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Man says urologist who botched procedure already was under investigation

By: Chris Dickerson

December 8, 2022

CHARLES TOWN – A Harpers Ferry man says a urologist who allegedly botched a procedure on him was under investigation and already had been reprimanded for injuring patients because of visual and dexterity problems.

Larry Thomas Krial filed his complaint November 30 in Jefferson Circuit Court against Dr. Mohammed Mohiuddin and Frederick Urology Associates PA, which is based in Maryland but has a facility in Charles Town.

According to the complaint, Krial presented to Mohiuddin at Frederick Urology’s Charles Town office on October 13, 2020, with complaints of urinary frequency. Mohiuddin recommended Krial continue taking his medications and scheduled a cystoscopy and TURP operation.

TURP, or transurethral resection of the prostate, is a surgery used to treat urinary problems caused by an enlarged prostate.

Later in the month, Mohiuddin performed the TURP operation on Krial at Jefferson Medical Center. After the operation, Krial says he was experiencing severe pain and pressure. Another doctor tried to contact Mohiuddin multiple times without success.

That doctor eventually contacted the on-call urologist at nearby Berkeley Medical Center who told him to change the Foley catheter, to assist in removing a clot and to contact Mohiuddin for further orders. He also irrigated the catheter multiple times, but there was no urine output. A repeat bladder scan showed Krial had retained fluid.

After several hours, Mohiuddin evaluated Krial and performed the cystoscopy for clot evacuation. Two days later, Krial was discharged with a Foley catheter, antibiotics and told to follow up with Mohiuddin as soon as possible.

On November 5, 2020, Krial says he went to Mohiuddin. He said he had pain and swelling in his genitals. The catheter was removed, and he was diagnosed with urine retention and benign prostatic hyperplasia with lower urinary tract symptoms. He was given medication and told to follow up in three months.

From January 1 to August 1, 2021, Krial presented to various doctors on at least six occasions with complaints and diagnoses that included blood in his urine, frequent urination, benign prostatic hyperplasia, urinary tract infection, chills, abdominal discomfort and aches.

On August 3, 2021, Krial went to Dr. John Riordan at University Urology Associates in Martinsburg. He performed a cystoscopy that revealed residual obstructing prostate tissue. Krial was given antibiotics and taught how to self-catheterize. He also was scheduled for a possible TURP “re-do.”

On April 27, 2022, Riordan said Krial’s PSA was elevated, saying prostate cancer needed to be ruled out before the possible TURP “re-do.” On June 9, Riordan performed a greenlight photovaporization of Krial’s prostate. It was noted Krial had “an abnormal adhesion involving the prostatic urethra … resulting in two channels that the scope could pass through to enter the bladder. There was also residual obstructing tissue involving right lobe of prostate.”

At a July follow-up, Riordan noted Krial was doing well and had not self-catheterized since the June procedure.

At the time of the 2020 TURP operation, Krial says Mohiuddin already was under investigation by a Maryland health care facility and/or the Maryland Board of Medicine for injuring patients during procedures while experiencing visual and dexterity problems.

A consent order noted a staff member reported Mohiuddin exhibited visual problems during a June 2, 2020, procedure to remove a kidney stone.

“Mohiuddin repeatedly asked the staff member to tell him when the guide wire was in the patient’s kidney,” the complaint states.

Two days later, the complaint states, Mohiuddin could not visualize a 3×4 cm bladder mass despite passing by the mass several times with a cystoscope. Mohiuddin then was suspended by the facility from performing surgical procedures and referred him for medical examination. His surgical suspension was lifted, but Mohiuddin was required to wear his prescription lenses during surgical procedures.

Another incident details a staffer saying Mohiuddin was confused by 12 pre-labeled specimen cassettes during a prostate needle biopsy. He then was placed on a precautionary suspension but later reinstated.

And less than three weeks after he performed the TURP operation on Krial, Mohiuddin again displayed visual and dexterity problems during two procedures at a Maryland facility. He allegedly refused to wear his prescription lenses and had visible hand tremors.

In the first procedure, a patient’s bladder was injured because Mohiuddin had difficulty cannulating the ureter and couldn’t locate the ureteral orifice in the bladder.

“(He) doesn’t have his glasses on and won’t put them on,” a staffer alerted leadership in a text message. “He can’t see.”

In the second procedure, Mohiuddin allegedly supported his right hand with his left hand across his chest during an operation. When leadership again was alerted via text message, Mohiuddin was ordered to stop the procedure. Another urologist completed the procedure.

On April 28, 2021, Mohiuddin was deemed unfit to perform urological operations by the Maryland Board of Medicine and found to be professionally, physically and mentally incompetent. He license was suspended May 14, 2021.

Mohiuddin, however continued to practice in West Virginia. Krial says he presented to Mohiuddin on May 6, 2021.

On May 12, 2022, Mohiuddin’s license was placed on probationary status for five years. He is not allowed to perform any surgeries in West Virginia or on any West Virginia patients.

The complaint also notes Mohiuddin previously was investigated by both the Maryland and West Virginia Boards of Medicine.

In 2013, he was reprimanded in Maryland for failing to disclose the results of an abdominal ultrasound to a patient. The results showed malignancy, and she later was diagnosed with metastatic breast cancer.

In 2016, he was fined in West Virginia for providing inaccurate information in his 2015 application for license renewal after failing to disclose the 2013 reprimand.

Krial says Frederick Urology is vicariously liable because it knew or should have known of the issues associated with Mohiuddin and his employment. He also says Mohiuddin deviated from the standard of care, resulting in severe and permanent injuries.

He says the defendants acted with conscious, reckless and outrageous indifference to his health and safety

Krial seeks compensatory and punitive damages as well as court costs and interests. He is being represented by Ben Salango and Christian Huffman of Salango Law in Charleston.

Jefferson Circuit Court case number 22-C-143