Struck-off doctor labelled a predator

By REBECCA WALSH

New Zealand doctor Warren Chan has finally been struck off the medical register after performing liposuction on a woman with a history of anorexia.

The Medical Practitioners Disciplinary Tribunal said in a decision released yesterday that Dr Chan was a danger to the health and safety of the public.

"The tribunal wishes to make it plain it is of the firm view that Dr Chan is an unsafe practitioner ... the removal of his name from the register is in the interests of public safety which should outweigh all other considerations including the punitive effect of de-registration," it said.

The tribunal - unanimous in its decision to have Dr Chan struck off - had described his conduct in relation to the 29-year-old woman as "seriously negligent" and an abuse of the privileges which accompany registration as a medical practitioner.

The woman saw Dr Chan at his Remuera clinic in January 2001, seeking liposuction to her hips, arms, bottom, thighs and stomach. She drove home after the surgery and was left bleeding and in pain for weeks.

She told the tribunal that much of the consultation had concentrated on the cost of the surgery.

The tribunal found, among other matters, that Dr Chan failed to exercise proper professional judgement in offering liposuction given the woman's history of eating disorders and failed to obtain informed consent.

It said her discharge on the same day as surgery was unsafe and noted failures with Dr Chan's surgical practice and post-operative care.

"The tribunal was left with the distinct impression that Dr Chan's attitude towards Ms A was mercenary and predatory, and took advantage of her vulnerability ... "

Dr Chan, whom the tribunal had previously found guilty of five charges of professional misconduct and four charges of conduct unbecoming, was found guilty of disgraceful conduct, the most serious of charges.

The tribunal can have doctors struck off the register only if they are found guilty of disgraceful conduct, have been practising beyond their certificate's limits or are convicted in court of a serious offence.

In her submissions to the tribunal, Kate Davenport, lawyer for the Complaints Assessment Committee, said it was the fourth time Dr Chan had appeared before the tribunal. He had also faced three charges before its predecessor, the Medical Practitioners Disciplinary Committee.

Ms Davenport said the decisions showed Dr Chan showed little regard for the need to fully inform a patient of the risks of any operation or to attend properly to consent procedures. He demonstrated little need to monitor patients during and after an operation and to deal promptly with their concerns and fears after surgery.

Despite the many charges laid against him, Dr Chan did not appear to have made any changes to his practice or to have heeded the criticisms of earlier committees, she said.

Professor John Campbell, president of the Medical Council of New Zealand, said the council was relieved Dr Chan had finally been removed from the register.

It had recommended that under the new Health Practitioners Competency Bill, all possible disciplinary action be available for all levels of offence, allowing the tribunal to deal with repeat offenders, even at a lower level.

The council would notify its counterpart in Australia, where Dr Chan is thought to be working.

Dr John de Waal, president of the New Zealand Foundation for Cosmetic Plastic Surgery, said the decision had been a long time coming, but vindicated the foundation's belief that Dr Chan was a danger.

"The word recidivist has been used in the past to describe him. I think it's probably a good word."

Dr Chan, who no longer lives in New Zealand and who in July asked that his name be removed from the medical register, was fined $15,000 and ordered to pay $23,913.99 in costs.

The Chan files

Before the Medical Practitioners Disciplinary Committee:

November 1993

Guilty of professional misconduct based on charges involving liposuction treatment of four women between February 1989 and October 1990. Censure, $900 fine, $64,000 costs.

December 1994

Guilty of professional misconduct in three respects, February-March 1992, relating to the care of a woman. Censure, $900 fine, $17,000 costs.

November 1996

Guilty of conduct unbecoming in management of a breast-surgery patient in 1993. Censure, $400 fine, 40 per cent costs.

Before the Medical Practitioners Disciplinary Tribunal:

October 1999

Guilty of professional misconduct in liposuction treatment of woman patient in May 1996. Censure, $975 fine and to undertake Ethics Review.

March 2001

Guilty of professional misconduct in liposuction treatment of woman in July 1996. Censure, suspended 9 months, must practise under supervision, $12,500 fine, $19,000 costs.

November 2002

Guilty of professional misconduct in respect of three women in 1995, 2000 and 2001. Guilty of conduct unbecoming in respect of four women between 1994 and 2000. Censure, $15,000 fine, suspended 3 years, conditions on practice, $73,412 costs.

March 2003

Guilty of disgraceful conduct in liposuction treatment of woman patient in January 2001. Censure, removal from register, $15,000 fine, $23,913.99 costs.