Dialogue Volume 15, Issue 3 2019 - Page 53

DISCIPLINE SUMMARIES sion relevant to the practice of medicine that would reasonably be regarded by members as disgraceful, dishonourable or unprofessional, and has failed to maintain the standard of practice of the profession. At the relevant times, Dr. Bray was the sole physician and the Medical Director of an Out-of- Hospital Premises (OHP), providing gastroenterol- ogy services. Dr. Bray contravened Out of Hospital Premises Inspection Program (OHPIP) standards and disre- garded his responsibilities as a medical director by administering propofol to patients in the absence of an anesthesiologist or other physician qualified to do so. The Committee is greatly concerned that Dr. Bray did not inform the OHPIP assessors of his clinic’s use of propofol. Although the assessors reviewed with Dr. Bray his practices and procedures with respect to sedation and controlled substances, Dr. Bray did not inform them that he was using propofol. A subse- quent unannounced visit to the premises prompted by an unannounced report to the College confirmed that Dr. Bray was administering propofol to patients without an anaesthesiologist present. This was con- firmed by the College expert, who found in 11 out of 25 charts reviewed that Dr. Bray had administered propofol. Dr. Bray failed to maintain the standard of practice in his administration of intravenous propofol as ad- ditional sedation during procedures and displayed a moderate lack of judgment both in his role as Medi- cal Director of the OHP and as most responsible physician to the patients in question. ORDER The Discipline Committee ordered: a four-month suspension on Dr. Bray’s certificate of registration; a public reprimand; and payment of hearing costs to the College in the amount of $6,000.00. For complete details of the Order, 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. Bray waived his right to an appeal and the Committee administered the public reprimand. DR. JEFFREY MARLOWE BROWN PRACTICE LOCATION: Thornhill AREA OF PRACTICE: General Practice (Weight Loss and Complementary/Alternative Medicine) HEARING INFORMATION: Admission; Agreed Statement of Facts; Joint Submission on Penalty On May 10, 2019, the Discipline Committee found that Dr. Brown committed an act of professional misconduct, in that he engaged in an act or omis- sion relevant to the practice of medicine that would reasonably be regarded by members as disgraceful, dishonourable or unprofessional, and failed to main- tain the standard of practice of the profession. The College commenced an investigation into Dr. Brown’s practice in 2014, followed by investigations into two public complaints received in 2014 and 2017. Dr. Brown’s care was reviewed by three experts retained by the College, who identified a number of deficiencies in Dr. Brown’s record-keeping: • Dr. Brown’s charts were disorganized, with test re- sults and patient history profiles inserted through- out the chart and sometimes duplicated, and with no way to identify who made a particular chart entry other than Dr. Brown; • Dr. Brown’s chart entries were frequently illegible; • In a number of charts, Dr. Brown did not docu- ment physical examinations, or record in the chart key relevant information about weight loss patients such as height, body mass index (BMI), or relevant diagnoses such as diabetes or metabolic syndrome; • Dr. Brown did not clearly document informed pa- tient consent to receive Complementary/Alternative Medicine in accordance with College Policy #3-11, Complementary/Alternative Medicine; • Dr. Brown did not have complete Cumulative Pa- tient Profiles in a number of charts; • Dr. Brown failed to clearly state prescription and supplement additions in a number of patient charts; • Dr. Brown did not always record tests that he or- dered or lab work received in the patient charts; ISSUE 3, 2019 DIALOGUE 53