discipline summaries
nectomies . The likely etiology of the epidural abscess was believed to be the epidural injection .
Reasons for Penalty The following facts were set out in an Agreed Statement of Facts for penalty and were accepted by the Committee :
1 . Dr . James was cooperative with the Toronto Public Health investigation , as well as the look-back process .
2 . The College retained Dr . EE , Medical Director of Infection Prevention and Control at an Ontario hospital , and associate professor of medicine at an Ontario university , to provide an opinion regarding Dr . James ’ infection control procedures . Dr . EE conducted an inspection and observation of Dr . James in January 2013 . Dr . EE had a few recommendations for further improvement but concluded : “ Dr . James meets the standard of practice of the profession with respect to infection control procedures . … Dr . James does not display a lack of knowledge , skill or judgment . … Dr . James ’ clinical practice , behaviour or conduct do not expose or are likely to expose his patients to harm or injury .”
3 . Dr . James retained Dr . GG , an expert in anesthesiology and chronic pain , to review the care and treatment that Dr . James provided to Patients A , B and C . Separate and apart from the issues of aseptic technique and infection control , Dr . GG was supportive of the care and treatment that Dr . James provided to Patients A , B and C and delivered expert reports outlining his opinions in that regard . Given the timing of the referrals to discipline of Patients D , E and F , Dr . James did not receive and provide to the College expert reports in respect of the care he provided to them .
4 . On April 1 , 2014 , the Inquiries , Complaints and Reports Committee approved an appointment of investigators to conduct a broad investigation into Dr . James ’ clinical practice in interventional pain management . The College retained Dr . JJ , FR- CPC , Anesthesiology , to review 25 patient charts , observe Dr . James in practice ( performing 10 procedures ) and conduct an interview . Three of the charts reviewed were Patient X , W and Z , revealed in the Toronto Public Health investigation as having contracted Staph aureus . In respect of each of the remaining 22 cases reviewed , and in respect of each of the 10 procedures observed , Dr . JJ concluded that Dr . James ’ care and treatment met the standard of practice of the profession . Dr . James did not display any deficiencies in knowledge , skill or judgment , nor did his practice , behaviour or conduct expose or likely expose his patients to harm or injury . Dr . JJ concluded Dr . James to be a knowledgeable , skilled and competent physician , practising to a high standard .
5 . On May 22 , 2015 , Dr . James completed a series of online infection control courses offered by Public Health Ontario .
6 . Dr . James advised the College of his intention to perform procedures at a new clinic . Prior to the opening of that clinic , the Associate Director of Infection Prevention and Control at a hospital network in Ontario was sent by the College to review the clinic ’ s physical layout , as well as its policies and procedures . The assessment report made some recommendations about changes to the premises ( for example , cupboards should be changed from being wall-mounted to being on the floor , sinks should be wall-mounted , certain configuration changes to the rooms should be made .) These changes were made and the premises received a pass with conditions on July 15 , 2015 . The Premises Inspection Committee will conduct a further inspection-assessment within six months of the new clinic becoming operational to observe procedures and review record-keeping documentation .
7 . On September 21 , 2015 , a College-approved assessor , the Medical Director of Infection Prevention and Control at Hamilton Health Sciences , attended for an unannounced inspection of Dr . James ’ practice at the Rothbart Centre for Pain Care . The assessor reviewed the setting and observed Dr . James perform two procedures : an epidural
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Dialogue Issue 1 , 2017