At his clinic in the chic Yorkville district of Toronto, where he offered cosmetic procedures such as tummy tucks, chin implants or breast augmentations, Eli Judah promoted his practice as a "safe and comfortable environment."
However, on Tuesday,Dr. Judah appeared before the College of Physicians and Surgeons of Ontario and was reprimanded for professional misconduct and incompetence in his treatment of 29 surgery patients.
Though he said he had trained in cosmetic surgery for three years, Dr. Judah was a general practitioner and wasn't certified as a surgeon.
In an agreed statement of facts, Dr. Judah admitted that he sedated patients excessively, without proper training or the help of a qualified anaesthesiologist.
He also admitted that he lacked training to administer intravenous sedation, that his nurses weren't appropriately trained and that he didn't properly store fat collected from liposuction.
The college's discipline committee banned Dr. Judah from injecting sedatives to his patients or performing cosmetic surgery, except for hair transplants.
He was also ordered to pay the college $3,650 for the costs of investigating him.
In an e-mail to the Globe after she was contacted to comment, Dr. Judah's lawyer, Dena Varah, underlined that none of the 29 patients "suffered any harm."
In 2009 and 2010, the college had mandated two expert plastic surgeons to investigate how Dr. Judah operated at his Yorkville Cosmetic Surgery Centre, on Bloor Street West, in an office block across the street from the Royal Ontario Museum.
Their reports were attached to the agreed statement of facts but Dr. Judah and his lawyer did not agree to their detailed contents.
"Dr. Judah does place his patients at risk as he does not appear to have adequate knowledge of the use and effects of the medications he uses to provide conscious sedation," said a May 11, 2010 report from expert Leonard Harris.
"Dr. Judah does not appear to recognize the signs of apnea, airway obstruction and the significance of decreased O2 saturations, nor their proper treatment."
Dr. Harris noted that Dr. Judah's three years of training in the United States in cosmetic surgery consisted of attending meetings and lectures and observing surgeries. "Dr. Judah had no formal 'hands-on' surgical experience" during that time, Dr. Harris wrote.
In another report, Dr. Harris faulted Dr. Judah for performing two major procedures, a liposuction and a tummy tuck, concurrently on an obese patient.
"We discussed the inherent risk of sedation in an obese patient ... we also discussed the increased risk of morbidity and death combining larger volume liposuction with abdominoplasty. Dr. Judah was not aware of this risk." Dr. Harris wrote.
A report, from February 5, 2010, raised concerns about the way the centre's nurses handled the patient's fat collected from liposuction, in glass containers which were opened and poured into other vessels.
Other reports mentioned a patient whose abdomen fat was collected and kept frozen, then grafted months later into her buttocks. "This is not a reasonable and safe approach to fat transplantation," Dr. Harris wrote.
Another expert, Craig Fielding, took issue with Dr. Judah's lengthy surgeries, which stretched over five hours.
"Dr, Judah describes himself as a general practitioner in cosmetic surgery. When asked if he tells patients he is not a surgeon, he answered 'I tell them I am not a board certified plastic surgeon," Dr. Fielding wrote.
"I consider this statement to be deceptive . . . In Canada, one is certified by the Royal College of Physicians and Surgeons of Canada as a surgical specialist, or one is not."