DISCIPLINE SUMMARIES
including restricting him from prescribing any controlled substances as defined by the Controlled Drugs and Substances Act , 1996 . On October 5 , 2006 , Dr . Sweet entered into an undertaking with the College , and agreed to cease to practise addiction medicine , chronic pain medicine and psychotherapy .
DISGRACEFUL , DISHONOURABLE AND UNPROFESSIONAL CONDUCT
Breach of 2002 Order Dr . Sweet breached the 2002 Order of the Discipline Committee by prescribing controlled substances on three occasions :
• On October 17 , 2014 , Dr . Sweet prescribed Androgel to Patient B .
• On January 3 , 2015 , Dr . Sweet renewed a prescription of Clonazepam to Patient C .
• On December 14 , 2016 , Dr . Sweet prescribed a hormone replacement therapy containing testosterone to Patient E .
Prescribing Botox to Patient E Dr . Sweet was Patient E ’ s family physician . In 2013 , the College commenced an investigation into whether Patient E , who is not a regulated health professional , was performing rhinoplasties and injecting Botox at a clinic in her home . In 2014 , in the course of its investigation of Patient E , the College interviewed Dr . Sweet . He indicated that Patient E was his patient since approximately 2010 . He noted that about one or two years prior , Patient E informed him that she was performing face lifts and injections and tried to “ lure ” him into her cosmetic work by asking him to order local anesthetics for her . Dr . Sweet indicated that he advised Patient E that these are obtained through a prescription and declined to order them . He stated that he had never purchased Botox or injected Botox in his entire career . Following a temporary injunction order , dated March 6 , 2014 and final injunction order , dated May 22 , 2014 obtained by the College from the Superior Court of Justice , Patient E was ordered to permanently refrain from performing all controlled acts and other acts relating to the practice of medicine , including administering a substance by injection . In 2016 , the College conducted an investigation into whether Patient E was in breach of these Orders . A College investigator learned that Dr . Sweet had prescribed Botox to Patient E since the College ' s initial investigation of Patient E . Dr . Sweet indicated that it did not occur to him that Patient E might be diverting the Botox given the small amount he prescribed .
Breach of October 5 , 2006 Undertaking In February 2015 , a community social worker at a homeless shelter informed the College that a shelter client ( Patient F ), who was a former addict , had received free samples of Ralivia ( also known as tramadol ) from Dr . Sweet for pain management . The College commenced an investigation into whether Dr . Sweet had breached his October 5 , 2006 undertaking to cease practising addiction and chronic pain medicine . The College retained an expert who reviewed 25 patient charts and interviewed Dr . Sweet . Dr . Sweet retained an expert who reviewed the same charts . The College expert , a specialist in family medicine , opined that Dr . Sweet engaged in the practice of chronic pain management and in the practice of addiction management in respect to one of the patients , Patient D , as follows :
• Between September 2012 and October 2014 , 15 of Patient D ’ s appointments with Dr . Sweet involved some level of assessment or treatment of Patient D ’ s chronic pain , and on at least two occasions tramadol prescriptions were provided outside of a clinic visit .
• Dr . Sweet failed to adequately attempt to transfer Patient D to another physician for the treatment of Patient D ’ s pain symptoms .
• Dr . Sweet prescribed clonidine and tramadol to Patient D and utilized tramadol for the treatment of addiction .
Dr . Sweet ’ s expert , also a specialist in family medicine , did not provide an opinion as to whether Dr . Sweet engaged in the practice of chronic pain management and in the practice of addiction management in respect of Patient D .
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DIALOGUE ISSUE 3 , 2018