Dialogue Volume 14 Issue 4 2018 - Page 80

DISCIPLINE SUMMARIES 80 he demonstrated lack of skill in advising tapering of benzodiazepines without specific instructions. The expert also opined that Dr. Syed demonstrated lack of judgment by allowing himself to be manipu- lated into repeat prescriptions of such a class of drugs and his prescriptions of narcotics, including Nucyn- ta, in this patient. The pharmacist brought to light Dr. Syed’s lack of knowledge of a potentially serious drug interaction be- tween Nuycynta and Cymbalta. Dr. Syed demonstrated a lack of judgment by stopping the antidepressant instead of the narcotic in this instance. The clinical practice of Dr. Syed with regard to Patient E had the potential in several instances to expose his patient to harm. ORDER The Discipline Committee ordered: a two-month suspension of Dr. Syed’s certificate of registration; and a reprimand. The Discipline Committee also ordered terms and conditions on Dr. Syed’s certificate of registration, following Dr. Syed’s return to practice. These in- clude monitoring of his prescribing practice as well as clinical supervision of his general practice and reassessments. The Committee also ordered costs of $10,180.00. For complete details, please see the full decision at www.cpso.on.ca. Select Find a Doctor and enter the doctor’s name. COMPLAINT OF PATIENT F In May 2016, the College received a complaint from Patient F expressing concerns that Dr. Syed failed to provide appropriate assessment, diagnosis and treatment when she attended the walk-in clinic with gynecological concerns about a growth. Dr. Syed did not conduct a physical examination of the patient and proceeded to prescribe her medication without adequate explanation. The patient consulted a phar- macist, who expressed some disagreement with the prescription. As a result, the patient did not fill the complete prescription. The College retained an expert who reviewed the standard of care provided by Dr. Syed to Patient F. The expert concluded, in part, that the care provided by Dr. Syed did not meet the standard of the profes- sion. The expert noted that the patient's concern was of the lesion on her labia, and it is standard practice to examine this lesion. According to the expert, sometimes a physician may defer an exam, but this would be based on agreement with the patient, which was not the case in this instance. Regarding the concern about the prescription provided, the expert noted that for a typical yeast infection, a patient may potentially be prescribed Diflucan 150mg for one day and/or a topical treatment (such as the Terazol 7), while Dr. Syed prescribed Diflucan for seven days along with a repeat. According to the expert, this is a definite concern, as it is not the standard treatment for a common yeast infection (as Dr. Syed implied it was in his letter). At the conclusion of the hearing, Dr. Syed waived his right to an appeal and the Committee administered the public reprimand. DIALOGUE ISSUE 4, 2018 DR. MICHAEL CLARENCE TJANDRAWIDJAJA PRACTICE LOCATION: Brampton AREA OF PRACTICE: Cardiology HEARING INFORMATION: Admission; Agreed Statement of Facts; Joint Submission on Penalty On June 25, 2018, the Discipline Committee found that Dr. Tjandrawidjaja committed an act of profes- sional misconduct, in that he engaged in an act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reason- ably be regarded by members as disgraceful, dishon- ourable or unprofessional. Dr. Tjandrawidjaja is a physician who currently practises as a cardiologist in Brampton. He received his certificate of registration authorizing indepen- dent practice in Ontario in 2012. At the time of the incidents described below, Dr. Tjandrawidjaja was a member of the Ontario Medical Association. TENTATIVE PHYSICIAN SERVICES AGREEMENT (tPSA) On July 11, 2016, the OMA and the Ontario