The loose-lipped anesthesiologist whose extremely insulting comments were inadvertently recorded by an anesthetized patient during a 2013 colonoscopy has been ordered to fork over $450,000 to the man she belittled while he was unconscious.

Excerpts of the taped conversations were submitted as evidence in the trial.

Tiffany M. Ingham, MD, 42, was ordered to pay $100,000 for defamation, $200,000 for malpractice and $150,000 in punitive damages. Aisthesis, the Bethesda, Md.-based anesthesia practice she worked for, must also pay $50,000 in punitive damages. Soloman Shah, MD, 48, the gastroenterologist who performed the colonoscopy, who was also named in the complaint, was dismissed from the case on the first day of a 3-day jury trial in Fairfax County, Va.

The patient, identified only as "D.B." in court papers, had been recording post-op instructions and left his phone on. He and his wife were shocked when they played the procedure-room conversation on their way home.

"After 5 minutes of talking to you in pre-op, I wanted to punch you in the face and man you up a little bit," Dr. Ingham is heard telling the unconscious patient. She and others in the room then joke about a rash on the patient, which Dr. Ingham says is "probably tuberculosis in the penis" or "penis Ebola."

She and Dr. Shah banter about how to avoid the patient after the procedure, with Dr. Shah telling an assistant to tell the patient that he talked to Dr. Shah, but "you just don't remember it." Dr. Ingham suggests a "fake page" — "Dr. Shah you're needed urgently in the office." She adds: "I've done the fake page before."

When an assistant notes that the patient had complained that he always passes out "when (he looks) at the IV," Dr. Ingham again mocks him: "Well, why are you looking, retard?"

She's also heard belittling him for having attended the University of Mary Washington, previously an all-women's college, suggesting that he might be gay.

In a sequence of events that led to charges that she'd falsified medical records, she's heard saying: "I'm going to mark hemorrhoids (on his chart) even though we don't see them and probably won't. I'm just going to take a shot in the dark." She reportedly did write a diagnosis of hemorrhoids on his chart.

This story is yet another reason to keep cell phones out of the OR. Lawyers for Dr. Ingham and Dr. Shah had argued that the recording was illegal, but Virginia, where the colonoscopy took place, is a one-party consent state, meaning that only one party involved in a recorded conversation needs to agree. The doctors' lawyers also noted that the patient didn't miss any work and had not suffered any physical injuries.

But the jury decided that the patient should receive at least a portion of the $1.75 million in damages he'd requested. The patient's complaint charged that he'd been "verbally brutalized" and that he suffered with anxiety, embarrassment and several months of lost sleep.

Dr. Ingham did not respond to calls from Outpatient Surgery Magazine. An official at Aisthesis says Dr. Ingham no longer works for the anesthesia company and declined further comment.

Ironically, during the procedure, as the insults flew, Dr. Ingham remarks at one point: "I feel bad. I shouldn't be so mean." Safe to say she feels a lot worse now.

Jim Burger