discipline summaries
and they were ultimately referred to another physician
for surgical termination of the pregnancy. In the other
two cases, the failed terminations were not recognized
until the late stages of pregnancy and the patients delivered live infants with multiple congenital anomalies.
The issues of concern with respect to the balance of
Dr. Prévost’s Obstetrics and Gynecology practice are
set out in the Agreed Statement of Facts and Admission. The case of Patient 25 was of particular concern
to the Committee. This patient presented to the
hospital in premature labour at 34 weeks gestation.
That hospital was not equipped to deal with preterm
infants of this gestation which necessitated transfer to
a tertiary centre. The nursing staff called Dr. Prévost to
notify him of the patient’s admission. He was obviously aware of the situation as he left admission orders
with the nurse. An hour and a half later the hospital
staff called and requested that Dr. Prévost attend the
patient and initiate the transfer. His office was located
across the street from the hospital. Dr. Prévost’s office
assistant advised that Dr. Prévost could not attend on
the patient and advised that the obstetrician on call be
notified. That physician responded that he was more
than an hour away and arranged for a third obstetrician who was not on call, but available in the hospital
to assume the care. The third physician subsequently
assessed the patient, arranged for the transfer and actually accompanied the patient in the ambulance.
The Committee was frankly shocked at Dr. Prévost’s
blatant disregard for the welfare of this patient. In the
remainder of the cases cited in the Agreed Statement
of Facts and Admission, this cavalier approach to his
patients and colleagues is evident throughout.
Counsel for Dr. Prévost argued that the failures described in the Agreed Statement of Facts and Admission
were inadvertent, not deliberate. She also submitted
that, although clearly below the standard of care, Dr.
Prévost’s individual deficiencies were relatively minor
in nature. Apart from the four pregnancy terminations
that were unsuccessful, she submitted that the remaining cases may have involved real potential risks to
patients but that no actual complications occurred. She
also submitted that the joint submission should be considered as evidence that Dr. Prévost has demonstrated
insight into his deficiencies and that he has demonstrated remorse and regret by admitting to the allegations
The Committee was not persuaded by these argu-
46
Dialogue Issue 1, 2016
ments. It does not accept that any of the misconduct
described in the evidence could be characterized as
minor. The sheer volume and repetitive nature of his
failings are nothing short of egregious. Although the
Committee is prepared to accept that Dr. Prévost has
gained a measure of insight into his behaviour as a
result of these protracted discipline proceedings, the
fact that he was well aware of his pregnancy termination failure rate and subsequent failures in follow up,
demonstrates to the Committee that he chose not to
learn from his experiences. The Committee does in no
way characterize his misconduct as inadvertent.
Counsel for Dr. Prévost submitted that he could
have brought forward evidence at a penalty hearing to
suggest that a lengthy suspension and remediation may
have been a viable alternative inasmuch as there was no
evidence before the panel that Dr. Prévost lacks skill or
knowledge. The Committee accepts that deficiencies in
skill and knowledge can often be remediated, but lack
of judgment is much more difficult.
The Committee concluded that due to the serious,
repetitive and egregious nature of the misconduct, the
Committee accepted the Joint Submission on Penalty
and Costs. The only remedy that can adequately address
the issue of public safety and fulfill the other penalty
principles is removal of Dr.