Professional Conduct reports – July 2023

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Decision to cancel practice permit of Dr. David Odugbemi upheld

A CPSA Hearing Tribunal upheld their decision to cancel the registration and practice permit of family physician Dr. David Odugbemi.

Background

In 2019, Dr. Odugbemi was found guilty of unprofessional conduct for failing to abide by a Terms of Resolution Agreement (TORA) he signed with CPSA in 2015.

The Tribunal felt Dr. Odugbemi demonstrated a pattern of ungovernable conduct based on his repeated acts of non-compliance with the TORA and ordered the cancellation of his practice permit.

Dr. Odugbemi appealed the Tribunal’s decision to a CPSA Council Review Panel, which allowed his appeal and his request to present new evidence and directed the matter back to the Hearing Tribunal to reconsider the ungovernable finding and sanction of cancellation. The Tribunal met in June 2022 and after considering the new evidence brought forward, concluded that while Dr. Odugbemi may not have been acting intentionally due to a medical disorder when he failed to comply with the TORA, his conduct did constitute unprofessional conduct. The Tribunal determined that the cancellation of Dr. Odugbemi’s registration was appropriate and consistent with the public’s interest in the safe and proper practice of medicine. The decision can be reviewed in full on CPSA’s website.

Dr. Odugbemi has not been in practice since 2020, when he was suspended for violating his agreement with CPSA to withdraw from practice.

Learnings

Trusting healthcare professionals to follow through on the agreements they enter into with their regulators is an important part of profession-led regulation, and failing to do so calls into question CPSA’s ability to regulate its members and maintain trust from Albertans. CPSA also has a responsibility to the public to ensure physicians practising in this province are able to provide safe care to their patients.

Publication in this case was delayed due to administrative processes.

CPSA Hearing Tribunal sanctions Dr. Morgan Osborne

Dr. Morgan Osborne, a general practitioner from Medicine Hat, was sanctioned by a CPSA Hearing Tribunal after admitting to unprofessional conduct.

Background

Dr. Osborne was accused of not following the requirements outlined in CPSA’s Prescribing: Drugs Associated with Substance Use Disorders or Substance-Related Harms and Patient Record Content standards of practice, specifically by:

• Prescribing opioids to a patient between 2017 and 2018 without documenting any goals established for the patient’s pain or function, the risks associated with opioid use, or the justification for prescribing a long-term opioid at a dose exceeding the recommended daily maximum dose.
• Not documenting whether any independent sources were used to confirm which prescriptions were previously dispensed to the patient.
• Not keeping adequate patient records on several occasions between 2016 and 2018.

Dr. Osborne admitted to the allegations and the Hearing Tribunal accepted a joint submission on sanction:

• Dr. Osborne will receive a reprimand.
• At his own cost, Dr. Osborne will complete courses on prescribing and medical record keeping, and participate in an Individual Practice Review through CPSA’s Continuing Competence department (these have been completed).
• Dr. Osborne is responsible for 25 per cent of the costs of the investigation and hearing, to a maximum of $2,500.

The written decision can be reviewed in full on CPSA’s website.

Learnings

Under CPSA’s Patient Record Content standard of practice, regulated members are responsible for ensuring patient encounters are fully and accurately documented. This responsibility includes specific documentation requirements when prescribing medications with a higher risk of addiction or misuse, as outlined in the Prescribing: Drugs Associated With Substance Use Disorders Or Substance-Related Harm standard of practice. The standard sets expectations including (but not limited to) reviewing the patient’s medication history before initiating or renewing a prescription and justifying prescribing decisions with documented evidence of the patient’s assessment. Physicians who would like to enhance their prescribing knowledge can contact CPSA’s Prescribing team at AIR.Inquiries@cpsa.ab.ca for recommendations on educational opportunities that best suit your needs.

The Canadian Medical Protective Association (CMPA) has several resources available on medical records, and the University of Calgary has a course on medical record keeping, which is eligible for CPD credits.

Dr. De Nguyen guilty of unprofessional conduct

General practitioner Dr. De Nguyen of Edmonton was found guilty of unprofessional conduct by a CPSA Hearing Tribunal.

Background

It was alleged Dr. Nguyen did not respond to communications from CPSA (letters, emails and phone calls) between 2020 and 2021, about a complaint resulting from his refusal to engage with CPSA’s Continuing Competence program. After considering the evidence, the Tribunal found the allegations were proven and constituted unprofessional conduct. The Tribunal’s written decision can be reviewed in full on CPSA’s website.

Dr. Nguyen was not in attendance for the hearing. The Tribunal proceeded in his absence after evidence showed Dr. Nguyen received reasonable and proper notice of the hearing, and confirmed in writing that he did not plan to attend.

The Tribunal will reconvene at a later date to determine sanction. Dr. Nguyen has not been in practice since 2020, when his permit was suspended under section 65 of the Health Professions Act for his refusal to engage with CPSA and respond to concerns about his practice.

Dr. Kevin Mowbrey sanctioned after criminal conviction

After pleading guilty under the Criminal Code of Canada to one count of knowingly using a forged prescription between 2018 and 2019 while in residency, Dr. Kevin Mowbrey was sanctioned by a CPSA Hearing Tribunal for unprofessional conduct.

Background

A criminal conviction is a breach under both Alberta’s Health Professions Act (HPA) and CMA’s Code of Ethics and Professionalism. The Hearing Tribunal accepted Dr. Mowbrey’s admission of unprofessional conduct and after considering submissions on sanction, their orders included the following:

• Dr. Mowbrey’s practice permit is suspended for six months, which is considered complete as Dr. Mowbrey has not been in practice since 2020.
• Before returning to residency, Dr. Mowbrey must complete a program to confirm he is fit to practise medicine and his permit shall be subject to any conditions recommended by the program assessors.
• Dr. Mowbrey will be monitored by CPSA’s Physician Health Monitoring Program (PHMP) and is prohibited from prescribing benzodiazepines and opioids, unless under specific circumstances as outlined in the hearing decision. The need for monitoring will be reassessed by PHMP when Dr. Mowbrey completes his residency.
• Dr. Mowbrey is responsible for 10 per cent of the costs of the investigation and hearing, to a maximum of $2,000.

The written decision and sanctions can be reviewed in full on CPSA’s website.

Learnings

Physicians are leaders in their communities and are held to a high standard of conduct. With that comes a duty to self-report incidents or situations which may impact the delivery of patient care—this includes notifying CPSA of criminal charges or convictions.

Under the Code of Ethics and Professionalism, physicians must limit treatment (which includes prescribing) of themselves to minor or emergency interventions, and only if another physician is unavailable. When issues arise that might impact their health and the care they provide, physicians also have a duty to seek help and appropriate care from qualified professionals—for their own wellbeing and that of their patients. Physicians who are struggling and need support can reach out to CPSA’s Physician Health Monitoring Program, the Alberta Medical Association’s Physician and Family Support Program, or the Canadian Medical Protective Association.