The Health Professions Appeal and Review Board (HPARB) returned a matterto the Inquiries, Complaints and Reports Committee (ICR) of the College of Physicians and Surgeons of Ontario (CPSO), directing the ICR to reconsider its decision and issue a further decision with written reasons. This came after the Applicant sought a review of the finding.
The HPARB found that the ICR’s initial decision to issue a Caution to the Applicant had been based on a mistaken belief that the Applicant had a significant history of complaints to the CPSO. In fact, there was only one previous complaint which was for a completely unrelated issue for a breach of the CPSO policy on Treating Self and Family Members.
The Applicant, a physician, was the subject of a complaint by the wife of a now-deceased patient. The patient had died of a heart attack four days after surgery to relieve muscle-invasive bladder cancer and incidental prostate cancer. The operation had been performed by another urologist. The original surgeon last saw the patient in the late afternoon or early evening the day prior to his death. The surgeon was concerned with the patient’s condition but believed the situation would resolve itself. The patient’s care was then transferred to the Applicant, who was the on-call urologist. There was no communication of the original surgeon’s concerns to the on-call urologist.
There were two calls made by the nursing staff to the on-call urologist. The first was a few hours after the surgeon had seen the patient, to clarify a medication to be administered. The second call was a few hours later to report that the patient had vomited. The Applicant ordered a fluid bolus to rehydrate the patient. Vomiting was a known side effect of radical cystectomy surgery. In neither call did the nursing staff communicate to the on-call urologist that the patient was unduly sick or that he needed to be seen urgently.
The complaint expressed her concerns as follows:
HPARB concluded that the ICR’s investigation was adequate.
However, the HPARB found that the decision was unreasonable because it had been based on the false assumption that the Applicant had a significant history of complaints when in fact he had only one. This previous complaint had marginal relevance at best to the current complaint and that fact should have been assessed and considered by the ICR.
A caution, following a disciplinary hearing, carries with it significant consequences for any health professional. The results when published on the CPSO public register can impair their reputation, their licence and hospital privileges. If there is any concern about the adequacy of the investigation or the reasonableness of the decision a health professional should seek legal advice and consider a review request.
At Wise Health Law, we focus on health and administrative law, including appealing and seeking judicial review of disciplinary committees. Our lawyers have significant trial and appellate experience and are passionate about helping regulated health professionals and healthcare organizations understand and protect their legal rights. We will guide you through the process, help you understand potential risks and legal implications, and assist you with or skillfully represent you at the proceedings. To find out how we can assist, contact us online, or at 416-915-4234 for a consultation.
The Chief Medical Officer of Health for Ontario has issued an updated Directive #2 (dated May 26, 2020) for Regulated Health Professionals in the province.
Pursuant to the updated Directive #2, all deferred non-essential and elective services by health care providers may be gradually restarted – subject to the rest of the requirements set out in the Directive.
The updated Directive #2 does not provide particularly detailed guidance to health professionals on how to proceed, likely because it applies to such a broad spectrum of health care and health professionals. It does, however, provide some principles to assist health care providers in making decisions as we enter this transitional period.
In addition to the mask and hand sanitizer shortages, Ontario’s response to COVID-19 highlights the need for more frontline health care workers. Each regulated health profession’s college responded differently, and we have discussed some of those changes in other posts to keep you apprised.
Today, we focus on the College of Physicians and Surgeons of Ontario (CPSO), who set out to increase the number of available and licenced physicians out on the frontlines through certificates of registration that authorize supervised practice of short duration. The temporary licences authorize practice for 30 days.
Undoubtedly, COVID-19 has affected how health professionals practice. Pharmacists across the country are not only experiencing changes in how they practice (for example, accepting emailed prescriptions, where appropriate) but the scope of their practice as well. The latter change is not permanent, although the disruptions in practice may be felt long after the COVID-19 emergency subsides.
On March 19, 2020, Health Canada issued a short-term section 56(1) exemption under the Controlled Drugs and Substances Act (CDSA) that would authorize pharmacists to prescribe, sell, or provide controlled substances in limited circumstances, or transfer prescriptions for controlled substances (the CDSA Exemption).