Haines, Alexander Milton (CPSO#: 59413)

Current Status: Active Member as of 23 Aug 1989

CPSO Registration Class: Independent Practice as of 07 Oct 2016

Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education:The University of Western Ontario, 1988

Practice Information

Primary Location of Practice
Barrie Family Medical Centre
18 Cundles Road East
Barrie ON  L4M 2Z5
Phone: (705) 737-1887
Electoral District: 05

Hospital Privileges

Hospital Location
Royal Victoria Regional Health Centre Barrie

Terms and Conditions

Details

(1) Dr. ALEXANDER MILTON HAINES may practise only in the areas of medicine in which Dr. HAINES is educated and experienced.

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 15 Jun 1988
Expired: Terms and conditions of certificate of registration Expiry: 14 Jun 1989
Subsequent certificate of registration Issued: Independent Practice Certificate Effective: 23 Aug 1989
Transfer of class of certificate to: Restricted certificate Effective: 25 Jul 2014
Terms and conditions imposed on certificate Effective: 25 Jul 2014
Transfer of class of registration to: Independent Practice Certificate Effective: 07 Oct 2016

Previous Hearings

Committee: Discipline
Decision Date: 25 Jul 2014
Summary:

On July 25, 2014, the Discipline Committee found that Dr. Haines committed an act of 
professional misconduct, in that he has failed to maintain the standard of practice of the 
profession in his care and treatment of sixteen patients. Dr. Haines admitted to the 
allegation. 
 
The College began an investigation into Dr. Haines’ practice following the receipt of 
information from the Office of the Chief Coroner for Ontario regarding the death of one 
of his patients. The cause of the patient’s death was determined to be Oxycodone toxicity. 
 
As part of its investigation, the College retained a medical inspector, Dr. X.  Dr. X 
reviewed the charts of 25 of Dr. Haines’ patients.  The patients whose charts were 
reviewed had all been treated with pain control medications for chronic pain due to 
various causes and clinical backgrounds.  
 
Dr. X noted that Dr. Haines’ charts were generally clear to read, organized and reflected 
genuine concern by Dr. Haines for his patients. Nonetheless, Dr. X opined that certain 
concerning issues recurred a number of times in Dr. Haines’ practice.  The areas of 
concern identified by Dr. X were as follows: 
   •  There were ongoing prescriptions for opiates and benzodiazepines in patients a) 
      with substance abuse problems as proven by urine drug testing; or b) with written 
      concerns by other doctors who saw these patients and advised that prescribing 
      such medications was likely causing problems for the patients.  The office records 
      did not address such concerns. 
   •  Combining high dose opiates and benzodiazepines. This combination is known to 
      be a factor in opiate related deaths. 
   •  Prescribing multiple opiates and multiple benzodiazepines simultaneously. This 
      increases the risk of adverse effects without potential benefit. 
   •  Two patients were given on-going prescriptions for opiates without any office 
      assessment for over a year. 
   •  Many patients had blood cholesterol testing, however Dr. X did not find any chart 
      using the cholesterol results to calculate the patient’s heart risk – the 
      “Framingham risk score”. Such a risk calculation is needed to establish the need 
      for medication and treatment goals. Similarly, two patients with heart disease had 
      cholesterol (LDL) levels above target. 
   •  There was a lack of screening for colon cancer. Many patients came in for an 
      Annual Health Exam and some had colonoscopy exams.  Dr. X did not find any 
      home kit Fecal Occult Blood Testing results.  The standard of care in Ontario now 
      is to utilize this test widely in patients over 50. 
 
With respect to the specific patient who was the subject of the coroner’s report, Dr. X 
opined that Dr. Haines did not meet standard of care, demonstrated a lack of skill and 
knowledge, and that it is probably a danger to safety in combining benzodiazepines with 
moderately high opiate dosing in patient who could unpredictably take other illicit drugs 
and who has shown significant impulsivity in overdosing. 
 
 Overall, Dr. X concluded that the care provided in 16 of the 25 charts reviewed did not 
 meet the standard of practice of the profession and demonstrated a lack of knowledge, 
 skill or judgment.  Dr. X also concluded that Dr. Haines’ care in 10 of the charts exposed 
 patients to potential harm or injury, ranging from mild or minimal danger to serious 
 safety concerns. 
  
 Dr. Haines entered into an undertaking in response to the College’s concern to protect the 
 public. Further to the undertaking, Dr. Haines was required, among other things, to practice 
under the guidance of a clinical supervisor acceptable to the College. Dr. Haines supervisor 
 consistently indicated in his monthly reports to the College that he has identified no material 
deficiencies with respect to Dr. Haines’ standard of practice.   
  
 After learning of the College’s investigation, Dr. Haines took steps at his own initiative to 
 update his medical knowledge and his prescribing practices in respect of narcotics. In 
 addition, throughout 2013, Dr. Haines completed several continuing medical education 
 programs, targeted at addressing deficiencies identified by Dr. X specifically, as well as 
 reviewing family medicine issues generally.   
  
 Following an interview, Dr. X made a number of observations about Dr. Haines’ 
 generally heightened knowledge and skill, and also highlighted the various improvements 
 in Dr. Haines’ practice. 
  
 The Committee ordered and directed that: 
 •  the Registrar impose the following terms, conditions and limitations on Dr. Haines’ 
    certificate of registration: 
       a) Dr. Haines, at his own expense, to submit to an assessment of his practice by 
           an assessor selected by the College approximately twelve months after the 
           date of this order.  The assessment shall pertain to Dr. Haines’ practice 
           overall, with a specific focus upon the areas of concern outlined in the 
           reports of Dr. X including safe prescribing and overall preventative 
           care.  The reassessment shall include, at minimum, a full day direct 
           observation component. 
      b) Dr. Haines shall abide by the reasonable recommendations made by the 
           Assessor.  Dr. Haines shall be permitted to make written submissions on his 
           own behalf within 30 days of receipt of the assessment to the Inquiries, 
           Complaints and Reports Committee. The Inquiries, Complaints and Reports 
           Committee may or may not vary the recommendations of the Assessor upon 
           receipt of Dr. Haines’ written submissions. Any recommendations accepted 
           by the Inquiries, Complaints and Reports Committee that are limitation(s) or 
           restriction(s) shall constitute terms, conditions or limitations on Dr. Haines’s 
           Certificate of Registration and shall be included on the public register. 
•  Dr. Haines appear before the panel to be reprimanded. 
•  Dr. Haines pay costs to the College in the amount of $4,460.00, within 60 days of the 
   date of this Order. 

Decision: Download Full Decision (PDF)
Appeal: No Appeal
Hearing Date(s): July 25, 2014