Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Tuesday, December 13, 2016

Egregious Malpractise

"This is really an important example of the court offering timely and efficient justice."
"These cases are too often vigorously defended by the doctors and at significant public expense. This was one of those cases that cried out for an expedited court proceeding. We had an extensive public-health investigation, which came to clear and unambiguous conclusions."
"I believe [Ontario law] is there, in theory, so that doctors’ care can be questioned in order to improve quality without fear of being sued. But that’s not how it’s being used [generally]."
"It’s used as a shield against the doctor, and requires the plaintiff to, in essence, re-invent the wheel. It also gives the doctor the opportunity to say one thing to the college and another thing in court…It just elongates a process that is ultimately all being done at the public’s expense."
Paul Harte, lawyer, class-action lawsuit

"The committee found that there were very serious breaches occurring over many months, and the consequences have been devastating."
"The breaches affected people’s lives permanently, physically and emotionally, with significant effects for patients and their families. Dr. James’ breaches also undermined his patients’ trust in the medical profession."
"Your [Dr. Stephen James] care — or, better said, lack of proper care — and procedures you performed on these patients is, and was, simply unacceptable."
College of Physicians and Surgeons of Ontario disciplinary committee
Dr. Stephen James outside the College of Physicians and Surgeons of Ontario, in November 2015.
Dr. Stephen James outside the College of Physicians and Surgeons of Ontario, in November 2015.  (Andrew Francis Wallace / Toronto Star)

Dr. James was an anesthesiologist working at the Rothbart Centre for Pain Care in North York (Toronto) against whom a number of clients who suffered grievous health outcomes as a result of treatment obtained there, are lodging a class-action lawsuit. A year ago he was brought before a professional disciplinary committee to answer to charges of incompetence and disgraceful, dishonourable and unprofessional conduct relating to unhygienic care given to his patients, some 13 in number who became disastrously ill.

This health professional avoided pleading guilty to the charges, and on the other hand he made no effort to contest the facts, since they are, after all facts. His patients became deathly ill when they were infected with Staphylococcus aureus bacteria, in 2012. One of the facts in the case, and a most damning one, was that it was their doctor himself who carried the bacterium on his skin. He was a vector of the bacterium who never himself fell victim to it, passing it on to other, medically vulnerable patients, instead. Staph A presents as a potentially life-threatening infection if it enters the body via infection or a wound.

And Dr. James was injecting  patients; five of them underwent epidural injections and ended up with meningitis as a result, an inflammation of the membranes surrounding the spinal cord and brain. Another three patients had the misfortune to develop epidural abscesses, while another patient developed a blood infection. All of these incidents represented facts revealed through an investigation by the Toronto public health department. One of Dr. James's patients suffered a spinal abscess which led to permanent nerve damage leaving her bladder- and bowel-incontinent.

Another half-dozen patients had been infected with bacteria of the same genetic strain as the doctor carried on his skin, while other patients' long-term problems have led to their suffering from cognitive impairment. Dr. James's practices had been audited by Toronto public health officials who discovered a range of infection-control deficiencies, among them that surfaces in the doctor's procedure room were disinfected only once weekly. Dr. James used surgical gloves too large for the size of his hands, failed to properly pinch his face mask nose piece, overlooked hand disinfection, and made use of non-sterile gauze.

All of which was sufficient for the College of Physicians and Surgeons of Ontario last year to hand down a ten-month suspension for this doctor, reflecting his lack of appropriate care for patients, the obligation of all medical practitioners. Despite which, as class-action suit lawyer Mr. Harte charged, the publicly tax-funded Canadian Medical Protective Association's lawyers defended Dr. James irregardless of the evidence arrayed against him as an incompetent medical practitioner.

Now, Justice Paul Perell has reviewed all the facts in this disturbing case, to arrive at a determination that he feels the lawsuit should proceed. He has certified that the case is approved to move forward toward trial or settlement by Dr. James and his clinic. But Justice Perell didn't stop there. He issued a judgement against the physician, finding that he had failed in his professional duty of patient care through substandard infection-control procedures. In Mr. Harte's experience this marks a first, in Canadian class action, where a summary judgement has been issued against a defendant.

Dr. Stephen James gave at least six of his patients serious infections while performing epidurals like this, a judge has ruled.
Getty Images   Dr. Stephen James gave at least six of his patients serious infections while performing epidurals like this, a judge has ruled.

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