Hippocratic "Do No Harm"

"Dr.James not only failed to properly advise his patients of the medical risks they faced in having him perform an epidural injection on them. He actively obscured the risk in order to protect his reputation and to continue what the evidence shows had become a lucrative practice."

Justice Edward Morgan, Ontario Superior Court

 

"Your care — or, better said, lack of proper care — and procedures you performed on these patients is, and was, simply unacceptable."

"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."

College of Physicians and Surgeons of Ontario disciplinary committee

That 'lucrative practice' was one owned by an unscrupulous disgrace to the medical fraternity, an anesthesiologist who has been found dangerously negligent in exposing his patients to infections time and again through his absent attention to what is considered by the medical community to be normal actions taken automatically during surgical procedures to ensure they are conducted safely and effectively with proper attention to medical hygiene.

Toronto Public Health had investigated three cases of bacterial meningitis -- spinal cord area infections known for potentially devastating effects -- surfacing in the patients whom Dr.Stephen James had treated with steroid injections. Staphylococcus aureus bacteria had invaded the area around their spinal cord, with six of the cases constituting a rare strain. The investigators discovered evidence of that strain in Dr.James where the bacteria is often housed in nasal passages and is inactive. 

 

During surgical procedures Dr. James spurns the use of masks and gloves. In all, investigation revealed  24 people to be infected with meningitis, epidural abscesses placing pressure on the spinal cord, or related infections, after having received steroid injections from Dr.James. Normally such infections occur in one in ten thousand of such treatments, but in Dr.James's patients' experience the rate was 60 times normal.

 

Dr.James himself owned to not wearing surgical masks or gloves during "candal" injections into the tailbone area. As well, placing surgical instruments on contaminated surfaces instead of on "surgical drapes" which are special sterile fabrics. In a 2015 decision the College of Physicians and Surgeons decided on revoking this man's licence for ten months in the background of describing patients who suffered severe back pain, confusion, fever, vomiting and hallucinations until being diagnosed with Staph A spinal infections.

This doctor's infection-control practices went beyond sub-standard. Having become aware that one of his patients developed a serious abscess in his spinal column following a pain injection, he failed to alter  his lax-to-non-existent infection control. He continued with another needle to the military veteran's back; no mask, no gloves. When 23 other patients in the Toronto practice suffered similarly severe infections, resulting in a death, he failed again to take heed.

This series of patient misadventures and lack of the most basic regard for customary anti-infection technique, has a nine-year history with this doctor. His legal defence when brought to trial was defended by the defence agency representing the medical profession, the Canadian Medical Protective Association. Ontario's medical regulator found Dr.James guilty of misconduct six years ago. Toronto public-health three years earlier placed an outbreak of meningitis and other infections on this doctor's lax practices.

In May of this year the College of Physicians and Surgeons ordered him to take remedial courses on record-keeping and interventional pain treatment following an assessment that "raised concerns about his standard of practice".  One patient, Anne Littleton, died two weeks following an injection and Dr.James neither noted the death on her chart, nor did he contact the hospital where she died, or speak to her family. 

 

The discipline committee described James’ antiseptic technique at the time as “extremely poor” and said he had displayed a lack of “self-scrutiny” in his practice.

 

Another patient, Anne Levac, who is chief plaintiff in the class action suit against Dr.James, remains debilitated by her 2012 infection. Many of the patients affected by this man's practice are elderly, two of whom died while awaiting resolution of the case. Anne Levac described being close to death after developing an epidural abscess after treatment administered by Dr.James. She was faced with learning to talk again following ten weeks in hospital. Many years on, she still suffers disabilities keeping her house-bound.

When she eventually discovered that her case was not necessarily unique linked to this doctor, she was shocked. Several of Dr.James' patients had become ill before she had. Logic would have it that someone whose practice was so wanting in the most basic of infection-prevention techniques when dealing with vulnerable patients in areas of the human body susceptible to serious infections, would have had his licence permanently revoked long ago. "I didn't have to be infected, and that's the hardest part", she commented.