Dialogue Volume 11 Issue 4 2015 | Page 65

discipline summaries DR. STEPHEN CHARLES HUEBEL Practice Location: Toronto (Scarborough) Practice Area: General Practice (Emergency Medicine) Hearing Information: Agreed Statement of Facts, Admission, Agreed Statement of Facts on Penalty, Joint Submission on Penalty On January 19, 2015, the Discipline Committee found that Dr. Huebel committed an act of professional misconduct, in that he failed to maintain the standard of practice of the profession. Dr. Huebel admitted to the allegation. Patient A presented to the emergency department in August 2012 with back and chest pain and a history of some slurred speech. She was seen by an emergency physician, had some investigations done and was discharged with a diagnosis of transient ischemic attack and chest pain not yet diagnosed. The blood work conducted that day at the emergency department was unremarkable. She was to have follow-up tests. Patient A returned to the emergency department two days later at approximately 9:50 a.m. complaining again of pressure between the shoulder blades associated with chest pain radiating to the epigastriac area. The pain was associated with weakness and nausea. Patient A’s vital signs at Triage were: temperature 36.2; heart rate 64 irregular; respiratory rate 28; blood pressure 71/54 and 100/72; and oxygen saturation of 96% on room air. Her past medical history of atrial fibrillation and thyroid disease were documented at Triage. Dr. Huebel saw Patient A at 10:15 and documented her past medical history of atrial fibrillation on Coumadin and her history of thyroid disease. He documented her history of a sudden sharp chest and mid-back pain that occurred two days prior with an episode of an altered state of consciousness. He noted that the CT head scan done at that time showed no acute abnormality and that the troponin done at that visit was negative. There are scant details of a physical examination, which was essentially unremarkable. Dr. Huebel ordered blood work (including a D-Dimer), a chest x-ray, a thoracic spine x-ray and a CT scan to rule out pulmonary embolism. He also ordered medication, including Zofran and Toradol. Dr. Huebel’s next documentation was at 13:45, and then at 19:45, at which time it is documented that the patient returned from diagnostic imaging with a d XYۛ