Defence case begins in €700,000 fraud trial

A consultant surgeon charged with a €700,000 breast cancer insurance fraud broke down in tears at Dublin Circuit Criminal Court as he described the day he said his wife discovered a lump in her left breast.

"I’ll never forget it," said Dr Emad Massoud. "She was taking a shower because we were going out to celebrate her birthday. As a human being you don’t think the worst is going to happen to you."

Dr Massoud (aged 52) and his wife, Mrs Gehan Massoud (aged 43), of Woodview, Brownstown, Ratoath, Co Meath have pleaded not guilty to intent to defraud two companies by falsely pretending that Mrs Massoud had suffered breast cancer and that there was an obligation on them to settle serious illness claims.

They deny intent to defraud €685,658 from Scottish Provident Ltd on March 25, 2002 through having it made payable to Permanent TSB and €45,338 on February 22, 2002 from Lifetime Assurance Company Ltd by having that sum transferred to their account at the Bank of Ireland in Letterkenny, County Donegal.

Dr Massoud told his defence counsel, Mr John Peart SC (with Mr Charles Corcoran BL), that his wife discovered the lump in September 2001. He said she had suffered injuries to her breast during a car accident eight months previously and he first thought the lump was caused by that and would therefore be benign.

He said he would not suggest to any patient to excise a lump before first carrying out a biopsy to establish if it was benign. He said "other protocol" would include a patient getting a mammogram to test if the lump was malignant but his wife was "in a panic" and he decided not "to follow standard medical protocol".

Earlier, Dr Massoud told the jury that he received a joint degree in medicine and surgical medicine from his home city of Alexandria in Egypt and he then spent four years as the only doctor for a community of 150,000 people in a remote mountain village in Egypt.

He was responsible there for carrying out a large range of surgeries from amputations to caesarian sections, in poor lighting conditions, because the main hospital was too far away for most of his patients to travel.

He said he met his wife in 1985 and they moved to England to secretly marry because they were from different religious backgrounds which would have caused trouble for their families.

Dr Massoud said he spent the next number of years working in hospitals in Mullingar, Co Westmeath, Letterkenny, Co Donegal, Bantry, Co Cork, Enniskillen, Co Fermanangh, the Mater Hospital in Dublin and also in Norwich and Chesterfield in England.

He said that 11 years ago he decided to settle down for a better family life after his second child was born and he moved to Castleknock, in Dublin, having decided to set up his own private practice.

Doctor Teresa Wilson, a lecturer in DNA analysis and witness for the defence, told Mr Cormac O Dulachain SC (with Mr Seamus Clarke BL), for Mrs Massoud, that she compared the cancerous breast tissue sample alleged to have been taken from Mrs Massoud with a blood sample from the accused to see if the DNA matched.

She found a lot of failings in her readings and concluded that the DNA in the tissue sample was so degraded that any results would be unreliable.

She added that a tumour formed following genetic damage in the cells and therefore it would often be found that DNA extracted from such a cell would not match the DNA of the person it was taken from.

Dr Wilson said that research had shown that the places in the DNA where this was most likely to happen were in those locations that were commonly tested in DNA analysis.

Dr Wilson told Mr O Dulachain that she would therefore be "very cautious" about taking DNA from a cancerous tumour for the purpose of DNA profiling.

She said she had six cases that she dealt with herself where tumours cells were used for DNA profiling and in all but one the DNA extracted from the blood was "an exact match" with the tissue donor.

Dr Wilson told Mr Dominic McGinn BL, prosecuting, that she agreed with the conclusion from the State’s forensic witness, Dr Maureen Smith, that the tissue sample did not match the blood sample from Mrs Massoud but she had a different opinion as to why the samples didn’t match.

She accepted that in the six cases she tested only one person had a different DNA profile in their blood to that of their cancerous tissue and there was only two "mismatches" between the locations compared, whereas in Mrs Massoud’s case there were five "mismatches".

"Yes but that was a very small sample I tested," she replied to a query by Mr McGinn on this.

She agreed that if these results had been obtained after comparing a tissue sample found at a crime scene with a blood sample of the suspect, she could not come to court and say that the tissue sample belonged to the suspect.

She accepted a suggestion from Mr McGinn that if the tissue sample had come from Mrs Massoud’s mother, Dr Smith’s results, were "exactly" what you would expect.

Dr Wilson said she agreed with Dr Smith’s calculation of "probability of paternity" between the tissue sample and Mrs Massoud as being 99.53 % (percent) but said there was another possibility that this was a tumour tissue from Mrs Massoud and it had been genetically damaged which had caused the difference between the DNA profile of the blood and the tissue.

She accepted that DNA extracted from tumours and non-tumorous cells from the breast tissue matched each other but didn’t accept that this implied that no genetic change had taken place because of the cancer.

"It’s my understanding that this tissue was taken from an area close to the tumour, so it could have been affected by the same DNA changes as the cancerous cells," Dr Wilson replied.

The trial continues before Judge Patrick McCartan and a jury of four women and seven men.