Perth cardiologist Keith Woollard has been accused of "careless or incompetent" conduct after he allegedly over-inflated a catheter balloon while operating on a 70-year-old woman, causing it to burst and requiring the patient to undergo open heart surgery.
Dr Woollard, the husband of independent MP Janet Woollard and one-time president of the Australian Medical Association, is defending himself at a two-day disciplinary hearing in the State Administrative Tribunal.
The Medical Board alleges Dr Woollard ordered the balloon to be inflated to 18 atmospheres - the measurement of pressure - during an angioplasty to clear a lesion in the woman's right coronary artery at the Mount hospital in August 2006.
The tribunal was told today the recommended pressure level is 14 atmospheres.
Lawyer Paul Yovich, for the Medical Board, said the balloon burst which caused a hole or tear in the artery, prompting the patient to need bypass surgery to repair the damage. He said the patient recovered from the procedure.
Mr Yovich said it was "unsafe" for Dr Woollard to have the balloon inflated to such a level and his conduct amounted to "carelessness ... or incompetency".
He said in a letter written by Dr Woollard to the board in 2007 the cardiologist said balloon ruptures in these cases were "not uncommon". Mr Yovich alleged that claim was incorrect.
Dr Woollard's lawyer John Ley said his client, whose "livelihood is at risk", claimed he never inflated the balloon to 18 atmospheres.
Mr Ley said Dr Woollard instructed the scrub nurse to inflate the balloon to 15 atmospheres - aware it was one above the recommended level - but it had no effect on the lesion.
He said it was then decided to deflate the balloon and re-inflate it. Dr Woollard consulted with a supervising doctor because at the time he was not accredited to perform angioplasties on his own at the Mount.
Mr Ley said Dr Woollard's instruction was to again inflate the balloon to 15 atmospheres but when it reached about 10 atmospheres, for some unknown reasons, it burst. He said Dr Woollard was able to remove the catheter, but not the balloon.
Mr Ley said it was "reasonable and acceptable" practice for a cardiologist to inflate a balloon to that level to dilate a lesion. He said that position would be supported in evidence by at least one other doctor.
Registered nurse Carole Collins told the tribunal today she could not remember the incident, but her interpretation of the event log she filled out was that the balloon was inflated to 18 atmospheres for 29 seconds.
She said balloon ruptures happened occasionally as complications in angioplasties.
The tribunal hearing continues.