A cardiologist who went on to ask a Northampton patient to sexually excite herself was still able to work despite a similar incident three years before.
A tribunal panel yesterday struck off Dr Nilesh Jagjivan after hearing he made the lewd suggestion to a medical student - 'Miss A' - who he had offered to examine while he was a locum cardiologist at Northampton General Hospital in 2017.
And it has now emerged that a previous tribunal panel that failed to ban Jagjivan for asking the same thing of a Leicester patient in 2013 did so after the doctor told them he was not sexually interested in either men or women and had never had sex.
The same panel -sitting in 2016 - also heard from witnesses who said Jagjivan had never engaged in sexual banter and he had not sought a sexual relationship with the woman, called 'Patient B'.
The 2016 panel found it proved that Jagjivan had indeed suggested that Patient B could stimulate herself to raise her heart rate but concluded that his conduct was not sexually motivated.
The 2016 tribunal held that the conduct was "deplorable" and amounted to misconduct, but did not find that Dr Jagjivan's fitness to practice was impaired.
Although Jagjivan could therefore not be banned, the 2016 panel could have issued a warning but did not do so. They did stipulate that he must have a chaperone while examining women, but he got around that by offering to examine the medical student during a ward round.
The High Court later ruled that Jagjivan's conduct was in fact sexually motivated but the doctor has appealed and no sanctions were ever put in place.
The 2016 tribunal decision meant Jagjivan was free to make a similar suggestion to Miss A at NGH the following year.
Hearings over the past week heard that the doctor also kissed and stroked her and touched her breasts while doing an echocardiogram despite her telling him "no" several times.
Yesterday panel chair Sara Fenoughty took the strongest action at her disposal, banning Jagjivan for life from the Medical Register with immediate effect.
She said: "The tribunal considered that Dr Jagjivan’s behaviour had been of a predatory sexual nature and had had a significant impact on Patient B and Miss A as set out in the evidence before this Tribunal and the 2016 Tribunal.
"It noted that while his misconduct with respect to Patient B was opportunistic, his behaviour towards Miss A was deliberate and planned.
"It found that he had violated both Miss A’s and Patient B’s trust and put his own interests first in both instances by disguising his sexual motivation within a clinical setting.
"It considered that both Miss A and Patient B had been vulnerable, being semi-naked and alone with a male doctor.
"The Tribunal considered that Miss A’s vulnerability was exacerbated by the fact Dr Jagjivan had a professional hold over her and she knew she had to work with him again the following day, as a very junior colleague."