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High-profile surgeon Dr Munjed Al Muderis held a “clinic” or “catch-up” in New York to meet potential patients when he did not have a licence to provide medical services in the United States, his defamation trial has heard.

Al Muderis is suing The Sydney Morning Herald, The Age and 60 Minutes over reports published and aired in September 2022. He alleges the reports convey a range of defamatory meanings, including that he negligently performed osseointegration surgery and illegally performed surgery in the US where he is not licensed to practise.

Barrister Sue Chrysanthou, SC, (left) and Munjed Al Muderis’ partner Claudia Roberts outside the Federal Court in Sydney on Tuesday.Credit: Dion Georgopoulos

Osseointegration involves inserting titanium pins into the residual bone of an amputee, which allows prosthetic limbs to be connected.

Nine, the owner of the media outlets, is seeking to rely on a range of defences, including a new public interest defence, truth, and honest opinion.

Al Muderis’ partner Claudia Roberts, who shares two children with the surgeon and was previously his clinic co-ordinator and rehabilitation manager, gave evidence in the Federal Court in Sydney on Tuesday. She was grilled at length about the “clinic” or “catch-up” at the New York Hilton Midtown on June 9, 2018.

In an email shown in court, dated May 9, 2018, Roberts identified herself as clinical co-ordinator and told at least 96 potential patients she was “delighted to tell you that Munjed will be running an Osseointegration clinic in New York on 9th of June and has allocated time to meet and examine you”.

Roberts wrote that “we will have some of our older patients attending who have already had osseointegration who you will be able to talk to as well” and “in our experience after nearly 500 cases, this type of clinic is the most valuable”.

Matt Collins, KC, acting for the media outlets, asked Roberts if the older patients were attending for “follow-up consultations”.

“Not a consultation but a meeting, yes,” Roberts said. She said Al Muderis “did examine patients” in America, but it was only once he was back in Australia that he would make any assessment.

Collins put it to Roberts that she had “given that answer … because you know that it’s a felony under American law for a person who is not a licensed practitioner to practise as a physician in the United States”.

Surgeon Munjed Al Muderis, his partner Claudia Roberts and his legal team outside the Federal Court in Sydney on September 4.Credit: Steven Siewert

“I’m still not familiar with what the laws are,” Roberts replied.

Asked if she had been “told it was a grave offence for an unlicensed physician to provide medical services in the United States”, Roberts said she was “not told that”.

Roberts was shown an email from Dr Solon Rosenblatt, one of Al Muderis’ representatives in the US, in which Rosenblatt told Roberts, Al Muderis and others on May 14, 2018: “Please do NOT call the gathering in New York a clinic. Munjed will get into trouble for holding a medical clinic without a medical license. That is a grave offence and could mean serious fines and also revoking of his visa.”

Collins put it to Roberts that she “understood … that it would have been a grave offence for Dr Al Muderis to conduct a medical clinic without a medical licence”.

“I understand that’s what Dr Rosenblatt said, but I still don’t know myself. I still don’t know what the laws are myself,” Roberts said.

“You understood … that it was a very serious matter for Dr Al Muderis to provide medical services in the United States without a licence?” Collins said.

“Yes,” Roberts replied.

Roberts would later describe the New York event in an internal email on May 17, 2018, as a “catch-up/gathering” rather than a clinic.

In an email on May 15, 2018, a US associate, Fred Hernandez, wrote: “So now there’s no presentation, only Munjed seeing patients? If so, there is no need to blast social media on this. As he has no credentials to see patients in the US and a posting will only bring it to the attention of the wrong people.”

In another internal email, on May 14, 2018, Roberts said patients could be brought up to a hotel room “for a consultation”, and emailed potential patients on June 6, 2018, that “we are very much looking forward to catching up with you”.

“If you do have any recent x-rays please bring them with you,” she said.

But Roberts told the court that Al Muderis did not give advice, and she did not believe he would have said osseointegration would be “a good thing” for particular people.

She told the court it was “an error” to use the word consultation in her email, and “there was another instance where I called it a clinic, and I have said that it was an error”.

“You called it a clinic repeatedly in multiple emails over many days,” Collins said.

“The reason you’ve questioned my use of the word consultation is you know very well that it would be unethical and illegal, a grave offence, for Dr Al Muderis to conduct a consultation with a patient in the United States.”

“I don’t know,” Roberts replied.

“I want to suggest to you, Ms Roberts, that that’s a dishonest answer and you know it’s a dishonest answer,” Collins said.

“No,” Roberts replied.

Collins told the court that Nine would ultimately submit that “this conduct in the United States was not only unethical, it was illegal”. But Sue Chrysanthou, SC, acting for Al Muderis, said Nine had never alleged in court pleadings that it was illegal or unethical to conduct clinics.

The court heard that one of Al Muderis’ American patients, Billy Wynne, was scheduled for surgery on June 6, 2018, before he left the US.

“Payment will need to be cleared before you arrive in Australia please allow 7-10 working days for the transfer to be complete,” Al Muderis’ account manager Renee Zamani wrote in an email to Wynne on May 2 that year.

Al Muderis’ lawsuit names The Age reporter Charlotte Grieve as among the respondents. Grieve wrote in October last year that her investigation “came from a conversation with my father”, Don Grieve, KC.

“He is an amputee who had a consultation with Al Muderis years ago and was told if he did not immediately have osseointegration surgery, he would soon be in a wheelchair,” Grieve wrote.

Roberts said on Tuesday that she was present at the meeting with Grieve snr in 2018 and recalled he was told that “the risk for the surgery would outweigh the benefits” at that time, and he should avoid having osseointegration surgery for the time being.

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