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