Minutes later, a family member came running with a cane to help the fraudster with his injured leg, just in time to see the 53-year-old taken into custody for the start of a likely lengthy jail stint.
The crooked construction boss had earlier failed to show for his own bail hearing on Friday morning at a Darlinghurst courthouse, instead appearing via a video link from Northern Beaches Hospital.
A warrant was issued for his arrest before he showed up to the NSW Supreme Court to be taken into custody over his role in a $10 million fraud.
His family watched on as an officer led him down the courtroom stairwell and out of sight while Justice Desmond Fagan read through the details of the case.
Alex will be held on remand until his sentencing on November 21.
George Alex faces incarceration for "a significant amount of time", the court was told. (Nikki Short/AAP PHOTOS)
The labour-hire operator had previously been granted bail to receive medical treatment despite being found guilty with four co-conspirators of a plan to defraud the Australian Tax Office.
Alex and the other men were also found guilty after a marathon trial of either conspiring to or intentionally dealing with proceeds of crime worth more than $1 million.
The group used a number of second-tier "shield" companies to hide more than $10 million of pay-as-you-go tax from the ATO between 2018 and 2020.
Alex's doctor previously convinced the judge to keep him out on bail to receive opioid treatment in the hospital, where he had been since August 23.
But Justice Fagan said he was "left with no alternative" but to issue a warrant for his arrest after he failed to re-appear in court.
"I think it's inevitable he will be incarcerated for a significant amount of time," he said.
Alex's barrister, John Agius SC, raised concerns that the construction-industry figure would not receive appropriate treatment for his addiction while in custody.
"The price he will pay for this is the loss of his leg," he said.
Alex picked up an opioid addiction in 2014 when he self-medicated for a leg injury he got in a motor-vehicle accident 30 years ago, the court heard.
His opioid use peaked at 240mg per day.
As a consequence, Alex was receiving a buprenorphine substitute in hospital for a treatment plan organised to wean him off the opioids.
But Justice Fagan told Alex's legal team the matter had moved "too far" and private health treatment would have been an option before he was found guilty.
He said he didn't accept a health issue could become a sudden crisis after a six-month trial.
Special conditions could not be established after Alex effectively went "on a bender", the judge said.