An Indian surgeon dubbed 'Dr Death' whose alleged incompetence may have killed up to 20 patients at an Australian hospital was first investigated for unprofessional conduct more than 20 years ago, it emerged yesterday. Jayant Patel, 55, was found guilty of intimidating patients and falsifying medical records when he worked in the United States in the early 1980s. He was at the start of his surgical career when authorities in New York declared him incompetent and morally unfit to practise medicine. Dr Patel fled Australia during Easter while he was the subject of a clinical audit over his treatment of at least 14 patients at the main hospital in Bundaberg, a small town in Queensland. He was tracked down last week to Portland, Oregon, but is now believed to have gone into hiding in India. The nurse who exposed the scandal, Toni Hoffman, believes Dr Patel could be linked to the deaths of 20 patients during the two years he worked in Bundaberg. Dozens of other patients claim they were victims of Dr Patel's incompetence and at least 12 need urgent corrective surgery. Questions over why his shady past was not uncovered by Queensland's medical authorities have fuelled public anger and created a crisis for the state's Premier Peter Beattie. Mr Beattie has been forced to order a commission of inquiry into the scandal, amid calls from the state opposition for a wider investigation into the Queensland health system. Australia's booming economy has created an acute labour shortage, with many professionals, including doctors and nurses, in high demand. Unable to fill positions with Australian medical staff, hospitals have turned to foreign doctors. Queensland alone employs around 1,700 overseas doctors. The Australian Medical Association says that most are highly skilled, and play a vital role in keeping hospitals adequately staffed. A minority, however, needed to be closely scrutinised. 'In the last few years both state and federal governments have known that doctors can come into this country with credentials that don't meet Australian standards,' association president Bill Glasson said. Dr Patel was recruited as director of surgery by Bundaberg Base Hospital despite the fact that he was called before a medical complaints panel in New York state in 1983 on a range of charges. They included failing to examine patients prior to surgery, abusing patients who made complaints and entering fraudulent information on patients' medical records. He was suspended from practising for six months after authorities found him guilty of gross negligence. Nevertheless he managed to gain accreditation to practise medicine in Australia and arrived in Bundaberg in 2003. Mr Beattie has vowed to track down Dr Patel and have him extradited to Australia.