DISCIPLINE SUMMARIES
In June 2016, Patient A attended Dr. Choong with
complaints of pain in her rectum due to constipa-
tion. Given Patient A’s presentation, Dr. Choong
offered to conduct a digital rectal examination, which
the patient accepted.
Dr. Choong directed Patient A to take off her pants
and undergarments and failed to provide the patient
with any draping. He then asked Patient A to bend
forward and lean over the examining table, raising
her rectum towards him. Dr. Choong’s positioning
did not allow for adequate visual examination and
he inadvertently inserted his finger in the patient’s
vagina in a manner the patient experienced as force-
ful. Patient A responded quickly stating, “Oh no,
not there.” Dr. Choong then released his finger and
proceeded to insert it in her rectum to perform a
digital rectal exam.
Given Patient A’s presentation and finding, Dr.
Choong believed she had an anal fissure and pre-
scribed an analgesic cream.
An expert retained by the College concluded that
a digital rectal exam was clinically indicated in the
circumstances. However, the expert opined that Dr.
Choong failed to maintain the standard of practice
of the profession in this case, explaining that the
standard of practice for a female digital rectal ex-
amination is for the patient to be in the lithotomy
position (on her back with legs open as for a pelvic
examination) or lying on her left side. According to
the expert, one would proceed in the lithotomy posi-
tion, if the patient was being evaluated for possible
pelvic complaints and a rectal examination was also
required. If only a rectal examination is indicated
based on the complaint, the left side lying position
is standard. Given that Patient A was complaining
specifically of rectal pain and she was constipated, a
side lying examination was indicated.
The expert further concluded that Dr. Choong’s
digital rectal examination technique displayed a lack
of judgment. Not only did he not employ the ap-
propriate technique for female patients, he also failed
to provide modesty draping, demonstrating a lack
of judgment and a failure to maintain the standard
of practice. The expert noted that the examination,
which was “clumsily performed”, may have a lasting
negative effect on the patient.
On January 30, 2018, Dr. Choong entered into an
undertaking with the College, wherein he agreed to
resign from the College effective immediately and
to not apply or re-apply for registration to practise
medicine in Ontario or in any other jurisdiction.
ORDER
In light of this undertaking, and the assurance that
the public would be protected, the Committee or-
dered a reprimand. Dr. Choong was also ordered to
pay costs to the College in the amount of $5,500.
For complete details, please see the full decision at
www.cpso.on.ca. Select Find a Doctor and enter the
doctor’s name.
At the conclusion of the hearing, Dr. Choong waived his
right of appeal and the Discipline Committee adminis-
tered the reprimand.
DR. PETER DIARMUID DAVISON
PRACTICE LOCATION: Ottawa
AREA OF PRACTICE: General Practice
HEARING INFORMATION: Admission; Agreed Statement of
Facts; Joint Submission on Penalty
On May 1, 2018, the Discipline Committee found
that Dr. Davison committed an act of professional
misconduct, in that he engaged in conduct or an act
or omission relevant to the practice of medicine that,
having regard to all of the circumstances, would rea-
sonably be regarded by members as unprofessional.
Dr. Davison is a family physician practising in Ot-
tawa. He received his certificate of registration autho-
rizing independent practice in Ontario in 1975.
PATIENT A
Patient A, a man in his 90s, has been a patient of Dr.
Davison since mid-1990s.
In 2015, a general evaluation was conducted of
Patient A in hospital by a geriatric nurse. The out-
come of the evaluation was “suspected dementia” and
“probable mixed mild dementia.”
In July 2016, Dr. Davison was experiencing acute fi-
nancial difficulties, both of a professional and personal
nature, including with respect to paying office rent.
ISSUE 4, 2018 DIALOGUE
53