Dialogue Volume 14 Issue 4 2018 - Page 79

DISCIPLINE SUMMARIES use" that were in fact for himself and his wife. This prescribing was contrary to the College policy, Physician Treatment of Self, Family Members, or Others Close to Them. ORDER The Discipline Committee ordered: revocation of Dr. Shuen’s certificate of registration; a reprimand; and payment to the College for costs in the amount of $40,720.00. For complete details, please see the full decision at www.cpso.on.ca. Select Find a Doctor and enter the doctor’s name. DR. NASEERUDDIN SYED PRACTICE LOCATION: Peterborough AREA OF PRACTICE: General Practice HEARING INFORMATION: Admission; Statement of Agreed Facts; Joint Submission on Penalty On March 5, 2018, the Discipline Committee found that Dr. Syed committed an act of professional mis- conduct, in that he failed to maintain the standard of practice of the profession. INVESTIGATION ONE In August 2014, Dr. Syed’s former nurse contacted the College expressing concern regarding various as- pects of Dr. Syed’s practice, including his prescribing practices. Based on the information requested by the College in April 2015 regarding claims for all moni- tored drugs made by Dr. Syed’s patients, the College commenced an investigation. The College retained an expert who reviewed 25 of Dr. Syed’s patient charts, pharmacy records, narcotic monitoring system data and conducted an interview with Dr. Syed. The expert stated that he had concerns about Dr. Syed’s knowledge and judgment which may expose his patients to possible harm. He also was of the view that Dr. Syed’s skill was difficult to determine due the extremely poor and woefully sparse documen- tation on the charts reviewed. He concluded that 24 of 25 charts reviewed failed to meet the standards. INVESTIGATION TWO The College received information from two physi- cians who practise in a methadone maintenance practice in Peterborough. They outlined concerns re- garding Dr. Syed’s prescribing of high doses and large amounts of benzodiazepines to several methadone patients. Concerns regarding serious or fatal respira- tory depression were relayed. Six patients were iden- tified and concerns were raised about an admission to the local hospital’s Intensive Care Unit in the group of patients due to recent benzodiazepine overdose. Dr. Syed stated to the College investigator that he was not aware that the six patients were being pre- scribed methadone. The manager of the pharmacy located at the same address as Dr. Syed’s practice, relayed to the College investigator concerns regarding the early release of medications in patients claiming to have lost their prescriptions and regarding the maximum dosages of benzodiazepines being prescribed. The College retained an expert who reviewed Dr. Syed’s general medicine practice, including his pre- scribing practice. After reviewing 10 patient charts, pharmacy records and interviewing Dr. Syed, the expert concluded, among other things, that there were glaring absences of documentation in the vast majority of charts reviewed, such that not one met record-keeping standards. COMPLAINT OF PATIENT E In March 2015, the College received a complaint from Patient E expressing concerns that Dr. Syed failed to provide appropriate care when ordering medications for him during a walk-in visit. Specifi- cally, Dr. Syed prescribed a medication that Patient E was allergic to, prescribed high doses of benzodi- azepines, knowing that Patient E on methadone, and has a general lack of knowledge concerning mental health patients and is over-prescribing to them. The College retained an expert who reviewed the standard of care provided by Dr. Syed to Patient E. The expert opined, in part, that not one of the patient’s eight visits in 2015 contained the required elements to meet the standards of record-keeping of the College. The expert opined that Dr. Syed demonstrated a lack of knowledge concerning the management of drug-seeking, habituated methadone patients and ISSUE 4, 2018 DIALOGUE 79