The surgeon has sued Nine for defamation over a series of reports he claims ruined his reputation and set back his field of prosthetic limbs by 20 years.
The reports featured in The Sydney Morning Herald and The Age newspapers and aired on 60 Minutes in September 2022.
Nine defends the claims as true or otherwise protected as journalism in the public interest.
The company's barrister Matthew Collins KC continued cross-examining Dr Al Muderis in the Federal Court on Wednesday, asking about a patient who sought advice at a hospital in Melbourne after complaining following the insertion of an implant in his humerus.
Dr Collins suggested staff at The Alfred had identified something Dr Al Muderis missed months earlier, which the surgeon said was an inappropriate statement.
"Is this seriously your evidence?" Dr Collins asked.
"That (the doctor) should not be commenting on whether a CT scan shows your implant breached the head of the humerus of this patient?"
The surgeon, who told the trial on Tuesday it was not his nature to belittle his colleagues, clarified what he meant.
"Well, all I'm saying is that doctor … is a plastic surgeon, not an orthopedic surgeon," Dr Al Muderis said.
He told the court two documents showing the patient being consulted and operated on the same date was due to an erroneous date on one of the documents.
The surgeon said exceptional circumstances could prompt a practitioner to consider surgery on the same day of a patient's first consultation, although it was not the standard approach.
Dr Collins asked what the circumstances might be.
Dr Al Muderis responded: "I don't know, maybe they have a … I don't know … time is irrelevant."
"Medicine is not black and white and there are no standard rules," he said.
"Time is irrelevant as long as there is sufficient material given to the patient, sufficient understanding and sufficient information."
The patient later complained in a June 2016 email.
"This seems like the wrong implant," he said.
Dr Al Muderis saw the email for the first time on Wednesday and told the court the complaint was not factual.
Medical imaging testing indicated an infection and osteomyelitis when the patient later sought a second opinion at The Alfred.
Dr Al Muderis said the scan was not clinically relevant and the surgery meant it would return unreliable results.
He received a report from the hospital's osseointegration team.
"(The patient) feels frustrated by the whole negative experience, that means experience with you, doctor, and is worried he could lose his arm," Dr Collins said.
Dr Al Muderis responded: "That's what the person writing this letter is stating."
Dr Collins: "But you understood that didn't you?"
Dr Al Muderis: "That's what the person writing this letter is stating."
Dr Collins: "You don't accept things at face value do you doctor?"
Dr Al Muderis: "That's what the person writing this letter is stating."
The hearing continues on Thursday.
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