discipline summaries
to infection control procedures and maintenance of
equipment in his practice. [His] care in relation to
infection control as of March 12, 2015, displayed a
lack of knowledge, care and judgment in that he was
unaware of and/or did not implement basic office
infection control processes and procedures that are
readily available to all Ontario physicians through
Public Health Ontario,” stated Dr. Z.
“In my opinion, his deficit is severe as the breaches
in infection control were numerous and place pa-
tients at risk,” stated Dr. Z. “Dr. Ng’s practice,
behaviour, and conduct in relation to infection
control as of March 12, 2015, exposed his patients to
harm and was likely to expose his patients to injury.
Significant risks resulting from his practice, behav-
iour and conduct include transmission of respiratory
pathogens such as influenza, enteric pathogens such
as C difficile and blood borne pathogens such as
hepatitis B or C,” he continued.
Dr. Ng wrote to the College on August 7, 2015,
in response to the forensic document report as well
as Dr. Z’s report. Dr. Ng maintained in his response
that he had not altered Patient A’s chart, despite the
forensic document report.
Section 75(1) Investigation
Based on Patient A’s letter of complaint and the Col-
lege’s unannounced inspection of Dr. Ng’s clinic on
February 27, 2015, the Inquiries, Complaints and
Reports Committee approved the appointment of
investigators to conduct a broader investigation into
Dr. Ng’s practice on March 10, 2015.
On March 3, 2015, the College notified Toronto
Public Health that Dr. Ng was using unacceptable
infection prevention and control practices while pro-
viding patient care at his office.
On March 6, 2015, an inspection by Toronto
Public Health concluded that Dr. Ng failed to use
adequate infection prevention and control practices.
On the same day, Toronto Public Health gave a
verbal order under section 13 of the Health Protec-
tion and Promotion Act, requiring Dr. Ng to close his
office until further notice.
On March 11, 2015, Toronto Public Health served
a written order requiring Dr. Ng to make improve-
ments to his office, including disposing sharps in an
approved sharps container; ensuring the premises is
clean and in good repair at all times; ensuring there
is an area that has a sink for cleaning and disinfecting
instruments; and ensuring that single-use items are
discarded safely after use.
On March 23, 2015, Toronto Public Health re-
inspected Dr. Ng’s practice and concluded that he
made the necessary corrective infection prevention
and control measures and reopened the premises for
patient care.
On July 2, 2015, the College conducted a re-in-
spection of Dr. Ng’s office which revealed continuing
infection control issues.
The College retained Dr. Z to review Dr. Ng’s
standard of care. Based on an office inspection, an
observation of Dr. Ng’s practice, an interview with
Dr. Ng, and a review of 26 patient charts as well as a
review of five patient charts whose care she observed
on June 8, 2015, Dr. Z stated that:
• In 25 charts, Dr. Ng failed to properly maintain a
CPP, medication record or immunization record.
• In 16 charts, Dr. Ng failed to meet the standard in
assessing, documenting, investigating and manag-
ing patients with a thyroid nodule, microcytic
anemia, low hemoglobin/hematocrit, ulcer pain,
infected heel wound, ongoing albuminuria, diabe-
tes, toothache and not referring patients for den-
tal care, using non-evidence based treatments for
prostatitis, H pylori titers, zoster infections, carpal
tunnel syndrome, enuresis in a 2-year-old child, in
having performed a laryngoscopy on a patient, and
not having used a growth chart and not following
the Ontario immunization schedule.
• Dr. Ng failed to meet the standard of care in five
out of five of the patients observed, including
performing blood pressure assessment, assessing
a patient’s complaint of fatigue and back pain,
following up on an abnormal HbA1C, assessing a
patient’s complaint of chest pain and shortness of
breath, managing a patient’s oral pain.
• Dr. Ng demonstrated a lack of knowledge/skill/
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Issue 2, 2017 Dialogue
65