Ordinance Group, are set to be rolled into 0:13:57.240 --> 0:14:00.800 one organization. There will also be a dedicated agency to 0:14:00.840 --> 0:14:04.800 decide what projects to prioritize within Defense. While no job 0:14:04.840 --> 0:14:07.640 cuts are expected, Miles says the reform is designed to 0:14:07.640 --> 0:14:13.040 give taxpayers more bang for buck and Israel's Prime Minister 0:14:13.120 --> 0:14:16.920 Benjamin Natya, who has formally asked Israel's President Isaac Herzog 0:14:17.240 --> 0:14:20.080 to grant him a pardon for bribery in fraud charges 0:14:20.400 --> 0:14:23.880 and an end to the corruption trial he faces. Nanna, 0:14:24.000 --> 0:14:26.240 who has argued that pardoning him would be in the 0:14:26.320 --> 0:14:30.520 national interest. Israel's presidential office has called it an extraordinary 0:14:30.600 --> 0:14:35.800 request with significant implications, which will now consider I'm Ruby Jones. 0:14:35.840 --> 0:14:36.840 This is seven am. 0:14:36.880 --> 0:14:37.600 Thanks for listening.