A second American psychiatrist allowed to work in New Zealand had been accused of having sex with a former patient in the United States, the Weekend Herald can reveal.
Dr Robert Ivan Fink began working for the Waikato District Health Board in August 2015, one month after fake psychiatrist Mohamed Siddiqui was arrested for using forged documents to work at Waikato Hospital.
Fink's employment as a locum in adult mental health services came 18 months after another American psychiatrist, Dr Paul Fox, left the DHB when he was exposed as facing misconduct charges in the United States.
Fox was eventually jailed in Connecticut for the sexual assault of a vulnerable teenage patient.
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Fink, from Seattle, was accused by his former American patient of sexual misconduct in November 2015, but he failed to tell Waikato DHB.
In April 2016, when notified the complaint was being investigated, he again failed to tell the DHB or alert the Medical Council of New Zealand, which is responsible for doctor registration.
It wasn't until July that year, when the outcome of that investigation was that Fink should have restrictions on his practice, that he made DHB managers aware of the situation.
He was immediately sacked and stripped of his registration in New Zealand.
But it was only after US-based private investigator Ken Kramer contacted the Weekend Herald, that the full details of the allegations against Fink came to light.
In the list of allegations against Fink, the State of Washington Medical Quality Assurance Commission said he was issued with a licence to practice as a physician and surgeon in 1978.
The Commission alleged that, as a psychiatrist, Fink began treating a woman known as patient A in 2007. He had first met patient C who later referred patients A and B - a couple - to do various repair jobs on his properties.
Patient A had attention deficit hyperactivity disorder [ADHD] and a history of substance abuse.
In 2011 Fink allowed the woman and her partner to move into his home, after which he allegedly began having sex with her.
"Patient A performed repair work on respondent's [Fink's] home and respondent and patient A went to the casino together," the licence surrender documents state.
"Respondent took patient A to the railroad tracks where he took photographs of her posing in a costume."
Fink also allegedly prescribed addictive chronic pain medications to all three patients without referring the trio to a pain management specialist.
The licence surrender document claims: "At no time did respondent attempt to properly evaluate pain levels, establish a treatment plan, document that he discussed the risks and benefits of treatment, and failed to document treatment alternatives prior to prescribing opioid pain medication".
The Commission said Fink violated the standard of care to the three patients by treating them when he was socially involved with them and the alleged sex with the patient amounted to sexual misconduct.
"In his first letter to the Commission, respondent stated that he thought it might be all right to treat friends on occasion but later realised that he was unable to manage their health care needs appropriately, and as intended."
The Commission claimed Fink also dismissed several indications that patient A was still abusing substances, including her openly admitting that she misused substances.
Fink surrendered his licence to practise in Washington state on September 21, 2016 but kept ties with New Zealand, returning to Hamilton to undertake film studies at Wintec. He also has shares in a popular city bar.
Fink told the Weekend Herald the allegations had "nothing to do with New Zealand".
When asked why he did not disclose the complaint to Waikato DHB and the Medical Council as obligated to do, Fink said "that's not an accurate statement" and declined to talk about the matter further.
Kramer, who runs PsychSearch.net - a website dedicated to compiling records on psychiatrists - said Fink was no longer registered in the US, but no charges had been laid against him by police there.
The same month Fink joined the Waikato DHB, an inspection of its mental health services was undertaken by the Ministry of Health after the death of Nicky Stevens in March 2015, and other serious events.
The inspection report, released in April 2016, specifically addressed the recruitment of Siddiqui, the doctor who posed as an American-trained psychiatrist of the same name, saying Waikato DHB had undertaken best practice in the recruitment and there were no obvious red flags.
Medical Council deputy chief executive Aleyna Hall said since the Fox case, the council had gone to greater lengths to get information about doctors applying to work in New Zealand if they disclose a complaint.
Medical Council chairman Dr Curtis Walker said the council had a zero-tolerance position on doctors who breached sexual boundaries with a patient.
In Fink's case, because the complaint came after he was registered, Walker said they relied on Fink to notify them or colleagues overseas to raise concerns.
"Doctors have an obligation to inform us immediately in these circumstances."
As part of registration, the council obtains a certificate of professional status which notifies any complaints, investigations, or disciplinary action, and asks questions about a doctor's health, conduct, character, and professional competence.
"Dr Fink did not make any disclosures to us on his application form. We do not specifically ask the doctor whether they have had a sexual relationship with a patient as this is covered in the question: 'Have you ever breached any code of ethics relating to boundary issues regarding patient relationship?'."
The Weekend Herald put questions to Waikato DHB about Fink on Wednesday; however, the DHB said it would treat the questions as an Official Information Act request which gives it 20 working days to respond.
Former acting chief executive Derek Wright previously said no concerns had arisen in Fink's clinical practice for the DHB.
"Dr Fink saw the vast majority of his patients in the company of another member of staff or family member. He was respected by his patients and their families and has been described as professional and appropriate in all his dealings with others."