Controversial neurosurgeon Charlie Teo has been accused of giving "opportunistically untruthful" evidence to a medical disciplinary board as well as lacking empathy and insight.
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Dr Teo appeared before a Health Care Complaints Commission inquiry in Sydney on Tuesday to defend brain tumour surgeries he performed on two women, from which they never recovered and died soon after.
One of the women who was left in a vegetative state after surgery was repatriated to WA, causing her family great emotional trauma and expense, the hearing was told.
Commission counsel Kate Richardson SC said Dr Teo's claims the woman's husband had been "hoodwinked" into making a complaint against him showed a "lack of empathy and lack of ability to reflect".
Ms Richardson accused Dr Teo of being "opportunistically untruthful" throughout the hearing in regards to the risks involved with the surgery and how he conveyed that to the patient, arguing he should be "rejected as a witness of credit".
The commission is seeking a professional reprimand for Dr Teo and wants additional conditions imposed on his work as a surgeon.
Dr Teo has admitted his actions were responsible for the womens' poor outcomes, but firmly rejects any suggestion he was negligent.
"I think in fact I've been too aggressive," Dr Teo said of his surgery on the first woman.
"I think that I've probably gone across the midline ... one to one-and-a-half millimetres ... but that's enough to damage a patient when you're doing surgery in this area."
In the case of the other woman, Dr Teo defended his decision to operate after two other neurosurgeons deemed her tumour inoperable.
Dr Teo said the woman's pre-surgery brain scans showed a displacement of tissue, known as a midline shift, which placed her at risk of death at any moment.
"This patient could have died at any time. Within minutes of the scan, or days or weeks of the scan," he said.
"I've made errors in the past where I haven't appreciated the urgency of a midline shift and they've died.
"I would rather err on the side of caution now and say 'you could die at any minute'."
Dr Teo said in conducting a partial right frontal lobectomy on the woman it was likely he unknowingly removed a part of the brain that was crucial to her functioning.
"I agree I took out a bad part of the right frontal lobe that caused the deficit."
Dr Teo argued he did not remove an excessive amount of the patient's right frontal lobe - an area of the brain considered responsible for higher level functions such as language and speech.
He said there are brain networks in the right frontal lobe he didn't even know about at the time of the surgery that are not widely considered in "mainstream" neurosurgery.
"I think you could have avoided this terrible outcome with the knowledge we have today," Dr Teo said.
"I will not do a right frontal lobectomy now without mapping those networks. It's not mainstream, but it should be."
After Monday's hearing, Dr Teo told reporters the disciplinary process had taken him out of the operating theatre.
"I haven't been able to save lives that I know I can save," he said.
The hearing is expected to wrap up on Wednesday before a decision is made about Dr Teo's fate.
Australian Associated Press
