discipline summaries steroid injection and a radiofrequency ablation of the L5 root. The assessor concluded that Dr. James“ continues to meet the standard of practice of the profession in respect of infection prevention and control procedures. There was no evidence of lack of knowledge, skill or judgment, and there was no unnecessary risk of harm or injury.”
In addition, the following facts accepted by the Committee were set out in a Supplementary Agreed Statement of Facts for Penalty:
1. On November 12, 2015, Dr. HH, the Associate Director of Infection Prevention and Control at a hospital network in Ontario, attended for an unannounced inspection at Dr. James’ new clinic. She observed him perform two procedures, a lumbar epidural injection on one patient and a cervical epidural inspection on a second patient.
2. Dr. HH opined that Dr. James met the standard of practice of the profession with respect to infection prevention and control, and that he did not display a lack of knowledge, skill or judgment in respect to infection prevention and control. Dr. HH made some recommendations.
3. As a result of recommendations made by Dr. HH and others, Dr. James has entered into an undertaking with the College, formally setting out his agreement to follow the recommended infection control practices for specified procedures. That undertaking constitutes further terms, conditions and limitations on Dr. James’ certificate of registration, and will be relied upon by the College in its compliance and monitoring activities.
Counsel for the College together with counsel for Dr. James made a joint submission as to an appropriate penalty and costs order. Initially, the jointly-proposed order included the following provisions:
• that Dr. James be prohibited from holding the position of medical director in any facility;
• that Dr. James be required to perform all injections in the presence of a regulated health professional who would observe each injection, as well as sign and date the patient record;
• that, if Dr. James were to become aware of a patient developing an infection following a procedure that he performed, he be required to report this infection to the College within seven days;
• that Dr. James would be subject to: o the reassessment of his practice, including his sterile technique, within six months of his return to practice; and o periodic assessments, both announced and unannounced, at the discretion of the College;
• that Dr. James be required to complete the next available medical record-keeping course approved by the College;
• that Dr. James be required to complete the next available course in communications approved by the College;
• that Dr. James be required to engage in a preceptor acceptable to the College regarding infection and treatment of infection in interventional pain medicine for a minimum of four hours; and
• that Dr. James’ certificate of registration be suspended for a period of 10 months, effective 30 days after the date of this order.
The Discipline Committee accepted the above penalty provisions as appropriate, but considered that an even more serious penalty was called for on the facts of this case. As a result, the Committee asked both the College and counsel for Dr. James to reconsider certain aspects of the proposed order in their joint submission on penalty. They did so, returning with a strengthened requirement for the monitoring / education program( a clinical supervisor, who will meet with Dr. James monthly for a year; reviewing patient charts and discussing infection control) and added a requirement that Dr. James complete an ethics program that will be individualized to his specific needs. In its consideration of penalty, the Committee took into account aggravating and mitigating factors.
Full decisions are available online at www. cpso. on. ca. Select Doctor Search and enter the doctor’ s name.
Issue 1, 2017 Dialogue 51