Pain clinic doctor faces disciplinary hearing after outbreak

Anesthesiologist Dr. Stephen James accused of incompetence in infection control and misconduct during probe.

Lucas Oleniuk / Toronto Star Order this photo

 

Anne Levac developed a serious infection in her spine following an epidural steroid injection for back pain two years ago at the Rothbart Centre for Pain Care. 

By: Theresa Boyle Health, Published on Thu Sep 25 2014

 

An anesthesiologist alleged to have infected patients during an outbreak at a Toronto pain clinic that was kept secret from the public has been ordered by the College of Physicians and Surgeons of Ontario to face a disciplinary hearing.

The move comes as Toronto Public Health begins exploring ways to let the public know more about outbreaks at clinics and as Health Minister Eric Hoskins urges the physician watchdog to do the same.

Meantime, a proposed multimillion-dollar class-action lawsuit has been launched on behalf of patients who developed serious infections after being treated at the Rothbart Centre for Pain Care. It charges that the clinic and anesthesiologist Dr. Stephen James failed to maintain adequate infection-control procedures.

James told the Star in an email it would be inappropriate to comment on any litigation, adding, “I take very seriously the physician-patient relationship and the responsibilities that derive from that relationship. I sincerely regret that any of my patients experienced health complications. My primary goal as a physician is to improve quality of life.”

The clinic’s medical director, Dr. Peter Rothbart, did not respond to a request for comment.

The actions follow publication of a Star story about nine patients who developed meningitis and epidural abscesses during a 2012 outbreak at the Dufferin St. clinic.

Toronto Public Health said all nine patients were injected by the same individual working at the clinic.

James earlier told the Star in an email that he was unknowingly “colonized” with Staphylococcus aureus bacteria at the time. The bacteria was present on his skin, but did not make him sick. Staph A. is potentially deadly if it enters the body through a wound.

Among the nine patients who developed infections are Anne Levac, 68, of Fenelon Falls, and Tracey Martin, 46, who lives north of Toronto. They say they became seriously ill after getting epidural steroid injections from James for back pain.

They suffered permanent nerve damage and are now bladder and bowel incontinent, and unable to walk without the aid of canes, they say.

Both filed complaints about James and Rothbart to the College, which is still investigating Rothbart.

The decision by the College to order James to appear for a disciplinary hearing was based on two complaints. The College does not make public the names of complainants.

A “notice of hearing” posted on the college’s website says James is facing allegations of professional misconduct and incompetence. A date for a hearing has not yet been set.

The notice says James is alleged to have told clinic nurses how to answer questions from College inspectors who were investigating complaints against him:

“Dr. James engaged in disgraceful, dishonourable or unprofessional conduct in the manner in which he dealt with the college’s investigation, including by providing clinic nurses with a document to which they should refer during interviews with the college.”

Though the outbreak occurred in late 2012, the notice alleges wrongdoing by James from 2012 to 2014: “Dr. James failed to maintain the standard of practice, and displayed incompetence in his care and treatment of patients, in his aseptic technique and infection control practices.”

The Rothbart Centre outbreak was never made public by Toronto Public Health, which investigated it and found 170 infection-control deficiencies at the clinic. Nor was the outbreak made public by the College, which is responsible for inspecting clinics. Some of the infected patients were never made aware their infections were related to their treatment at the clinic.

Dr. Michael Finkelstein, associate office of health for Toronto, said Toronto Public Health is looking at making more information available on its website about infectious disease outbreaks in community health-care premises, including clinics.

“We think there are certain pieces of information that it appears we can move toward disclosing, but we still have to protect the … personal health information of people we deal with,” he said.

Finkelstein said that while Toronto Public Health has just started exploring options to increase transparency, “I think we can provide, for most if not all outbreaks,” information about the location, date and infectious agent.

Still to be determined, he said, is whether details can be made public of outbreak investigations, specifically the number and type of infection-control breaches found, and whether people have been harmed or have died.

Source: http://www.thestar.com/life/health_wellness/2014/09/25/pain_clinic_doctor_faces_disciplinary_hearing_after_outbreak.html