Exclusive: Surgery performed by Emil Shawky Gayed masked growth of uterine cancer as officials fear other women could be at risk

A woman died of cancer after unnecessary and negligent surgery she received at the hands of a disgraced doctor in New South Wales, health officials have confirmed.

She was one of dozens of women harmed by Emil Shawky Gayed, who over the course of at least one decade mutilated and performed harmful surgery on patients.

Health authorities fear there may be many more women still to come forward.

The chief medical officer of the Manning Rural Referral hospital in Taree, Dr Osama Ali, confirmed that the woman had died this year. This follows an investigation by Guardian Australia that revealed Gayed needlessly removed women’s reproductive organs.

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Five years ago, tests ordered by Gayed showed the woman had endometrial hyperplasia, an overgrowth of uterine lining that can progress to or be a sign of cancer. After discovering the hyperplasia Gayed performed endometrial ablation surgery on the woman, which removes and destroys layers of the uterus.

Ali said ablation should never be performed on women with hyperplasia because scarring from the procedure can mask cancer growth, and trigger the development of cancerous cells.

In February this year the woman returned to the hospital’s emergency department with heavy vaginal bleeding. Doctors found she had uterine cancer.

“By the time she came back to us in February she had cancer,” Ali said. “We treated her, and unfortunately, she passed away.”

Facebook Twitter Pinterest Closed doors … Dr Emil Shawky Gayed’s medical practice in Taree. Photograph: Carly Earl/The Guardian

The woman was told about Gayed’s error before she died and received counselling and support. The Hunter New England health district and the hospital are in the process of meeting her relatives to offer counselling and explain their legal options.

Ali has reviewed Gayed’s clinical notes for all other ablation procedures he performed at the hospital over the past decade. He identified nine more women who are are at high risk of harm because they received ablation and had hyperplasia.

While their risk of cancer varies, Ali said there was a “high chance” of cancer in three of the women and a “low risk” in the remaining six. Ali contacted all of the women last week and they are returning to the hospital for biopsies. Ali also found that Gayed performed ablation procedures between 50% and 60% more frequently than other gynaecologists at the hospital.

The more you look into it there is more to it, in terms of his personality and the damage he has created Dr Osama Ali

The woman’s death follows an investigation by the Health Care Complaints Commission (HCCC) which found that Gayed inappropriately treated seven women, including performing an unnecessary hysterectomy on one and removing the healthy fallopian tube of another. As a result, the NSW civil and administrative tribunal found Gayed guilty of professional misconduct earlier in June, and barred him from practising medicine for three years.

Ali said Gayed should be banned for life.

“I would stand him down for life,” Ali said. “I investigated all of this, I’m in the heart of it, and I feel that at least banning him from registration in Australia for life would be the minimum these ladies should get as an outcome. Three years is not good enough.”

Gayed resigned from the Manning Rural Referral hospital, which is a public hospital, in February 2016, months after the HCCC alerted him that he was under investigation. Five weeks after he resigned, restrictions were placed on him by health authorities, barring him from performing major surgeries. He continued to practise in his own private rooms in Taree as well as in Dee Why and Mona Vale in Sydney. He then abandoned his private clinics and relinquished his registration before the HCCC investigation was complete, though he will be eligible to apply for reregistration once his ban expires in 2021. The website of his Dee Why practice says he has “retired”.

Gayed now lives in Sydney. He has not returned calls from Guardian Australia.

Ali said Gayed has repeatedly denied any wrongdoing.

Facebook Twitter Pinterest Michael DiRienzo, the chief executive of Hunter New England Health, and Dr Osama Ali, the chief medical officer at the Manning Rural Referral hospital. Photograph: Carly Earl/The Guardian

“We have put forward the allegations and complaints we got, and he looked at them and he defended every single one of them,” Ali said. “He says, ‘This wasn’t the case, this wasn’t intentional,’ or he comes up with a conclusion that it’s not his fault. The more you look into it there is more to it, in terms of his personality and the damage he has created.”

Ali urged any women who believed they had been mistreated by Gayed to call the hospital, and their cases would be reviewed.

“It is our task now to try and rebuild the trust in the community and at the hospital,” he said. “It should not have happened and we are here to address what happened and provide those women with the best care.”

The chief executive of the Hunter New England health district, Michael DiRienzo, also said Gayed should be banned for life. He said the hospital and the health district were not aware Gayed was problematic until receiving notice from the HCCC that he was under investigation in 2015.

DiRienzo said the majority of additional cases had come to light after Gayed resigned from the hospital and then closed down his private clinics. Several of his private patients then went to Manning hospital for treatment instead, where doctors identified problems in the way they had been cared for by Gayed.

But those women were now struggling to obtain their medical records from Gayed, DiRienzo said.

“I’m really worried that a lot of women went through his private rooms and a lot of that medical information remains with him, we don’t have it,” DiRienzo said. “What we do have is information for some of the women who also came through our emergency departments and operating theatres and received treatment from him there, where we were able to gather information.”

Nine more women may have been affected by gynaecologist's misconduct Read more

The HCCC investigation revealed that Gayed kept poor medical records. Procedures and complications that should have been recorded and reported were not, the investigation found.

The scandal also raises questions about how those who worked with Gayed did not notice his errors or question unnecessary surgeries and report him earlier. The president of the Medical Error Action Group, Lorraine Long, told Guardian Australia that she had written to the then NSW health minister John Hatzistergos about Gayed in 2006 because her organisation had received so many serious complaints about him.

But DiRienzo said the hospital had reviewed its database and annual performance reviews for Gayed, and no issues had been recorded or raised until 2015.

“The issue is we is we don’t know how many women have been affected by him at the moment ... it is a terrible thing,” he said. “I am deeply sorry for what they’re going through. We will do all we can to identify and support support women and to provide any additional information to the HCCC.”