Dialogue Volume 14 Issue 1 2018 - Page 49

DISCIPLINE SUMMARIES ing heard, and that she was not being treated with respect. She stated that, several times, she was told “there’s nothing we can do.” Patient C stated that she contacted other sources asking for assistance. She was soon able to obtain a replacement CPAP machine from a supplier in an- other Ontario city, with assistance from a nurse in a second Ontario city, whom her former sleep medi- cine physician had recommended. Patient C never returned to Dr. Botros’ sleep clinic. She obtained a referral to another sleep clinic. The Committee accepts Dr. Z’s expert evidence that Patient C was at high risk for severe symptoms and a variety of complications on account of her severe dis- order, her untreated state, and her co-morbid issues including obesity. Dr. Botros should have recognized this and responded quickly. The Committee found that his failure to do so means he failed to meet the requisite standard of practice. Law Firm Ms. Y, a receptionist at the X Law Firm, testified before the Committee. The firm, which specializes in personal injury litigation, had requested the com- plete clinical notes and records of Patient T, a former patient of Dr. Botros’ sleep clinic. Ms. Y testified about the difficulties she had en- countered in obtaining the requested medical records from Dr. Botros’ sleep clinic. A dispute arose when Dr. Botros requested $200 in pre-payment before he What does this mean? We provide definitions for the legal terminology used in the discipline process Admission The physician admits that the facts alleged amount to professional mis- conduct and/or incompetence. Plea of No Contest The physician does not contest the facts. The College files a statement of facts as an exhibit at the hearing. The Discipline Committee can accept the facts as correct and make a finding of professional misconduct and/or incompetence. The physician does not admit to the facts or findings for the purpose of any other proceeding. Agreed Statement of Facts A statement of facts that are negoti- ated and agreed to by the College and the physician. It is filed as an exhibit at the hearing. Joint Submission on Penalty A penalty that is proposed to the Committee as an appropriate penalty by both the College and the physi- cian. In law, the Discipline Committee must accept a joint submission on penalty unless it would be contrary to the public interest and bring the ad- ministration of justice into disrepute. Contested Hearing The physician denies the allegations. The College must prove the allega- tions on a balance of probabilities (the civil standard of proof) by calling evidence such as witnesses. If one or more of the allegations is proved, a penalty hearing is scheduled. The College and the physician may agree and jointly propose a penalty to the Committee or they may disagree and a contested penalty hearing takes place. Aggravating, Mitigating Circumstances Aggravating and mitigating circum- stances may be considered by the Discipline Committee in determining an appropriate penalty. Mitigating and aggravating circumstances are considered by the Committee, so that the penalty imposed is proportionate to the gravity of the physician’s con- duct, and the degree of responsibility of the physician. Mitigating circum- stances tend to reduce penalties, whereas aggravating circumstances tend to increase penalties. Aggravating circumstances could include: a high degree of vulnerability of the person(s) affected by the phy- sician’s conduct; a prior disciplinary history with the College; and a lack of insight by the physician into his or her own misconduct. Mitigating c ircumstances could in- clude: a clean disciplinary record; an admission to the facts underlying the allegations in advance of a hearing; cooperating with the investigation; a demonstration of remorse or regret about the effects of the misconduct on others; taking remedial steps on the physician’s own initiative prior to a finding or an order by the College. ISSUE 1, 2018 DIALOGUE 49