Two doctors disciplined by Manitoba college

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This article was published 22/03/2022 (1491 days ago), so information in it may no longer be current.

Two Manitoba doctors have recently been censured by the profession’s regulatory body for failing to meet ethical or professional standards.

The College of Physicians and Surgeons of Manitoba’s discipline committee issued the censures Dec. 15, but the decisions were only made public Tuesday. Censures create a disciplinary record which can be considered in future investigations or hearings.

A rural physician was censured after essentially falsifying a document to indicate he had physically examined a COVID-19-positive patient when he hadn’t, before the patient was transferred to the Health Sciences Centre in Winnipeg, among other lapses in judgment. He also had to pay the costs of the committee’s investigation ($4,000).

Dr. Amrinder Singh Mann was on call covering the emergency department of the rural hospital Jan. 16, 2021, when a 59-year-old man arrived by ambulance with shortness of breath just before 3 p.m. The patient was diagnosed with COVID-19 six days earlier, and had a history of asthma and type 2 diabetes, the committee’s decision reads.

The location of the hospital was not included in the committee’s decision.

Mann verbally ordered various treatments over the phone to the nurses handling his care, and eventually ordered the patient be transferred to Winnipeg shortly after 4 p.m. A nurse noted less than an hour later, the patient was feeling better after two of the treatments and no longer required oxygen. The nurse told the doctor the patient improved and suggested he might not need to be transferred.

Mann was angry about that suggestion, the nurse documented, and the patient was transferred to Winnipeg shortly after 7 p.m.

The next day, the doctor wrote a history and physical examination as if he had taken the history and personally examined the patient, when in fact he had done neither, the decision notes — a failure of professional and ethical standards.

The nurse manager raised the concern with the hospital’s chief medical officer, which was then brought to the attention of the regional health authority’s vice-president of medical services. Mann was then restricted from working in emergency departments in the region (the restriction remains in place) and the college was contacted.

The discipline committee’s decision noted the doctor co-operated with its investigation, expressed remorse over his actions, and is committed to learning from the experience, among other points.

Dr. John Ihor Mayba was also censured Dec. 15 for continuing to prescribe high dosages of benzodiazepines and opioids to a patient who moved out of province without assessing him and without creating medical records, the discipline committee’s decision reads, which showed a lack of judgment in the practice of medicine.

Mayba became the patient’s family physician in 2007. The patient had a pre-existing orthopedic injury that caused difficult to control lower-back pain, and already had opioid prescriptions. Over the next 10 years, the doctor continued to treat the patient in Manitoba, twice referring him to surgeons who said the patient’s pain could not be alleviated by surgery.

In 2017, the patient moved out of province and Mayba wrote him a one-month prescription for the medications he was already taking, and advised him to seek out a new doctor in his new home region. The patient contacted Mayba about two months later, saying he couldn’t find one, requesting Mayba continue as his physician. At that point, the doctor faxed prescriptions monthly to a pharmacy in the province the patient lived.

Mayba said he had monthly contact with the patient by phone and letter, which he compared to telemedicine, a practice that became commonplace amid the COVID-19 pandemic. In his opinion, the doctor had no reason to believe the patient was misusing the medications.

Mayba provided documentation to the committee, which supported that belief as well as his belief the patient was having difficulty finding a new family doctor.

The committee also decided he failed to meet ethical and professional standards by accepting monthly cash payments of about $200 in the same time frame, totaling $6,000, without creating any financial record for or otherwise accounting for the funds.

The doctor did not return the funds to the patient until after the college became aware of his conduct.

Mayba had not made use of the money, he told the college, and instead kept it secured and brought to his clinic administrator to be counted. Mayba said he believed the patient provided the money to retain his services, but would be returned once passed through the clinic.

The committee did not accept the doctor’s explanations, ruling his conduct unacceptable and representative of a significant breach of ethical and professional standards, as well as reflecting very poor judgment. He paid the investigation’s costs ($6,000).

erik.pindera@freepress.mb.ca

Twitter: @erik_pindera