It took me the longest while to think of this, but one reason for his anger at Dr. Mayfield was that his original "victim" (the other doctor) was still alive, but "hanging in the balance." So for a change, Columbo wasn't just angry about something the other character HAD DONE, but about something else, that could be PREVENTED. So in a way, it was almost a one-of-a-kind scene for THAT reason too. Someone mentioned very mild cases of anger. In "Blueprint For Murder", Columbo goes from apologizing to Markham for those reporters (typical of him) to getting just a little mad when he finds out that Markham HIMSELF called the reporters (which is, of course, less typical).