Dr Ben Mak completely incorrect blamed for medical misdiagnosis

In 2008 Dr Ben Mak, a Dutch surgeon, who worked three years as a surgeon and at the end as the lead surgeon in a private English Centre, was suddenly under suspicion of medical misdiagnosis with colonoscopy.
The private Centre suspended Dr Ben Mak and initiated a medical review of his 1823 colonoscopies performed by him.
English newspapers, the BBC and Channel four informed the English public, concerning the medical mistakes made by him.
Not one of the publicity media contacted Dr Ben Mak in order to hear his side of the story.
Dr Ben Mak did never resign from the Centre as the newspapers suggested, but with the private Centre a deal had been agreed to separate.

What happened in reality?
General information regarding literature of colonoscopies
Results Dr Ben Mak
Investigations
Conclusion

What happened in reality?
After the suspicion of a misdiagnosis of a malignancy in the colon, the Centre suspended Dr Ben Mak and started a review.

This was possible because the Centre was probably the first and only one or at the highest one of the very few Centres in the UK which made DVD recordings of all the procedures at this time. In other words, what was seen by Dr Ben Mak could later be reviewed by other experienced endoscopists.
Because of the review the public was made aware of the investigation and a psychological mass reaction developed.


General information regarding literature of colonoscopies
In colonoscopies misdiagnosis can be made. In the official NHS public information paper a misdiagnosis rate up to 5 % is presented. In real literature the misdiagnosis rate is between 2.4 – 4.8%. Which means that in the here discussed series of colonoscopies 40 misdiagnosis would be acceptable in the hands of the most experienced endoscopists.
Secondly 0.2% complication rate is the lowest described in world literature. This means perforations of the colon or serious bleeding. For the here presented material about 4 persons with serious complications would have been a normal finding.


Results Dr Ben Mak
However the results of Dr Ben Mak are completely the opposite of these findings. By the review by experienced endoscopists they were not able to find any misdiagnosis. Not one complication happened during the three years. (Complication rate of 0%)


Investigations
Dr Ben Mak had to attend a hearing of the GMC.
The decision of the hearing by the General Medical Council:

Dear Dr Mak

Notification of Decision of the Interim Orders Panel

On 18 February 2009 the Interim Orders Panel of the GMC considered whether it was necessary for the protection of members of the public or was otherwise in the public interest or in your own interests to make an order under Section 41A(1) of the Medical Act 1983 as amended (the Act).

You were present at the meeting but were not represented.

At the conclusion of the proceedings of the Interim Orders Panel in your case on 18 February 2009 the Chairman announced the Panel’s determination as follows:

“Dr Mak”: The Panel has considered all the information before it including the documents submitted and the submissions made today. The Panel has been greatly assisted by your attendance and by your detailed submissions. It notes that you feel considerably embarrassed by this referral, and that you have had a distinguished and excellent career without complaint thus far.

The Panel has considered the four pages of information received from NHS Shepton Mallet NHS Treatment Centre. In the information provided there is a concern raised regarding your professional practice, in that your undertaking of colonoscopies may be below average and/or out of date.

However, the Panel also notes that in the same information the Shepton Mallet Treatment Centre confirms that all the procedures were carried out safely, with a very low incidence of bowel perforation, and that their overall view was that you were a “skilled operator”. The Panel has also had in mind that the Shepton Mallet Treatment Centre confirms that there is no clear evidence reported of any missed diagnosis and that in relation to all the complaints received relating to you there was no significant trend nor any cause for serious concern.

Furthermore, in considering any issue of complaint or concern regarding your professional attitude, the Panel accepts that you were working as a surgeon in challenging circumstances whereby you were responsible for their sedation and clinical care during recovery.

The Panel has also considered the information presented that you have remained in full time practice since the assessment carried out in November 2007. It notes that the Council has received no further concerns, complaints or details of incidents clinical or otherwise having occurred since then and at no time has the Council received any complaint from another registered medical practitioner, registered nurse practitioner or patient.

This Panel must be satisfied that it is necessary for the protection of members of the public, in the public interest or in your own interests for an interim order to be imposed. It is not sufficient that such an order may be advantageous or desirable. In applying its test the Panel must be satisfied both that there may be an impairment of your fitness to practise, and that such impairment poses a real risk. In all the circumstances, the Panel is not satisfied either that you pose a real risk or that an interim order is necessary to protect the members of the public, the public interest or your own interests, nor is it satisfied that an interim order would be appropriate or proportionate.

The Panel is very concerned that your case has been referred to the IOP on the basis of the information presented. The four pages which contain the allegations made against you relate to an audit which took place over 15 months ago. There is no independent corroboration of the figures submitted by Chester Barnes, Registered Manager of the Shepton Mallet Treatment Centre nor is there any provenance as to the qualifications of the assessors carrying out an audit and the parameters and guidelines for such audit.

Notification of this decision will be served upon you in accordance with the Medical Act 1983 (as amended).”

April 2009 the Treatment Centre (SMTC) presented the report of the Joint Service Investigation into the review of colonoscopies to Board members and the public:
(The complete text is published on internet)

The main conclusions of the report:
Colonoscopy review finds no evidence of misdiagnosis at Shepton Mallet Treatment Centre

In: NHS issues / Outsourcing
On: 22/04/2009

The long awaited report following the review into 1,828 colonoscopies performed on NHS patients referred to the Shepton Mallet Treatment Centre between June 2005 and March 2008, has concluded that there was no evidence to support any suggestions of misdiagnosis.

The report also concludes that there is no need to take any action in relation to consultant Ben Mak who undertook the majority of colonoscopies at the centre up until March 2008.

The report made public today following the investigation says the General Medical Council has concluded it is not necessary to take any action in relation to his registration with the GMC and there is no reason to question his qualification, abilities or fitness to practice in any hospital in the UK, independent or NHS.

The review was subject to an independent clinical review by leading specialists accredited by the Joint Advisory Endoscopy.Group on GI


Conclusion
Dr Ben Mak had an excellent career without any complaint against him

Dr Ben Mak, who worked three years in a private Centre has not had one proven misdiagnosis and not one complication during more than 1800 colonoscopies.

These results are better than in almost any published international review.

Why the Centre suspended him and, because of the review, developed a psychological mass reaction under their patients can only be answered by the Centre itself.