discipline summaries
Text of Public Reprimand
Dr. Noriega, the Committee has found that you committed the most serious form of professional misconduct, the
sexual abuse of a young adolescent patient in your care.
Your misconduct must be denounced in the strongest
terms. You misused your position of trust and authority with respect to this unfortunate and disadvantaged
young girl, for your own selfish interests. As a pediatrician you were well aware of your privileged status with
respect to a vulnerable adolescent in your care. Yet you
chose to victimize this troubled young girl with no apparent concern for the grievous harm which you caused.
This harm is not limited to the trauma which was
inflicted on this individual patient, but extends widely
to include the medical community and the public at
large. The maintenance of public trust in the integrity of
the profession, and of confidence in the College’s ability
to protect the public from predatory and abusive physicians, are dealt a serious blow by your misconduct.
The Committee is truly disturbed by your behaviour.
This is a very unfortunate way for you to end your medical career. You will be remembered as a physician who
violated the trust of his patient in a most egregious and
offensive fashion. We can only hope that, on reflection,
you can learn to take responsibility for your misconduct,
and to come to terms with the harm that you have done.
DR. GEORGE WILLIAMS OTTO
Practice Location: Toronto
Practice Area: General Practice
Hearing Information: Agreed Statement of Facts,
Admission, Joint Submission on Penalty
On October 5, 2015, the Discipline Committee found
that Dr. Otto committed acts of professional misconduct, in that he has failed to maintain the standard of
practice of the profession; and he has engaged in conduct or an act or omission relevant to the practice of
medicine that, having regard to all the circumstances,
would reasonably be regarded by members as disgraceful, dishonourable or unprofessional.
Dr. Otto admitted to the allegations.
In March 2012, the Ministry of Health and LongTerm Care expressed concerns to the College regard-
ing Dr. Otto’s completion of Special Diet Allowance
(SDA) applications. The Ministry reviewed 25 patient
records which were selected based on claim submissions of an assessment code and a code for completing
an application for a SDA. The records submitted were
for families where all of the patients within the family
were billed on the same service date. Fifteen of the records were for patients 18 years of age and under. The
Ministry’s review revealed that of those 15 records, 13
records included the phrase ‘anceiform rash all over
body’ and also noted an opinion of lactose intolerance
or milk allergy.
Based on the information received from the Ministry, the College commenced an investigation. In
the course of its investigation, the College received
billings for the 25 patients reviewed by the Ministry.
The College retained the services of an expert, Dr. X,
who opined that of the 24 charts she reviewed, only
three met the standard of care with respect to the
completion of the SDA application forms. In general,
documentation and investigations to support the
conditions indicated in the SDA forms were lacking.
It was also noted that many patients had frequent
assessments over a very short period of time, prior to
the completion of the SDA forms, and that many of
the clinical entries for those repeat assessments were
identical.
During the College’s investigation, in November
2012, Dr. Otto participated in a medical record-keeping
course and submitted proof of completion to the
College. In May 2014, Dr. X reviewed 10 additional
records of Dr. Otto and found that four of them did
not meet the standard of care of the profession in
relation to his completion of SDA forms, in that there
was no documentation of the symptoms, investigations or treatment recommendations to support the
condition(s) reported on the SDA form. However,
Dr. X noted improvement with regards to Dr. Otto’s
charting and patient assessments that were conducted
to support the clinical conditions indicated in the
SDA and to satisfy the requirements of the Ministry
when completing the SDA forms, and that Dr. Otto
provided sound rationale for supporting dietary and
Full decisions are available online at www.cpso.on.ca.
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Issue 3, 2016 Dialogue
47