Speaker 1: I'm Ruby Jones and you're listening to seven AM. Limb
Speaker 1: lengthening surgery where bones in your leg are broken, a
Speaker 1: rod inserted and extended can be high risk and is
Speaker 1: especially controversial when it's done for cosmetic reasons. The procedure
Speaker 1: is a specialty of the Florida based Pale Institute, which
Speaker 1: now plans on opening an Australian arm The center is
Speaker 1: no stranger to controversy, and neither is the man they're
Speaker 1: partnering up with, the once celebrated surgeon, doctor Munjed Almadeiras,
Speaker 1: who recently lost.
Speaker 2: A defamation case against the nine newspapers. Today investigative reporter
Speaker 2: at the Age Charlotte Greeve on how she exposed Dr
Speaker 2: Munjed Al Madeiras and what she's learned about his plans
Speaker 2: for the Pale Institute.
Speaker 3: It's Tuesday, December.
Speaker 2: Two, Charlotte, thank you for speaking with me. You've been
Speaker 2: reporting on munded Amadeiras for a long time. So where
Speaker 2: did that start for you?
Speaker 4: Yeah, so I first started looking into munjed Armadiras in
Speaker 4: twenty twenty two. The origin story for why I got
Speaker 4: there is kind of a personal story, and the basis
Speaker 4: of the books that I'm about to publish called Duty
Speaker 4: to Warn. So my father is an amputee and he
Speaker 4: went to a consultation with doctor Almadias in twenty eighteen,
Speaker 4: and doctor Amadurras is famous for a particular type of
Speaker 4: surgery called ossio integration, which is for amputees and basically
Speaker 4: involves putting a titanium rod into the bone of the
Speaker 4: residual limb, which protrudes through the skin and connects to
Speaker 4: a prosthetic limb.
Speaker 5: This give an amputee a higher mechanical and functional capacity
Speaker 5: and a greater comfort compared to a combersome, archaic style
Speaker 5: off captain hook socket prosthesis.
Speaker 4: Now, doctor Almaderris has performed the most of these surgeries
Speaker 4: than anyone on the planet, and our investigation ultimately revealed
Speaker 4: similar problems of over operating, unnecessary surgeries and risks being minimized.
Speaker 4: But yeah, that story really started with my dad's experience
Speaker 4: and an uneasy feeling that he got when he went
Speaker 4: for consultation back in twenty eighteen.
Speaker 2: Right, So, your dad had what sounds like an uneasy
Speaker 2: experience which prompted you to look into this further. So
Speaker 2: how did you approach your reporting.
Speaker 4: I started by reaching out to patients, to surgeons and
Speaker 4: really just taking a sort of light touch approach, asking
Speaker 4: open ended questions to people about their experience, what they thought,
Speaker 4: how the promises matched reality of this surgery, which you know,
Speaker 4: at its best, can be.
Speaker 3: A very miraculous surgery.
Speaker 4: It can help people walk who have been confined to
Speaker 4: a wheelchair for their life.
Speaker 5: Five years down the track after being in a wheelchair,
Speaker 5: he walk his dog every day, He played golf that's
Speaker 5: in his backyard, by the way, and he has his
Speaker 5: life back.
Speaker 4: But quickly, what I discovered is that there was this
Speaker 4: underclass of patients who didn't have the miracle experience, and
Speaker 4: for them, when the surgery fails, it can go horribly
Speaker 4: horribly wrong.
Speaker 6: Is that good at talking that you think that he's
Speaker 6: going to be the one to fix all your problems? Well, no,
Speaker 6: it doesn't make them worse.
Speaker 4: Actually for me, Doctor al Madeiras would say, well, these
Speaker 4: are just complications of surgery. The patient said, we were
Speaker 4: never warned about this.
Speaker 6: I actually didn't know what to do. I was just
Speaker 6: dumbfounded that this was happening. I don't know what to do. Actually,
Speaker 6: for the first time in my life, I don't know
Speaker 6: how to fix this, and I sent the video to
Speaker 6: Mundid straight away and I never got a response from.
Speaker 4: Him, And so it all boiled down to informed consent.
Speaker 4: And what we discovered is, in fact, no, they didn't
Speaker 4: know what they were signing up for, and behind that
Speaker 4: there was a major profit motive for the surgeon to
Speaker 4: keep prescribing this particular procedure.
Speaker 2: And so how did Amadeiras respond to your reporting?
Speaker 4: So he responded by suing for defamation.
Speaker 7: In twenty twenty two, an investigation by sixty Minutes, The
Speaker 7: Age and The Sydney Morning Herald revealed the dark side
Speaker 7: of his booming practice, finding al Madeiras's care was not
Speaker 7: up to scratch, that he downplayed the risks and used
Speaker 7: high pressure sales tactics. Al Madeiras claimed nine was running
Speaker 7: a malicious campaign against him.
Speaker 4: He denied all the allegations against him. He branded all
Speaker 4: of his patients as liars. He labeled the surgeons and
Speaker 4: experts who spoke out against him as biased or trying
Speaker 4: to tear him down for financial reasons or jealousy reasons.
Speaker 3: And the end result was a three month trial.
Speaker 4: So it was the third longest defamation trial in Australian history.
Speaker 4: There were thirty five patients and their family members who
Speaker 4: gave evidence for us. There were surgeons, experts, whistleblowers all
Speaker 4: took to the stand and gave evidence about the truth
Speaker 4: of the allegations. It was a year long wait for
Speaker 4: the judgment and when the results came in, we won
Speaker 4: on all counts.
Speaker 3: So it was a good end.
Speaker 4: It was a good result, but certainly took a long
Speaker 4: way to get there.
Speaker 2: And tell me a bit more about that judgment. What
Speaker 2: did the Federal court decide?
Speaker 4: So it was a very comprehensive judgment. It was seven
Speaker 4: hundred and seventy one pages long and essentially justice. Wendy
Speaker 4: Abraham found failures in munjed Almadeiras's surgical practice from the
Speaker 4: very beginning of his interaction with patients, So the types
Speaker 4: of people he decided were appropriate to operate on she
Speaker 4: found were often wrong. Then on the operating table itself
Speaker 4: she found he made mistakes. Then in the aftercare, the
Speaker 4: post operative care period, she found that he neglected patients
Speaker 4: when they needed him. So right across the full spectrum
Speaker 4: of his practic does she found he was negligent, unethical
Speaker 4: and placed profits before people.
Speaker 2: And so what does a finding like that mean for
Speaker 2: al Maderis's capacity to work as a surgeon.
Speaker 4: Well, strangely enough, the regulators the h Triple Ce in
Speaker 4: New South Wales and are pro the National Healthcare Regulator.
Speaker 4: When the judgment first came out they said, you know,
Speaker 4: we're carefully reviewing this. But months later there's been no
Speaker 4: update from either of those parties. For now, it seems
Speaker 4: that yeah, there's no consequences for those findings in the
Speaker 4: Federal Court.
Speaker 2: Coming up the cosmetic limb lengthening powerhouse set for Australian
Speaker 2: Shores Charlotte. Despite the court ruling in your favor, doctor
Speaker 2: Munjed Amadeiras is still allowed to practice in Australia. And
Speaker 2: you've discovered that he has ties to a Florida based
Speaker 2: medical tourism behemoth called the Pale Institute. So tell me
Speaker 2: about them. What do they do?
Speaker 4: So? The Pale Institute are known for selling what they
Speaker 4: brand as innovative surgeries. The surgery that it's most well
Speaker 4: known for is limb lengthening, which is a surgery that,
Speaker 4: as the name suggests, lengthens your limbs for either medical
Speaker 4: reasons or cosmetic reasons.
Speaker 3: On its website, it's found to draw.
Speaker 4: Paley is described as a miracle man, a bone wizard,
Speaker 4: so he does the surgeries that many other surgeons refuse
Speaker 4: to do.
Speaker 3: How cosmetic lim lengthening works.
Speaker 4: Is you put rods into the bone and those rods
Speaker 4: can be operated externally using magnets or remote controllers to
Speaker 4: move over a series of months. And what that does
Speaker 4: is it breaks the bones from the inside, and so
Speaker 4: over a period of months your bones are sort of
Speaker 4: constantly breaking and healing to make it get longer. And
Speaker 4: the risks involved in that are that you can create
Speaker 4: nerve damage, there's always the ever present risk of infection,
Speaker 4: you can create problems later on in your life in
Speaker 4: terms of arthritis. There's a full gamut of reasons. And
Speaker 4: I guess it's like any kind of cosmetic surgery. You know,
Speaker 4: there are risks whenever you're going under the knife, or
Speaker 4: whenever you're putting a foreign body into your body.
Speaker 3: There are risks there.
Speaker 4: But this is an irreversible and permanent surgery that can
Speaker 4: have serious consequences for people.
Speaker 2: And you've uncovered some complaints about things that have potentially
Speaker 2: gone wrong in their US operations. Can you tell me
Speaker 2: a little about that.
Speaker 4: What I found when I was investigating the Pale Institute
Speaker 4: is a couple of medical negligence claims that have been
Speaker 4: heard before the Florida courts this year. There three that
Speaker 4: I really honed in on. One was a ten year
Speaker 4: old girl who underwent surgery at the Pale Institute, and
Speaker 4: she alleged that she was left permanently disfigured, scarred.
Speaker 3: And injured.
Speaker 4: Another man died on the operating table during a complex
Speaker 4: spinal surgery. And the third was a thirty year old
Speaker 4: man who underwent limb lengthening surgery that went allegedly horribly wrong,
Speaker 4: and he had to have the surgery reverse, so he's
Speaker 4: sewing as well. So while medical negligence cases aren't necessarily rare,
Speaker 4: what was common throughout all three of those cases was
Speaker 4: these allegations or patterns of unnecessary surgery, high pressure sales tactics,
Speaker 4: and devastating consequences for patients.
Speaker 2: Right And these cases they're still before the courts, so
Speaker 2: they're just claims at this point. But in the meantime,
Speaker 2: what have you found out about what exactly doctor Munjed
Speaker 2: Almadiras's plans are for the Pale Institute here in Australia.
Speaker 3: Yeah.
Speaker 4: So he wrote a letter to GPS earlier this year
Speaker 4: saying that his longer term plan is to bring the
Speaker 4: Pale Institute to Sydney, Australia. We don't know what that
Speaker 4: would entail or how it would work. McCrory Uni Hospital
Speaker 4: certainly said that they had never heard of the plans.
Speaker 4: When I went to doctor Almadeiras and Draw Paley for comment,
Speaker 4: they simply didn't respond. So we have no real details
Speaker 4: around how it would work or what it would look like.
Speaker 4: But one thing I have noticed is that doctor Almadeiras
Speaker 4: earlier this year was promoting cosmetic limb lengthening in the media.
Speaker 4: There was a Mumma mea article where he gave an
Speaker 4: interview and he said, cosmetic limb lengthening is really popular
Speaker 4: among women these days because giving examples such as, you know,
Speaker 4: people who were shorter get bullied and women need to
Speaker 4: be taller for you know, jobs and to be considered
Speaker 4: for certain roles. So he was really taking a promotional
Speaker 4: approach earlier in the year, sort of which seemed to
Speaker 4: me to be laying the groundwork for he wants to
Speaker 4: expand this practice in Australia, and all the surgeons I
Speaker 4: speak to have said cosmetic limb lengthening is way beyond
Speaker 4: their risk profile, and it's a high risk operation and
Speaker 4: it's a cosmetic procedure. And you know, the dominant thinking
Speaker 4: in Australia has been the risks outweigh the benefits.
Speaker 3: So if he.
Speaker 4: Does bring the Pale Institute to Australia, I'm sure we'll
Speaker 4: see a lot more of that surgery being offered to
Speaker 4: people of all ages.
Speaker 2: But there is I suppose no legal reason that something
Speaker 2: like this couldn't go ahead or that Almoderis couldn't practice right,
Speaker 2: So how lackly does it seem that this is going
Speaker 2: to materialize exactly?
Speaker 4: I mean, Australian health care has been open for business
Speaker 4: for foreign investment for a long time. We have major
Speaker 4: foreign companies owning large chunks of our private healthcare network.
Speaker 4: So there are very few checks and balances or roadblocks
Speaker 4: that would get in the way of something like this
Speaker 4: coming to Australia.
Speaker 2: Well, Charlotte, thank you so much for your time.
Speaker 3: Thanks Ruby.
Speaker 2: Also in the news, Defense Minister Richard Miles has announced
Speaker 2: the largest reform to the Australian Defense Force in fifty years.
Speaker 2: Three groups within Defense, the Capability Acquisition and Sustainment Group,
Speaker 2: the Naval Shipbuilding and Sustainment Group, and the Guided Weapons
Speaker 2: and Explosive Ordinance Group, are set to be rolled into
Speaker 2: one organization. There will also be a dedicated agency to
Speaker 2: decide what projects to prioritize within Defense. While no job
Speaker 2: cuts are expected, Miles says the reform is designed to
Speaker 2: give taxpayers more bang for buck and Israel's Prime Minister
Speaker 2: Benjamin Natya, who has formally asked Israel's President Isaac Herzog
Speaker 2: to grant him a pardon for bribery in fraud charges
Speaker 2: and an end to the corruption trial he faces. Nanna,
Speaker 2: who has argued that pardoning him would be in the
Speaker 2: national interest. Israel's presidential office has called it an extraordinary
Speaker 2: request with significant implications, which will now consider I'm Ruby Jones.
Speaker 2: This is seven am.
Speaker 3: Thanks for listening.