Sir Charles Gairdner Hospital allowed a Russian-trained heart surgeon to operate on patients despite being warned he had twice failed the Australian professional standards exams.
The Royal Australasian College of Surgeons is still concerned about the qualifications of Igor Konstantinov, 40, who worked at SCGH for a year until June last year.
Dr Konstantinov attracted complaints from a surgical colleague and one of WA's leading cardiothoracic surgeons before leaving to work at Melbourne's Royal Children's Hospital.
He continues to perform heart surgery on children. He still has not passed the exams.
He was replaced at SCGH last July by Dr Jaffar Shehatha, who was suspended from surgery in February amid an investigation into 18 of his patient files.
John Quinn, executive director for surgical affairs of the Royal Australasian College of Surgeons, told Channel Nine News that while Dr Konstantinov was certified to practise as a doctor, he did not meet the standard for a surgeon.
"There is a level people have to practise for the safety and protection of the community," Dr Quinn said.
"We would like him to sit and pass the exams … but we are not a regulatory authority and we are not able to police or enforce that. The college assessed Dr Konstantinov's qualifications, experience and knowledge against Australian and New Zealand-trained surgeons - and they are not substantially comparable."
Dr Konstantinov said his clinical results were excellent and he did not need college fellowship. He was lured to Melbourne amid excellent reviews of his work at SCGH. "There are many consultant surgeons in Australia who are not fellows of the RACS," he said. "There is no such law or requirement."
Dr Konstantinov started training for the college exams four years ago, failed them in May 2007 and failed again in September 2007.
It is understood he performed so dismally, the college notified the hospital and the WA Medical Board. SCGH allowed him to continue operating.
The hospital acknowledged yesterday that it received the college warning and that the doctor's contract required "appropriate" Royal College qualifications. "As Igor was in the process of pursuing his fellowship, this was deemed 'appropriate'," spokesman Ray Dunne said.
"Clearly, these concerns were acted on. Igor's clinical outcomes were investigated and he was found to have excellent results."
Mr Dunne said Dr Konstantinov's surgery was unsupervised but his "practice" was supervised because the head of the unit, Mark Newman, monitored his results.
He said Dr Konstantinov was a major loss to WA and the hospital would "take him back in a heartbeat".
In July 2007, one of the State's leading cardiothoracic surgeons wrote to the hospital to complain about Dr Konstantinov. He received a reply saying that Mr Newman thought Dr Konstantinov operated "with excellence".
A senior cardiothoracic surgeon at SCGH, John Alvarez, raised concerns about Dr Konstantinov's qualifications in October 2007 with the hospital but they were dismissed.
Dr Konstantinov quit SCGH and moved to the Melbourne children's hospital.
Dr Konstantinov said: "The Royal Children's Hospital was very keen to get me as my results spoke for themselves. I left WA with mixed feelings … I felt my knowledge and skills were needed there.
"While in Perth I felt that I was viewed as a competitor threatening the income and financial wellbeing of some surgeons. All allegations were investigated by the hospital and were found unsubstantiated.
"My results compared favourably to the results of any cardiothoracic surgeon in Perth or elsewhere in Australia."
Dr Konstantinov had four years to satisfy the college. That has run out.
Dixie Marshall is a journalist/newsreader for Channel Nine News