Pa. suspended a weight-loss doctor who performed intimate exams on women. He still sees patients in Brooklyn.

At his weight-loss clinic in Philadelphia, physician Prabhakara Tumpati directed female patients to lie on an upholstered couch that served as his exam table.

Then he would examine their genital area without explaining what he was doing or why, state records show.

He did it at least three times in a three-month span in 2017: Tumpati asked a 30-year-old to lower her pants and underwear, then performed a vaginal examination so detailed it included inquiries about her use of a tampon. He ran an ungloved finger along another patient’s stomach, into her jean shorts waistband and down her inner thigh. He reached into the pants of an undercover state investigator, who was posing as a patient, and touched a scar right by her genital area.

Yet Tumpati was allowed to keep practicing medicine in Pennsylvania for six more years before state authorities limited his access to patients.

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Tumpati is appealing Pennsylvania’s decision to suspend his medical license for three years. The state’s Board of Medicine found in October that his conduct was unprofessional, and his medical care violated professional standards.

The board, which regulates the licenses of medical doctors and other health professionals, also penalized Tumpati for allowing a medical assistant to dispense medications, which is not permitted under state law. These included prescriptions for strictly regulated weight-loss medications, which were not reported as required to a state database.

The physician will be allowed to shorten his suspension after the first year, and his discipline could be reduced to probation for the remaining two years.

Tumpati declined an interview request from The Inquirer. He is appealing his suspension in court, saying his discipline should be reduced to probation.

“We understand that discipline may have been appropriate, but we believe the board’s sanction was harsher than it needed to be,” said Peter Good, his lawyer, who works with the Harrisburg-based firm Caldwell & Kearns.

On his website, Tumpati says he is a weight and sleep medicine physician with offices in Philadelphia, King of Prussia, Cherry Hill, and New York City.

He can practice medicine in New Jersey and New York, where his medical license remains active, public records show. Tumpati doesn’t currently practice in New Jersey, Good said.

He is still accepting appointments at his Brooklyn office, The Inquirer found through phone calls.

To patient-safety advocates, his case underscores a long-standing concern that medical boards take years to discipline doctors and impose lenient penalties, at most. Often, doctors’ licenses are suspended or revoked only after they are found guilty of crimes.

Inappropriate touching is commonly dismissed as a professional breach that can be addressed without the harshest sanctions, said Azza AbuDagga, a researcher who has studied physician misconduct with Public Citizen, a consumer rights nonprofit based in Washington.

She thinks such cases should be treated as sexual abuse. “The proper punishment should be revocation” of a medical license, AbuDagga said.

The first two publicly reported complaints against Tumpati were filed by female patients in July and September of 2017. State authorities responded quickly.

On Oct. 31, 2017, the Pennsylvania Department of State sent Sherilyn Gillespie, a professional conduct investigator, to check out his Philadelphia office. She posed as a patient seeking to lose weight. During her undercover visit, she documented the medical care provided:

Tumpati directed her to lie down on the upholstered couch in his office. There, he pulled up Gillespie’s shirt, pulled her pants down, and without warning reached into her underpants, disciplinary records show. Tumpati ran his ungloved thumb multiple times over Gillespie’s scar from a hysterectomy, the mark left by an incision below her bikini line from a surgery to remove her uterus.

After her exam, Gillespie received a cocktail of weight-loss medications from a medical assistant, who was not allowed to dispense drugs. All the patients cited in disciplinary records similarly received medications from the unlicensed assistant.

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It is unclear why the state did not discipline Tumpati for six years after her visit. The Pennsylvania Department of State, which oversees medical discipline, declined to answer questions, citing confidentiality laws.

A six-year delay is unusually long, even for state medical boards, said Robert Oshel, a retired patient-safety advocate. Oshel ran a database that tracks physicians accused of wrongdoing, which is intended to help health systems and state licensing boards protect patients.

“Here’s a case where they’ve got apparently as good evidence as they could ever get,” Oshel said. “It just seems pretty outrageous that it would take that long.”

The board called Tumpati’s behavior “appalling” when it finally suspended his license.

“[Tumpati] exhibited a complete disregard for the patients’ emotional and physical well-being during these examinations,” the board wrote.

Tumpati has denied inappropriate examinations, state disciplinary and court records show.

The upholstered couch was intended to give his clinic the ambience of “Grandma’s living room” and make patients feel more comfortable, his lawyers wrote.

Tumpati also denied specific details, such as examining the vagina of the 30-year-old who filed an official complaint. He told the board that she had a skin condition that required extensive examination. He did not document that part of her physical exam in her chart, he said, because the skin condition was irrelevant to weight loss.

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The physician testified that he washed his hands before each patient visit, and didn’t need to wear gloves because he didn’t perform internal exams.

Tumpati said he touched the scar of the undercover investigator to verify her hysterectomy, claiming some weight-loss medications can cause birth defects.

Experts and the state medical board rejected his explanation.

Weight-loss physicians do ask about reproductive plans, contraceptives, and past surgeries before making decisions about what medications to prescribe, said Holly Lofton, an obesity medicine specialist at NYU Langone. But there is never a reason to physically touch a hysterectomy scar.

“0% of the time is that necessary,” Lofton said.

When a complaint against a medical doctor is investigated and discipline is warranted, the Pennsylvania State Department staff recommends a penalty. But discipline is decided by the 13-member Board of Medicine, which is mostly composed of medical doctors.

In Tumpati’s case, state department staff recommended that he practice under probation for one year.

But the board of medicine imposed the harsher penalty of three years’ suspension, with only the last two reduced to probation.

In his appeal in Commonwealth Court, Tumpati said the board abused its authority when it imposed the stricter penalty.

The six-year delay showed the board didn’t view him as an immediate threat to patients, his legal appeal stated.

“There was not an immediate concern to impose a sanction sooner,” Tumpati’s lawyers wrote in the appeal.

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The board told the court the “egregious nature” of his misconduct required the license suspension.

Pennsylvania regulators declined to say whether they alerted other states to Tumpati’s discipline, though the state participates in a notification system that is supposed to flag any disciplinary action to other states.

Currently, the New York and New Jersey websites show no discipline record.

“The patient in New Jersey or New York is not going to know that this guy may be a problem,” Oshel said.