Regulator imposes restrictions on city surgeon following patient injuries

A Winnipeg doctor specializing in obstetrics and gynecology has been reprimanded after he injured two women during surgical procedures, but he is being allowed to continue to work in the operating room.

The College of Physicians and Surgeons of Manitoba has ordered Dr. Zakaria Mohammad Abdullah Al-Moumen not to perform several specific operations involving the female reproductive system unless he is assisted by a specialist or sub-specialist in the procedure.

One of the patients required emergency surgery, removal of a portion of her bowel and required the use of a colostomy bag.

As part of the professional regulator’s order, Al-Moumen signed an agreement stating the restrictions will be in force until the college determines it “is no longer required to ensure that I am able to practise medicine safely.”

Al-Moumen, who pleaded guilty to professional misconduct, has also been ordered to pay $22,000 in costs.

The decision, released last month, followed an investigation and college inquiry panel and a joint recommendation from lawyers representing Al-Moumen and the college.

The panel did not suspend the doctor, instead taking “a restorative approach,” because he agreed to the conditions, had no previous disciplinary actions against him, showed remorse for what happened and will take remedial education about record-keeping.

“It should not be seen as a lesser penalty as it does not include a suspension of Dr. Al-Moumen’s practice,” the panel said in a 17-page decision. “Rather, having regard to the undertaking and agreement that Dr. Al-Moumen has agreed to, the work to be done on the part of Dr. Al-Moumen will be significant.

“The approach allows for Dr. Al-Moumen to continue to provide needed medical services while ensuring protection of the public.”

The decision noted there were concerns about deficiencies in the surgeries of two other women, but Al-Moumen didn’t provide enough detail in his operating reports to determine what happened.

The panel also said that, as of July 4, Al-Moumen can no longer practise dermatology.

He could not be reached for comment. His lawyer at the hearing in April said he has been instructed not to comment on the matter.

The registrar for the college was not available for comment.

Al-Moumen practises at the Winnipeg Clinic, as well as several other locations, including the Women’s Hospital at the Health Sciences Centre, Brandon Regional Health Centre, St. Anthony’s General Hospital in The Pas and the Bridgwater Medical Centre.

He graduated in 1995 from the College of Medicine and Medical Sciences at Saudi Arabia’s King Faisal University. He completed his post-graduate training in obstetrics and gynecology at the University of Manitoba in 2005 and registered to practise in the province in 2013.

According to a Manitoba Health report under the Public Sector Compensation Disclosure Act, Al-Moumen billed the province for $990,888.35 last year.

The Aug. 11 bowel injury occurred when Al-Moumen perforated her uterus during fibroid removal surgery, according to the panel’s decision.

The patient was released about five hours after the surgery, but returned to hospital the next day “in severe pain.”

“She was assessed and found to have peritonitis secondary to bowel injury,” the report said. “She required emergency surgery, which included removing part of the bowel. The remaining rectum was sealed, creating what is known as Hartmann’s pouch. The remaining colon was redirected to a colostomy.”

The use of a colostomy bag has since been discontinued with additional surgery.

A later investigation of the original surgery concluded the patient should never have been released from hospital after the perforation without “an urgent abdominal exploration with laparoscopy or laparotomy,” or by keeping her overnight for observation “at the very minimum.”

The woman and her family provided impact statements during the hearing so the panel could “appreciate the severe and prolonged impact this experience has had on (her) and her entire family.”

“In accepting the gravity of the impact on (the patient), and her family, the panel believes Dr. Al-Moumen showed genuine remorse and acknowledged the deficiencies in his care.”

The panel heard about another patient referred to him about a pre-cancerous lesion. When the doctor did a procedure to remove it, his scalpel cut through the woman’s cervix.

The doctor said he told the patient what had happened after the surgery, but she said he hadn’t, and there was no documentation in the record noting he’d made the disclosure.

Questions were also raised about a drain inserted into that patient but a consultant couildn’t determine if the doctor had followed the correct procedures because the operating report was “lacking precise details respecting instruments used, anatomy and significant steps.”

Al-Moumen operated on a fourth patient immediately following a hysterectomy done by another surgeon. Deficiencies in the doctor’s dictation and documentation “made it difficult for the consultant to follow the details of the procedures that were performed,” the consultant concluded.

kevin.rollason@freepress.mb.ca