INVESTIGATIONS & RESOLUTIONS
Members of the veterinary profession have a responsibility to uphold standards to ensure the public has access to
safe, quality veterinary care. When those standards are compromised, the College responds. Every veterinarian can
learn from these situations and publishing the details of complaints received and resolved is intended to support
that learning. Learning from peers is best. The example below is taken from an actual case that went before the
Complaints Committee and is offered as a self-reflection tool to improve practice across the province.
LEARNING IN PRACTICE
CASE SUMMARY
The member examined a neutered cat
that had blood in his urine. Urine was
collected and sent for urinalysis and
culture and sensitivity. The member
performed a no cost abdominal
ultrasound to collect the urine and look
at the bladder. The cat was sent home
on prazosin (a urethral relaxant) and
buprenorphine (for pain management).
The following morning, the client noticed
the prazosin label was for a different
cat with different instructions than were
provided at discharge. The client tried
to contact the hospital but it was closed
due to a holiday. The client contacted
her regular veterinarian, who clarified the
correct medication dosage.
CASE OUTCOMES
The panel decided the nature of the
allegations involving the member did not
warrant a discipline hearing.
The member was advised of the panel’s
concerns regarding her professional
accountability for all aspects of veterinary
services provided to patients, including
situations where auxiliary staff are
dispensing medication. Ultimately, the
actions of the auxiliary staff are the
veterinarian’s responsibility and errors
in dispensing medication could have
grave consequences for the patient. In
addition, the member must be aware of
the breach of patient confidentiality that
occurs when medication is mixed up.
Advice is meant to be educative and not
punitive and serves as a remedial tool
to assist licensed members in correcting
specific areas of practice identified by the
panel as problematic. Specifically, such
advice is intended to provide education
about professional standards and
expectations in order to improve and/or
6
College Connection Winter 2019 cvo.org
change the veterinarian’s practice in the
identified areas and to underscore the
seriousness of the issues addressed by
the panel so that concerns of a similar
nature do not arise again in the future. fills the prescription, goes through
discharge instructions, and dispenses
the medication. In the process, the cat’s
medication was swapped with another
cat’s.
CASE CONSIDERATIONS The member indicated she has
recommended the emergency clinic
establish a protocol that the medication
labels be read to the owner to verify
identification of the patient and the
medication verified at discharge.
When deliberating on the case, the panel
considered the client’s concern that she
could not speak with the veterinarian
who treated the cat. The panel wishes
to clarify how emergency veterinary
hospitals operate. The relationship
between the veterinarian, client and
patient was not the same as an ongoing
treatment relationship between a regular
veterinarian and the veterinarian’s
patients.
The member was assisting with
emergency services at the hospital over
the holidays. Most veterinarians who
work part-time in emergency hospitals
are locum veterinarians, covering random
shifts. Once the emergency veterinarian’s
shift is completed and the veterinarian
leaves the hospital, this veterinarian
does not follow up on the services
provided. The panel drew the analogy of
an emergency room physician in human
medicine.
All necessary information was
documented in the medical record for
the next veterinarian to provide follow-
up. The panel also took into account the
hospital provides after hours emergency
services and is often closed during the
day so no one is available to be in touch
with clients during these hours.
In her submission, the member said
she was the attending veterinarian
for the cat. She prescribed prazosin
and buprenorphine and wrote the
prescription and printed out the
medication label. A veterinary technician
When reviewing this issue, the panel
noted it is common practice for
the veterinary technician to review
medication and discharge instructions
with the client. This is acceptable,
however, it is ultimately the veterinarian’s
responsibility to supervise auxiliary staff.
Regarding the client’s concern about
a breach of confidentiality when she
received someone else’s medication,
the panel concurred this was a serious
issue. The panel noted it was clear the
confidentiality breach occurred as a
result of an inadvertent error. The panel
expects that the discharge protocols
at the hospital have been changed to
prevent such errors from recurring.
In conclusion, the panel was satisfied
the cat’s treatment was appropriate.
Although the medication error was
inadvertent and did not cause any
harm, the panel wishes to underscore
the member is responsible for the
actions of auxiliary staff acting under
her direction. In this case, the error
was inconsequential because the same
medication was given to the cat at an
acceptable frequency. The panel noted,
however, that if this had been a different
medication, the negative impact could
have been significant.