A NSW anaesthetist who put his finger in a patient's rectum without consent was giggling continuously with the surgeon, even when photos were taken on a mobile phone, a nurse has told a tribunal.
"They were making such a huge mockery of looking after a patient," the female nurse, who can't be identified, said through tears at a NSW Civil and Administrative Tribunal hearing in Sydney on Tuesday.
Anaesthetist Dr Adam Hill says he was reluctant to examine the 37-year-old man at a hospital in November 2018 after the surgeon, whose name is also suppressed, discovered a large tumour during a colonoscopy and asked him to feel it.
"I don't enjoy doing examinations in that vicinity. I've never enjoyed it," Dr Hill said, noting he had initially declined.
"(But) he was insistent."
Dr Hill denied giggling but conceded he didn't think about the lack of consent at the time of the rectal examination and he had no clinical reason for inspecting the patient's tumour.
The anaesthetist is appealing the suspension of his registration by the Medical Council of NSW in March after a complaint was made about the incident.
The NCAT in April ruled Dr Hill could return to work "pending the hearing and determination of the appeal" against his suspension.
His barrister, Arthur Moses SC, told a NCAT hearing on Tuesday that it was a "one-off transgression" and the medical council had sought to attribute the surgeon's actions to Dr Hill.
He said Dr Hill didn't know the surgeon wanted to take photos in the operating theatre and didn't pose for them.
"The applicant did not regard the actions of the surgeon to be a joke he was participating in," the barrister said.
The evidence of the nurse, who testified about the giggling, had "chopped and changed" including whether the surgeon said to Dr Hill it was a "once in a lifetime opportunity" or "once in a lifetime tumour to feel", Mr Moses said.
Dr Hill made a mistake and has expressed deep shame and remorse, he added.
Barrister Henry El-Hage, acting for the medical council, said Dr Hill violated the relationship of trust that existed between doctor and patient.
"It was inconsistent with the honour and integrity of the profession," Mr El-Hage said.
"He shirked what were fundamental responsibilities."
Dr Hill had every chance to change his mind but continued with the examination on the unconscious and vulnerable patient, Mr El-Hage said.
A second nurse testified she saw the colorectal surgeon take out his mobile phone, point it at Dr Hill during the examination and say: "We finally have evidence of you doing work."
She said Dr Hill made "a snigger, a giggle" noise at the "common joke" but, upon spotting the mobile phone, said: "That's not funny. Put that away."
The four tribunal members, including Judge Susanne Cole, reserved their decision.
Australian Associated Press