Disciplinary hearing told doctor tried to thwart investigation
Court is told infected patients lost mobility, independence and control of their bladders
A doctor whose patients fell seriously ill after he treated them in unsterile conditions attempted to thwart an investigation by the College of Physicians and Surgeons of Ontario, his disciplinary hearing has heard.
Anesthesiologist Dr. Stephen James tried to tell nurses with whom he worked how to answer questions by college investigators, who were probing how patients became infected with potentially deadly Staphylococcus aureus bacteria, college prosecutor Amy Block said Monday.
He typed up scripted answers for them, she said.
James, 42, has pleaded no contest to
“What will it take for someone to stand up to doctors and say that carelessness is not OK?” PATIENT B
charges of incompetence and to disgraceful, dishonourable and unprofessional conduct, related to his treatment of 13 patients.
The hearing was told they became infected with the bacteria when he was treating them with injections for pain at the Rothbart Centre for Pain Care in North York in 2012.
Some were given epidural steroid injections and developed meningitis and epidural abscesses.
James was colonized with the bacteria, meaning it was present on his skin but never made him ill. About 25 per cent of the population is colonized with staph A. It can become life-threatening if it enters the body through a wound or injection.
The college launched an investigation after learning of a meningitis outbreak at the clinic. Some patients underwent emergency surgery and were hospitalized for weeks. They permanently lost control of their bladders and bowels and cannot walk without the aid of walkers or canes.
Some of their stories were profiled in a Star investigation last year.
Block told the hearing that James provided a “prep document” to nursing staff, advising them on how to answer questions from college investigators. But his strategy backfired when investigators came into possession of the document.
It said he always wore sterile gloves and mask when treating patients, but nurses told investigators that was not the case, Block noted.
When investigators asked him why he prepared it, he said he did so at the request of nurses who were apprehensive about being interviewed by the college officials. But the nurses told the investigators they never made such a request.
He prepared the prep document to “influence” the nurses’ response, Block told the hearing.
“His actions in doing so and in misrepresenting his purpose of the interview prep document to the college constitute disgraceful, dishonourable and unprofessional conduct,” she said.
College prosecutors and James’s lawyers jointly proposed a penalty order that included a 10-month licence suspension and a requirement that a health professional always be present whenever he gives injections in future. But in an unusual move, a five-member discipline panel rejected the proposal, saying it was not harsh enough.
Among the reasons cited by panel chair Dr. Marc Gabel was James’s “unethical conduct” during the college investigation.
The panel is expected to make a decision on James’s penalty before Christmas.
Through his lawyer, Eric Pellegrino, James said he was “chastened” and felt “great remorse.”
The patients, through victim-impact statements read by a prosecu- tor, told the hearing of how their lives have been turned upside-down and how they have lost faith in the medical profession.
Most said they were not informed there had been an infection outbreak at the clinic until they read about it in the Star.
Many said they now use adult diapers, have suffered permanent nerve damage and can no longer enjoy sex. Their mobility has been impaired and they are largely confined to their homes. They suffer from depression and isolation.
“I no longer daydream of horseback riding or kick-boxing. Instead, I worry about whether I will ever recover any sense of independence or quality of life back,” said one woman, known only as Patient A.
“Who will protect us? What will it take for someone to stand up to doctors and say that carelessness is not OK?” asked Patient B.