discipline summaries
Dr. RICHARD CONOLLY AUSTIN
Practice Location: No Practice Address
Practice Area: Obstetrics and Gynecology
Hearing Information: Agreed Statement of Facts,
Admission, Joint Submission on Penalty
On March 18, 2014, the Discipline Committee found
that Dr. Austin committed an act of professional misconduct, in that he failed to maintain the standard of
practice of the profession in his care and treatment of
four patients in 2005 and 2006. Dr. Austin admitted
to the allegations.
In April 2007, Dr. Austin agreed to terms, conditions and limitations on his certificate of registration
that restricted his obstetrical practice to office prenatal care only, and required that his major gynecological surgery and elective cesarean sections only be
performed in the presence of another obstetrician/
gynecologist. These terms were to remain in effect
until May 26, 2007, after which he would cease such
surgery completely and would independently perform
only minor gynecological surgery. In 2008, Dr. Austin
resigned his membership with the College.
An independent expert retained by the College
opined that Dr. Austin failed to maintain the standard
of practice as follows:
Patient A
In 2005, Dr. Austin inappropriately selected a patient
for a laparoscopic procedure. He displayed a lack of
judgment in choosing to perform a laparoscopy for
lysis of adhesions in a patient with numerous laparotomies and known adhesions. He also failed to take into
account, discuss and/or document the specific risk factors for complications that this patient had, including
a failure to make full disclosure and/or document full
disclosure following the patient’s complication from
surgery.
Patient B
In 2005, Dr. Austin did not fully assess the risk of malignancy of a simple ovarian cyst in a postmenopausal
woman. He also did not clearly consider and/or document the risk of operative intervention as compared
with conservative management.
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Patient C
In 2006, Dr. Austin failed to adequately document his
assessment of Patient C and failed to adequately document a description of the laparoscopy he performed.
Patient D
In 2005, Dr. Austin did not comply with the College’s Policy on Disclosure of Harm when he failed to
advise Patient D about a bowel perforation promptly
after gynecological surgery, failed to tell her how the
complication was managed and failed to advise her of
any future consequences that might arise as a result of
the complication.
Reasons for Penalty
The relevant penalty principles in this case are general
deterrence, maintaining the integrity of the profession
and providing public confidence that the profession
is being regulated in the public interest. Considering
that Dr. Austin had resigned from the College, public
protection, specific deterrence and rehabilitation would
not apply in this case.
The Committee considered aggravating and mitigating factors. The principal aggravating factor accepted
by the Committee was that Dr. Austin’s errors covered
not just one area of care, but the spectrum of care of
the four individual patients. Specifically, he fell below
the standard of care in appropriate patient selection,
in appropriate procedure selection, in lack of timely
disclosure of harm, and in lack of appropriate documentation. The lack of appropriate patient selection and
procedure selection led to patient harm.
A mitigating factor was the Agreed Statement of Facts
and the Joint Submission on Penalty, which avoided the
costs and time of a contested hearing.
Although Dr. Austin resigned from the College,
disciplinary action serves as a general deterrent, maintains integrity of the profession, and maintains public
confidence in self-regulation in the public interest. A
professional misconduct hearing must consider not only
the individual, but also the effect of the misconduct
on patients, and on the reputation and integrity of the
profession as a whole. Public confidence and trust in the
medical profession can be eroded by the misconduct of
an individual physician.
The Committee accepted the joint submission on
penalty and costs as appropriate in the circumstances.