discipline summaries
Dr. WAGDY Abdalla Botros
Practice Location: Kitchener
Area of Practice: Psychiatry( Full-time sleep medicine)
Hearing Information: Contested; 12 Hearing days
On July 31, 2015, the Discipline Committee found that Dr. Botros committed an act of professional misconduct, in that he failed to maintain the standard of practice of the profession and he has 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 Committee also found that Dr. Botros is incompetent. The Committee found that Dr. Botros failed to maintain the standard of practice of the profession in his care and treatment of 22 patients in his sleep medicine practice between 2007 and 2010 including:
• He failed to maintain the standard of practice with regard to his sleep study interpretation regarding all 22 patients. Sleep Medicine Standards are clear that the sleep medicine physician must provide a report of his / her interpretation of the sleep study data so that the referring physician would know what the diagnosis was and if there was a problem, the recommendation. Dr. Botros’ Standard Sleep Study Interpretation form documented neither of these.
• He failed to triage all patient referrals as required by the Standards.
• He failed to complete a physical examination for one patient, and either did not do a physical examination or did not chart a physical examination with respect to three additional patients.
• He prescribed inappropriate Continuous Positive Airway Pressure( CPAP) pressures following CPAP titration with respect to five patients.
• He failed to take appropriate steps to treat three patients with severe obstructive sleep apnea within a reasonable time frame.
• He allowed two patients to be prescribed CPAP without first being seen by a sleep physician.
• He incorrectly or incompletely diagnosed five patients.
• He failed to appropriately notify or follow up with the Ministry of Transportation regarding three patients.
• He failed to appropriately prescribe supplemental oxygen for one patient who was on CPAP therapy.
• He demonstrated poor knowledge and understanding of CPAP treatment.
The Committee also found Dr. Botros incompetent, in that his care of patients showed a lack of knowledge, skill or judgment generally, and specifically in the care of four patients who had severe conditions and one patient who was inappropriately diagnosed and managed. The Committee also found that Dr. Botros engaged in behaviour that was unprofessional in his treatment of the College investigators. During an office visit, Dr. Botros interfered with the investigators’ chart pull and made comments that were derogatory and demeaning to the professionalism of the College investigators. Following a medical inspector’ s review of 10 of Dr. Botros’ charts, Dr. Botros failed to comply with multiple requests for information within a reasonable period of time.
Penalty and Reasons for Penalty Counsel for Dr. Botros and Counsel for the College disagreed on an appropriate penalty. Both parties agreed that a reprimand would be appropriate in this case as it expresses the profession’ s abhorrence for the actions of the doctor. The Committee concurred. However, the Committee did not agree with Dr. Botros’ counsel who argued that the reprimand would sufficiently address the issue of Dr. Botros’ lack of cooperation with College processes. Counsel also disagreed on the length of a suspension for Dr. Botros. The College submitted that a suspension of six months is appropriate; Dr. Botros’ counsel requested a four-month suspension. The Committee concluded that a four-month suspension would not be sufficient in this case. When looking at the context, there were multiple areas in which Dr. Botros failed to maintain the standard of
Issue 4, 2016 Dialogue 59