Cambridge professor cleared of faking poor IQ test in £1m compensation claim
Dr Mohamed Atef Hakmi argued that medical errors had left him with brain damage
A Cambridge University professor and orthopaedic surgeon, accused of deliberately failing IQ and memory tests to bolster a £1 million brain damage claim against the NHS, has been cleared of dishonesty by a High Court judge.
Dr Mohamed Atef Hakmi, 64, a lecturer at the Cambridge school of medicine, suffered a stroke in November 2016, leaving him with permanent disabilities and forcing him to cease surgical practice.
He subsequently sued the NHS at London's High Court, seeking over £1 million in damages.
He alleged that medical errors denied him crucial treatment, leading to brain damage and physical impairments.
However, Dr Hakmi faced accusations of “fundamental dishonesty” from the NHS after scoring a “very bad” 84 on a pre-trial IQ test.
This result placed him below the UK average and, by some measures, within the “borderline mental disability” bracket, despite his continued teaching at Cambridge.
The health service contended that he had intentionally exaggerated his disabilities to inflate 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 dishonesty.
Judge David Pittaway said he was convinced that Dr Hakmi's poor test results stemmed not from dishonesty, but from his exhaustion, partially down to problems in his family life.
“I do not consider that Mr Hakmi was performing badly on the tests ... to exaggerate deliberately the extent of his impairment,” he said.
“If Mr Hakmi had deliberately been underperforming, it would run contrary to all that he has done to rehabilitate himself following his stroke.”
However, Dr Hakmi was refused a payout from the NHS as the judge found that, even if he had received the treatment his lawyers claimed he needed, he would not have made a better recovery.
The court heard Dr Hakmi was a Herts-based orthopaedic surgeon and medical educator, who specialised 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 Cambridge University, where he performs a teaching role, the court heard.
He first suffered a stroke in September 2016, but was given clot-busting thrombolysis treatment and made a very good recovery, returning to the operating theatre within weeks.
But his barrister, Robert Kellar KC, said the surgeon had suffered a second stroke in November 2016, first spotting the symptoms while he worked late at night on paperwork.
When the symptoms returned again in the early hours, he went to Lister Hospital, in Stevenage, calling ahead and telling staff that he was having a stroke.
However, he was not given the same treatment as before after being examined by an A&E doctor and then having spoken to a stroke specialist on the phone in line with the NHS' remote stroke treatment system.
He says he was told he would not be offered thrombolysis because he was “not having a stroke”, with the remote doctor suggesting it could be simply a migraine or epilepsy.
It was not until 9am that day that his stroke was diagnosed at the hospital, at which point it was too late to be treated with the same drugs as before.
Dr Hakmi accused the NHS of “cumulative and inter-related” failings, which prevented him receiving the thrombolysis treatment which he claimed would have provided a better outcome.
Mr Kellar said Dr Hakmi had been left permanently disabled by the stroke, but that the worst of the injuries could have been avoided if not for the negligence of staff at Lister and on the remote stroke line.
As well as a limp and reduced sensation in his fingers and toes, he suffers from fatigue in his right arm, hand and grip, preventing him performing complex tasks for long periods.
He was also left with a brain injury, which has resulted in short-term memory impairment, impaired concentration, reduced processing speed and “executive deficits”.
The NHS denied liability for the injury, claiming that Dr Hakmi's stroke was not serious enough to warrant thrombolysis and that it would have been too long after his symptoms began to be effective.
Such treatment can also be risky, carrying a significant risk of brain haemorrhage and death, and even if he had been given it the outcome would probably have been the same, lawyers sad.
They also accused Dr Hakmi of “fundamental dishonesty” in relation to the way he performed in testing before the trial.
As well as the “very bad” IQ score, he had scored at the very bottom of the range in memory tests, NHS barrister John de Bono KC told the court.
He said that Dr Hakmi had scored only 84 on an IQ test, putting him below 86 per cent of the general population, adding: “That's very bad - it suggests it would be hard to function as a surgeon or as an educator at that level.”
He had also been assessed by two neuropsychologists, who had performed memory tests, with “very surprising” and sometimes “astonishing” results which he said raised a “serious concern about whether he was putting forward his best effort” in the tests.
Dr Hakmi was unable to recall more than four single digit numbers in a row during one examination and scored so low in the tests that in some respects he was below 99% of the population, despite continuing to work as an “educator” at undergraduate level.
But Dr Hakmi denied playing up for the medics who assessed him pre-trial, telling the court he had found the tests “exhausting”.
“Anybody can fail a test but they must be given the best chance,” he continued.
“I definitely have a memory problem, slow effort. I have done everything to mitigate my losses. I know definitely I'm not as before I had the stroke.”
Ruling on the case, Judge Pittaway said: “Having considered the totality of the evidence, I have concluded that the claim that Mr Hakmi has been fundamentally dishonest fails.
“I do not consider that the defendants have established to the civil standard that Mr Hakmi was dishonest whilst being examined by the defendants' experts.
“I have had the advantage of observing Mr Hakmi being cross-examined for a full day...I do not consider that he was trying to mislead the court in any way.
“He is a proud man against whom a serious allegation has been made which, if found proven, could have serious consequences on his registration and employment.
“He has also adduced statements and letters from four colleagues at the hospital which attest to his honesty and integrity, as well as the steps that he has put in place to mitigate his disability following his stroke.
“I find that Mr Hakmi honestly believes that the diagnosis and treatment he received was suboptimal and that if he had been treated with thrombolysis, then, he would have made a full or nearly full recovery.”
Despite finding that Dr Hakmi was not dishonest, the judge found in favour of the NHS on his negligence claim and rejected his compensation bid.
He said Dr Hakmi's stroke symptoms were not serious enough until it was too late for the thrombolysis treatment to be provided within the four-and-a-half hours cut-off time.
Due to the Lister Hospital's protocols, the fact he had had that sort of treatment for his first stroke recently was also “an absolute contra indication for further thrombolysis.”
And even if he had undergone the thrombolysis treatment, the judge said it would not have made a difference to the level of Dr Hakmi's recovery.
“I have concluded that thrombolysis would probably not have altered the outcome in this case, in circumstances where Mr Hakmi has made a very good, if imperfect, recovery from his second stroke.”
The judge dismissed Dr Hakmi's compensation claim, but also the NHS' fundamental dishonesty allegation, ordering the NHS to pay 15 per cent of the surgeon's costs of the case.
The damages claim was against the East and North Hertfordshire NHS Trust, which runs the Lister Hospital, and the Norfolk and Norwich University Hospital NHS Foundation Trust, where the remote stroke doctor who spoke to Dr Hakmi was based.
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