DISCIPLINE SUMMARIES
ultrasound appointment and blood work for the next
morning. The ultrasound results suggested that the
common bile duct was obstructed and blood work
indicated that Patient X’s bilirubin had increased
over the previous three days. Dr. Ghumman advised
Patient X that the clip he was concerned about had
actually been placed incorrectly and had likely caused
obstruction of the patient’s common bile duct. He
organized Patient X’s immediate transportation to
London Health Sciences Centre for emergency ad-
mission and surgery.
Following the surgery, the hepatobiliary surgeon
noted that there was a clip going across Patient X’s
entire bile duct. The surgery was complicated by
intra-operative and post-operative bleeding, which
required transfusion of eight units of blood. Patient
X remained hospitalized in London for approximate-
ly one week after the surgery.
In October 2015, the College retained an expert,
a general surgeon, to provide opinion regarding Dr.
Gumman’s care of Patient X. The expert opined that
although the technical complication involving the
clip applier during surgery was beyond Dr. Ghum-
man’s control, his actions in response to the problem
were below the standard of pr