An unqualified cosmetic surgeon who put patients at grave risk by excessively sedating them during tummy tucks, breast augmentation, liposuction and facelifts in Toronto’s tony Yorkville neighbourhood has been ordered to stop by Ontario’s medical regulator.

The order Tuesday against Dr. Eli Judah, following his admission to incompetence and misconduct with 29 patients, means his Yorkville Cosmetic Surgery Clinic can now offer only lip injections and hair transplants, although even the hair transplants remain under review, and may yet be prohibited.

It also caps a series of parallel investigations launched by the College of Physicians and Surgeons of Ontario after the deaths of two women who underwent cosmetic surgery in Toronto, in which other unqualified doctors have seen their licences suspended, restricted or revoked.

‘Dr. Judah was unable to cite any references, or colleagues who perform this procedure’

A tribunal on Tuesday found Dr. Judah used “extremely dangerous drugs without proper training,” and that his “cavalier” attitude to risk was “appalling.” but because he made a plea deal and saved the College the cost and effort of a contested hearing, his only punishment was a reprimand, and an order that he cannot do any cosmetic surgery that requires anesthesia. He must also pay the College’s legal costs of $3,650.

Dr. Judah, who once failed to properly store harvested fat that he later injected into a woman’s buttocks, escaped a more severe punishment that could have cost him his licence. In that case, he extracted the fat, froze it for 12 weeks at -4C, then thawed it at room temperature before reimplantation, with no testing.

“Dr. Judah was unable to cite any references, or colleagues who perform this procedure,” wrote an expert reviewer, who also found him “purposefully vague” about his minimal surgical training. In anesthesia, he was even less qualified, with six weeks experience in the United States with no “hands-on” training. Nevertheless, sedation at his clinic was performed by nurses he trained.

Dr. Judah went to medical school at McGill University and has been registered as a general practitioner in Ontario since 1988. He has not completed a formal surgical residency or certification process, and since 1999, has done only cosmetic surgery.

He disputes some of the findings in the expert reports filed with an agreed statement of facts, but concedes he was incompetent in cosmetic surgery and that he failed to maintain the standard of practice of the profession.

In one of those reports, Dr. Leonard Harris, a plastic surgeon, observed a breast augmentation and had “major concerns” about his use of “conscious sedation,” which implies the patient is easily rousable, which Dr. Harris doubted because the woman was “snoring” and had “obvious airway obstruction.”

A chart review found several instances where anesthesia records about patient condition had been “pre-checked,” rather than based on actual observation.

There was a tense moment after the hearing, when Dr. Judah went into an small meeting room and refused to leave because photographers for the National Post and Toronto Star were waiting outside the College building.

Fifteen minutes later, he came out and said his case is an example of “legislative pressures” provoking a College investigation, and that the cosmetic surgery industry has “borne the brunt” of this suspicion.

Unmentioned in the day’s events was Krista Stryland, who died in 2007, aged 32, after a liposuction procedure. her case brought public attention to the problem of unqualified cosmetic surgeons, and reached a conclusion last month when her anesthesiologist, Bruce Liberman, lost his medical licence. In December, Behnaz Yazdanfar, the unqualified cosmetic surgeon who performed the operation, had her licence suspended for two years and was banned from any future solo surgeries.

‘[Dr. Judah used] extremely dangerous drugs without proper training’

But there was another death, about which less is known, that played a similar role in sparking the College to action on unqualified cosmetic surgeons, and it happened in Dr. Judah’s clinic.

In December 2006, a woman died two days after Dr. Judah performed liposuction and an abdominal panniculectomy, or the removal of hanging fat and skin. four months later, according to a ruling of the Ontario Court of Appeal, “the College received a letter from the Office of the Chief Coroner advising that his investigation made him suspicious that there might be an issue around the quality of care provided to the patient prior to her death.”

That September, Ms. Stryland’s death caused a public outcry.

In its ruling, which also involved Dr. Liberman and others, the Ontario Court of Appeal ruled the College was within its rights to order observation of the risky cosmetic procedures by doctors suspected of misconduct or incompetence. That decision enabled the investigation that has now led to Dr. Judah’s reprimand and restrictions, among others.National Post• Email: jbrean@nationalpost.com

Nips, tucks & tragedy: Regulator orders Yorkville doctor to stop surgeries after admission of incompetence