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.
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).
The past several weeks have been a challenging time for everyone. Health professionals have been bombarded with Emergency Orders and other pronouncements that can be confusing and at times seem contradictory.
With the rules and restrictions changing so rapidly, it is advisable to keep an eye on the website, social media feeds, and other communications from your respective regulatory College for your College’s interpretation and position on what you should and should not be doing during the pandemic. While the Emergency Orders and pronouncements apply to a broad spectrum of health professionals, individual Colleges can provide guidance and interpretation about how those orders and pronouncements relate to your specific profession.
But what if you’re still unsure about whether you can provide a particular service to a specific patient/client; or some other aspect of your professional obligations at this uncertain time?
Earlier this year, Wise Health Law succeeded on a motion for summary judgment in a dental malpractice case on the basis that the limitation period had expired before the Statement of Claim was issued. The (unreported) decision was delivered orally on the day of the motion.
In part, the plaintiff argued that she did not discover her claim until the Royal College of Dental Surgeons of Ontario (the “RCDSO” or “College”) rendered its decision, as she did not know if the defendant was negligent when she complained to the RCDSO, but merely had a “suspicion”.