A Malaysian cosmetic surgeon practicing in New South Wales (NSW), Australia has had his medical registration annulled by authorities as he admitted to taking a sedative and falling asleep in the middle of a liposuction procedure on a patient.

The Health Care Complaints Commission (HCCC) found Dr. Chin Kuen (Tony) Tan, guilty of professional misconduct for his actions at his clinic in Fairfield, committed on 4 July 2014.

The NSW Civil and Administrative Tribunal (NCAT) heard on 15 and 16 August 2016, that Dr. Tan was performing liposuction on a patient's neck when he administered himself 1 to 2ml of Propofol, a strong sedative.

He fell asleep for an hour before waking up and completing the operation. Dr. Tan told the HCCC it was the only time he used drugs on himself prior or while performing a procedure on a patient.

The NCAT also heard that several days after the incident (7 July), his brother-in law found him unconscious again at the clinic and he was consequently rushed to Liverpool Hospital for treatment. The hospital's officials reported his Propofol use to medical authorities and Dr. Tan closed his clinic on July 2014 to enter rehabilitation for drug and alcohol addiction.

Other malpractices since 2013

The HCCC also found that Dr. Tan wrote prescriptions for Pethidine, a painkiller, for two patients on separate occasions - 20 November 2013 and 16 June 2014 - but kept the drugs for himself. He was also reprimanded for performing a "significantly below reasonable standard" nose job on a 29-year-old woman.

The woman requested for a minor change to the tip of her nose in February 2014, but the operation dramatically changed her appearance, and made breathing and sleeping difficult.

Following the ordeal, he paid an unnamed physician to travel from Malaysia to perform a second surgery on the woman a month later. The woman was under the impression that the Malaysian doctor was only there to assist, and Dr Tan would perform the operation himself.

Tribunal unconvinced by Dr. Tan's attitude

After the hearing, the NCAT was not convinced that Dr. Tan understood his obligations and ethical wrongdoings. They took into account the fact that he was being treated for a mental health condition as well as drug dependence.

His lawyers claimed that Dr. Tan's drug problem was under control, and he had embraced prayer to "address his vulnerabilities". However, the Tribunal made a final ruling that they "have little confidence at this stage that the respondent has a mature, and well-developed understanding of his ethical and professional obligations".

Dr. Tan can have his medical registration reviewed in a year upon application. Meanwhile, the clinic has been operating continuously since April 2016, and has an operations manager, a doctor and two nurses. It opens on Tuesdays and Wednesdays.

NSW to crackdown surgery industry

In June 2016, the NSW Government announced a crackdown on the state's cosmetic surgery industry. From 2017 onwards, procedures such as breast implants, tummy tucks and liposuction, will need to be carried out in facilities that have the same licensing standards as private hospitals.

The Medical Board has also implemented tougher national guidelines for doctors who perform cosmetic surgery, including mandatory cooling off periods for patients who choose to undergo surgery and stricter guidelines for providers. MIMS

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Sources:
https://www.caselaw.nsw.gov.au/decision/583fa9efe4b058596cba2123
http://www.abc.net.au/news/2016-12-13/nsw-cosmetic-surgeon-deregistered-after-falling-asleep/8117066
https://tenplay.com.au/news/national/december/nsw-surgeon-deregistered-after-falling-asleep-during-procedure