Dialogue Volume 15, Issue 3 2019 - Page 56

DISCIPLINE SUMMARIES medicine practice, including that: • There was no effective initial triage process to distinguish between severe patients and routine patients; • There was a failure to report unsafe drivers to the Ministry of Transportation or to recommend to patients that they not drive; • The presenting complaint was not addressed in the consultation report provided by Dr. Denys to the referring physician; • There was no effective triage following sleep studies, with the result that some patients with extremely severe sleep apnea experienced 6-9 month delays in getting treatment; • The quality of the sleep study reports and consulta- tion reports provided to the referring physician was poor; • In some cases there was no evidence that the patient had attended for a consultation with Dr. Denys following the sleep study, nor any evidence that attempts had been made to contact the patient or that the referring physician was advised that the patient did not attend for the consultation. The expert opined that Dr. Denys failed to meet the standard of practice of the profession in his care and treatment of patients in 45 of the 50 patient charts reviewed, that Dr. Denys demonstrated a lack of knowledge, skill and/or judgment in 44 of the 50 patient charts reviewed, and that Dr. Denys’ clinical practice exposed, or was likely to expose, patients to a risk of harm in 25 of the 50 patient charts re- viewed. Disgraceful, Dishonourable and Unprofes- sional Conduct Dr. Denys’ daughters own the licenses of Essex County Respiratory Services and Essex County Di- agnostic Services, the Independent Health Facilities where the pulmonary function tests were performed, and Dr. Denys is the main interpreting physician for 56 DIALOGUE ISSUE 3, 2019 pulmonary function tests at both facilities. Referring patients for testing without appropriate clinical in- dication and from which he and his family members received a benefit constitutes disgraceful, dishonour- able and unprofessional conduct. Dr. Denys failed to comply with conflict of inter- est requirements, which also constitutes disgraceful, dishonourable and unprofessional conduct. Section 17 of Ontario Regulation 241/94 made under The Medicine Act, 1991, provides that: 17. (1) It is a conflict of interest for a member to order a diagnostic or therapeutic service to be performed by a facility in which the member or a member of his or her family has a proprietary interest unless, (a) t  he fact of the proprietary interest is disclosed to the patient before a service is performed; or (b) t  he facility is owned by a corporation, the shares of which are publicly traded through a stock exchange and the corporation is not wholly, substantially or actually owned or controlled by the member, a member of his or her family or a combination of them. (2) A member who or whose family has a proprietary interest in a facility where diagnostic or therapeutic services are performed shall inform the College of the details of the interest. Dr. Denys failed to inform the College of his conflicts of interest in respect of Windsor Sleep Disorders Clinic, Essex County Respiratory Services, Essex County Diagnostic Services and Denys Sleep Supplies and Services Inc. until he submitted the Conflict of Interest declaration forms on August 16, 2017. Undertaking On April 12, 2019, Dr. Denys entered into an Undertaking with the College in which he agreed to cease practising sleep medicine in all jurisdictions and to never resume doing so.