A Toronto cosmetic surgeon has been found guilty of professional misconduct after performing liposuction work on a woman who later died.
Dr. Behnaz Yazdanfar was found to be incompetent in the care of liposuction patient Krista Stryland, and another woman, by the Ontario College of Physicians and surgeons.
Both patients underwent the operations in 2007 at the Toronto Cosmetic Clinic.
She was also found incompetent in her care of fat-removal patients in her practice from 2005 to 2007, and two patients who had breast augmentation work done in 2007 and 2008.
In total, Yazdanfar was accused of failing to maintain the standard of practice of the profession and incompetence in respect to 28 patients.
In Stryland's case, a 2009 disciplinary hearing heard that she was unresponsive an hour after being left in a room to recover from the surgery, which removed 6.6 litres of fat.
According to evidence, however, the clinic did not call 911 until 40 minutes after Stryland became unstable.
Paramedics later found Stryland in a pool of blood, it was heard.
According to evidence also heard at the hearings, Ontario guidelines say five litres of fat is the maximum that can be removed from a patient.
In its findings, released Wednesday, the college said: "Dr Yazdanfar failed to consider that she was performing inappropriate surgery when, even after the death of Ms Stryland, she continued to do large-volume procedures."
Yazdanfar's lawyer Clayton Ruby declined to comment on the case on Wednesday.
During the hearings, Yazdanfar said she would consider altering her practices in the future.
"I'll consider smaller repeat procedures," she said. "The higher the volume the higher the risk ... if I have to I will follow other guidelines to avoid being attacked."
However, in its decision, the college said Yazdanfar continually denied responsibility for the death of Stryland, to the extent that she claimed her contribution was nothing more than accepting her as a patient in the first place.
The college also said she demonstrated an "unjustifiable overconfidence" with regard to her care of patients.
The document went on to say that Yazdanfar did not know what to do in a crisis because she either had insufficient training or expertise.
With regard to another patient, the hearing heard that after surgery the woman's husband had to cover her bed with garbage bags after she began bleeding.
Rather than the usual recovery time of two weeks, it took the woman nine months to get back to normal, the hearing heard.
On top of the findings about Yazdanfar, an anesthesiologist who worked at the clinic, was also found to have committed professional misconduct in Stryland's case.
Dr. Bruce Liberman was said to be incompetent in his post-operative care of Stryland.
The college said his failure to treat the patient's low blood volume and call 911 when his initial treatment failed was disgraceful, dishonourable and unprofessional conduct.
The college found that Liberman refused to bring forward evidence that he alone "could have brought before the tribunal" and that he chose not to testify about the "missing documentation" from a patient's chart.
The report said that although Yazdanfar and Liberman need to work as a team, they did not.
College spokeswoman Kathryn Clarke said the committee plans to hold penalty hearings for the doctors in the future.
The hearings could result in fines and restrictions on licences, licence suspensions or licence revocation.
