A Toronto plastic surgeon is facing a disciplinary charge on allegations that he filmed thousands of patients at his clinic, including while they were fully or partially naked, without proper notification or consent.
Dr. Martin Jugenburg, whose two-storey clinic is located in Toronto's Royal York hotel, is also accused of posting images of a patient's bare breasts on his social media without her consent.
It's also alleged the surgeon — who calls himself "Dr. 6ix" — allowed a television crew to film a breast augmentation surgery against another patient's wishes.
"What this case is about is Dr. Jugenburg's repeated breaches of his patients' privacy, his repeated breaches of his patients' confidentiality," Carolyn Silver, a lawyer representing the regulator, told the disciplinary panel.
"And these breaches by Dr. Jugenburg involved not only his own patients, but many other patients who were seen at his office in downtown Toronto by other physicians who he allowed to use his office space."
In a video conference hearing before the disciplinary committee of the College of Physicians and Surgeons of Ontario on Wednesday, a lawyer for Jugenburg said the doctor admits he committed professional misconduct.
However, Jugenburg disputes parts of the allegations against him and evidence on those issues will be heard in the coming days.
According to an agreed statement of facts, 24 cameras were installed throughout the clinic in early 2017, some that recorded audio as well as video. These were located in examination and operating rooms, in the reception area, in hallways and other spaces, even areas used by other doctors at the clinic.
There were two signs noting the presence of cameras: one in one of the lobbies and another in the operating room, though the latter was not easily visible to patients, the document said.
"There were no signs notifying patients that they were being recorded during their patient encounters, consultations and/or procedures. (Jugenburg) also did not tell patients that these recordings were accessible to him on his phone" through an app, it said.
In some recordings obtained by the regulator, patients had their "breasts, buttocks and genitals exposed," the document said.
In late 2018, Jugenburg sent an email to patients he had seen over the last two years, explaining there had been cameras for "security purposes" and apologizing for not being more "proactive" in communicating their presence, the statement said. He did not contact the patients of other doctors at the clinic.
Over this time period, Jugenburg and the other physicians would have seen thousands of patients, the document said.
Some of the patients the regulator spoke to during its investigation said they were unaware of the cameras and would not have gone through an examination or consultation had they known, the statement said. Some were "upset, embarrassed and or distressed about the surveillance," it said.
Last year, the regulator ordered the surgeon to remove all cameras from examination rooms and other areas where patients may move or remove clothing.
The statement of facts also laid out an incident involving a patient identified only as L.P., who underwent a breast augmentation, tummy tuck and liposuction in May 2016.
After the successful procedure, Jugenburg asked L.P. if he could use images of her on his social media accounts, which included Instagram and Snapchat, the document said.
L.P. agreed to have her voice in a Snapchat video but no images, and signed a consent form on the understanding that Jugenburg would follow those verbal instructions, it said.
The initial Snapchat post used only her voice but images of L.P. were later published on social media twice due to a "mistake," it said.
In one instance, the surgeon was filming a tour of the clinic for Snapchat and showed a computer screen which displayed L.P.'s image before and after the surgery, the statement said.
"The photo displayed Ms. L.P.'s entire torso, including her bare breasts," but did not show her face or name, it said.
On a second occasion, those photos were posted to Jugenburg's Instagram account, although with her nipples censored, it said.
L.P. discovered the images and was "mortified," it said. She called the clinic to have the photos taken down. Jugenburg called her to apologize and said it had been an error.
The woman said she felt she had been pressured to contribute to Jugenburg's social media accounts and that "his focus was on his social media rather than her recovery."
Later in 2016, a Global News crew filmed a breast augmentation surgery performed by Dr. Jugenburg, the statement said.
When looking into the patient's chart during the investigation, the regulator found that a note had been added a year later to say that the patient was aware the procedure would be recorded, the document said.
In her opening arguments, however, Silver said the patient — identified only as C.B.P. — had in fact objected to having a TV crew present when asked for her consent immediately before the surgery.
C.B.P. was "extremely upset" when she found out a segment on her surgery had aired, the lawyer said.
"There is not one iota of documentary evidence... suggesting that Ms. C.B.P. did consent to have Global TV in the operating room for her surgery or filming for surgery, not one iota of documentary evidence that was contemporaneous at the time," she said.
Jugenburg, 45, is expected to testify Thursday. The identities of the patients are protected under a publication ban.
A proposed class-action lawsuit against the doctor was also launched late last year in connection with the surveillance cameras.
