A trainee surgeon has been suspended for eight months after he left a patient with 'catastrophic' injuries by drilling too deep into her ear. Dr Amir Farboud left the woman with 'life-changing' injuries after he continued to drill into 'the wrong place'.
A misconduct hearing of the Medical Practitioner's Tribunal Service heard he tried to 'cover up' the damage he had caused by lying to other doctors, so by the time the disastrous effects were realised it was too late. It was discovered more than a week later that Dr Farboud had damaged her inner ear and facial nerve.
The patient was left with facial drooping which 'significantly' affected her appearance and she was unable to walk far unaided. Dr Farboud, who qualified from University of Wales College of Medicine in 2005, was practising as a final year trainee Ears, Nose and Throat (ENT) Surgeon at Cardiff and Wales NHS Trust at the time of the incident.
The tribunal heard Dr Farboud was part of a team performing cortical mastoidectomy surgery on a patient in September 2017 to investigate the cause of her hearing loss by drilling into her middle ear. But three quarters of the way through the surgery, Dr Farboud had to be shown where to drill and when he became 'unsure' again he carried on and did not seek assistance from a more senior colleague.
In a text about to weeks after the incident, he told an ENT consultant 'I have to accept that I was in the wrong place when I was drilling. I have lost my landmarks and position'.
Dr Farboud told the tribunal 'I accept I should have realised and needed more help' and admitted he was 'struggling to complete the operation' because 'he was not as good as surgeon as he thought he was'.
However, Dr Farboud carried on drilling and caused injuries to her inner ear and facial nerve. About four hours after the surgery, hospital notes recorded the patient was 'feeling nauseous and vomited twice' and the left side of her face was drooping, while a staff nurse said the patient was suffering from vertigo.
The tribunal heard Dr Farboud lied to the patient by saying her facial weakness was as a result of the tight bandage on her head. He then failed to complete proper post-op assessments to check whether there was any damage to the patient's facial nerve and if she suffered from vertigo.
In a statement, he claimed he did complete the assessments, but forgot to record this in her notes because 'I was feeling panicked by my growing suspicion that I had injured [the patient] during the operation'.
But he told the tribunal 'I have not fully appreciated the severity of the injury at that point. I failed on that front to elicit a full examination'.
The tribunal also heard he failed to conduct a hearing test with a tuning fork following the surgery, despite texting his ENT consultant supervisor that he had done this and she was 'just unsteady'.
Kathryn Johnson, representing the General Medical Council, told the tribunal: "Dr Farboud’s poor standard of care... had resulted in life changing consequences for her. [The patient's] appearance had been significantly affected, she was unable to work or walk far unaided.
"His failures on the day of the operation and during the procedure itself, were compounded by his failures postoperatively. As a result of Dr Farboud’s failure to appreciate the extent of the injury, [the patient] had not been properly assessed for a significant period of time.
"It was only when she was seen nine days later that the catastrophic nature of the damage was appreciated. By that time, an earlier opportunity for an earlier management plan and surgery had been at lost. He sought to minimise the symptoms of [the patient] and to go further and to cover up what he had done."
Julia Oakford, chair of the tribunal, said: "Dr Farboud had failed to recognise where he was when he was drilling, failed to stop drilling and failed to seek assistance from a senior colleague and following these failings a catastrophic injury occurred.
"Following surgery, he had failed to carry out an adequate and appropriate post operative assessment of [the patient]. The Tribunal found the care of [the patient] to be misconduct which was serious."
Dr Farboud was suspended for eight months.
