Bhuban Choudhury, a registrar at the Derriford Hospital in Plymouth, sent six anonymous letters to patients of consultant surgeon Joe Rahamin, the General Medical Council was told.
The letters gave details of operations which Mr Choudhury claimed had gone wrong and encouraged the patients, or their relatives, to start legal proceedings against Mr Rahamin, who still works in the hospital's thoracic department.
Mr Choudhury, from east London, denies writing the letters, sent in August and December 1995.
But Linda Strudwick, a barrister representing the GMC, told the hearing that he was the only person with the necessary medical expertise and access to patient records to be able to send the typed letters.
The GMC was told that suspicion had originally concentrated on a consultant surgeon in the department who was made redundant in August 1995. But subsequent letters written in December showed he could not be responsible, said Ms Strudwick.
Only Mr Choudhury was present at the operations or follow-up appointments of all the patients concerned.
At least two of the letters were amended in Mr Choudhury's handwriting according to an expert witness. All six were sent while the registrar was on a six month contract with the hospital.
One of the patients, Peter Bentley, told the hearing he had been "panic stricken" when he received one of the letters shortly before Christmas 1995.
He had operation in 1993 to remove his thyroid and a lump in his chest. X-rays later showed that some of the lump appeared to have been left. But Mr Bentley said he had been reassured during a follow-up appointment with Mr Rahamin in 1994.
The hearing also heard from Barry Swindon, 50, from Exmouth in Devon. His wife, Eileen, received an anonymous letter in August 1995 after he had an operation on his oesophagus. The letter alleged that the procedure was wrong and had been botched because his gullet had been ruptured, requiring major surgery to put right.
In another letter the wife of a patient read of her husband: "You might have realised he is not going to get better. He is going downhill every day until he dies." The woman's husband was still in the hospital when she received the letter.
Again the letter alleged that anoperation was botched and that attempts to repair the damage had not succeeded.
The writer said he was giving this information in confidence because he was upset to see the patient was suffering. He suggested that the family should consider legal action. The man subsequently died, the hearing was told.
After the letters were sent, the hospital launched an inquiry to try to identify the author. But the investigations led nowhere.
Mr Choudhury was investigated by police about the letters but no action was taken by the Crown Prosecution Service.
He denies serious professional misconduct. The hearing continues.Reuse content