discipline summaries
Dr . WAGDY Abdalla Botros
Practice Location : Kitchener
Area of Practice : Psychiatry ( Full-time sleep medicine )
Hearing Information : Contested ; 12 Hearing days
On July 31 , 2015 , the Discipline Committee found that Dr . Botros committed an act of professional misconduct , in that he 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 . The Committee also found that Dr . Botros is incompetent . The Committee found that Dr . Botros failed to maintain the standard of practice of the profession in his care and treatment of 22 patients in his sleep medicine practice between 2007 and 2010 including :
• He failed to maintain the standard of practice with regard to his sleep study interpretation regarding all 22 patients . Sleep Medicine Standards are clear that the sleep medicine physician must provide a report of his / her interpretation of the sleep study data so that the referring physician would know what the diagnosis was and if there was a problem , the recommendation . Dr . Botros ’ Standard Sleep Study Interpretation form documented neither of these .
• He failed to triage all patient referrals as required by the Standards .
• He failed to complete a physical examination for one patient , and either did not do a physical examination or did not chart a physical examination with respect to three additional patients .
• He prescribed inappropriate Continuous Positive Airway Pressure ( CPAP ) pressures following CPAP titration with respect to five patients .
• He failed to take appropriate steps to treat three patients with severe obstructive sleep apnea within a reasonable time frame .
• He allowed two patients to be prescribed CPAP without first being seen by a sleep physician .
• He incorrectly or incompletely diagnosed five patients .
• He failed to appropriately notify or follow up with the Ministry of Transportation regarding three patients .
• He failed to appropriately prescribe supplemental oxygen for one patient who was on CPAP therapy .
• He demonstrated poor knowledge and understanding of CPAP treatment .
The Committee also found Dr . Botros incompetent , in that his care of patients showed a lack of knowledge , skill or judgment generally , and specifically in the care of four patients who had severe conditions and one patient who was inappropriately diagnosed and managed . The Committee also found that Dr . Botros engaged in behaviour that was unprofessional in his treatment of the College investigators . During an office visit , Dr . Botros interfered with the investigators ’ chart pull and made comments that were derogatory and demeaning to the professionalism of the College investigators . Following a medical inspector ’ s review of 10 of Dr . Botros ’ charts , Dr . Botros failed to comply with multiple requests for information within a reasonable period of time .
Penalty and Reasons for Penalty Counsel for Dr . Botros and Counsel for the College disagreed on an appropriate penalty . Both parties agreed that a reprimand would be appropriate in this case as it expresses the profession ’ s abhorrence for the actions of the doctor . The Committee concurred . However , the Committee did not agree with Dr . Botros ’ counsel who argued that the reprimand would sufficiently address the issue of Dr . Botros ’ lack of cooperation with College processes . Counsel also disagreed on the length of a suspension for Dr . Botros . The College submitted that a suspension of six months is appropriate ; Dr . Botros ’ counsel requested a four-month suspension . The Committee concluded that a four-month suspension would not be sufficient in this case . When looking at the context , there were multiple areas in which Dr . Botros failed to maintain the standard of
Issue 4 , 2016 Dialogue 59