Dialogue Volume 11 Issue 3 2015 | Page 66

discipline summaries DR. BEHNAZ YAZDANFAR Practice Location: Toronto Practice Area: Family Medicine (Cosmetic Medicine) Hearing Information: Agreed Statement of Facts, Admission, Joint Submission on Penalty On May 26, 2014, the Discipline Committee found that Dr. Yazdanfar committed acts of professional misconduct, in that she failed to maintain the standard of practice of the profession, and she engaged in conduct or an act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional. The Discipline Committee also found that Dr. Yazdanfar was incompetent with respect to her care of Patient A. Dr. Yazdanfar admitted to the allegations. With respect to Patient A, in August 2009, the College received a letter of complaint about two liposuction procedures performed on her by Dr. Yazdanfar in February and April 2008. Dr. X, an independent expert retained by the College, concluded that Dr. Yazdanfar failed to meet the standard of practice of the profession and displayed a lack of knowledge, skill and judgment in her performance of large-volume liposuction on Patient A and by failing to appropriately recognize and respond to the complications that arose from the procedure. With respect to Patient B, in July 2009, the College received a letter of complaint regarding a breast augmentation Dr. Yazdanfar performed on her in October 2007. Dr. X concluded that Dr. Yazdanfar failed to meet the standard of practice of the profession and displayed a lack of knowledge, skill and judgment in failing to appropriately respond to the unsatisfactory outcome of the breast augmentation procedure. In addition, Dr. Yazdanfar engaged in disgraceful, dishonourable or unprofessional conduct in her communications with both patients post-operatively. Expert Opinion The Committee reviewed the opinion of the College’s independent expert regarding Dr. Yazdanfar’s care of the two patients. In the case of Patient A, the independent expert provided evidence that the standard of care was 66 Dialogue Issue 3, 2015 not met because the total volume of aspirated material far exceeded published guidelines and such an operation should not have been done in a private clinic with no formal hospital link. In addition, Dr. Yazdanfar failed to recognize that inner thigh liposuction has been recognized as a high-risk site for vascular injury. In the case of Patient B, the independent expert stated that the failure to acknowledge a post-operative deformity demonstrated a lack of knowledge, skill and a disregard for the welfare of her patient. Since breast augmentation is considered an aesthetic operation, patients expect a result that they are satisfied with. The expert stated that some sort of additional surgery should have been offered to Patient B given her subsequent concerns. The Committee noted that Dr. Yazdanfar’s admission explicitly acknowledged the validity of the expert’s opinions with regard to Patients A and B. Penalty and Reasons for Penalty Counsel for the College and counsel for the member made a joint submission as to an appropriate penalty and costs order. The Committee considered the established general principles in determining the appropriate penalty. These principles include protection of the public and maintenance of the public trust, maintenance of the integrity of the profession and the College’s ability to govern the profession, a denunciation of the conduct, specific and general deterrence and consideration of the member’s potential for rehabilitation. The Committee was provided with the previous Penalty and Reasons for Penalty of the Discipline Committee imposed on December 21, 2011 (the “First Dr. Yazdanfar Case”), with regard to Dr. Yazdanfar to assist in its deliberation and to understand the background to the joint submission under consideration. In the First Dr. Yazdanfar Case, the Committee hearing that case held a 67-day hearing which commenced in July 2009, and resulted in Reasons for Decision dated May 4, 2011, and the reasons for penalty outlined below. The First Dr. Yazdanfar Case considered a number of complaints and took a broad look at Dr. Yazdanfar’s practice. Among other things, the Committee in the First Dr. Yazdanfar Case undertook a careful review of the circumstances surrounding the death of one of Dr. Yazdanfar’s patients, Ms. Krista Stryland. In the First Dr. Yazdanfar Case, the Committee found