Neurosurgeon gets two-month suspension for not doing five-minute brain drainage check

A Québec doctor who refused repeated requests to do a five-minute check of the setting of a drainage device he had installed in a patient’s brain has been suspended for two months. Dr. Khalil Khalaf, a neurosurgeon at Hôpital de Hull in Gatineau, acknowledged to the disciplinary board of the Collège des médecins du Québec that he should have confirmed the calibration of the drainage device in a patient who had complained repeatedly of headaches and dizziness. It would have taken him less than five minutes to do the check, with an instrument he would have positioned behind the patient’s head, according to the decision document. The patient’s persistent problems required a second operation, performed by another neurosurgeon who noted that the patient’s subdural hematoma may have been the result of excessive drainage of cerebrospinal fluid or a head trauma. Read: Video: Four things to know before specializing in neurosurgery Dr. Khalaf first met in 2015 with the patient, who had been diagnosed with communicating hydrocephalus, a problem with cerebrospinal fluid resorption. Dr. Khalaf decided the best course of action was a ventriculoperitoneal shunt surgery. In March 2017, Dr. Khalaf implanted a tube in the patient’s brain to drain the cerebrospinal fluid, along with a small device to control the drainage rate. About two weeks later the patient showed up in the emergency department complaining of headaches and dizziness. Dr. Khalaf saw him and concluded the device was installed properly. In June 2017, the patient went for an MRI. According to the decision document, the implanted device designed to control the flow of cerebrospinal fluid drainage was made largely of magnet. Ten days after the MRI, the patient saw Dr. Khalaf and told him he was suffering from headaches and felt pressure in his head. As he had done during previous appointments with the patient, Dr. Khalaf refused a request to check the drainage setting. Read: Surgeon suspended 10 weeks for failing to inform patient of cancer diagnosis In November 2017, the patient returned to the emergency department, dizzy and reporting that he had hit his head the previous month. During a subsequent visit about three weeks later, the on-call surgeon checked the drainage device and saw it was set at a level for maximum drainage. The on-call surgeon calibrated the device to reduce flow. Just over a month later, the patient went back to the emergency department. The following day, another neurosurgeon operated on the patient for a subdural hematoma. The patient met again with Dr. Khalaf in January 2021. During this meeting, Dr. Khalaf asserted that the radiologist who performed the MRI in June 2017 should have verified the drainage device settings. Dr. Khalaf also told the patient he believed the radiologist had done so. However, according to the decision document, the hospital's protocol in June 2017 did not require radiologists to check for displaced or deprogrammed drainage devices after an MRI. It was only in February 2020 that such a protocol was put in place at Hôpital de Hull. While the discipline board concluded that Dr. Khalaf’s lack of follow-up with his patient "has an intrinsic gravity, because the quality of medical practice is at stake,” it also noted this was an isolated act and that Dr. Khalaf had no previous disciplinary record. Consequently the board decided to support the joint recommendation of both parties for a two-month suspension–effective March 19–which "reflects a balance between the need to protect the public and the respondent's right to practice his profession as well as the overall impact of this sanction on the respondent.” Read: Guilty finding against doctor hired to write 'secret' psychiatric opinion on controversial professor

Neurosurgeon gets two-month suspension for not doing five-minute brain drainage check

Register for free access or login.

Related Topics