Footage has emerged of a doctor punching a patient in the chest just after a heart bypass operation.
Highly-regarded Russian anaesthesiologist Dr Andrey Votyakov told investigators he was extremely tired after a 36-hour shift and grew angry when the patient started abusing him.
He is seen hitting the man in the face and striking his fist at his chest while he is strapped on to a bed.
The patient reportedly died later at the Federal Centre for Cardiovascular Surgery in Perm, a city in the Urals, although his death is not believed to be linked to the attack.
Dr Votyakov said: "As soon as I came into the room with my team he started to call me various derogative names. And I just got blown away by it.
"We had spent so much time with his very complicated case to help him recover and he said not a single word of gratitude.
"And then the chronic tiredness added to it. I got carried away, and I punched him several times."
Dr Votyakov said he was "very sorry" and has reportedly apologised to the patient's parents.
It happened in February and at the time the doctor was head of anaesthesiology and intensive care at the hospital.
He was sacked after the incident became public and it is being investigated by police.
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