A Virginia man whose doctors' discussion during his colonoscopy was recorded on his smartphone was shocked to discover that they had insulted him throughout his examination. The vicious words led to a lawsuit, and last week it resulted in a $500,000 verdict for medical malpractice and defamation against his anesthesiologist, Tiffany Ingham.

Ingham joked with an assistant about avoiding the patient after the procedure was done. "After five minutes of talking to you in pre-op, I wanted to punch you in the face and man you up a little bit," she told him after he went under anesthesia. She also said she would place a diagnosis of hemorrhoids on the patient's chart, even though he didn't have the condition. That false diagnosis was not contradicted by the gastroenterologist who was performing the colonoscopy, Soloman Shah.

A report about the lawsuit (including audio from the recording) published in today's Washington Post doesn't name the patient, who is identified only as "D.B." in court papers.

The verdict came after a three-day jury trial. Shah was dismissed from the case on the first day of the trial, so the verdict stands against Ingham and the medical practice she worked out of, called Aisthesis.

When an assistant told Ingham that D.B. said he got queasy watching a needle go into her arm, Ingham said: "Well, why are you looking then, retard?"

When the assistant pointed out that D.B. had a rash, Ingham told her if she "rubbed up against it" she might get "some syphilis on your arm or something." Then she said, "It's probably tuberculosis in the penis, so you'll be all right."

Ingham mocked the amount of anesthetic required to sedate the patient, and Shah followed that up with a comment that another doctor they knew "would eat him for lunch."

She also called him a "big wimp," saying, "People are into their medical problems. They need to have medical problems."

"I call it the Northern Virginia syndrome," said Shah. "Here it's holier than thou, too much Internet use, a little too much information."

The jury awarded $100,000 for the defamation, which was specified as $50,000 each for the comments about the man having syphilis and tuberculosis. They also awarded $200,000 for medical malpractice, and $200,000 in punitive damages.

While the traditional idea of libel or slander involves broad publication in something like a newspaper, liability can be established by "publication" to any third party, even a single individual. Lee Berlik, a lawyer specializing in defamation law who spoke to the Post, said the case was unusual, in part because conversations between doctors would usually be privileged. But there was at least one non-doctor in the room, making them all subject to a defamation claim.

In order to win on a defamation claim, the plaintiff also has to establish that the claims are "literal assertions of fact." In this case, "the jury apparently was just so offended at this unprofessional behavior that they're going to give the plaintiff a win," he said. "That's what happens in the real world."

A juror interviewed by the newspaper said the man's attorneys asked for $1.75 million, and the $500,000 was a compromise between a juror who thought the plaintiff deserved nothing and others who thought he deserved more.

The plaintiff said he began the recording on his smartphone before he went under anesthesia with the intention of having a record of the post-op instructions. The phone was taken from his pants and placed under the operating table, capturing the entire procedure.

Lawyers for both sides refused to comment to the Post. The newspaper was unable to locate Ingham, who no longer works at Aisthesis.

Update 6/25: Aisthesis sent the following statement to Ars: "We apologize to this patient and regret the distress and suffering that this most unfortunate incident caused. The anesthesiologist involved is no longer with our practice. Once we learned of this incident we assured that every anesthesia staff member reviewed and reiterated their pledge to abide by our professional organization’s code of ethics."