Skin cancer plastic surgeon takes to the stand in trial
THE jurors in a sexual assault and common assault case involving a Rockhampton doctor were each given an opportunity to wear the doctor's specialised gear yesterday.
Dr Elamurugan Arumugam, 55, has pleaded not guilty in Rockhampton District Court to sexual assault and alternative charges of common assault.
Patients' allegations range from inappropriate touching of their breasts to Dr Arumugam sticking his fingers in their mouths during consultations.
The court heard Dr Aru - as he is known among colleagues and patients - claimed he always wears a magnifying loupe to visually check patients for early stage skin cancers, for which six of the alleged victims had been consulted by Dr Aru.
The court heard one of the allegations involved Dr Aru looking at another part of a patient's body using the loupe while inserting his fingers inside the patient's mouth.
The court was told another allegation involved Dr Aru deliberately turning his head to use the light on the loupe to distract a child in the room while he placed his hand under a patient's bra and touched her nipple.
Dr Aru denied touching breasts for sexual gratification.
An expert witness, the immediate past president of the Australian Society of Plastic Surgeons, Dr James Savundra, told the court the Australian standard practice for oral examinations should only take five to 10 seconds, require the medical practitioner to wear gloves, and if the need arose to palpate, cheek extractors would be used.
Dr Savundra also said the standard practice for breast examinations was a visual exam first while the patient was bra-less and then palpate areas of concern.
Dr Aru said Central Queensland was the skin cancer capital of the world as a result of UV ray intensity and, being settled by mostly fair-skinned Caucasian people, the most prominent areas where skin cancers are found in patients were the lips, face and hands.
"I specialise in early cancers,” he told the jury.
Dr Aru said those early cancers included actinic cheilitis caused by serious sun damage to the lip.
"Most patients are unaware they are suffering from actinic cheilitis,” he said.
"The transition is very subtle from actinic cheilitis to carcinoma.”
Dr Aru said the reason why he focused on this area was because actinic cheilitis could be treated by laser, avoiding deforming the patient's lips that need to be cut to remove cancer.
"I'm not disagreeing with (Dr Savundra) about the 10 seconds but for me, if there is a significant lesion on the lip, I would take probably a minute or a minute and a half to examine the lip,” he said.
"Unless one comes and practices in this area.... you won't get a feel for the cross-section of patients in the city.”
During cross examination, Crown prosecutor Tiffany Lawrence asked Dr Aru if he had informed patients what he was about to do before he started the oral examination.
Dr Aru said each patient was told about the full body examination before he started as his hands worked his way up to the arms, shoulders and face.
Dr Aru said because of the concentration levels he needed for examinations, he did not give a "running commentary” as he stepped through the examination. He did admit he had issues communicating with patients and had completed a course to rectify the issue.
The trial continues this morning.