Govind Tekale
Estimated reading time: 7 minutes
Dr. Yasser Adly Abdel Rahman, an NHS locum surgeon from Egypt, has been permanently erased from the UK medical register following a catastrophic surgical error that left his patient in “uncontrollable pain” for weeks. The Medical Practitioners Tribunal Service concluded his misconduct was “fundamentally incompatible with continued registration” after hearing evidence of multiple failures during and after an emergency bowel operation.
The tribunal’s July 2026 ruling (recently published in August) marks the end of Rahman’s UK medical career. But the case highlights systemic vulnerabilities in surgical practice oversight and raises questions about patient safety protocols when obvious post-operative complications emerge.
What Went Wrong in Theater
On August 25, 2020, at Royal Oldham Hospital in Greater Manchester, Rahman performed emergency surgery on a young patient with an acute bowel crisis. During the procedure, he made a critical anatomical error: he connected the wrong part of the patient’s intestine to the stomach, creating what the tribunal called a “closed loop” structure.
The mechanics matter medically. Normal digestion moves bowel contents in one direction: through the intestines toward elimination. Rahman’s misconnection created a circular path—contents could enter the stomach but had nowhere to exit except back through the same route they entered. Think of it as a one-way valve connected backward: material flows in but can’t flow out normally.
This trapped bowel contents in the closed loop, unable to proceed through normal digestive passages. The consequences were inevitable: accumulation of waste, bacterial overgrowth, pressure buildup, and abdominal pain.
Post-Operative Agony and Failure to Recognize Error
Days after surgery, the patient reported increasing abdominal pain, persistent vomiting, and absence of normal bowel movements—textbook signs of post-operative obstruction. Family members and nursing staff expressed concerns to Rahman. At this point, competent surgical practice demands investigation: imaging studies (CT scans), surgical consultation with colleagues, or preparation for corrective re-operation.
Rahman, the tribunal found, did none of these. He didn’t consider that something might have gone wrong surgically. He dismissed symptoms as expected post-operative discomfort. For weeks, the patient suffered, waiting for “normal” recovery that never came.
A month post-operation, Dr. Anthony Rate—a different surgeon—took over care, obtained imaging, identified the error immediately, and performed corrective surgery with formation of a stoma (permanent bowel outlet). The patient finally received relief. But the delay meant unnecessary suffering and risk: prolonged obstruction carries risk of perforation, sepsis, and death.
Expert Assessment: “As Bad as It Gets”
The tribunal heard from a former consultant general and colorectal surgeon who served as the General Medical Council’s expert witness. His assessment was blunt: Rahman’s procedure was “not known to man”—essentially, not a recognized or defensible surgical approach. The error was “as bad as it gets” in bowel surgery.
This wasn’t a reasonable surgical choice with unfortunate consequences. This was fundamental anatomical misunderstanding or carelessness that created an impossible situation for the patient. Expert surgeons don’t make these errors because the anatomy is straightforward and techniques are standardized across centuries of surgical practice.
Compounding Failure: Breaking Work Restrictions
The tribunal identified an additional failure that “aggravated” the case. After the original incident, the MPTS had imposed restrictions on Rahman’s work in July 2021. These conditions limited what assignments he could accept and how he could practice.
In February 2022, Rahman breached these conditions by applying for and accepting a locum position at Affidea Express Care Clinic in Ireland. He violated a formal order restricting his practice—a second misconduct alongside the original surgical error. The tribunal ruled this breach demonstrated lack of insight and unwillingness to comply with safety oversight.
This aggravating feature transformed the case from “serious surgical error” to “serious surgical error plus deliberate violation of regulatory restrictions.” It suggested Rahman didn’t accept responsibility or agree he needed to change his practice.
The Tribunal’s Reasoning
The MPTS tribunal concluded Rahman’s conduct was “fundamentally incompatible with continued registration.” Translation: He can no longer practice medicine in the UK under any conditions. He cannot take different job roles hoping to avoid high-risk scenarios. He cannot practice with additional supervision. He cannot work under different specialties. He’s done.
The tribunal didn’t find evidence of deliberate malpractice—Rahman wasn’t criminally negligent or reckless in a calculated sense. But competent surgery requires specific knowledge and judgment. When someone repeatedly fails to meet those standards (the surgical error plus post-operative failure to recognize/act on obvious complications), and then violates regulatory conditions imposed to prevent repetition, continued registration becomes unconscionable.
Broader Implications for Patient Safety
Cases like this highlight NHS vulnerabilities. Multiple safeguards failed:
1. Intra-operative checks: Modern surgical practice includes anatomical verification before closure. Team time-outs specifically confirm “correct patient, correct site, correct procedure.” No evidence suggests this occurred.
2. Post-operative monitoring: Obvious complications should trigger imaging and reassessment within 48 hours. The week-long delay is indefensible by contemporary standards.
3. Peer oversight: When a colleague questions your post-operative plan, openness to discussion and consideration of alternatives is expected. Not dismissing concerns suggests insular practice.
4. Regulatory compliance: Once work restrictions are imposed, compliance should be automatic. Violating them signals someone not committed to safety improvement.
“Never Events” and Accountability
Bowel surgery errors of this magnitude are termed “never events”—surgical incidents that should never happen because safe practices, if followed, prevent them completely. Unlike infections or unexpected bleeding, which are sometimes unavoidable, connecting the wrong anatomy represents pure preventable error.
The NHS tolerates some “never events” as statistical inevitability in high-volume systems. But individual surgeons accumulating multiple never events raise serious concerns. Tribunal findings don’t indicate whether Rahman had prior complications—just that this 2020 case was egregious enough to merit erasure.
Comparison to Other Surgical Errors
Similar cases reach tribunals periodically. A 2017 case involved a surgeon removing a patient’s ovary instead of their appendix due to poor eyesight. Another involved wrong-site surgery on multiple occasions. These cases typically result in striking-off because they represent unacceptable patient harm and inability to perform basic surgical requirements.
What distinguishes this case is the combination of initial error plus delayed post-operative management plus regulatory violation. Each alone might warrant practice restrictions. Combined, they justified permanent erasure.
Patient Outcome and Lessons
The patient survived thanks to Dr. Rate’s corrective intervention. Recovery from two abdominal surgeries within a month carried complications—infections, adhesions, prolonged recovery. But the patient is alive. The case could easily have ended in death from perforation or sepsis during the month-long delay.
For the NHS, the lesson is systemic: oversight mechanisms worked eventually (the tribunal eventually struck off Rahman), but patient protection depended on a different surgeon recognizing and correcting someone else’s error. Ideally, safeguards prevent bad outcomes before a second surgeon must rescue patients from a first surgeon’s failures.
The case concluded with erasure. Rahman cannot practice medicine in the UK. Whether he practices elsewhere is unknown. The tribunal’s jurisdiction is limited to UK registration. International medical coordination on surgeon performance remains weak—doctors can migrate between countries after professional failure in one, though registration checks by receiving countries increasingly screen for prior issues.
For patients, cases like this reinforce the importance of asking questions during hospital stays: “Has a different surgeon reviewed my post-operative course?” “Why haven’t we obtained imaging to confirm the surgery worked?” Speaking up when recovery feels wrong can identify problems early rather than waiting weeks for obvious symptoms to become critical.
The tribunal’s July 2026 ruling, published in August 2026, sends a message: significant surgical error, compounded by failure to recognize complications and violation of regulatory oversight, results in striking off. It’s accountability, but it comes after the patient suffered. Better systems might prevent such errors before patients bear the cost.
