SAN DIEGO - A plastic surgeon could permanently lose his license to practice medicine in California for botched surgeries that one expert said showed a disregard for human welfare, according to lawsuits and an accusation by the state medical board.

The accusations against Dr. William E. Watkins include allowing an untrained office clerk to stitch up her mother's breast, accidentally cutting off a patient's earlobe during a face-lift and running a filthy operating area, The San Diego Union-Tribune reported Wednesday.

The claims by Watkins' patients prompted an administrative law judge in August to suspend his medical license. A hearing is scheduled for June to determine whether it should be permanently revoked.

Watkins, 59, who has been licensed since 1974, has denied wrongdoing at his practice in the San Diego suburb of Vista. He says the women's claims are based on their misunderstanding of medical procedures and a faulty recall of their surgery.

"Dr. Watkins acted appropriately in the care of these patients," said his attorney, Gabe Benrubi.

One patient, Faye Townsley, told the Union-Tribune that she met Watkins through her daughter, who was working as the doctor's office assistant, and asked him to replace her old implants and reshape her breasts.

After hours of painful surgery, Watkins sutured one of Townsley's breasts and then ordered her daughter to close the other one, according to an accusation filed in July by the Medical Board of California.

Another patient, Amanda Bloxton, told the medical board that Watkins got frustrated during a 2001 breast surgery and walked out, leaving Bloxton to beg her friend in the operating room to reach into her surgically opened breast to remove an old implant.

"His disregard of human welfare in his consulting room, in the room he erroneously thinks of as an operating room, are alarming, and worthy of decisive action," wrote Dr. Jack Fisher, a UC, San Diego surgery professor employed by the state to review Watkins' care.

Beyond requiring a valid medical license, there are no state regulations governing doctors who perform plastic surgery in their offices.

Four civil lawsuits filed since 2001 by former patients claim that Watkins' surgery caused "grotesque deformities" and "extreme amounts of pain" and put their lives in "grave danger."

Each lawsuit has been settled for an undisclosed amount of money. Benrubi noted that each of the women returned for follow-up treatment and two came back for additional surgery.