Medical authorities knew a gynaecologist was performing surgeries that subjected patients to harm and providing substandard care during pregnancies as far back as 1997, but failed to permanently stop him for another two decades. Instead, authorities repeatedly found the standard of his care was “reasonable”.

On Tuesday the New South Wales civil and administrative tribunal (CAAT) published its full decision in the case against disgraced gynaecologist Emil Shawky Gayed, heard over three days in June.

The case was brought against Gayed by the Health Care Complaints Commission (HCCC) and was made public following a Guardian Australia investigation.

But the tribunal’s full findings were not published until now.

They reveal a shocking and detailed history of complaints against Gayed that prompted numerous performance reviews led by the NSW Medical Board, which found ultimately Gayed’s conduct was “reasonable”.

By the time of the tribunal hearing in June, Gayed had relinquished his medical licence. The tribunal ruled on numerous complaints made between 2011 and 2017 involving seven patients. But during the hearing it was revealed Gayed had a comprehensive history of performing surgeries riddled with complications long before those complaints were made. Much of this history has not been made public until now.

The tribunal heard that in 1997 Gayed perforated a patient’s bowel, ilium and uterus in a number of places, with the cuts ranging from 1cm to 5cm. He was dealt with by a professional standards committee, who ordered he undergo a performance assessment.

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In 1998 the HCCC received a complaint from the Southern Area Health Service alleging Gayed breached protocols for infection control, failed to obtain informed patient consent, altered medical records, and possibly had visual impairment and communication issues. Later that year the HCCC received similar complaints about Gayed from Cooma Health Service.

In 2001 the HCCC imposed conditions on Gayed’s registration that limited the surgeries he could perform.

Numerous other complaints relating to bleeding following surgery and substandard care were made, before a woman complained to the HCCC in 2004 that she went into labour at 22 weeks pregnant with twins. She said Gayed refused to transfer her from a regional hospital to another hospital with facilities to care for very premature babies.

She alleged her babies were left to die when they were born at 23 weeks. There was an investigation but no further action was taken. Instead, a performance assessment found Gayed provided care to a reasonable standard. The Medical Board in 2006 then conducted a review of the 2001 conditions imposed on Gayed’s registration, and decided to remove them.

The board received notice in 2007 that Gayed had been involved in a “number of clinical incidents” at Mona Vale hospital and as a result had resigned. In April 2008 conditions were again imposed on Gayed to limit the types of surgery he could perform, and requiring him to have a mentor. But in 2009 the performance committee of the Medical Board decided Gayed no longer required mentorship.

More allegations and complaints to the HCCC were made in the years that followed, including by a woman who said Gayed did not obtain informed consent from her before removing three-quarters of her cervix. Another performance review panel hearing held in 2014 again found Gayed’s performance was to a reasonable standard.

A case against Gayed was finally brought by the HCCC before the CAAT in June this year, by which time Gayed had voluntarily relinquished his right to practice medicine. The tribunal heard about the cases of seven women who received inappropriate medical treatment from Gayed from 2011 onwards. One of those women underwent a hysterectomy she did not consent to even though she could have been treated with painkillers and bed rest.

Gayed paid for another woman to go to a Sydney clinic for an abortion, telling her there was a high risk her foetus was not healthy after he performed an ablation procedure on her without realising she was pregnant. Gayed agreed with expert evidence given to the tribunal that he recommended the abortion even though he had no evidence of any damage to the foetus.

The tribunal found Gayed guilty of professional misconduct in all seven cases, and determined were he still a registered medical practitioner, the tribunal would cancel his registration. The tribunal disqualified him from being registered as a health practitioner for three years.

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Bill Madden, a leading medical lawyer with Carroll & O’Dea, is representing many of Gayed’s alleged victims. He said details uncovered by the tribunal’s decision suggested medical authorities such as the HCCC, the Medical Tribunal and the Australian Health Practitioner Regulation Agency (Ahpra) could be liable.

“There are rare circumstances where you would consider a claim against the medical board or Ahpra,” Madden told Guardian Australia. “That’s an unusual approach to take and it can be entirely unnecessary when people obtain compensation from, for example, Gayed’s insurer and the hospitals involved. But this decision raises questions about whether there has been an adequate response by authorities on the way to establishing this unfortunately detailed history of complaints against Gayed.”

Guardian Australia’s investigation into Gayed prompted NSW health authorities to appoint senior barrister Gail Furness to independently investigate Gayed and the management of complaints against him. Her report is due on 31 October.

Gayed obtained his bachelor of medicine at Ain Shams University in Egypt. He became a fellow of the Australian College of Obstetricians and Gynaecologists in 1993. His current whereabouts are unknown.

Do you know more? melissa.davey@theguardian.com