The MPTS facts decision for Dr Muhammad Ali Qureshi was handed down this afternoon - 226 pages
Bobby Qureshi did not attend the hearing, which is now adjourned until Monday 9 September, when the tribunal will consider whether the doctor’s fitness to practise is impaired based on the facts found proved.
'Dr Muhammad Qureshi (4155241)
DETERMINATION ON THE FACTS – 04/09/2019
1. Mr Qureshi obtained his BSc from the University of St Andrews, Scotland in 1992. He then went on to qualify as a doctor three years later having attended Guy’s and St Thomas’ Medical School and obtaining his MBBS from the University of London in 1995. Post qualification Mr Qureshi went on to specialise in ophthalmology obtaining Senior House Officer (‘SHO’) and Specialist Registrar (SpR) posts in hospitals both in the United Kingdom and abroad, including a year at Moorfields Eye Hospital in London. He achieved Fellowship of the Royal College of Surgeons of Edinburgh in 2000 by specialist examination in ophthalmology. Between 2001 and 2008 Mr Qureshi undertook a number of SpR and subsequently consultant posts at different hospitals. In 2008 Mr Qureshi obtained a post of consultant ophthalmologist at East Surrey Hospital and in 2011 left NHS practice to undertake, on a full time basis, private practice as an ophthalmologist.
2. Up until circa July 2017, Mr Qureshi practiced from his private eye hospital, London Eye Hospital Limited (‘LEH Limited’) trading as the London Eye Hospital Limited (‘LEH’) as a Consultant Ophthalmologist. During the period of the alleged incidents, he had, and has to date, a considerable interest in research, particularly in relation to intraocular lenses (‘IOLs’). Mr Qureshi now lives and works in Dubai and also conducts research in Spain.
3. During the period of the alleged incidents (2003-2017) Mr Qureshi was the ‘Medical Director’ of the LEH and sole director and shareholder of LEH Limited.
4. Mr Qureshi was also the sole director and shareholder of LEH Pharma Limited (formerly known as London Eye Hospital Pharma Limited) a company concerned in the development of IOL lenses. It is alleged that LEH Pharma Limited was the patent holder of the IOLAMD and the EyeMAX Mono lenses. Mr Qureshi had been intimately involved in the invention and development of these innovative IOL’s.
5. The allegations against Mr Qureshi relate to the treatment of 24 patients and him advising and/or performing specialist lens replacement surgery for the treatment of age-related macular degeneration (‘AMD’) and / or cataracts. The Allegations in general terms relate to:
• making false statements as to the improvement in vision that could be expected to be achieved from lens replacement surgery;
• failing to advise adequately, or at all, as to potential risks of the surgical procedures;
• failing to obtain informed consent from the patients;
• failing to communicate with other doctors/health professionals involved in his patients care;
• performing procedures on patients that were not clinically indicated and which would confer no benefit to the patient and would expose them to risk;
• allowing the use of pressure selling techniques to persuade patients to undergo IOL procedures;
• in relation to a number of the above matters, it is alleged that Mr Qureshi’s actions were dishonest and/or financially motivated.'
I will update when I've had time to read through...
'The facts decision will be handed down in public on Wednesday 4 September...'
I am of course attending, and will publish the tribunal's decision as soon as the hearing adjourns
I am also aware that I haven't yet published the MPTS list of the General Medical Council (GMC) allegations against Dr Muhammed Ali Qureshi - 26 pages! - but I will scan and post on this forum as soon as I have time to do so!
Update on the MPTS hearing for Dr 'Bobby' Muhammad Ali Qureshi...
It's a complex process, and although it's been spelled out to me, I'm not going to attempt to explain it to you in anything other than simple terms
In camera, the tribunal will look at all the evidence, discuss, and decide whether or not they accept the allegations brought against Dr Qureshi as having happened in the way they were presented by the GMC.
If not, the hearing will end when the tribunal hand down that decision in August, date to be advised nearer the time.
However, if the allegations are accepted as true, then further evidence and submissions will be presented in September, after which the tribunal will make their decision on Dr Qureshi's fitness to practise.
He could receive a warning just not to repeat his actions, a suspension, or erasure from the GMC register, which would prohibit him from ever practising as a doctor in the UK again.
Meantime, I haven't yet had time to go through my notes, but when I get a chance I will post some of the evidence heard from Bobby Q on days I attended the hearing in Manchester last month.
'From: "Lewis Stubbs (0161_)" <lewis.stubbs@
Subject: RE: GMC Ref: 4155241
Date: 6 March 2019 at 12:59:36 GMT
Dear Ms Rodoy,
Thank you for your email and call yesterday and for allowing me to take time to respond to the important points you raise.
I have now had the opportunity to seek clarification on these matters. In summary, it appears your main concern is that Dr Niall Patton, the GMC-instructed expert, misled the Tribunal when he stated he did not perform refractive surgery. You have noted a number of enquiries you have made suggests that Dr Patton does in fact carry out refractive surgery.
The issue of Dr Patton’s expertise and practise was discussed a number of times throughout his evidence on 7, 12, 14 and 15 February. In answer to this question, Dr Patton confirmed that he performs cataract and retinal surgery as the bulk part of his clinical practice. Strictly speaking, there are elements of this which are refractive surgery, however Dr Patton does not carry out refractive surgery in the absence of the context of cataract surgery and in light of this is not a refractive surgeon.
Dr Patton has confirmed that he does not carry out Clarivu procedures. I note in your email you state that calls to Optegra recently confirmed that Dr Patton does in fact do this. In response to this suggestion, Dr Patton has confirmed that he has checked the Optegra website and seen that it does indeed state he carries out Clarivu procedures. Dr Patton has confirmed that this is an error and he has not performed any Clarivu procedures in the 8 years he has worked for Optegra. In your call to Optegra, you will have spoken to an individual in a call centre working for Optegra who would have advised of the services carried out by Dr Patton based on that as advised on this website, which as noted above was in error.
The error on the Optegra website has been made apparent to them. The have confirmed that it is in error and they will correct it as a matter of urgency to prevent any further confusion.
Furthermore and central to the suggestion that Dr Patton misled the Tribunal in claiming to be a refractive surgeon, although the above evidences that Dr Patton is not a refractive surgeon, even if he had been it would in no way affect the validity of his evidence before the Tribunal at this hearing.
I hope the above clarifies matters for you and as such you will be removing what has now been established as wholly inaccurate comments regarding the GMC expert from your blog. This includes confirming that you will not be uploading the email below as I note you mentioned you had considered doing when we spoke yesterday.
With regards to the emails you sent to me on 3 March, I note that it appears [redacted] states his complaint has already been investigated by the GMC. It may be that the further information you have received from him was not uploaded with his initial complaint and as such he is at liberty to provide this to the GMC so we can consider whether it justifies reviewing at this complaint.
General Medical Council'
Dear Mr Stubbs
Thank you for your detailed response.
Before I address your points, please note that there is an error in the sixth paragraph of your email.
And, with respect, by its very definition, you are wrong to say that their are elements of refractive surgery in cataract and retinal surgery: cataract and retinal operations are performed for medical reasons, while refractive surgery is not, hence it being unavailable on the NHS.
I would also like to make it clear that I employ due diligence before publishing any information on my sites, and can assure you that it was not only an individual in Optegra’s call centre who advised that Mr Patton performed Clarivu.
In fact, across a period of two weeks, a total of four phone calls were made to Optegra’s London and Manchester clinics, when both a colleague and I were advised that Mr Patton definitely performed Clarivu, and would be available for a consultation with that procedure in mind. I do not accept that the individuals we spoke with had to refer to the Optegra website for their information.
Although I note that Optegra have now removed ‘Clarivu’ from under his list of specialities on their website, I have recently discovered further information to support my argument that Mr Patton misled the tribunal, and I believe it most definitely casts doubt on the validity of his evidence in this case, and I intend to provide the GMC with this as soon as possible.
I will therefore not be removing anything from my ‘blog’ - as you so describe it, but in the interests of transparency I will be publishing both my previous email and your response...'
So whilst Optegra have removed Clarivu from Mr Patton's list of specialities, Doctify have not.
Simon Jackson QC, lead counsel for the GMC, has been cross examining Dr Bobby Qureshi since Monday afternoon, during which time the doctor has provided the tribunal (and me) with some fascinating information!
But before telling you more, this was my email to both GMC and defence solicitors
GMC response to follow...
(Read 7 February post for more about Niall Patton)
Update on Dr Bobby Qureshi's MPTS hearing - ‘New case of impairment by reason of misconduct’.
NB: When I have time, I will photocopy and publish the GMC’s lengthy list of allegations: 24 patients, anonymised as Patients A to X.
For the last two days the doctor has been giving evidence, opening yesterday with a Power point presentation to illustrate his tutorial on cataract surgery techniques, explaining the difference between wet and dry macular degeneration, and the intended benefit of iolAMD and EyeMax Mono lenses.
And that’s all I'm going to say on the presentation, because although interesting and informative, way too long for me to attempt to summarise!
Questioned by his own counsel, Mr Russell Davies, Dr Qureshi was asked to respond to the GMC’s allegations point by point, and this will continue on Monday, so it's possible that the GMC’s cross examination may not start until Tuesday or Wednesday.
When Mr Davies asked for his client's response to one of the allegations concerning financial motivation, I had to smile when Bobby Q disarmingly replied, ‘I don't believe I was financially motivated in any procedure I performed.’
There goes another flying pig
Last week I was contacted by one of Bobby Qureshi’s Light Adjustable lens patients: left with serious problems after bilateral implants in 2011, he underwent numerous reparative operations and subsequently made a complaint to the GMC, who told him there was no case to answer!
I have criticised the GMC on countless occasions, and will continue to do so, because in my opinion, like most of these organisations, they’re not fit for purpose.
And I have no doubt that had the Macular Society not stepped in and complained to the GMC, then Bobby Qureshi would be indulging his hobby of flying helicopters in Monaco, schmoozing with Sir Philip Green and others of his ilk, and his only problem juggling UK visits as a tax exile!
Meanwhile, another hypocrite - not least because Saj Khan operated on a number of London Eye Hospital patients whose complaints to the GMC are included in the allegations levelled at Bobby Qureshi, while Saj Khan is nowhere to be seen at the MPTS hearing, and nor has ever offered to support My Beautiful Eyes campaign for regulation!
4.6 The following are considered socially irresponsible and are prohibited:
4.6.1. Time-limited deals
4.6.2. Financial inducements
4.6.3. Package deals, such as ‘buy one get one free’ or reduced prices for friends and family.
4.6.4. Offering eye surgical procedures as competition prizes.
I've struggled with this post, not least because my notes are very lengthy - sometimes illegible, often unable to see what I'm writing due to poor vision, but I've also had difficulty deciding what to include or leave out, so finally decided to focus on my observations concerning Niall Patton
I have never previously met Niall Patton, nor mentioned him on my sites, and don't think I'd never heard of him until told his name as the GMC’s medical expert witness in Dr Qureshi's tribunal hearing. But I have of course mentioned Optegra many times (with their own thread on this forum should you care to read it), and made numerous complaints to the ASA about their misleading advertising (mostly upheld), so perhaps that might explain Mr Patton’s rudeness and complete lack of civility towards me.
His antagonism was almost tangible, not even thanking me when I held a door open for him, whilst even Dr Bobby Qureshi now greets me with a smile, often politely gesturing for me enter the tribunal hearing room in front of him, and I believe that he, like many other refractive surgeons, has the intelligence to appreciate that it's not personal, I am simply doing my job.
Niall Patton's churlish behaviour was in fact a compliment, because I must be doing something right to have upset him, so I simply smiled sweetly in response to his childish pretence that I was wearing Harry’s invisibility cloak.
The hearing began with GMC counsel Christopher Rose asked Mr Patton for details of his qualifications and clinical practice.
Casually dressed, in a nondescript colour suit with just above ankle length trousers and a pale coloured open necked shirt, Niall Patton explained that he’s a consultant ophthalmologist, with a specialist interest in vitreoretinal surgery, at the Manchester Royal Eye Hospital.
Asked about the nature of his private practice, he said that it was primarily conducted at the Optegra [private] eye hospital in South Manchester. He claimed he had - and here I quote - 'a mixture of cataract and retinal patients, maybe occasionally the general ophthalmology patient, but the majority will be cataract and retinal.'
Naming a few more private clinics where he sometimes worked, he added, ‘I also operate about once a month in Optegra in Central London’.
It should be considered that, besides Bobby Qureshi, with no other ophthalmologist present, the tribunal will trust what Niall Patton tells them to be factual and honest, and indeed, taking the moral high ground, he arrogantly presented himself as an ethical doctor with an impeccable history.
The hearing continued with an informative and interesting powerpoint presentation from the doctor: lasting approximately two hours it taught me a lot more about lens surgery, and I thoroughly enjoyed his lecture.
However, I question the GMC’s judgement in choosing Niall Patton as their expert, and will do my best to explain my reasons for this.
Attempting to discredit Bobby Q’s data in his presentation, Niall Patton provided selective data from randomised trials that was possibly - in my humble lay opinion - open to challenge, and I believe could be argued by another expert with a differing view, because some of what he said seemed to be based entirely on his own opinion.
The afternoon was mostly taken up with Mr Rose asking Mr Patton questions about the London Eye Hospital's brochures and consent forms, and I was impressed by the barrister's knowledge and understanding of lens surgery procedures, showing that he'd obviously done an incredible amount of research.
In contrast to his didactic demeanour in the morning, and aware that I was noting down every gem that fell from his lips, Niall Patton was less confident than he had been earlier in the day, and I hoped it wasn’t just me who noticed his discomfort when answering questions about his own consent procedures.
Because of course the majority of refractive surgery legal claims are based on lack of informed consent, and whilst Mr Patton won’t have details of the increasing numbers of legal claims brought against Optegra and its surgeons, it would be of interest to know how many he might have/had himself.
In my opinion Niall Patton misled the tribunal by omission, failing to disclose that he mostly operates at Optegra to remove healthy natural lenses from eyes WITHOUT cataracts, sold under the Clarivu brand name...
I believe Niall Patton’s integrity as a medical expert witness in this case is compromised, and in some instances his criticism of the LEH patient consent process shows double standards, which leads me to conclude that for a hearing of this magnitude there should be two medical expert witnesses.
I’d like to know what led the GMC to choose Mr Patton (other than his convenient Manchester location) instead of an experienced ophthalmologist without bias, i.e. not profiting from refractive surgery. There are still some around, although I know for a fact that the more eminent ophthalmologists generally won’t touch medicolegal work (unless retired), not least because they're too busy, whilst Niall Patton has, 'over eight years experience in providing expert witness medico-legal reports.'
Highly critical of Dr Qureshi’s consent process, and his alleged failure to warn patients of the risks involved with procedures, I would remind Mr Patton of what was essentially an advertorial for him and Optegra: published in the Daily Mail in 2012, with no mention of the risks of reduction of loss of vision or blindness following a vitrectomy, or that there is a very high chance of a cataract forming within two years after the procedure, and that a cataract would be likely to form immediately if the lens is touched. And one surgeon told me, following a vitrectomy, cataract surgery can then be more complicated than usual.
Niall Patton should be mindful of the old adage that people who throw stones should make sure they’re not living in glasshouses [sic]!
As well as celebrity endorsements Optegra are currently advertising £300 off the price of laser surgery, and £500 off refractive lens replacement - although when I spoke with Optegra’s call centre a few minutes ago I was told it’s only £300 off lens exchange (available until the end of February) and I pointed out the discrepancy.
And, just like Optical Express, Optegra have a ‘Refer A Friend’ scheme!
A full transcript will be available from the MPTS at the end of the hearing, and it could be beneficial for lawyers to get copies of Niall Patton’s evidence concerning consent procedures, especially if representing Optegra damaged patients.