Updated

A judge refused to reinstate the medical license of a fertility doctor who gave Octomom Nadya Suleman all 14 of her children, ruling Thursday that the California Medical Board's revocation was the appropriate action.

In firmly rejecting Dr. Michael Kamrava's appeal, Superior Court Judge James C. Chalfont told the physician's attorneys the medical board should have been even harsher in its evaluation of Kamrava.

"I don't think your client understands what it is to practice medicine and exercise judgment no matter what the patient wants," he told the lawyers.

The attorneys argued that revoking Kamrava's license was akin to issuing a death sentence to his medical career. Attorney John Martin asked the judge to amend the board's ruling to instead place Kamrava on probation.

Chalfont quickly dismissed that idea.

"I think your client is so far away from what his duties as a physician are there's no reason to put him on probation," the judge said.

Suleman already had six children when she gave birth to eight more in January 2009. The medical board found Kamrava violated proper standards of care when he implanted 12 embryos in her.

Chalfont said he spent two weeks reviewing the case before rendering his decision, adding he did not reach it lightly.

He said the doctor, who had already delivered Suleman's first six children, should not have been so quick to implant new embryos.

Chalfont did not refer to Suleman by name, although he used her initials from the court files and said her name was widely known. He called her "a patient who is an extreme narcissist," and said Kamrava should have referred her to mental health experts.

"Your client's failure to refer this woman for a mental health evaluation is a serious breach of the standard of care," he said.

The judge acknowledged that the medical board did not find Kamrava guilty of that violation but added that he would have.

"My conclusion is the medical board did not go far enough in its conclusions about your client," he said.

Chalfont said he realized Kamrava had gone through 10 years of training to become a doctor and, with his license revoked, "all of that goes does the drain."

But he said that, ultimately, his decision was not a difficult one to reach.

"This is not a close case," he said. "I have no compunction about revoking his license."

In court papers, Kamrava blamed negative media coverage for the California Medical Board's decision in July to revoke his license.

Suleman initially told the media she had been implanted with six embryos and two of them split, resulting in her octuplets, However, medical records discussed during Kamrava's licensing hearing revealed she had been implanted with 12 embryos.

Kamrava has apologized for implanting so many embryos, saying he felt bound to do it because Suleman was so insistent.

The number of implanted embryos was six times the norm for a woman her age, and the resulting pregnancy could have been dangerous for Suleman and her babies.