Doctor struck off for five years over death of mum, 38

The mother-of-four, 38, died in hospital after being rushed from overseas-trained Atef Sallam’s Taree surgery after saying she couldn’t breathe following an injection into her spine that he had no training to give her.

An “incompetent” doctor who had already been disciplined for oversupplying dangerous drugs killed a mother-of-four when he injected her in the spine after “tossing up” what was wrong with her, a tribunal said on Monday.

The woman, 38, died in Manning Base Hospital after being rushed from his Taree surgery after saying she couldn’t breathe following a third injection in her spine that same day.

The shocking case was revealed when overseas-trained Atef El-Sayed Mahmoud Sallam, 59, was struck off the medical register for just five years on Monday by the NSW Civil and Administrative Tribunal.

The patent’s name was suppressed but known as Patient A, she visited the GP at Medisense Health Care in June and July 2018. The clinic has since closed.

The woman died after being rushed to hospital.

Three years earlier Sallam had been banned by the Medical Council of NSW from possessing and prescribing fentanyl, oxycodone, alprazolam, anabolic steroids and other drugs of addiction.

In March 2018, the state’s health watchdog, the Health Care Complaints Commission had begun proceedings in the NSW CAT to have him struck off for oversupplying the dangerous drugs to patients who he should have realised were “doctor shopping”.

But he was not suspended until August 2018 after the death of Patient A.

In September 2018, his registration to practice was cancelled for 12 months because of the oversupply of drugs. He did not apply to be re-registered and on Monday the tribunal said he should be disqualified for another five years.

The tribunal said Sallam was not properly trained to perform spinal neck injections, although he had done on at least another 57 occasions on other patients.

He did not use radiological imaging to work out where to put the injections.

“(This) meant that his conduct was fraught with danger when injecting his patients in the cervical area, including the neck area,” the tribunal said.

“(His) treatment of his patients was incompetent.

“Further, the answers provided by (him) suggest that (he) has no real insight into the risks that he was undertaking. There has been no real expression of remorse.”

The tribunal said Sallam had diagnosed Patient A’s pain as a “toss-up between fibromyalgia and chronic pain syndrome” which was not supported by “an adequate assessment or appropriate investigations such as a CT or MRI”.

An expert witness, Dr Geoffrey Parker, a neuroradiologist, had told the tribunal that all 57-plus treatments “fell significantly below the standard expected of a practitioner, because the site of the injection cannot have been known to Dr Salam with sufficient accuracy to avoid a severe or catastrophic complication”.

The tribunal said Patient A was injected with “Depmedrol [sic] 40 milligrams x 3 diluted into 6 millilitres of lignocaine into her neck for management of pain”.

Sallam had told her that he had done the same many times without adverse side effects.

“(He) then provided two injections, one above the other, with no adverse effects. However when he administered the third injection, Patient A complained of pain, moved her head and thereafter stated she couldn’t breathe.

“She became unresponsive and an ambulance was called to take her to hospital, where she later died.

“It was identified on examination at the Manning Base Hospital that “the injection had gone into the thecal sac resulting in a high spinal block”.

Sallam graduated with a Bachelor of Medicine/Bachelor of Surgery from Cairo University in 1989. and migrated to Australia in 2001. In 2004 he completed his Australian Medical Council Certificate and was registered in NSW, the tribunal said.

Sallam has not been charged over the death of his patient and a report has been prepared for the coroner.

Editor’s Note: This article originally included a photograph of the Taree Medical Practice. As stated above, Doctor Sallm worked at Medisense Health Care which has since closed. The photograph of Taree Medical Practice was published as a result of a production error that dailytelegraph.com.au regrets.