Tribunal told top facial surgeon punched patient in the face “like a boxer” during treatment

Ipswich Hospital where Peckitt worked. Archant

A top facial surgeon who punched a patient in the face during treatment to correct a cheek fracture hit him up to ten times ‘‘like a boxer’’ whilst the man’s head was being held by a colleague, a tribunal has heard.

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Former Ipswich Hospital surgeon Professor Ninian Peckitt, 63, was attempting to reduce the fracture when he unexpectedly curled his hand into a fist, pulled it back around six inches and struck the patient who was under anaesthetic.

An experienced dental surgeon who was then instructed to hold the patient’s head told the Medical Practitioners Tribunal Service hearing that there were ‘gasps’ from others in the operating theatre and she was left in a state of ‘total shock’.

The man, known as Patient A, had suffered serious injuries in an industrial accident which required facial surgery, but a cheekbone became displaced when he fell out of bed while in hospital, requiring a second procedure two weeks later.

Prof Peckitt, who was working as an honorary locum consultant in oral and maxillo-facial surgery at Ipswich Hospital, undertook both procedures.

Describing the second operation on February 14, 2012, to reduce the fracture to the left zygomatic bone, Erica Rapaport, an associate specialist in oral and maxillo-facial surgery and dental surgeon with more than 30 years’ experience said Prof Peckitt initially punched the man without warning colleagues.

“He made his hand into a fist and he hit the patient in the face on the left side of his cheek,” she said.

“His hand was about six inches away. I think the first time he punched the patient I wasn’t holding the patient and it was then that I was instructed to do so by Prof Peckitt.

“He said that when the patient fell out of bed, the cheekbone which was already fractured was moved outwards so he was trying to reposition the cheekbone without having to make further cuts to the face. He said this at least after the first punch. `

“He applied about ten punches like a boxer. He took aim and then punched. The first punch was unexpected and then he explained what he was doing. He spoke as he punched again and again.”

At the tribunal hearing in Manchester, Miss Rapaport was asked to clarify the analogy by panel member Dr Shazad Amin who suggested it implied Prof Pickett took a ‘larger swing’.

Asked if the punch was more ‘of a jab’, she added: “I meant he was looking to take aim. When I said it was like a boxer I meant he was carefully aiming where he wanted to hit. Then he pulled his hand back to get the maximum hit as he touched the patient’s face.

“I can remember a feeling of total shock the first time he hit the patient because I wasn’t expecting it and I think anyone who saw what happened was reacting in a similar way and then he asked me to assist by holding the patient’s head.

“[The punches] were his fist aimed at the side of the patient’s face. He was looking himself and inspecting it and asked if anybody thought the fracture had moved.

“I understand generally it is nice not to have to make an incision but I do not understand the uncontrolled nature of hitting someone. I didn’t challenge him at the time. I was too shocked.”

Prof Peckitt, formerly of Doncaster but now believed to be working as a consultant surgeon in Dubai, has elected not to attend the hearing but issued an email in which he ‘emphatically denies’ the allegations.

As well as the punching incident, he is alleged to have walked out of the hospital on March 29 of the same year without giving an explanation to patients or organising a handover of care. He did not return to his post.

He is also accused of failing to properly check medical records when treating a woman – known as Patient B – where he is said to have attempted surgery which had already been undertaken.

Miss Rapaport added that following the operation, Prof Peckitt told her to write that the cheek had been adjusted by ‘external pressure’ in her operating notes.

She said: “Prof Peckitt asked me to write up the note and I felt very challenged by what he had just done. I asked him if he would write it and he said he would dictate the exact words for me to write down.

“He said ‘the left malar was adjusted by external pressure’. They were precisely his words. I particularly [didn’t want to] write the note because accurately I would have had to write ‘Prof Peckitt punched the patient to try and move the left zygoma’ and that’s not something I would have wanted to do.

“I didn’t challenge him. Partly because he is a consultant and partly because I was so shocked that I didn’t have the strength to argue. I didn’t see any damage, I just thought it was a very unusual technique.

“I was holding his head very still. It must have moved a little [when he punched] but not much. Prof Peckitt is much stronger than I am so I could only give as much support as I could so it might have moved a little. If I asked you to hold something still then I punched it, you don’t know how hard someone is going to punch so you don’t know how much resistance to apply.”

Prof Peckitt has pioneered ‘engineering-assisted’ surgery techniques and written extensively on the subject, as well as cosmetic surgery.

Miss Rapaport said she came into the hospital on her day off to take part in surgery with Prof Peckitt to learn about his renowned techniques while he was working as a locum.

She added: “The benefits might be outweighed by the larger risks. Without control, punching a patient can lead to damage. That’s how some patients get fractured zygomas in the first place.

“I had seen so little of this man’s work that I didn’t know if it was a one-off or whether it was the way he worked.”

Panel chair Ian Spafford said: “You talk about people in the theatre gasping and they were as shocked as you. Who was gasping?”

Miss Rapaport replied: “I can’t remember. It was just a general sense of ‘wow’. If there was anyone in that theatre that could have stopped this it was me, but I didn’t because I was too overwhelmed.

“He is a consultant, he is older than I am, bigger than I am and has a very strong personality.”

In defence of Prof Peckitt, she added: “I did come to appreciate his manner and caring attitude towards patients and he was very much admired and liked by patients, including this gentleman we are talking about. They had a lot of faith in him.”

After graduating in medicine from the University of Sheffield in 1979, Mr Peckitt completed further training with the Royal College of Surgeons of England and became a Fellow of the Australasian College of Cosmetic Surgery in 2009.

The hearing continues.