The former chief of heart and chest surgery at Bethesda Naval Hospital, who lost his right to practice at the hospital earlier this year when doctors there raised questions about his competence, has been charged in connection with four deaths as a result of a special military inquiry that revealed he was suffering from severe loss of sight in his right eye.

Dr. Donal M. Billig will face a general court-martial, the most serious of military proceedings, on four counts of involuntary manslaughter and 22 counts of dereliction of duty, alleging that he performed heart operations without proper supervision, a Navy spokesman said yesterday.

The hospital's former commanding officer, Commodore James J. Quinn, its former chief of an internal review committee, Capt. Leon Georges, and the former head of surgery who was directly responsible for supervising Billig, retired Capt. John Raymond Fletcher, will also face severe sanctions for their appointment of Billig, according to a statement released last night.

Seven other officers have been sanctioned or will face sanctions in connection with the service of Billig, the Navy said. Among those seven are two who are being investigated for recruiting Billig. Investigating the recruiting process is a highly unusual move, according to Navy sources.

Quinn, who had been elevated to vice commander at the Naval Medical Command, and Georges, commanding officer of the Naval Health Sciences and Training Command in Bethesda, have been reassigned to nonsupervisory positions and recommended for formal censure, Navy spokesmen said yesterday.

Fletcher, who retired in 1983 and is practicing in Nashville, has been recommended for recall to active duty, in order that he too might face a general court-martial, Navy spokesmen said.

Billig, his attorney Neal Worden and Quinn could not be reached for comment last night. Georges declined to comment and Fletcher, reached in Tennessee, said he had not been informed of the investigation's conclusions.

Among the seven other officers, Capt. Reginald E. Newman and Lt. Cmdr. Jerry D. Penn have been charged with contributing to the deaths of the four patients by withholding information about Billig, and Capt. Alfred J. Martin has been charged with not adequately checking Billig's competence, a Defense Department news release said.

Questions raised by doctors on the naval hospital staff in November led to the formation of a board of inquiry in April.

The board's probe was not the first time Billig had faced such an inquiry by his peers, nor was it the first time the Navy reviewed concerns raised by other doctors.

Court documents detailed by The Washington Post in April revealed that physicians at Monmouth Medical Center in New Jersey had said in 1980 that Billig lacked good surgical judgment, proper motivation, competence and honesty. He was asked to leave the hospital and later retired his New Jersey license, according to court and state records.

Bethesda officials were informed of that assessment in written correspondence from Monmouth but hired Billig in January 1983 after reviewing his credentials, which showed that he had trained under renowned heart surgeon Dr. Michael DeBakey.

Doctors who testified before the internal inquiry board have told The Post that Billig had not performed heart surgery for six years at the time of his hiring. Six months after his introduction to the hospital, however, Billig was named head of the surgical unit.

Billig was hired with the understanding that he would undergo training for six months, said Dr. Benjamin Aaron, a former Naval surgeon who is now chief of cardio-thoracic surgery at George Washington University Hospital. The results of that training were reviewed by the internal board but were not released yesterday. One doctor who was supervising Billig's work, Dr. Reginald Peniston, has told The Post that he recommended in an evaluation in May 1983 that Billig not be allowed to operate alone.

However, he was operating alone by June 1983, Peniston said.

During the recent inquiry, Billig was ordered to undergo an eye exam. He was found to have reduced vision of 20/400 in his right eye, Navy spokesman Lt. Stephen Pietropaoli said.

New Jersey court documents obtained by The Post reviewed yesterday show that Billig's eyesight was a source of concern to doctors at Monmouth, who said he "could not find or properly tie bleeding arteries and vessels."