The New York plastic surgeon, who operated on a Limerick woman before she collapsed in his surgery on March 15th and later died, admitted at least two counts of negligence on a patient he had earlier treated, according to a report issued by the New York Board of Professional Medical Conduct and shown to The Irish Times yesterday.
The report's findings, which banned Dr Michael Evan Sachs from performing certain unsupervised cosmetic operations and placed him on probation for three years, became effective in February 2004, six months before Kay Cregan (42), is thought to have seen a feature on his work in an Irish Sunday newspaper magazine.
The professional conduct board found that Dr Sachs "did not contest the charge of negligence on more than one occasion," following an investigation of his practice. The investigation followed a series of complaints by a "Patient A", treated by Dr Sachs between May 1985 and December 1993.
On January 9th, 2004, Dr Sachs signed a consent agreement in which he admitted he "treated Patient A inappropriately over the course of a multiple nasal surgical procedures and failed to keep appropriate records". He also agreed to undergo three years probation, to hand over all documents requested and to meet any agent sent by the board.
It ruled that Dr Sachs could not perform complex nasal surgery without the supervision of a plastic surgeon with at least 10 years experience. Any supervising doctor would have to be certified by the American Board of Plastic Surgery or the American Board of Otolaryngology and have a fellowship in facial-plastic surgery.
The ban on Dr Sachs's solo operations included surgery that involved more than two planned procedures as well as "serial reconstructive procedures" including corrective surgery on congenital malformations. He specialised in reworking unsuccessful plastic surgery by other doctors, most of which was covered by the ban.
However, the board ruled that Dr Sachs could carry out routine procedures, including "routine nasoplasties, open rhinoplasties and cartilage or synthetic grafts".
The ruling followed serious complaints from a patient whose corrective surgery at his clinic went seriously wrong.
His lawyer, Jay Butterman, said the ban did not extend to the type of straightforward nasal surgery performed on Ms Cregan. Dr Sachs had performed more than 30,000 operations, he added, and Dr Sachs and his staff were not responsible for Ms Cregan's death.
Dr Sachs, who did not return calls yesterday, is a high-profile figure in Manhattan's thriving plastic surgery business.
Bill Van Slyke, a spokesman for New York's Department of Health, said Ms Cregan's death would be investigated, as were all unexpected deaths during surgery.