Huebel, Stephen Charles (CPSO#: 59312)

Current Status: Active Member as of 13 Jun 1988

CPSO Registration Class: Restricted as of 19 Jan 2015

Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education:University of Toronto, 1988

Practice Information

Primary Location of Practice
Scarborough & Rouge Hospital
Centenary Site
2867 Ellesmere Road
Scarborough ON  M1E 4B9
Phone: (416) 898-0061
Electoral District: 10
View Professional Corporation Information

Professional Corporation Information

Corporation Name: Dr. Stephen C. Huebel Medicine Professional Corporation

Certificate of Authorization Status: Issued Date:  Jul 22 2014

Shareholders:
Dr. S. Huebel ( CPSO# 59312 )

Business Address:
2867 Ellesmere Road
Scarborough ON  M1E 4B9
Phone Number: (416) 898-0061

Hospital Privileges

Hospital Location
Rouge Valley Centenary Health Centre,Toronto Toronto
Scarborough Hospital,General Site Toronto
Scarborough Hospital-Birchmount Campus Toronto

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 13 Jun 1988
Transfer of class of registration to: Independent Practice Certificate Effective: 29 Jun 1989
Transfer of class of certificate to: Restricted certificate Effective: 19 Jan 2015
Terms and conditions imposed on certificate Effective: 19 Jan 2015
Terms and conditions amended by Inquiries, Complaints and Repo Effective: 03 May 2017

Pending Discipline Hearings

Summary: Allegations of Dr. Huebel’s professional misconduct have been referred to the Discipline Committee of the College. It is alleged that Dr. Huebel is incompetent and/or failed to maintain the standard of practice of the profession in his care of patients.

Notice of Hearing: Download Full Notice (PDF)

Hearing Date(s): June 6-8, June 11, 12, 14, June 27-29, July 9-13, July 16-18, 2018

Practice Restrictions

Imposed By Effective Date Expiry Date Status  
Inquiries, Complaints and Reports Committee Effective: 03 May 2017 Active View Details [+]
            (1 of 2)

            As from 12:01 a.m., May 3, 2017, by order of the Inquiries, Complaints and
            Reports Committee of the College of Physicians and Surgeons of Ontario, the
            following terms, conditions and limitations are imposed on the certificate of
            registration held by Dr. Stephen Charles Huebel:

            1.    Dr. Huebel's practice shall be restricted in accordance with the clinical
                  supervision requirements set out below at items 2-6.  For greater
                  clarity, Dr. Huebel shall not engage in practice unless the clinical
                  supervision requirements set out at items 2-6 are met.

            2.    Dr. Huebel shall engage a clinical supervisor acceptable at the College
                  at his own expense (the "Clinical Supervisor"), who shall: attend in
                  person all of Dr. Huebel's encounters with patients; review all patient
                  charts following patient encounters by the end of each shift; and meet
                  with Dr. Huebel every week to discuss any issues or concerns arising from
                  his or her observations of Dr. Huebel's patient encounters and reviews of
                  records, as well as to provide recommendations to Dr. Huebel.

            3.    Dr. Huebel shall fully cooperate with and abide by any recommendations of
                  his Clinical Supervisor, including with respect to patient care, practice
                  improvements, and continuing education.  For greater certainty though
                  without limiting the foregoing, if during or after an observation of a
                  patient encounter or a chart review the Clinical Supervisor is of the
                  view that any conduct or care on Dr. Huebel's part will put a patient or
                  patients at risk, Dr. Huebel shall immediately comply with any
                  recommendations made by the Clinical Supervisor to protect the patient(s)
                  from risk.

            4.    The Clinical Supervisor shall provide reports to the College on a monthly
                  basis in reasonable detail, containing all information to assist the
                  College in evaluating Dr. Huebel's standard of practice, as well as his
                  participation in and compliance with the requirements set out herein.

            5.    The Clinical Supervisor shall execute and comply with the obligations set
                  out in an undertaking in the form attached hereto as Appendix 1.

            6.    Dr. Huebel shall, on an ongoing basis, provide the College with addresses
                  of the locations where he is practising.

            2 of 2

            As from 11:59 p.m., January 19, 2015, by order of the Discipline Committee of
            the College of Physicians and Surgeons of Ontario, the following term,
            condition and limitation is imposed on the certificate of registration held by
            Dr. Stephen Charles Huebel:

                  B.    UNDERTAKING
                  
                  (4)   I, Dr. Huebel, understand and agree that I am bound by the terms
                        and conditions of this Undertaking from the date on which I sign
                        it.
                  
                  (5)   I, Dr. Huebel, undertake to inform the College of each and every
                        location where I practice including, but not limited to,
                        hospital(s), clinic(s) and office(s), in any jurisdiction
                        (collectively my "Practice Location(s)"), within 15 days of
                        executing this Undertaking.  Going forward, I further undertake to
                        inform the College of any and all new Practice Locations within 15
                        days of commencing practice at that location.
                  
                  (6)   Clinical Supervision
                  
                        (a)   I, Dr. Huebel, undertake to practice under the guidance of a
                              clinical supervisor who is acceptable to the College (the
                              "Clinical Supervisor"), at my own expense.
                  
                        (b)   I, Dr. Huebel, acknowledge that I have reviewed the Clinical
                              Supervisor's undertaking, attached hereto as Appendix "A",
                              and understand what is required of the Clinical Supervisor,
                              including reports to the College.
                  
                        (c)   I, Dr. Huebel, acknowledge and agree that the Clinical
                              Supervisor will meet with me once every two months until
                              December 31, 2015, or longer if the Clinical Supervisor is of
                              the opinion that the supervision should continue beyond
                              December 31, 2015.  The first meeting will occur within 30
                              days of the date this Undertaking is signed. At these
                              meetings, the Clinical Supervisor will review 10 charts
                              selected by the Chief of Emergency Medicine or his designate,
                              which will be cases triaged at CTAS 1, 2 or 3. 
                  
                        (d)   I, Dr. Huebel, acknowledge and agree that at each meeting,
                              the Clinical Supervisor will discuss my assessment,
                              differential diagnoses, and management, to review the care I
                              have provided and to ensure that I am familiar with best
                              practices based on current literature. To guide the
                              discussion, the Clinical Supervisor will use the Practice
                              Assessment Report Emergency Medicine Management, or a similar
                              document with emphasis on assessment and management
                              decisions.
                  
                        (e)   I, Dr. Huebel, acknowledge and agree that at each meeting,
                              the Clinical Supervisor will identify learning objectives for
                              personal study, which I will study after the meeting and
                              review with the Clinical Supervisor at subsequent meetings.
                  
                  (7)   Continuing Medical Education
                  
                        (a)   I, Dr. Huebel, acknowledge and agree to continue the
                              Alternative Route for Certification program, whereby I am
                              undergoing education and training with Dr. Tavir Ahmed to
                              obtain my CCFP Designation. 
                  
                        (b)   I, Dr. Huebel, acknowledge and agree to meet all CPD
                              requirements for membership in the CPSO and the CCFP on an
                              annual basis.
                  
                        (c)   I, Dr. Huebel, acknowledge and agree to keep a learning
                              portfolio documenting the topics, learning objectives,
                              evaluation methods and outcomes from the Clinical Supervisor
                              meetings, Alternative Route for Certification program,
                              conferences attended, group learning activities and
                              self-directed learning projects. I will provide proof of my
                              educational activities to the College. 
                  
                  (8)   I, Dr. Huebel, undertake to co-operate fully with the supervision
                        of my practice, conducted under this term of the Undertaking and
                        Appendix "A" attached, and to abide by the recommendations of my
                        Clinical Supervisor, including but not limited to, any recommended
                        practice improvements and ongoing professional development.
                  
                  (9)   I, Dr. Huebel, undertake to ensure that Appendix "A" to this
                        Undertaking is signed and delivered to the College within thirty
                        (30) days of the date I execute this Undertaking.
                  
                  (10)  I, Dr. Huebel, undertake that if a person who has given an
                        undertaking in Appendix "A" to this Undertaking is unable or
                        unwilling to continue to fulfill its terms, I shall, within thirty
                        (30) days of receiving notice of same, obtain an executed
                        undertaking in the same form from a similarly qualified person who
                        is acceptable to the College and ensure that it is delivered to the
                        College within that time.
                  
                  (11)  I, Dr. Huebel, agree that if I am unable to obtain a Clinical
                        Supervisor on the terms set out above, I will cease practicing
                        medicine until such time as I have obtained a Clinical Supervisor
                        acceptable to the College.
                  
                  (12)  Dr. Huebel, agree that if I am required to cease practice as a
                        result of paragraph B(11) above this will constitute a term,
                        condition or limitation on my Certificate of Registration and said
                        term, condition and limitation will be included on the public
                        register.
                  
                  (13)  Reassessment of Practice
                  
                        (a)   I, Dr. Huebel, undertake that, approximately 18 months and 24
                              months after the execution of this Undertaking, I will submit
                              to Reassessments (the "Reassessments") of my practice by an
                              assessor selected by the College (the "Assessor"), such
                              Reassessment to occur regardless of whether I continue to
                              have a Clinical Supervisor.  I acknowledge and agree that the
                              Reassessment may include a chart review, direct observation
                              of my care, interviews with colleagues and co-workers,
                              feedback from patients and any other tools deemed necessary
                              by the College.
                  
                        (b)   I, Dr. Huebel, undertake to co-operate fully with the
                              Reassessments of my practice and to abide by the
                              recommendations of the Assessor regarding my emergency
                              medicine practice.
                  
                        (c)   I, Dr. Huebel, acknowledge and agree that my Clinical
                              Supervisor(s) may receive and review the findings of the
                              Assessor, and may discuss with the Assessor any issues or
                              concerns arising from the Reassessment.  I also acknowledge
                              that the results of the Reassessment will be provided to me
                              and reported to the College and the report may form the basis
                              of further action by the College. 
                  
                        (d)   I, Dr. Huebel, acknowledge and agree that the Assessor may
                              contact the Clinical Supervisor(s) and obtain such
                              information from the Clinical Supervisor(s) as the Assessor
                              deem relevant to the assessment process.
                  
                        (e)   I, Dr. Huebel, understand and agree that if I am of the view
                              that any of the Assessor(s)' recommendations is unreasonable,
                              I will have 30 days following my receipt of the
                              recommendations within which to provide the College with my
                              submissions in this regard.  I further understand and agree
                              that thereafter, the Inquiries, Complaints and Reports
                              Committee ("ICR Committee") will consider my submissions
                              including the reports from my Clinical Supervisor(s) and any
                              other materials relevant to my practice and make a
                              determination regarding whether or not the recommendations,
                              or any of them, are reasonable and that decision will be
                              provided to me.
                  
                        (f)   I, Dr. Huebel, undertake that, following the decision
                              referenced in subparagraph (14)(e) above, I will abide by
                              those recommendations of the Assessor(s) that the ICR
                              Committee has determined are reasonable.  I understand and
                              agree that I have the right to seek judicial review of
                              decision of the ICR Committee if I am of the opinion that it
                              is unreasonable.
                  
                  (14)  Monitoring 
                  
                        (a)   I, Dr. Huebel, undertake and agree that I will submit to, and
                              not interfere with, unannounced inspections of my office(s),
                              practice(s) and patient charts by a College representative
                              for the purposes of monitoring my compliance with the terms
                              of this Undertaking.
                  
                        (b)   I, Dr. Huebel, give my irrevocable consent to the College to
                              make appropriate enquiries of the Ontario Health Insurance
                              Plan and/or any person or institution that may have relevant
                              information, in order for the College to monitor my
                              compliance with the terms of this Undertaking.
                  
            C.    ACKNOWLEDGEMENT

            (15)  I, Dr. Huebel, acknowledge that a breach by me of any term of this
                  Undertaking may constitute an act of professional misconduct and/or
                  incompetence, and may result in a referral of specified allegations to
                  the Discipline Committee.

            (16)  I, Dr. Huebel, acknowledge that if a referral of specified allegations to
                  the Discipline Committee is made in relation to the terms of this
                  Undertaking, the College will be entitled to introduce this Undertaking
                  as evidence at a hearing before the Discipline Committee.

            (17)  I, Dr. Huebel, acknowledge that I shall be solely responsible for payment
                  of all fees, costs, charges, expenses, etc. arising from the
                  implementation of any of the terms of this Undertaking. 

            (18)  I, Dr. Huebel, acknowledge that I have read and understand the terms and
                  conditions provided in this Undertaking and that I have obtained
                  independent legal counsel in reviewing and executing this Undertaking, or
                  have waived my right to do so.

            D.    CONSENT

            (19)  I, Dr. Huebel, give my irrevocable consent to the College to provide this
                  Undertaking to any Chief(s) of Staff, or a colleague with similar
                  responsibilities, at any hospital or Practise Location where I practice
                  or have privileges ("Chief(s) of Staff"), and to provide said Chief(s) of
                  Staff with any information the College has that led to the circumstances
                  of my entering into this Undertaking and/or any information arising from
                  the monitoring of my compliance with this Undertaking.

            (20)  I, Dr. Huebel, give my irrevocable consent to the College to provide the
                  following information to any and all Clinical Supervisors and/or
                  Assessors:

                  (a)   any information the College had that led to the circumstances of my
                        entering into this Undertaking; 
                  (b)any information arising from any investigation into, or assessment of,
                  my practice; and
                  (c)any information arising from the monitoring of my compliance with this
                  Undertaking.
                  
            (21)  I, Dr. Huebel, give my irrevocable consent to all Chiefs of Staff,
                  Clinical Supervisors and Assessors to disclose to the College, and to one
                  another, any information:

                  (a)   relevant to this Undertaking;
                  (b)   relevant to the terms of the Clinical Supervisor's undertaking set
                        out at Appendix "A"; 
                  (c)   relevant to the Reassessments;  
                  (d)   relevant for the purposes of monitoring my compliance with this
                        Undertaking; and/or
                  (e)   which comes to his or her attention and which he or she reasonably
                        believes indicates a potential risk of harm to patients.

Previous Discipline Hearings

Committee: Discipline
Decision Date: 19 Jan 2015
Summary:

 On January 19, 2015, the Discipline Committee found that Dr. Huebel committed an act of 
professional misconduct in that he failed to maintain the standard of practice of the profession. 
Dr. Huebel admitted to the allegation.  
 
Patient A presented to the Emergency Department in August 2012 with back and chest pain and 
a history of some slurred speech. She was seen by an emergency physician, had some 
investigations done and was discharged with a diagnosis of TIA and chest pain not yet 
diagnosed. The blood work conducted that day at the Emergency Department was unremarkable.  
She was to have follow-up tests.  
 
Dr. Huebel saw Patient A when she returned two days later and documented her past medical 
history. He documented her history of a sudden sharp chest and mid-back pain that occurred two 
days prior with an episode of an altered state of consciousness. He noted that the CT head scan 
done at that time showed no acute abnormality and that the Troponin done at that visit was 
negative. There are scant details of a physical examination, which was essentially unremarkable.  
Dr. Huebel ordered blood work, a chest x-ray, a thoracic spine x-ray and a CT scan to rule out 
pulmonary embolism.  He also ordered medication, including Zofran and Toradol.    
 
Dr. Huebel’s documentation indicates that the patient returned from diagnostic imaging with a 
diagnosis of dissection of the carotid artery. The chart appears to contain a provisional diagnosis 
of probable thoracic degenerative spine disease/spasms/carotid dissection.  When the patient 
returned from the CT scan, a Code Blue was called. The patient could not be revived.  
 
Dr. X, Assessor for the College, was asked to provide his opinion on the care provided by Dr. 
Huebel to Patient A.  Dr. X stated that Dr. Huebel fell below the standard of care for a practising 
emergency physician in Ontario, among other things: 
 
When a patient with severe back pain radiating to the front presents with such a difference in 
blood pressures, the standard of care would be to consider an aortic dissection first and 
foremost above all other diagnoses and to order immediate investigations to rule out that 
possibility. Any delays by ordering other different types of tests would be inappropriate in the 
presence of such a classical presentation of an aortic dissection…the standard of care would 
have been to order an immediate ECG, and to arrange an immediate CT scan to rule out an 
aortic dissection… 
 
Patient B was an insulin-dependent diabetic female who was pregnant at the time Dr. Huebel saw 
 her in January 2013. She presented to the Emergency Department with an altered mental status.  
 Dr. Huebel provided Patient B with food to verify that she was PO tolerant and to give her a 
 more complex source of carbohydrates to prevent a relapse into hypoglycemia.  He discharged 
 Patient B with a final diagnosis of hypoglycemia.  
  
 Dr. Y, Assessor for the College, opined, among other things, that the evaluation and care of 
 Patient B and Dr. Huebel’s documentation were inadequate, and the risks posed to the unborn 
 fetus were not accurately considered and assessed.  Dr. Huebel failed to maintain the standard of 
 practice of the profession in his care and treatment of Patient B. 
  
On the basis of two complaints in 2008 and Dr. Huebel’s history with the College (Caution in 
person in 2004, Caution in writing in 2006), the College commenced an investigation of Dr. 
Huebel’s emergency medicine practice.   
 
In 2010, Dr. Huebel entered into an Undertaking with the College. That Undertaking provided 
that Dr. Huebel would be subject to supervision for a period of six months, after which he would 
be reassessed by the College. 
 
In her report to the College, Dr. Q, Assessor for the College, noted that Dr. Huebel’s charting 
was illegible, that there was a consistent pattern of deficiencies in Dr. Huebel’s documentation of 
patient history, physical exam, working or provisional diagnosis and reassessments prior to 
discharge, that significant results for investigations and lab tests were not documented, and that 
Dr. Huebel’s use of consultants was problematic as he relied on them to assume care of his 
patients with no further management by him.  
 
Commencing in 2013, Dr. Huebel has undertaken significant remedial and educational efforts to 
expand his knowledge base and improve his practice, which included: becoming a member of the 
College of Family Physicians of Canada, obtaining 198.3 CME credits from January 2013 to 
October 2014, and he applied for and was accepted into the Alternative Route for Certification 
(ARC) program, which is a practice eligible route to the CCFP Designation. 
 
In the context of its investigation of Dr. Huebel’s emergency medicine practice, the College 
retained Dr. Y to review Dr. Huebel’s practice. Dr. Y found Dr. Huebel’s clinical handling of the 
14 patient encounters he reviewed to be appropriate and that he met the standard of care expected 
by the profession and did not expose any of his patients to harm or injury. 
 
In March 2014, Dr. S, Chief of Dr. Huebel’s Emergency Department, advised the College of 
improvements to Dr. Huebel’s clinical practice over the past year.   
 
In May 2014, Dr. Huebel entered into an undertaking with the College, pending this hearing.  
Pursuant to the undertaking, Dr. Huebel retained Dr. T, Chief of Emergency Services, as a 
clinical supervisor. To date, Dr. T has expressed no concerns about Dr. Huebel’s care or 
treatment of patients. 
 
On January 13, 2015, Dr. Huebel signed an undertaking with the College requiring him to 
continue supervision with a Clinical Supervisor, continue in the ARC program, and submit to 
two reassessments of his practice. 
 
The Discipline Committee ordered and directed that:  
1. Dr. Huebel appear before the panel to be reprimanded. 
2. the Registrar impose the terms of Dr. Huebel’s undertaking with the College dated January 
   13, 2015, as terms, conditions and limitations on Dr. Huebel’s certificate of registration. 
3. Dr. Huebel 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): January 19, 2015