FOUR elderly patients were left blind in one eye, a fifth lost substantial vision, a sixth suffered "surgical trauma" and another four were injured by the time the NSW Medical Council dismissed three complaints against Hunter eye specialist Eugene Hollenbach in September, 2018.
The council found there was no public interest reason to take action against Dr Hollenbach after dismissing Hunter New England Local Health District and patient complaints about his vitreoretinal eye surgery, and a Pharmaceutical Regulatory Unit complaint over his use of cocaine drops as a local anaesthetic.
But this week the NSW Civil and Administrative Tribunal found Dr Hollenbach guilty of professional misconduct and ordered him to stop vitreoretinal surgery from September 1 after substantiating a "significant" 10 of 13 complaints involving his "professional capacity in performing surgical procedures".
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"The numbers of complaints over a period of years together with the nature of his conduct are, it is submitted, demonstrably serious," the tribunal said.
But it rejected a NSW Health Care Complaints Commission call for Dr Hollenbach's registration to be cancelled after a barrister for the commission asked if the public could "properly be protected by an order other than one requiring cancellation".
The tribunal said the public would be "appropriately protected" by conditions restricting his practice, after evidence he planned to continue voluntary eye surgery work in Myanmar.
Thirteen patients complained after surgery by Dr Hollenbach at Hunter public and private hospitals between 2007 and 2015, including a woman who said he used an unsterilised standard razorblade to remove a stitch from her left eye after cataract surgery at Maitland Private Hospital in October, 2013.
The woman's daughter said Dr Hollenbach "bang(ed) it on one side then the other which broke the blade" and the broken blade was then used to "quickly remove the stitch".
Two elderly patients had already died by tribunal hearings in 2018 and February this year, including a woman, 87, whose cataract surgery at Muswellbrook Hospital in November, 2012 was criticised by an expert witness as an "old technique.. used in the third world", followed by repair surgery 10 days later at Kurri Kurri Hospital which left her suffering "surgical trauma".
Dr Hollenbach described the woman's surgery as "complicated but I do not accept that it was entirely due to my poor technical performance".
She was one of a number of patients implanted with a type of lens not designed for a certain part of the eye.
A man was left blind in his right eye after a "heavy liquid" that can have toxic effects on the retina after three weeks was left in his eye for 10 weeks in 2012.
Dr Hollenbach said he was booked to remove the "heavy liquid" following two failed surgeries in June and August, 2012 "but the equipment we had did not work properly".
He operated on the man another five times between September, 2012 and March, 2013, without referring the patient to another surgeon for a second opinion, a situation described as "quite extraordinary" by an expert to the tribunal.
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Dr Hollenbach acknowledged eight procedures were "with the benefit of hindsight, 'probably too many attempts to fix an intractable problem'," the tribunal said.
Asked to transcribe his own records of the patient's treatment, Dr Hollenbach said he was "unable to read a portion of his own notes".
The tribunal found Dr Hollenbach guilty of unsatisfactory professional conduct after 13 complaints that he kept inadequate medical records, after he was strongly criticised by several specialists for notes that were "unduly cryptic", "largely illegible", "quite inadequate and not signed", and which Dr Hollenbach conceded were "very hard to read" and "often scant".
An elderly woman patient was left "effectively blind" after repeated laser surgeries on both eyes between October, 2004 and November, 2005, in a case where Dr Hollenbach had "confidence in his own capacity to manage the condition".
"Sadly, she has had one of the worst outcomes that any of my patients has had," he told the tribunal.
A woman, 81, was left with "painful blindness" in her left eye after repeated failed surgery by Dr Hollenbach between June, 2009 and February, 2010, which occurred despite another eye specialist recommending against further surgery.
A male patient lost 33 per cent vision in his left eye after cataract surgery at Muswellbrook Hospital in June, 2012, where Dr Hollenbach told the tribunal he used a lens not designed for a certain part of the eye because he was "not familiar with the facilities" at the hospital.
"He had not checked the availability of lenses or other equipment... in the operating facilities at that hospital," the tribunal said.
Dr Hollenbach trained as a ophthalmology registrar at John Hunter Hospital from 1995 and has practised in the Hunter since 2001.
Dr Hollenbach said that in pursuing repeat surgeries in each case he was "motivated by a desire to provide the patient with a better surgical outcome than had initially been achieved, even where such a result was unlikely to be achieved".
"Dr Hollenbach acknowledges, in hindsight, that he was wrong to have proceeded as he did but to do so was misjudgment rather than the product of a wrong intention," the tribunal said.
He apologised to "all the patients and relatives to whom I caused distress or who had poor visual outcome" symptoms, pain and discomfort as a result of complications following surgery performed by him, the tribunal said.
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