Doctor guilty of professional misconduct

A DOCTOR who e-mailed photos and medical information about one of his patients to RTÉ’s Liveline has been found guilty of professional misconduct and poor professional performance by the Medical Council.

Dr Laszlo Ruscsak, a consultant anaesthetist who worked at Haven Cosmetics in Stillorgan in Dublin, failed to provide a psychological review or counselling for Lucia Dowd in advance of arranging a gastric band operation for her in a hospital in Hungary in October 2009. He also failed to adequately respond to her contacts following the operation.

Ms Dowd, from Lucan in Dublin, told a Medical Council fitness to practise inquiry she was a “classic yoyo dieter” and her weight was affecting her health. She found Dr Ruscsak on the internet because she could not afford to have the gastric band procedure, which would restrict food intake and help her lose weight, carried out in Ireland. He offered the operation in Hungary and said he would provide two years of aftercare in Dublin. She went to see him and a few days later agreed to have the operation at a cost of €7,000. She gave him €3,500 in advance.

The operation was arranged for October 21st, 2009, and Ms Dowd, who was suffering from depression, flew to Budapest with Dr Ruscsak the night before.

“I got alarmed when I saw the hospital; it was very old. I knew things wouldn’t be as modern as in Ireland, but I got a bit freaked,” she told the inquiry. No one at the hospital, including the operating surgeon, spoke English and Dr Ruscsak left to see his family three hours away.

A fellow patient helped by translating for her, she said. When she returned home the following day, she began retching and vomiting and she contacted Dr Ruscsak in distress. He trivialised her problem and told her to calm down, she said.

She eventually called an out-of-hours GP who gave her treatment for dehydration. When she returned to Dr Ruscsak to have her stitches removed she told him she was unhappy with his aftercare. She paid him €1,000, but said she would not pay the balance until she was satisfied he would provide proper aftercare.

Later that day, he e-mailed her to say he was withdrawing her aftercare package. When she said she would have to talk to her solicitor he replied with “inappropriate language” and “You have right to sue me at any time – I am not afraid of it LoL ”.

Ms Dowd found someone else to provide her aftercare, but was still ill, vomiting a black substance, and in the summer of 2010 she had an operation to have the band removed at Tallaght hospital.

She was putting the matter behind her, when she heard complaints about Dr Ruscsak on Liveline so she phoned using a pseudonym.

RTÉ then contacted her to say the doctor had sent photos of her and medical information. “I was absolutely appalled, I couldn’t believe he could do such a thing,” Ms Dowd told the inquiry.

Also giving evidence, her friend Patricia Byrne described accompanying Ms Dowd to her first appointment and being alarmed that Dr Ruscsak answered the door of what seemed to be an apartment in tracksuit bottoms and flip flops. During the appointment, he told Ms Byrne she was also suitable for gastric band surgery to avoid “midlife weight gain”.

Expert witness Prof Donal O’Shea, consultant endocrinologist and physician at St Columcille’s Hospital, Loughlinstown, told the inquiry waiting times at St Columcille’s and St Vincent’s for people with body mass indexes (BMI) of over 50 was six months for the first visit and for those with BMIs over 40, it was two years. “That is why this medical tourism is happening,” he said.

Dr Ruscsak, who had also worked for the HSE in several public hospitals, did not travel from Hungary for the hearing. The Medical Council will decide what sanction should be applied.