A surgeon carried out controversial bowel procedures which weren't clinically indicated, failed to obtain informed consent from patients, and then dismissed their concerns when they were left in severe pain, a medical tribunal has heard.
Colorectal surgeon Dr Anthony Dixon also allegedly failed to discuss invasive treatments, failed to arrange chaperones for female patients, and made inappropriate and lewd comments.
Dr Dixon pioneered a technique known as laparoscopic ventral mesh rectopexy (LVMR), which involved surgical mesh being used to repair pelvic floor issues. He worked at Southmead Hospital and Spire Hospital, both in Bristol, but was dismissed by North Bristol NHS Trust (NBT) in 2019 following an investigation. It followed complaints from former patients that they were left in pain and with life-changing physical and psychological problems.
Surgeon Facing a Medical Practitioners' Tribunal
Dr Dixon, who is currently banned from practising in the UK, now faces a 6-week Medical Practitioners' Tribunal Service (MPTS) tribunal over misconduct allegations. He's accused of failing to provide good clinical care to six patients "in a number of areas" between 2010 and 2016, and it's also alleged his professional performance was found to be "unacceptable" following a General Medical Council (GMC) assessment.
The tribunal, taking place in Manchester, heard details of the 28 charges denied by Dr Dixon, who has always maintained that operations were carried out in good faith, and that any surgery could have complications.
Chloe Farley, counsel for the GMC, said an expert witness had provided reports in relation to the six patients and the allegations.
It's alleged Dr Dixon failed to arrange a chaperone for two female patients (referred to as Patients A and B) during examinations and, in some cases, recommended surgery without carrying out proper investigations and fully discussing the risks. Patient consent forms were often signed on the day of procedures, it's claimed, without patients being fully aware of the nature of the surgery and the non-surgical treatment options.
Dr Dixon is accused of failing to arrange a proctogram for Patient A, who had come to him following childbirth, prior to her undergoing a LVMR in February 2011. It's claimed he also failed to carry out a full investigation when she underwent a revision procedure 2 years later.
Patient in Severe Pain Dismissed as a 'Drama Queen'
He performed a revision of Patient B's LVMR in July 2016 when it wasn't clinically indicated, it's claimed, after he previously only told her that he would carry out a surgical resection of her bowel. Dr Dixon also told the woman, who had been diagnosed with irritable bowel syndrome, that he "could have got her pregnant on the operating table", the tribunal heard.
When Patient B later suffered "severe pain" from the procedure he was dismissive and told her that "it can't be all that bad" and that she was being a "drama queen". He also allegedly patted her on the bottom as she entered a hospital lift, and during a later discussion with the patient and her husband about whether they'd been able to have sex, he advised him to "go home and fill her up".
In a consultation with a male patient — Patient D — he continually interrupted him and told his wife, "Don't you feel like strangling [him]". Patient D, who also allegedly underwent a rectopexy procedure in March 2014 without being advised about other treatment options or being informed about the associated risks, later complained about ongoing pain and trouble defecating. But Dr Dixon dismissed his concerns and told him he was actually "getting better".
It's claimed Dr Dixon performed a stapled haemorrhoidectomy on Patient F, a consultant pathologist, which wasn't clinically indicated and without her knowledge, and made a "technical error" in excising a full-thickness section of the rectal wall during the procedure. When the patient later complained, she was told she was "lucky" he had carried out the operation and was dismissive of her pain, saying the "bowel does not feel anything". He also described the removal of a 3cm wedge of tissue as "just a piece of bowel", and MRI findings which highlighted post-operative complications as "completely normal".
Another patient — Patient G — also underwent a stapled transanal rectal resection which was "not clinically indicated", it's alleged.
Review Found Surgeon's Performance Was 'Unacceptable'
A review in 2018 found Dr Dixon's professional performance to be "unacceptable" in the areas of assessment of pelvic floor patients, clinical management, and working with colleagues, the tribunal heard. His approach to junior colleagues was deemed "unacceptable" and his "dominant nature" hindered open and honest discussion and the treatment of patients, it's claimed.
A review by NBT, that concluded last year, found that more than 200 of Dr Dixon's patients were harmed by procedures he carried out between 2007 and 2017. Patients should have been offered less invasive treatment first, it also found, and while the surgery was satisfactory, it was unnecessary.
Many former patients have taken legal action against Dr Dixon and while some cases have been settled, others are ongoing.
Last year, Dr Dixon failed in a legal bid not to be named in a case against his former employer NBT which was aimed at stopping documents being released to solicitors acting for ex-patients. Dr Dixon's lawyer argued at the High Court that being identified could harm his mental health, that he'd suffered suicidal thoughts, and was struggling with his libido, which he blamed on media attention.
The tribunal is proceeding.