A Twin Cities dermatologist has been banned from performing cosmetic surgery after he botched several procedures, including a breast implant and a tummy tuck, that harmed or injured patients.

Dr. Patrick Carney, who works out of five metro-area clinics, can no longer perform breast augmentations or reductions, tummy tucks, face-lifts or certain facial surgeries under a disciplinary order issued by the Minnesota Board of Medical Practice. The board cited Carney for unethical and unprofessional conduct, improper records management and improper prescribing practices in connection with three cases between 2007 and 2009.

"This has been a long and difficult ordeal," said Carney, who has practiced in Minnesota since 1987. "While I have had disagreements with the board throughout this process, I recognized that it was time for everyone to move on. This stipulation allows that to happen."

Carney's discipline comes 13 months after a Star Tribune investigation showed that the Minnesota board often shies away from punishing doctors whose mistakes harm patients or who demonstrate a pattern of substandard care.

The investigation showed that since 2000 at least 46 Minnesota doctors escaped board discipline, even though authorities in other states took action against them for such missteps as committing crimes, patient care errors or having inappropriate relationships with patients.

In addition, among the 74 doctors who lost their privileges to work in Minnesota hospitals and clinics over the past decade, more than half were never disciplined by the board, according to a federal database used by the health care industry to track actions against physicians. At least 13 of the 47 doctors who avoided discipline were flagged for incompetence, substandard care or inadequate skills.

Board officials said at that time that they do everything they can to protect the public from bad doctors. Robert Leach, the board's executive director, said then, and again Monday, that the record reflects a regulatory philosophy that favors correcting problems over punishing misconduct or mistakes.

Nevertheless, Gov. Mark Dayton later signed into law provisions requiring the board, which regulates Minnesota's 20,000 physicians, to provide more information about malpractice judgments and disciplinary actions taken against doctors by other states. The law also requires the board to address consumer complaints in a timely fashion.

Burns and wounds

The board's discipline of Carney stems from three complaints filed between July 2010 and January 2011.

The first involved a November 2007 chemical peel on Susan Zwaschka, an attorney who later won a $1 million jury award against Carney. The peel resulted in burns and open wounds on Zwaschka's face.

According to the board order, Carney failed to keep records on the case medical filings and prescriptions. At one point, the order said, he gave Zwaschka an antibiotic after removing the label from a bottle that had been returned to his office by another patient and failed to "verify the purity and safety of the medication" or provide written instructions for use or advise the patient of any potential side effects.

Zwaschka, who often has defended physicians in malpractice cases, was later treated by a plastic surgeon for her injuries.

The second complaint, filed in September 2010, documented a 2009 breast augmentation procedure that left the patient in "excruciating pain." After performing an implant on the woman's left breast without problems, Carney stopped the procedure on her right breast after she complained of pain. He tried it again several days later, but the patient again asked him to stop because of "extreme pain," the order said. The woman later saw a plastic surgeon at another office for corrective breast surgery.

The final complaint documented a July 2008 tummy tuck. Within a day of the procedure, part of the incision turned purple. Two weeks later, after the area had turned black, the patient sought treatment at a hospital emergency room. She was later admitted for corrective surgery, the board order said.

While meeting with the board's complaint review committee in March 2012, Carney acknowledged that Zwaschka's burns and scarring "may have been due to a reapplication" of a chemical to a spot on her face he had already treated. He also confirmed that he failed to document medications and admitted that giving her an antibiotic returned by another patient "was not in compliance with accepted prescribing standards," according to the order.

He denied, however, that the breast augmentation surgery was beyond his scope of practice or that he had represented himself orally or through advertising as a plastic surgeon. He said he stopped performing cosmetic surgeries following several "adverse outcomes," the order said.

Disciplined twice

Chris Messerly, a malpractice attorney who represented Zwaschka, said Monday that the board's action "is consistent with their charge. This will protect the public, and that's certainly a good thing."

The board's discipline of Carney is his second.

In 2000, he was reprimanded, fined and ordered to practice with various restrictions after the board accused him of engaging in "inappropriate conduct" with a female patient. He also was required to undergo a psychiatric assessment, which revealed a depressive disorder and a personality disorder with "narcissistic features," according to the 2000 board disciplinary order. He was found to be "prone to exercise exceeding[ly] poor judgment" and ordered to undergo individual psychotherapy.

The board reinstated Carney's full privileges in 2002, finding he met the state's requirements.

richm@startribune.com • 612-673-4425

howatt@startribune.com 612-673-1702