A doctor in New York has lost his medical licence after he carved his initials on a patient's stomach because he was so proud of the caesarian section he performed on her.

The hospital, where he worked, the Beth Israel Medical Centre, has been fined $14,000 dollars (about £9,000).

Dr Alan Zarkin used his scalpel to carve initials several centimetres high in the stomach of Liana Gedz because he said he believed the caeserian section he had performed on her was a work of art worthy of signing.

The carving left a scar and she sued the hospital for $5.5m in damages.

But though Dr Zarkin had already been the subject of several previous complaints about erratic behaviour, he was allowed to continue practising for another five months.

Only now has his licence been suspended and a report released indicating that he is suffering from a brain disorder.

The hospital has had the maximum possible penalty imposed - a harsh rebuke, a $14,000 fine and an order to reform its procedures.

But critics are demanding answers about why it took so long for authorities to stop Dr Zarkin from practising and why warning signs about his behaviour were apparently ignored.

The case has raised questions about the way complaints against doctors are dealt with in New York state, and reinforced demands that patients should have access to more information about those who treat them.