discipline summaries steroid injection and a radiofrequency ablation of the L5 root . The assessor concluded that Dr . James “ continues to meet the standard of practice of the profession in respect of infection prevention and control procedures . There was no evidence of lack of knowledge , skill or judgment , and there was no unnecessary risk of harm or injury .”
In addition , the following facts accepted by the Committee were set out in a Supplementary Agreed Statement of Facts for Penalty :
1 . On November 12 , 2015 , Dr . HH , the Associate Director of Infection Prevention and Control at a hospital network in Ontario , attended for an unannounced inspection at Dr . James ’ new clinic . She observed him perform two procedures , a lumbar epidural injection on one patient and a cervical epidural inspection on a second patient .
2 . Dr . HH opined that Dr . James met the standard of practice of the profession with respect to infection prevention and control , and that he did not display a lack of knowledge , skill or judgment in respect to infection prevention and control . Dr . HH made some recommendations .
3 . As a result of recommendations made by Dr . HH and others , Dr . James has entered into an undertaking with the College , formally setting out his agreement to follow the recommended infection control practices for specified procedures . That undertaking constitutes further terms , conditions and limitations on Dr . James ’ certificate of registration , and will be relied upon by the College in its compliance and monitoring activities .
Counsel for the College together with counsel for Dr . James made a joint submission as to an appropriate penalty and costs order . Initially , the jointly-proposed order included the following provisions :
• that Dr . James be prohibited from holding the position of medical director in any facility ;
• that Dr . James be required to perform all injections in the presence of a regulated health professional who would observe each injection , as well as sign and date the patient record ;
• that , if Dr . James were to become aware of a patient developing an infection following a procedure that he performed , he be required to report this infection to the College within seven days ;
• that Dr . James would be subject to : o the reassessment of his practice , including his sterile technique , within six months of his return to practice ; and o periodic assessments , both announced and unannounced , at the discretion of the College ;
• that Dr . James be required to complete the next available medical record-keeping course approved by the College ;
• that Dr . James be required to complete the next available course in communications approved by the College ;
• that Dr . James be required to engage in a preceptor acceptable to the College regarding infection and treatment of infection in interventional pain medicine for a minimum of four hours ; and
• that Dr . James ’ certificate of registration be suspended for a period of 10 months , effective 30 days after the date of this order .
The Discipline Committee accepted the above penalty provisions as appropriate , but considered that an even more serious penalty was called for on the facts of this case . As a result , the Committee asked both the College and counsel for Dr . James to reconsider certain aspects of the proposed order in their joint submission on penalty . They did so , returning with a strengthened requirement for the monitoring / education program ( a clinical supervisor , who will meet with Dr . James monthly for a year ; reviewing patient charts and discussing infection control ) and added a requirement that Dr . James complete an ethics program that will be individualized to his specific needs . In its consideration of penalty , the Committee took into account aggravating and mitigating factors .
Full decisions are available online at www . cpso . on . ca . Select Doctor Search and enter the doctor ’ s name .
Issue 1 , 2017 Dialogue 51