DISCIPLINE SUMMARIES
DR. PATRICK WING NIN YAU
PRACTICE LOCATION: Toronto
AREA OF PRACTICE: General Surgery
HEARING INFORMATION: Plea of No Contest; Statement
of Uncontested Facts; Joint Submission on Penalty
On April 12, 2017, the Discipline Committee found
that Dr. Yau committed an act of professional mis-
conduct in that he failed to maintain the standard of
practice of the profession.
Dr. Yau is a general surgeon who received his
certificate of registration authorizing independent
practice in Ontario in 1998 and has held privileges at
Scarborough General Hospital since 1999.
In addition, he held the position of a medical direc-
tor and practised general surgery, including bariatric
surgery, at the Prince Arthur Surgical Centre Inc.
(“the clinic”), an out-of-hospital premises, located in
Toronto, which offered weight loss surgical pro-
cedures, including adjustable laparoscopic gastric
banding. The clinic ceased operations as of March
22, 2017.
Patient A
In November 2013, Patient A attended at the clinic
for bariatric surgery with Dr. Yau.
Prior to meeting Dr. Yau in 2013, Patient A had
two previous bariatric surgeries. At the time of her
initial surgery, Patient A had a body mass index
(BMI) of 41 and was morbidly obese.
In a pre-surgery questionnaire, Patient A indicated
that she hoped to reduce her BMI to 21. She also
participated in a telephone pre-surgical consulta-
tion with a clinic nurse, during which her BMI was
noted to be 26, based on her self-reported weight
and height. In addition, prior to surgery, Dr. Yau
conducted a telephone consultation with Patient A,
as she resided in another province, but did not note
Patient A’s BMI at the time.
On the day of the surgery, Patient A was weighed by
clinic staff. Her BMI was recorded as being 24.9, which
is 10 lbs. less than the weight she self-reported during the
telephone pre-surgical consultation with a clinic nurse,
and is considered to be in the normal range.
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DIALOGUE ISSUE 2, 2018
Patient A consented to the gastric banding sur-
gery and Dr. Yau attempted the surgery on that day.
However, the surgery could not be completed due to
many dense adhesions that made dissection diffi-
cult. A tiny perforation was diagnosed and surgically
repaired. The surgery was aborted, a drain was placed
and the patient was sent to the hospital for observa-
tion. She was ultimately discharged home without
complications.
The College retained an expert in bariatric surgery
lap-band procedures and laparoscopy who opined
that Dr. Yau fell below the standard of practice of the
profession in deciding to perform the gastric band-
ing surgery on Patient A when the bariatric surgery
was not indicated given this patient’s normal BMI.
The expert further noted that Dr. Yau’s decision to
proceed with surgery exposed the patient to potential
harm or injury, particularly given the risk that the
patient’s well-functioning gastric bypass could be
damaged during surgery.
During the investigation, Dr. Yau advised the
College that he missed the BMI noted as 24.9 on
a computerized printout from an assessment done
on the day of surgery and, inadvertently, proceeded
with the surgery based on the initial numbers. Dr.
Yau also advised the College that he has since, on his
own initiative, implemented a number of changes to
his practice, including improved documentation of
patient discussions and indications for surgery, dicta-
tion of pre-operative notes and scrutinization of all
patients’ vitals, including morphological values, BMI,
height and weight on the surgery day.
Patient B
In January 2012, Patient B attended the clinic for a
laparoscopic gastric banding procedure to assist him
in losing weight. In addition to obesity, Patient B
suffered from Type 1 diabetes and hypertension, both
of which were medically controlled.
During Patient B’s post-surgery overnight stay in
the clinic, the nurses documented abnormal and high
glycemic results. At the time of his discharge from
the clinic the next morning, Patient B’s blood sugar
and glucose levels were not verified or recorded by
the clinic nurse.
Following his discharge from the clinic, Patient
B boarded a plane as he resided in a different prov-
ince. Upon landing, he checked into a hotel and was