discipline summaries
in a therapeutic abortion practice was inspected by the Premises Inspection Committee ( PIC ) and received a “ fail ”. Accordingly , Dr . Sim was prohibited from performing any “ procedures ” ( as defined in s . 44 ( 1 ) of the General Regulation O . Reg 114 / 94 , made under the Medicine Act , 1991 ), including therapeutic abortions , at his clinic . Among the reasons cited in the report for the “ fail ” was the clinic ’ s non-compliance with infection control standards set by the Outof-Hospital Premises Standards . The PIC notified the Registrar of the College of its concerns . Following an investigation , the Inquiries , Complaints and Reports Committee ( ICRC ) agreed that Dr . Sim should undertake in writing to undergo a re-inspection of his practice , as well as a re-assessment regarding record keeping and documentation and an infection control inspection of his premises . Additionally , the ICRC counseled Dr . Sim to ensure he practised within his scope of practice . After receiving the results of the reassessment and the inspection , the ICRC commenced another investigation of Dr . Sim ’ s practice . The College retained a medical inspector to investigate infection control issues in Dr . Sim ’ s practice . She found that Dr . Sim did not meet the standard of practice in infection control practices and instrument reprocessing . Additionally , she found that Dr . Sim ’ s infection control and reprocessing practices may put patients at significant risk for harm in terms of transmission of infectious microorganisms , including antibiotic-resistant organisms and blood-borne pathogens . The College retained another medical inspector to opine on Dr . Sim ’ s obstetrical and gynecological practice . He found that Dr . Sim ’ s practice did not meet the standard of care for the practice of the profession , and that Dr . Sim performed surgical procedures that should not be performed in an office setting . Dr . Sim ’ s practice of medically induced therapeutic abortions was of harm and danger to the patients because he converted many of these into surgical abortions if they did not succeed initially . The medical inspector concluded that , for this reason , Dr . Sim should cease from performing medical or surgical therapeutic abortions in an office setting .
Reasons for Penalty The Committee considered that protection of the public was the paramount consideration in determining the appropriate penalty . The Committee found that , in light of the multiple ways in which Dr . Sim placed his patients at risk , he could not be permitted to continue to practise . The Committee accepted the joint submission on penalty , whereby Dr . Sim undertook to resign from the College and to never reapply to practise medicine in Ontario . Had Dr . Sim not agreed to resign , based on the facts before the Committee , a very strong case could have been made that his certificate of registration should be revoked . The Committee stated that it was appalled by the conduct of Dr . Sim . The facts established a pattern of glaring deficiencies in his practice , insensitivity to the interests of his patients , lack of knowledge in critical areas , and impaired judgment . The effect was to place his patients at serious risk of harm . Although the evidence before the Committee did not establish that any of Dr . Sim ’ s patients suffered actual physical harm as a result of his treatment , the risk of harm was significant . In particular , the Committee considered the following :
• Dr . Sim fell below the standard of practice in both infection control and instrument reprocessing procedures . His hand hygiene was inadequate ; the white coat which he wore while performing procedures was an infection control hazard ; and his sterile gloves were ten years past expiry . He delegated instrument reprocessing to individuals in his office who were neither properly trained in this area nor aware of best practices . His instrument cleaning and sterilization were inadequate . Reprocessed instruments inspected were found to have visible rust and / or debris on them . This created another infection control hazard , to which Dr . Sim and his staff appeared to have been oblivious . The result of Dr . Sim ’ s practice deficiencies in this area placed his patients at risk of exposure to blood-borne pathogens and antibiotic-resistant organisms .
• Dr . Sim ’ s record keeping was totally inadequate . His notes were sketchy , disorganized , and hard to
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Dialogue Issue 2 , 2016