A PELVIC mesh surgeon's cross examination about a near-fatal mesh incident at Sydney Private Hospital in 2013 could be "significantly reduced" after a tribunal was told he was considering "making admissions".
Gynaecologist and pelvic mesh device inventor Peter Petros could amend his response to professional misconduct charges on Wednesday after evidence on Tuesday about a woman left in "dire" circumstances who required 14 units of blood following mesh surgery.
The woman was implanted with Dr Petros's Tissue Fixation System (TFS) device by gynaecologist Richard Reid only one week after the Ashfield hospital allowed him to return to surgery under Dr Petros's supervision, and on condition he used the TFS device for certain procedures.
Dr Reid was under conditions imposed by the NSW Medical Council at the time because of previous serious incidents involving women patients. In 2018 he was found guilty of professional misconduct after 17 women were left with serious injuries following mesh surgery at the Ashfield private hospital, with the majority receiving the TFS device.
Dr Petros started working at Sydney Private Hospital in March, 2013 after the Medical Board of Australia withdrew professional misconduct proceedings raised against him in 2011 following mediation.
The NSW Civil and Administrative Tribunal hearing new professional misconduct proceedings against Dr Petros was told he advised a Sydney Private Hospital medical advisory committee of surgeons and hospital executives that he invented the TFS and "received no income from its sale".
Dr Petros has already admitted to the tribunal that he received a financial benefit from the device between 2009 and July 7, 2014 through a complex financial arrangement involving a family trust company and the licensing of the device to Adelaide firm TFS Manufacturing, owned by former Newcastle Falcons basketballer Paul Zadow.
The undisclosed financial benefits he received from that arrangement formed part of the NSW Health Care Complaints Commission professional misconduct proceedings against him.
On Tuesday gynaecologist Tony Geraghty told the tribunal Dr Petros's financial benefit from the device Dr Reid was ordered to use at the hospital while under Dr Petros's supervision was "a conflict of interest because there was an incentive for the device to be used".
Patients had to be advised because Dr Petros had a "vested interest in the device" as inventor and promoter, Dr Geraghty.
The HCCC launched its investigation into Dr Petros after a woman left with serious and permanent injuries after she was implanted with the TFS device at the hospital, without her knowledge or consent, complained about Dr Petros's undisclosed conflict of interest.
The disclosure to patients was even more necessary after the Australia's medical device watchdog, the Therapeutic Goods Administration, cancelled the TFS in November, 2014, Dr Geraghty said. It was one of the first pelvic mesh devices in the world to be cancelled Mr Zadow's company failed to substantiate evidence of safety and efficacy. TFS Manufacturing lost its appeal against the cancellation in December.
The tribunal was told the medical advisory committee conducted a root cause analysis of a near fatal incident in June, 2013 after Dr Reid cut a major blood vessel while implanting the TFS device in a woman under Dr Petros's supervision.
Dr Geraghty described the unusual TFS procedure devised by Dr Petros according to his controversial "integral theory" as a "relatively blind procedure" because of how the device was implanted through a woman's vagina.
It required a surgeon to "put a device into tissue you hope is not vascular tissue (a blood vessel)", Dr Geraghty said.
The near-fatal incident was "very serious" and "you would have thought (the hospital's medical advisory committee) would have met to discuss the whole supervisory process", Dr Geraghty said.
He criticised a report about the incident by Dr Petros to the medical advisory committee, saying the "seriousness of the situation... seems to be unstated".
The hearing continues.