‘Some people pay the price’: Risk and reward in Charlie Teo’s world

By Kate McClymont and Thea Dikeos

Neurosurgeon Charlie Teo and Traci Griffiths, a former patient, leave a gala event in Sydney on Thursday.Credit:MEDIA-MODE.COM

The families of two children, who had terrible outcomes after Charlie Teo operated on what experts have maintained were “truly inoperable” tumours, have expressed their dismay over the controversial neurosurgeon’s responses to revelations about his surgical practices.

And medical experts have expressed concern at Teo’s admission that some of his patients were paying a high price for what he agreed could be described as “experimental” surgery.

“I am pushing the boundaries, but someone’s got to push the boundaries and unfortunately some people pay the price,” he told Today hosts Karl Stefanovic and Allison Langdon.

Teo’s appearance in multiple media outlets followed revelations in an investigation by The Sydney Morning Herald, The Age and 60 Minutes that he’d charged families extraordinary amounts of money for ultimately futile operations that have catastrophically injured young children.

Controversial neurosurgeon Dr Charlie Teo.Credit:Quentin Jones

“My operation ruined him,” Teo told A Current Affair of his botched surgery in Singapore on four-year-old Mikolaj Barman in 2018.

“I could not sleep the whole night,” said Prasanta Barman, an engineer from India, after learning via Australian television of Teo’s admission that the surgery had injured his son.

After the operation Mikolaj never walked or spoke again in the months before he died.

“This is totally new to me. He never told us that something wrong happened during surgery and that led to his critical condition. I came to know this only now and that also from the TV,” Barman said.

Mikolaj Barman (centre) was diagnosed with a very rare type of tumour – a diffuse intrinsic pontine glioma (DIPG). He is pictured with his father, Prasanta, and his mother, Sangeeta.

Gene Howard, the father of seven-year-old Bella, who was partially paralysed following surgery, rejected Teo’s claim that he’d recently absolved him of any blame.

Teo told Today that the Shoal Bay tradesman “wrote me an email the other night apologising to me about 60 Minutes … he didn’t want me to be condemned over Bella … he concedes it wasn’t my fault.”

Howard told this masthead that no one from the family had contacted Teo for the past year.

Barman and his wife, Sangeeta, were devastated when Mikolaj was diagnosed in 2018 with an incurable and inoperable tumour called a diffuse intrinsic pontine glioma (DIPG). A second neurosurgeon confirmed the diagnosis.

In October 2018, he paid $80,000 at a Singapore hospital for Teo’s 10-hour operation. After surgery, the brain surgeon spent 10 minutes telling the parents he’d removed 85 per cent of the tumour and that it appeared to be benign. With that, Teo was gone, and they never saw him again.

Barman said that after the operation Mikolaj was “in the bed in a vegetative state, he cannot play, he can just blink his eyes, and say yes or no to us”.

Gene and Sarah Howard with their daughter Bella.

Barman was devastated to hear Teo tell Tracey Grimshaw on A Current Affair he’d made a mistake during surgery and had injured his child.

“With Mikolaj for example, sure I took out the focal component, went one millimetre too far and took out some of the diffused components and damaged him,” Teo said.

Emails between Teo’s office and Barman after surgery made no mention of Teo’s mistake. Barman said when he emailed Teo to tell him how worried he was that Mikolaj was not breathing on his own after surgery, “Dr Teo’s team told us that they are not concerned as Mikolaj had a big surgery and it takes time to recover after such an extensive operation”. But Mikolaj never recovered.

Having seen Mikolaj’s post-operative scans, other specialists told this masthead it wasn’t a millimetre mistake. Instead, Teo had removed most of the child’s pons, which links the brain to the spinal cord.

Pre-eminent American paediatric neurosurgeon Mark Souweidane, who was not asked to comment on Teo or his surgeries, said an attempted resection of the tumour was not and had never been an option for DIPG and that it would be “incomprehensible” for anyone to attempt this.

Professor Souweidane, an expert in DIPGs, described it as an aggressive tumour which infiltrates the pons, “the part of the brain that decides when you breathe and when your heart beats”.

Any attempt at resection would result in devastating consequences, he said. “To go in and remove that area would remove the very part of the brain that keeps you alive.”

While Teo declined to speak to the joint investigation, in this week’s interviews, Teo offered contradictory explanations about his surgeries. He agreed that DIPGs were inoperable because their diffuse nature meant the tumour had spread.

“If you have a diffuse tumour and you operate on it, you’re gonna get problems.” He said it was “impossible” to resect as “it’s like taking sugar crystals out of a salt bowl … with a pair of chopsticks.”

Teo said that in his opinion Bella had a focal tumour, which is confined to a specific area and is amenable to resection.

This week he suggested Mikolaj did not have a DIPG but a brand new variation of the tumour and Teo said he “is trying to work out if it’s worthwhile trying to operate on these patients”.

Neurosurgeon Charlie Teo leaving his home on Tuesday.Credit:Rhett Wyman

Teo told A Current Affair, “I believe there’s a third category of diffuse and focal, a mixed glioma with a focal component and a diffuse component … Now the danger in that operation is you’ve got to stop at the focal component and don’t go into the diffuse component. With Mikolaj, I didn’t get it right. It only takes a millimetre too far and you can damage someone irreparably.”

One neurosurgeon said, “It’s interesting that he alone has discovered a brand new subtype of brain tumour and chosen to announce it on A Current Affair – you’d be announcing it to the scientific community and the WHO classification of tumours and getting yourself a Nobel Prize.”

The medical consensus is that DIPG tumours are inoperable except for taking a biopsy for research purposes or to confirm the presence of the genetic mutation for a DIPG.

Medical specialists were sceptical of Teo’s justifications for his surgeries based on his new theory. They said it raised questions regarding what kind of trials Teo had done, had he obtained consent from his patients and “where are the ethics proposals and where has he outlined his protocols?”

Barman rejected Teo’s claims on Today that he had chosen the surgery knowing all the risks.

Teo told Today “that father wanted a remote chance that I could buy him time, or possibly even cure him because we didn’t even have a diagnosis on him. He was willing to take that risk.”

“I am pushing the boundaries, but someone’s got to push the boundaries and unfortunately some people pay the price.”

On A Current Affair, Teo said it was “extremely unlikely” that his office had offered Mikolaj “a high likelihood of cure”.

However, one of the first emails sent to Barman by Teo’s executive assistant said: “Dr Teo has reviewed the scans and suggested urgent surgery. He said there is a very high likelihood of cure if he does the surgery before radiation.”

In a later email, Barman asked Teo if he could double-check his son’s scans because he’d been told by two Indian neurosurgeons that it was an inoperable DIPG. Teo’s office responded: “Our diagnosis and recommendation remains the same and we think we can cure Mikolaj with surgery.”

He played down the devastating outcome of his surgery on the little boy. “Mikolaj had a malignant brain stem tumour, he was dying. And that whole narrative of him looking up at the ceiling and being tragic, that would have happened anyway.”

He added Barman was “in pain now, he’s got to blame someone, blame me, I don’t care”.

“He’s got to blame someone, blame me, I don’t care.”

Teo told A Current Affair that he was “not sorry I operated” on either child and he’d learnt lessons from his futile operation on seven-year-old Bella Howard, describing “the lessons I’ve learnt from her operation, the wisdom I’ve gained from her suffering”.

In Bella’s case Teo said, “99 out of 100 neurosurgeons in the world … would call it a DIPG [but] my feeling was that it wasn’t, it was focal and it was worth giving it a shot.”

Bella’s cause of death was recorded as a DIPG. Post-operative pathology results showed both Mikolaj and Bella had the H3K27M molecular marker for DIPG which would have been evident if a biopsy had been performed before surgery.

Bella’s tumour was malignant, it came back and killed her “in a pretty short period of time”. Despite this, Teo remained unrepentant claiming he did “a fantastic resection.”

“The Bella Howards and the Mikolaj Barmans of this world are not lab rats,” said Grimshaw. “They’re not an experiment … They’re not a learning exercise or a training exercise.”

Teo replied, “When you get a bad result, you’re going to learn from it and you’re going to hopefully not do it again.”

Teo said it was an “insult” to Bella Howard for her bad outcome “to be used as a case against me” because he had learnt lessons and gained “wisdom … from her suffering”.

In his interviews, Teo expressed anger at the suggestion he was being portrayed as “some money-hungry bastard who is operating on and hurting children based on money, that’s what I want to correct”.

He told radio host John Laws that the joint investigation “wasn’t wrong” in pointing out that he had some bad outcomes.

“There’s actually more bad outcomes than they’ve identified on 60 Minutes,” said the surgeon. But what infuriated him was the suggestion these were cases in which he should never have operated or that he had performed them for financial gain.

“Talk to anyone who knows me, I don’t dress in nice clothes. I don’t have a nice car … If it wasn’t for Audi being generous and giving me a car I wouldn’t have one,” he said.

He told A Current Affair he’d never “interested myself in the money side or the financial side of my business”. He also said he was not aware that his patients were asked to pay $800 cash for an initial consultation.

Patients reported being dispatched to the local ATM if they didn’t have the cash. They disputed Teo’s claim that he was not aware of this. “There is no chance at all that he was unaware of this cash system because it is transacted in front of him or just outside his open door, multiple times a day,” said one woman of her experience.

Kathy Leslie and her husband Joe at their Brisbane home.Credit:Paul Harris

Teo was also asked in the past week to respond to reports that enormous prepayments were demanded, sometimes on the eve of an operation. In Bella’s case, her operation was contingent upon a $50,000 payment into Teo’s bank account the night before her operation. Bella’s bills show $45,000 for her hospital costs were paid separately to Prince of Wales Private.

In one interview he said he had to have payment up front because he had bad debtors and, in another, Teo said he used to collect money from his patients to pay the hospital. In a statement, the Prince of Wales Private disputed this. “The payment is made directly to the hospital.”

Despite the revelations about poor outcomes, many patients and their families have benefited from Teo’s successful outcomes.

But as one medical professional observed, “No one is criticising his surgical skill. But good surgical practice is about so much more than that … it’s knowing when not to operate,” the professional said. “It is crystal clear from a medical and a scientific perspective, that excising some of these tumours does nothing to improve life expectancy or address the cancer.”

Kathy Leslie, whose husband Joe was left blind and brain-damaged after Teo’s operation in 2018, was infuriated at Teo’s claim that he treats all patients like he would his family. The Leslies claim that after the surgery Teo “washed his hands” of Joe and his family.

Joe spent six weeks in and out of hospital in Sydney before returning to Brisbane, where he spent months in a public hospital.

“If you really were sorry about the outcome, then why did we never see you ever again? You just washed your hands and let other people deal with the mess,” said his wife.

Rebecca Anderson told the joint investigation her surgery was “cancelled” by Teo when she stopped him in the corridor to discuss what risks she was prepared to take in her forthcoming operation.

“I make no excuses for that,” Teo told 2GB host Ben Fordham. “If you have a patient that you don’t like because of whatever reason … and you go ‘Gee, I don’t like that person,’ you’re not going to operate your best.”

While he “couldn’t remember” apologising to Rebecca, this masthead published a letter he wrote to Anderson’s husband in 2010 in which Teo admitted his behaviour was “unprofessional” but went on to say, “I excuse myself knowing that in life we will always occasionally find someone with whom there is instant misunderstanding.”

In August 2021, seven months after Bella died, the NSW Medical Council was so concerned about Teo’s operations on brain stem tumours, including a DIPG, that they placed restrictions on his practising certificate.

In November 2021, Healthscope, which runs 41 private hospitals, withdrew Teo’s accreditation at Prince of Wales Private Hospital, where he has worked for years.

Later this year he is due to face a two-day disciplinary hearing after a lengthy investigation by the Health Care Complaints Commission.

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