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A Cambridge University Professor and Orthopedic Surgeon, Accused of deliberately failing IQ and memory tests £1 million to strengthen brain damage claim against NHShas been cleared of foul play high court judge.
Dr. Mohammad Atef Hakmi, 64, a lecturer at the Cambridge School of Medicine, suffered an illness stroke In November 2016, he was left with permanent disability and forced to close his surgical practice.
He later sued the NHS in the High Court in London, seeking damages in excess of £1 million.
He alleged that he did not receive vital treatment due to medical errors, which led to brain damage and physical harm.
However, Dr Hakami faced charges of “fundamental dishonesty” from the NHS after scoring a “very poor” 84 in the pre-trial. IQ test,
This result placed him below the UK average and, by some measures, within the “borderline mental disability” category, despite him continuing to teach at Cambridge.
The Health Service argued that he had deliberately exaggerated his disabilities to increase his compensation claim.
A High Court judge has now ruled that Dr Hakmi did not deliberately perform poorly in the tests, clearing him of any foul play.
Judge David Pittaway said he was confident that Dr Hakami’s poor test results were not due to dishonesty, but due to his exhaustion, which was partly caused by problems in his family life.
He said, “I do not believe that Mr. Hakami was performing poorly in the tests…deliberately exaggerating the extent of his impairment.”
“If Mr. Hakami were intentionally performing poorly, it would be contrary to all that he has done to rehabilitate himself after his stroke.”
However, Dr Hakmi was refused payment from the NHS because the judge found that, even if he had received the treatment that his lawyers claimed he needed, he would not have made an optimal recovery.
The court heard that Dr Hakamy was a Herts-based orthopedic surgeon and medical teacher who specialized in foot and ankle surgery, as well as lecturing in the UK and abroad.
He is a Fellow of the Royal College of Surgeons and an affiliated assistant professor at the University of Cambridge, where he holds a teaching role, the court heard.
He suffered his first stroke in September 2016, but was given clot-busting thrombolysis treatment and recovered very well and returned to the operating theater within a few weeks.
But his barrister, Robert Keller Casey, said the surgeon had suffered a second stroke in November 2016, with symptoms first becoming apparent as he worked late into the night on paperwork.
When the symptoms returned again in the early hours, he went to Lister Hospital in Stevenage, and phoned the staff to tell them he was having a stroke.
However, after being examined by an A&E doctor and then speaking to a stroke specialist over the phone in line with the NHS’s remote stroke treatment system, he was not given the same treatment as before.
He says he was told he would not be offered thrombolysis because he “hadn’t had a stroke”, with the remote doctor suggesting it could simply be migraine or epilepsy.
His stroke was not discovered in the hospital until 9 a.m. that day, by which time it was too late to treat him with the same medications as before.
Dr Hakami accused the NHS of “cumulative and inter-related” failures which prevented him from receiving thrombolysis treatment, which he claimed would have led to a better outcome.
Mr Keller said Dr Hakamy was left permanently disabled by the stroke, but the worst of his injuries could have been avoided had it not been for the negligence of Lister and the remote stroke line staff.
As well as having lameness and reduced sensation in his fingers and toes, he suffers from fatigue in his right arm, hand and grip, preventing him from performing complex tasks for long periods of time.
He also suffered a brain injury, resulting in short-term memory loss, impaired concentration, decreased processing speed, and “executive deficits”.
The NHS denied liability for the injury, claiming that Dr Hakamy’s stroke was not severe enough to require thrombolysis and that it would have been too long since his symptoms had taken effect.
Such treatment can also be risky, carrying a significant risk of brain hemorrhage and death, and even if he had been given it the outcome would probably have been the same, lawyers lament.
He also accused Dr. Hakami of “fundamental dishonesty” regarding the way he performed in the trial before trial.
NHS barrister John de Bono Casey told the court that as well as having a “very poor” IQ score, he had scored at the bottom of the range in memory tests.
He said Dr Hakami had scored only 84 on an IQ test, which puts him below 86 per cent of the general population, adding: “That’s too bad – it shows it would be hard to function as a surgeon or a teacher at that level.”
He was also evaluated by two neuropsychologists who conducted memory tests, the results of which were “very surprising” and sometimes “surprising”, which they said raised “serious concerns about whether he was giving his best effort in the tests”.
Despite continuing to work as a “teacher” at the graduate level, Dr. Hakmi was unable to recall more than four single-digit numbers in a row during an examination and scored so low on tests that in some cases he was below 99% of the population.
But Dr. Hakmi refused to play for the doctors who had evaluated him before the trial, and told the court that he had found the trial “tedious”.
He further said, “Anybody can fail in the exam but they should be given the best chance.”
“I definitely have memory problems, effort is slower. I’ve done everything I can to minimize my loss. I definitely know I’m not the same as before the stroke.”
Ruling on the case, Judge Pittaway said: “Having considered the totality of the evidence, I conclude that the claim that Mr Hakami is fundamentally dishonest fails.
“I do not believe that the defendants have established to the civil standard that Mr. Hakami was dishonest during the investigation by the defendants’ experts.
“I had the benefit of watching Mr. Haqmi being cross-examined throughout the day…I do not think he was trying to mislead the court in any way.
“He is a self-respecting individual against whom a serious allegation has been made, which if proven could have serious consequences on his registration and employment.
“He has also submitted statements and letters from four colleagues at the hospital attesting to his honesty and integrity as well as the steps taken to minimize his disability following his stroke.
“I think Mr. Hakami honestly believes that the diagnosis and treatment he received was not optimal and that if he had been treated with thrombolysis, he would have made a full or near-full recovery.”
Despite finding that Dr Hakmi was not dishonest, the judge found his negligence claim in favor of the NHS and rejected his compensation bid.
He said Dr. Hakmi’s stroke symptoms were not severe enough until it was too late to provide thrombolysis treatment within the four-and-a-half hour cut-off time.
He had recently received such treatment for his first stroke, due to the Lister Hospital protocol, it was also “an absolute contraindication to further thrombolysis.”
And even if he had undergone thrombolysis treatment, the judge said it would not have made any difference to Dr Hakami’s level of recovery.
“I conclude that thrombolysis would probably not have changed the outcome in this case, in the circumstances where Mr. Hakami made a very good, even if incomplete, recovery from his second stroke.”
The judge rejected Dr Haqmi’s compensation claim, but also rejected the NHS’s allegation of fundamental dishonesty, and ordered the NHS to pay 15 per cent of the surgeon’s costs in the case.
The damages claim was against East and North Hertfordshire NHS Trust, which runs Lister Hospital, and Norfolk and Norwich University Hospitals NHS Foundation Trust, where the remote stroke doctor who spoke to Dr Hakami was based.