DISCIPLINE SUMMARIES
• U
se of Demerol, a medication which has been
removed from almost all hospital formularies and
which has extremely limited indications;
• U
sage of antibiotics that was a significant variance
from the norm; and
• U
se of mesh in a potentially contaminated field,
which is contraindicated, reflecting a knowledge
deficit or a cavalier attitude towards patient care.
The College commenced a second investigation
as a result of a complaint from Patient A, who had
attended several times at the Cornwall Community
Hospital in 2013 and 2014 and received surgery
from Dr. Irwin in 2014 to detach a damaged bowel.
Patient A developed abdominal pain following the
surgery and later had to undergo further surgery
performed by another physician. Patient A indicated
that Dr. Irwin failed to properly communicate with
her and her family about her care.
The College’s expert opined that Dr. Irwin’s care of
Patient A fell below the standard of practice of the
profession and demonstrated a lack of knowledge and
judgment. Specifically, the expert found:
• D
r. Irwin failed to adequately justify Patient A’s
need for colon and ovarian surgery, and failed to
sufficiently document that he had informed, dis-
cussed, and ensured that the patient had a reason-
able understanding of her care;
• D
r. Irwin demonstrated a lack of knowledge and
judgment in failing to further investigate the pa-
tient’s presenting complaint;
• Dr. Irwin failed to adequately investigate the patient’s
right ovarian cyst as a cause of her symptoms, includ-
ing failing to seek an opinion from a gynaecologist;
• D
r. Irwin displayed inadequate judgment in resect-
ing both of the patient’s ovaries, with no docu-
mentation that the patient requested to have both
ovaries removed; and
• D
r. Irwin’s clinical practice subjected the patient to
colon and ovarian surgery that may not have been
entirely necessary and that resulted in complica-
tions and subsequent harm.
The College began a third investigation after a physi-
cian assessor expressed concerns about Dr. Irwin’s tech-
nique during an out-of-hospital premises inspection at a
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DIALOGUE ISSUE 4, 2018
clinic where Dr. Irwin practised.
The College’s expert opined that Dr. Irwin failed to
meet the standard of practice of the profession and
demonstrated a lack of knowledge, skill, and judg-
ment. In particular, the expert noted that:
• Dr. Irwin failed to meet the standard in his docu-
mentation, with incomplete charts, failure to follow
any organized format, missing consult notes, du-
plicative procedure notes which were significantly
different, and missing documentation, as well as
numerous grammatical errors;
• Dr. Irwin lacked knowledge, skill and judgment in
that he failed to keep up to date with current endo-
scopic guidelines; and
• Dr. Irwin’s lack of endoscopic proficiency may have
placed patients at risk by missing pathology and
increasing the risk of complications.
The Committee noted that Dr. Irwin had breached
an Inquiries, Complaints + Reports Committee
(ICRC) Order restricting his practice by failing to
advise the College about his “home practice” of visit-
ing approximately 10 patients in their homes, when
he was required to notify the College of the addresses
of all his practice locations. The Committee also noted
Dr. Irwin’s complaints history with the College, in-
cluding two prior cautions and a specified continuing
education or remediation program with respect to his
consent process and documentation of that process,
and two prior occasions on which the ICRC issued
advice to Dr. Irwin regarding his documentation and
patient care.
ORDER
The Committee ordered: a five-month suspension
on Dr. Irwin’s certificate of registration; a reprimand
and terms, conditions and limitations on Dr. Irwin’s
certificate of registration. These include clinical
supervision, a reassessment, restricting his practice to
providing small surgical procedures requiring local
anesthesia and surgical consultations.
The Committee also ordered Dr. Irwin to pay costs
of $10,180 to the College.
For complete details, please see the full decision at
www.cpso.on.ca. Select Find a Doctor and enter the
doctor’s name.