discipline summaries
wards and thumbs pointing outwards and then from the top manoeuvred his hands down between her bra and her chest and cupped her breasts . Ms . A testified that , when this incident occurred , Dr . LMN was standing at an angle approximately two or two-and-a-half feet away from her to her left . Ms . A acknowledged that prior to or during the incident on the third visit that Dr . LMN made no sexual comments , nor did he use inappropriate language . Ms . A also acknowledged there was no leering , fondling , or caressing when Dr . LMN examined other parts of her body . However , while sexual intent or purpose can be one factor in determining whether or not an act was of a sexual nature , sexual intent or purpose is not a prerequisite to a finding that the conduct was of a sexual nature . The Committee had difficulty with Ms . A ’ s description of the incident . If Dr . LMN had been standing in the location and at the angle that Ms . A described in her testimony , it would have been extremely difficult , if not impossible , for Dr . LMN to manoeuvre and position his hands inside her bra and cup her breasts as Ms . A had demonstrated . The Committee also found it implausible that the incident could have occurred in just a split second , as she stated . Dr . LMN testified that he often sweeps his palm across the areas of the upper chest which may be exposed to the sun . Dr . LMN testified that he would be looking for solar keratoses that are not discernible by the eye . The defence contended Ms . A misinterpreted this examination . Dr . LMN testified that this examination would only take a second . When sweeping his hand across the upper chest , it is very likely that his palm would also come into contact with the exposed breast tissue which is not covered by the patient ’ s bra . It is possible , if Ms . A was feeling upset , uncomfortable , and vulnerable , that she may have been caught off-guard by this action and therefore misinterpreted the “ sweep ” across the chest as something more than what it was , or that it became more than what it was in her thinking . Also contributing to the circumstances , the Committee finds that Ms . A displayed a lack of insight and did not have a clear understanding as to the clinical significance of an invasive melanoma and therefore , the consequent need for follow-up examination of other parts of her body . In referring to the skin lesion on her arm that was removed , she stated that it was only a small skin lesion and that Dr . LMN made it “ sound like a huge invasive malignant melanoma ” and that Dr . LMN was “ blowing everything out of proportion .” It is the Committee ’ s view , given the diagnosis of an invasive malignant melanoma , that Dr . LMN was not blowing things out of proportion . This was a serious medical issue .
Conclusion on Allegation 1 Based on the evidence before it , the Committee was not persuaded that Dr . LMN put his hands down the bra of Ms . A and cupped her breasts as she described . Given the inconsistences in Ms . A ’ s evidence , her inability to accurately recall specific events , and the implausibility of her testimony on this issue , the Committee finds that the evidence in support of the allegation was not clear , cogent or convincing . The Committee finds that Dr . LMN did not place his hands in Ms . A ’ s bra and cup her breasts . The Committee is aware that patients can be in error as to what happened not because they are lying but rather they may have been either confused or misinterpreted what in fact did happen . The Committee believes Ms . A misinterpreted the sweep of Dr . LMN ’ s hand across her chest for clinical purposes as something more than what it was .
Allegation 2 The patient privacy issue relates to Ms . A ’ s testimony regarding whether Dr . LMN left the room when she was removing her clothing or provided her with appropriate draping at the April 2014 office visit . Since Dr . LMN testified that he had no independent recollection of Ms . A , he said that he was unable to recall whether Ms . A was wearing pants or a skirt at the third office visit , or whether he had asked Ms . A to remove her pants if she was wearing them . Dr . LMN testified that his practice was to leave the examination room while a female patient undresses . Ms . A testified that Dr . LMN did not leave the examination room while she removed her pants , but that he did leave the room when she removed her shirt as well as when she put her pants back on . The Committee considered the reliability of Ms . A ’ s evidence on this point .
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Dialogue Issue 1 , 2017