GP did clinically unnecessary breast exams

A Sydney doctor carried out unnecessary breast examinations on two women, pulling at their nipples and making the demeaning comment "bunch of grapes" to one patient, a tribunal has found.

Tharumalingam Sinnathurai also breached Sexual Boundaries Guidelines by saying "you wouldn't want to get fat", suggesting a patient could spend money to buy a new dress and commenting how unattractive women are to men if they get drunk.

The NSW Civil and Administrative Tribunal on Thursday found him guilty of unsatisfactory professional conduct and professional misconduct but will impose a penalty on a later date.

It found he was not motivated by sexual gratification, but had breached sexual boundaries in several respects.

He carried out unnecessary breast and abdominal examinations on two patients, aged 18 and 28, while working as a GP in a medical centre in Merrylands in 2019.

"If his motivation was to properly care for his patients, then he should have armed himself with the clinical knowledge and expertise necessary for him to do so," the tribunal said.

"Even if these examinations had been justified, he performed them in an arrogant and insensitive manner."

The highly trained and experienced Sinnathurai was aged 71 at the time of the June hearing of complaints brought by the Health Care Complaints Commission,

The teenager, who wanted to renew her prescription for the pill, was told if she used a cheaper brand she could use the money to buy a dress or something.

He also said: "You wouldn't want to get fat. I recommend to all my patients, no sugar, bread or potatoes and you will be slimmer. Your weight will change but I expect that you will lose weight when you come for your next visit."

The third inappropriate comment related to no man liking a drunk woman.

"Making three sexual remarks to Patient A during the consultation constitutes a pattern of behaviour," the tribunal said, noting it exploited the power imbalance between doctor and patient.

He also inappropriately examined the woman's torso for acne, inappropriately conducted breast and abdominal examinations, and even if they had been appropriate did not obtain her informed consent.

He had massaged the patient's breasts with both his hands and pulled her nipples upwards, saying words to the effect of "it's like holding a bunch of grapes".

"There is no clinical reason to manipulate a patient's breast in that way," the tribunal said.

"We are satisfied that Dr Sinnathurai did so while demonstrating his point about the breasts of pregnant women looking like a bunch of grapes. Patient A was not pregnant."

The second patient had wanted a blood test to confirm she was pregnant, but was also subject to the two unnecessary examinations.

The tribunal found Sinnathurai inappropriately squeezed and twisted each of her breasts and squeezed her nipples hard.

"The abdominal examinations of Patient A and Patient B are more serious because they involved pulling down the patients' clothing, in one case exposing pubic hair, and carrying out an unnecessary physical examination without consent."

The tribunal found no mitigating factors.

"Dr Sinnathurai partially undressed and dressed these patients and did not offer a chaperone or even give them a sheet to cover themselves.

"While not meeting the definition of 'sexual abuse or exploitation' or 'sexual assault', which are at the highest end of the spectrum, these examinations involved a very significant departure from the standards of ethical practice.".