A SURGEON working at Dewsbury District Hospital sparked concern among medical watchdogs for his "seriously deficient" performance, it was claimed.
And the concerns grew after two of his patients died, the General Medical Council heard.
Dr Hurais Syed, 51, came to the attention of the GMC after the death of a 67-year-old kidney tumour patient identified only as JH in February 2000.
He spent 35 days in intensive care after surgery.
Another patient, a 78-year-old woman identified only as GA, died on the operating table a month earlier as Mr Syed tried to remove a cancerous kidney. He was cleared of her manslaughter at Leeds Crown Court in April, 2003.
Mr Syed, now of Acton, west London, was working as a locum consultant urology surgeon at Dewsbury from December, 1997, until February, 2000, when he was suspended pending a review of his performance.
The GMC's Fitness To Practise Panel, sitting in London, was told that his surgical skills are "highly flawed and likely to produce serious haemorrhaging".
A report produced by two consultant urological surgeons in April, 2000, recommended he should undergo a five-year urological training programme and pass the FRCS neurology exam before taking up independent work as a consultant.
He failed to keep accurate and contemporary records, had limited communication skills, used inappropriate techniques and there were questions over his ability to perform procedures, the panel was told.
Craig Ferguson, for the GMC, said: "He is a surgeon struggling to cope when faced with difficult surgical circumstances. Mr Syed's performance is not that expected of a consultant urologist, in particular the surgical technique he employed in the kidney is highly flawed and highly likely to produce serious haemorrhaging."
Mr Syed graduated in Karachi, Pakistan, in 1978 and gained further experience in Saudi Arabia before coming to Britain.
But Mr Ferguson said: "The assessors were concerned that Mr Syed appears to have had no structured surgical training at all. The urological training he had in the UK was not in a recognised training post.
"His experience in Pakistan and Saudi Arabia had not prepared him adequately for the responsibilities of a consultant urologist in the UK in the late '90s.
"It would appear that Mr Syed is a caring and compassionate doctor - where appropriate he spends considerable time talking to you.
"However, perhaps because of the number of patients he is responsible for, there are often occasions when he appears rushed and without a considered care plan for a patient."
Assessors who monitored Dr Syed also felt that criticism could be levelled at the Dewsbury District Hospital for not being "very supportive" of him.
Mr Syed had "very few junior staff" to work with throughout his time there, they found.
Mr Syed denies that his fitness to practise is impaired because of deficient professional performance.
The hearing continues.