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Dr. James D'Agostino leaves County Court today after a sex offender rating hearing.

(Douglass Dowty | ddowty@syracuse.com)

Syracuse, NY -- An Onondaga County judge is wrestling with how to treat a former Manlius doctor who spent time in a Cambodian prison for abusing a teen boy there.

Dr. James D'Agostino, convicted overseas in 2011 of paying a 15-year-old boy for sexual favors, returned to the Syracuse area recently to find authorities struggling to make sense of the foreign conviction. D'Agostino has denied the abuse.

Last year, the state Heath Department raised doubts about the validity of D'Agostino's conviction. But it suspended the doctor's license to practice barring additional evidence in the future.

And now, state Supreme Court Justice John Brunetti is tasked with deciding if the doctor should be rated a Level 2 sex offender. That would put him in the state's sex offender registry.

D'Agostino, a former pediatric emergency doctor at Upstate Medical University, traveled to Cambodia in 2009 to volunteer at a children's hospital.

At a hearing today, the judge and both lawyers spent much time searching law books, the Internet and legal precedents to help them in D'Agostino's case. Brunetti noted that a quick search in a legal database for a similar case came up empty.

The judge noted two issues:

• Should a New York court accept the conviction from a Cambodian court, or was the doctor not given "due process" as required under U.S. law?

• Should D'Agostino be a Level 2 sex offender, as a state sex offender board suggested, or should he be upped to a Level 3 offender because there were allegedly more victims?

Complicating matters is that Brunetti echoed the state health department in expressing serious questions about the validity of the overseas conviction.

A translated Cambodian court transcript showed that D'Agostino was convicted after his accusers recanted their allegations against him and the prosecution found insufficient evidence to prove the charges.

The heath department said last year that the transcript shows D'Agostino's alleged victims testified they were coerced by police and teachers to provide false testimony about the doctor. It also noted that prosecutors sought to withdraw the charges because of insufficient evidence.

In court today, D'Agostino's lawyer, Stuart LaRose, told the judge a tribunal ruled him guilty.

Brunetti did not make a ruling on whether or not the overseas conviction should make D'Agostino a sex offender here.

But he did note that judges can take into account additional victims in determining a sex offender rating, even if those victims weren't included in the conviction.

Brunetti said that he would have to do more legal research before ruling. He scheduled the hearing to resume next month.

D'Agostino did not comment after court. Upstate University has said that the school had nothing to do with his volunteer work overseas.