discipline summaries tients commented in their victim impact statements that they never received any contact from Dr. James expressing regret for his actions.
Mitigating Factors The Committee took into account that Dr. James has no previous disciplinary history. By pleading no contest to the allegations, he accepted the facts and allegations made against him. This spared the College the time and expense of a contested hearing and avoided causing the emotional turmoil that his patients would suffer if they were required to testify as witnesses. Also, Dr. James cooperated with Toronto Public Health during its investigation and look-back process, as well as with the decolonization procedure. The evidence before the Committee is that there have been no further episodes of infection in the past three years since Dr. James returned to work. He has passed four further inspections between January 2013 and November 2015, two of which were unannounced. Dr. James did not hide his status as a Staph carrier; it is significant that he did not know he was one and he fully complied when he was informed of this. Dr. James has demonstrated insight. He has been amenable to remediation and has completed an online infection control course offered by Public Health Ontario in May 2015. In addition, Dr. James recently moved to a practice in a new clinic, and has received a pass on infection control since his relocation.
In considering the revised joint submission of the parties, the Committee had regard to the legally mandated penalty principles and considered the nature and the circumstances of Dr. James’ misconduct. The Committee determined that the sanctions and measures of protection in the proposed penalty satisfy the basic principles underlying penalty orders – public protection, maintenance of the integrity of the profession, public confidence in the profession’ s ability to self-regulate in the public interest, specific and general deterrence, and rehabilitation of the member where possible The 10-month suspension is consistent with past decisions; the duration of the suspension serves to express the repugnance of Dr. James’ behaviour by the medical profession. By the reprimand, the Committee expresses publicly its abhorrence of the physician’ s misconduct. In addition, the penalty permits remediation, which, in this case, involves the appointment of a clinical supervisor who meets monthly with Dr. James for a one-year period, and a preceptor targeting treatment of infection in Interventional Pain Medicine. The various courses required – ethics, communications, record keeping, and infection control – are also imposed with the goal of remediation in mind. The ethics course and the communications course have no time limit, and can be tailored to Dr. James’ specific needs over time. The public is protected additionally by the requirement of the presence of a health-care practitioner who observes every injection that is administered, and by Dr. James’ obligation to report any patient infections within seven days. The public is further protected by the requirement of the preceptor and of the clinical supervisor; the ability to conduct announced and unannounced inspections; and the planned reassessment of the practice within six months after the end of the suspension. Dr. James’ undertaking, which addresses infection control procedures, adds to public safety. The fact that Dr. James will not be able to hold the position of Medical Director in any facility ensures he will be under an ongoing degree of clinical supervision. The penalty as a whole seeks to uphold the reputation of the profession and instills confidence in the public that the profession is capable of self-governance.
In summary, the Discipline Committee ordered: a 10-month suspension, terms, conditions and limitations on Dr. James’ certificate of registration, including the appointment of a clinical supervisor; a preceptorship; the presence of a health-care practitioner to monitor and observe all injections; educational courses in record-keeping, communications and ethics; a reassessment of his practice; and unannounced inspections. Dr. James is also prohibited from holding the position of Medical Director in any facility. If Dr. James becomes aware that a patient developed an infection following a procedure that he performed,
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Issue 1, 2017 Dialogue 53