discipline summaries
Dr . James shall , within seven days of date on which he became aware , report the infection to the College . Dr . James was ordered to pay costs of $ 4,460 ; and given a public reprimand . At the conclusion of the hearing , Dr . James waived his right to an appeal and the Committee administered the public reprimand .
Order For complete details of the Order , please see the full decision at www . cpso . on . ca . Select Doctor Search and enter the Doctor ’ s Name .
Dr . ROB JOSEPH KAMERMANS
Practice Location : Coe Hill Area of Practice : General Practice Hearing InformATion : Contested Hearing ( 9 days )
On November 7 , 2014 , the Discipline Committee found that Dr . Rob Kamermans committed an act of professional misconduct , in that he failed to maintain the standard of practice of the profession . The Committee also found that Dr . Kamermans is incompetent . Dr . Kamermans failed to maintain the standard of practice of the profession in his care and treatment in the Emergency Department of six patients ( Patients 1 to 6 ) and in his medical documentation regarding nine patients ( Patients 1 to 6 , 12 , 14 , and 22 ). Dr . Kamermans ’ deficiencies in his care and treatment of the six patients displayed a lack of knowledge and judgment of a nature and to an extent that the allegation of incompetence was proved .
Patient # 1 Patient # 1 was a child who presented with fever , stomach ache and vomiting . Dr . Kamermans failed to maintain the standard of practice in his documentation and care . Dr . Kamermans failed to do an ultrasound to rule out appendicitis , a significant differential diagnosis , and was deficient in his assessment and treatment of what he described as pharyngitis . Dr .
Kamermans ’ deficiencies in his care of this patient displayed a lack of knowledge and judgment .
Ruling out Appendicitis Both the College expert , Dr . X and the defence ’ s expert , Dr . Y , agreed that appendicitis was a significant differential diagnosis in a patient with this presentation and needed to be ruled out . The Committee was not persuaded that Dr . Kamermans considered appendicitis in this case . Dr . Kamermans ordered blood work , x-rays and laboratory work but he did not address appendicitis in his charting , one of the most serious potential problems given this presentation . When he signed off the chart that day and added the diagnoses , treatment and follow up instructions , Dr . Kamermans did not indicate in the record above his signature that appendicitis was a differential diagnosis , that it was ruled out or that the parents were given instructions about circumstances under which to return to the ER . In his testimony , Dr . X said that a differential diagnosis is a thought process about what could be accounting for the child ’ s symptoms , or some of the possible diagnoses to explain the symptoms and findings on the examination . He testified that , when he interviewed Dr . Kamermans , he asked him about his thought process , about a pediatric patient presenting with a fever , gastrointestinal complaints , pallor and a stomach ache , and Dr . X indicated that Dr . Kamermans was not able to answer beyond reference to the concrete information in the chart . Dr . Kamermans was not able to expand on what he would have considered in a patient with this presentation in order to fill in the gaps in his charting .
Treatment of Pharyngitis Dr . X testified that it is impossible to say with certainty whether or not an inflamed throat is due to strep bacteria . A throat swab is necessary to determine if the pathogen is strep and whether antibiotics are indicated , he said . Both Dr . Y and Dr . Kamermans thought otherwise . Dr . Y assumed that because Dr . Kamermans treated the child with Amoxicillin that the child must have had a “ bad ” pharyngitis , although there was no documentation to support that . Dr . Y said that he thought it was common practice to
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Dialogue Issue 1 , 2017