The patient's daughter was an agency nurse at the hospital where the procedure was being carried out, and had accompanied her mother on the day of the treatment.
The fitness to practise inquiry heard the first complaint arose after he carried out a procedure he was not asked to do on a woman at Midlands Regional Hospital in January 2011.
The patient's daughter, who worked as an agency nurse at the hospital, had accompanied her mother to support her.
The nurse told how Dr Elkhabir had approached her that morning and introduced himself to her mother.
He then proceeded to carry out the procedure himself – which involved the insertion of a cannula – and he was overheard saying to the woman: "This is my gift to you, and she will be your gift to me" in reference to the woman's daughter.
When questioned about his behaviour later, Dr Elkhabir said in his country people often did "favours for friends" and he liked the nurse in question.
He said if she "gave up alcohol and sex he would consider taking her as his wife".
Dr Elkhabir, whose professional body recommended striking him off for misconduct, was given a second chance to argue the penalty is too severe, the High Court heard yesterday.
He is appealing a decision of the Irish Medical Council that his name be removed from the medical register.
He was found guilty of misconduct by a fitness to practise committee inquiry in March last year for making inappropriate comments to a patient and for failing to attend to another patient.
The council applied to the High Court to confirm its recommendation that he be struck off, but the doctor then brought a cross-appeal saying he should have had an opportunity to defend himself at the inquiry but he was unable to do so because he was working in Saudi Arabia and was tied to a contract there.
He also sought an extension of time to appeal the council decision.
Yesterday, the court heard the Medical Council had decided to reconsider the penalty and was prepared to hear submissions from him on March 21.
Mr Justice Iarfhlaith O'Neill adjourned the matter until April 8 and Dr Elkhabir agreed to continue an undertaking he previously gave to the court not to practise in Ireland until then.
The inquiry also heard of a separate incident which occurred on February 2, 2011, when a 47-year-old woman, who had recently suffered a heart attack, presented at the A&E department with chest pains.
The nursing staff immediately contacted Dr Elkhabir, who was on-call.
However, despite repeated attempts to contact him, Dr Elkhabir did not see the patient until an hour and a quarter later.
Dr Elkhabir told the court yesterday the first complaint was the result of a misunderstanding while on the second occasion he had been working for 24 hours.