Previous Hearings
Committee: Discipline
Decision Date: 06 Jul 2015
Summary:
On July 6, 2015, the Discipline Committee found that Dr. Mary Elizabeth McIntyre
committed an act of professional misconduct in that she engaged in the sexual abuse of a
patient, in that she failed to maintain the standard of practice of the profession and she
engaged in conduct or an act or omission relevant to the practice of medicine that, having
regard to all the circumstances, would reasonably be regarded by members as disgraceful,
dishonourable or unprofessional. Dr. McIntyre admitted the allegations in the Notice of
Hearing, except for the allegation of sexual abuse of a patient, Ms Y, and the allegation of
disgraceful, dishonourable or unprofessional conduct in relation to Ms Y.
Dr. McIntyre is a family physician who practised at all material times as a sole
practitioner. The allegations arose from six public complaints received regarding her
conduct, as well as a Registrar’s investigation into her practice.
Public Complaints
In relation to the six public complaints, the Committee found that Dr. McIntyre failed to
maintain the standard of practice of the profession, and engaged in disgraceful,
dishonourable or unprofessional conduct in her dealings with six patients (Patients A to F)
and their families by:
? Failing to respond appropriately to requests by the College and the patients for
their medical records;
? Failing to appropriately maintain patient records;
? Improperly storing vaccines, resulting in a suspension of vaccination privileges
from Public Health;
? Not responding to patients’ care concerns;
? Failing to appropriately make referrals for patients;
? Failing to complete forms required by patients;
? Behaving rudely to patients and discharging them without justification or notice
and without following the College policy;
? Leaving the patients waiting for hours or more on one occasion;
? Failing to safeguard the patient’s privacy; and
? Mismanaging appointments with specialists.
Dr. McIntyre failed to maintain the standard of practice of the profession and engaged in
disgraceful, dishonourable or unprofessional conduct with respect to her clinical care and
treatment of patients, her failure to maintain boundaries, her failure to maintain proper
records, her failure to comply with public health requirements, including unsafe storage
of vaccines, and her failure to respond in a timely way to requests for patient records.
Conduct with respect to Patient A and children
Patient A and children were patients of Dr. McIntyre from 1990 until January 2011. As a
result of Dr. McIntyre ceasing to practise in 2011, Patient A and children suddenly had to
find a new family doctor and required copies of their medical records. Patient A made
multiple requests of Dr. McIntyre's office to provide a copy of medical records, but none
were answered. Patient A was also concerned that Dr. McIntyre had failed to refer her to
certain specialists despite Dr. McIntyre’s assurances to her that she would make these
referrals in the Fall of 2010. Patient A was also concerned about the safety and
effectiveness of various immunizations that Dr. McIntyre had administered to her
children, given that she had twice observed public health officials attend at Dr.
McIntyre’s office to remove boxes of expired and improperly stored vaccines.
The College investigator notified Dr. McIntyre of Patient A’s complaint on June 27,
2011. By October 7, 2011 the College had still not received any response or medical
records from Dr. McIntyre. By letter dated March 5, 2012, Dr. McIntyre’s counsel
advised that Dr. McIntyre's patient records were being held in a secure storage facility
and gave instructions on how the records could be retrieved. Despite following those
instructions, the investigator was still unable to obtain the requested records. At no time
did Dr. McIntyre or a member of her office provide the patient, or the College, with a
copy of the requested medical records.
During a concurrent investigation into Dr. McIntyre's practice under s.75(1)(a) of the
Health Professions Procedural Code, the College investigator completed a chart retrieval
at Dr. McIntyre's storage facility. During this search, paper charts were retrieved for two
of Patient A's children. The charts for Patient A and her other child were not located.
The Public Health Unit confirmed that, as a result of Dr. McIntyre’s ongoing failure to
store vaccines safely at the proper temperature, officials at the Public Health Unit had
attended Dr. McIntyre's practice on four occasions between July and November 2010 and
removed them. The Public Health Unit ultimately suspended Dr. McIntyre’s vaccine
privileges on October 14, 2010.
Conduct with respect to Patient B and her son
By letter dated June 13, 2011, Mr. M, counsel for Patient B and her son, advised that he
had been writing to his clients' family doctor, Dr. McIntyre, "for a couple of years" to
obtain copies of his clients' medical records. Dr. McIntyre had failed to provide the
patients' records, or even to acknowledge the requests, and Mr. M was seeking the
College’s assistance in obtaining the records.
The College investigator notified Dr. McIntyre of the complaint on June 27, 2011 and
asked for the records and any response to the complaint. By October 7, 2011, there was
still no response to the complaint.
On March 5, 2012, Dr. McIntyre’s counsel advised that the patient records were being
held in a secure storage facility. The College investigator followed Dr. McIntyre’s
instructions for retrieving the patient records by submitting a written faxed request to Dr.
McIntyre’s assistant. This was attempted on multiple occasions over the course of
multiple days. On each occasion a message was received that the fax line was "busy” or
there was a "poor connection." As a result, the records were not obtained.
The College investigator advised Dr. McIntyre, through her counsel, of the College's
unsuccessful attempts to retrieve the patient charts, and giving Dr. McIntyre one final
opportunity to provide the records to the College by no later than April 13, 2012. The
patient records were never provided.
During a chart retrieval in a concurrent s.75(1)(a) investigation, the College investigator
searched the storage facility where Dr. McIntyre was keeping her patients' records, but
was unable to locate records for Patient B or Patient B's son.
Conduct with respect to Patient C and her husband
On July 9, 2010, the College received a letter of complaint about Dr. McIntyre from
Patient C, on behalf of herself and her husband, related to their efforts to obtain their
medical records from Dr. McIntyre and her failure to complete a form that Patient C’s
husband required to receive his pension. Dr. McIntyre had indicated three months earlier
that she would send the form for him, but failed to do so.
Between July 2010 and December 2010, Patient C and an Advisor from the College's
Physician Advisory Services made numerous attempts to contact Dr. McIntyre, her
office, and Dr. McIntyre's counsel, to obtain the patients' medical records and to have the
pension form completed. None of these efforts was successful.
In December 2010, a formal complaint was opened. By letter dated May 13, 2011, the
College investigator requested that Dr. McIntyre provide the records for Patient C’s
husband by no later than June 17, 2011. It was not until December 21, 2011 that Dr.
McIntyre, through her counsel, provided partial medical records. To the date of the
hearing, complete copies of the records for these patients have not been provided by Dr.
McIntyre.
Conduct with respect to Patient D
Patient D’s complaint of May 12, 2010, described concerns about Dr. McIntyre's
unprofessional conduct in the brusque and dismissive manner in which she spoke to
Patient D and her husband, who was also Dr. McIntyre’s patient. Patient D further
complained about the manner in which Dr. McIntyre ran her practice, including, among
other things: lengthy wait times, failure to respond to telephone calls in a timely manner,
failure to ensure privacy and confidentiality when Dr. McIntyre discussed their health
concerns in the office, rude and discourteous behaviour by Dr. McIntyre and her staff and
Dr. McIntyre's failure to appropriately arrange appointments for the patients to be seen by
specialists.
In April 2010, Dr. McIntyre terminated Patient D and her husband's care without notice
or justification.
The College investigator provided Dr. McIntyre with a copy of the letter of complaint on
May 19, 2010 and further clarification of concerns by letter dated July 7, 2010. Dr.
McIntyre was asked to provide the medical records for Patient D and her husband, and
any response by August 10, 2010. It was not until October 26, 2010 that Dr. McIntyre
provided part of the medical records for Patient D and her husband. On January 24, 2011,
Dr. McIntyre, through her counsel, provided the College with a copy of Patient D's
additional medical records. It was not until May 12, 2011, one year after Dr. McIntyre
had been notified of this complaint, that she provided her response to the College.
By letter dated October 11, 2011, the College investigator wrote to Dr. McIntyre, through
her counsel, advising that the College had still not received the missing portions of the
medical records for Patient D and her husband. The material missing from the medical
records was never received.
Conduct with respect to Patient E
Patient E’s complaint, dated January 3, 2013, advised that she had been trying to obtain
her medical records from Dr. McIntyre for the past six months and had still not received
them. On January 11, 2013, a copy of Patient E’s letter of complaint was sent to both Dr.
McIntyre and her counsel with a request for a response by February 19, 2013. No
response was received until June 25, 2013, at which time her counsel advised that Dr.
McIntyre informed him that she had provided Patient E with her patient chart "some time
ago." On June 27, 2013, Patient E confirmed with the College investigator that, to date of
the hearing, she had not received her medical records, nor had she been charged by Dr.
McIntyre for a copy of it.
Conduct with respect to Patient F
Patient F was a patient of Dr. McIntyre’s for twelve years. On October 31, 2012, he wrote
a letter of complaint to the College outlining his numerous unsuccessful attempts for over
two years to obtain a copy of his medical records from Dr. McIntyre. Dr. McIntyre was
notified of the complaint on November 14, 2012. By June 25, 2013, the College had still
not received a copy of Patient F’s medical record from Dr. McIntyre. Ultimately, the
College received a copy of a part of Patient’s F’s medical record from the patient himself,
which when received from Dr. McIntyre, were not in chronological order, were missing
third party consultation notes, forms, copies of prescriptions, investigative results,
requisition forms, and contained no progress notes, nor a cumulative patient profile.
Registrar's Investigation – Clinical Care
On the basis of the public complaints, the Registrar of the College appointed investigators
to conduct an investigation of Dr. McIntyre’s practice under s.75(1)(a) of the Code. Dr.
Z, the independent expert retained by the College, concluded that Dr. McIntyre failed to
maintain the standard of practice of the profession and/or engaged in disgraceful,
dishonourable or unprofessional conduct with respect to her clinical care and treatment of
patients, her failure to maintain boundaries, her failure to maintain proper records, her
failure to comply with public health requirements including unsafe storage of vaccines,
and her failure to respond in a timely way to requests for patient records. The deficiencies
in Dr. McIntyre's practice and record keeping included (but were not limited to) the
following:
(a) The Patient Profile was frequently incomplete, making it difficult to determine
the general medical health of the patient from the chart;
(b) The charting of medications was unusual, with a separate sheet listing medications
prescribed in an alphabetized format, as a summary of the medications the patient is
taking regularly, but with no diagnosis associated with the medication. There was no way
of determining the amount of medication prescribed at each visit;
(c) The most significant concern was that the lines of professionalism and
relationships were often blurred, with Dr. McIntyre showing the greatest lack of
judgment in cases of patients with whom she had some type of relationship outside the
doctor-patient context.
In respect of the concerns regarding public health requirements, the College obtained
extensive documentation from the Public Health Unit documenting Dr. McIntyre's
repeated failures to comply with public health requirements and repeated breaches of
public health protocols (incorrect refrigeration temperature, incorrect vaccine storage,
failure to maintain log books, maintenance of expired vaccines). After attempted and
failed remediation plans, Dr. McIntyre’s office was ultimately suspended from the public
health programme through which physicians receive vaccines to administer to their
patients.
Registrar's Investigation - Disgraceful, Dishonourable, Unprofessional Conduct
In January 2011, investigators were appointed to inquire into and examine Dr. McIntyre's
personal and professional relationships with Mr. X.
Mr. X was a patient of Dr. McIntyre’s for about 20 years. Among other conditions, Mr. X
suffered from a mental illness and was recovering from substance abuse. During the
course of the doctor-patient relationship, Dr. McIntyre and Mr. X became close friends,
and she introduced Mr. X to her family, with whom he formed personal relationships.
In or around 2010, in part due to their increasingly close personal relationship, Dr.
McIntyre and Mr. X terminated their doctor-patient relationship. Dr. McIntyre and Mr. X
became increasingly closer. Approximately 12 months after the end of the doctor-patient
relationship, they began a sexual relationship.
The Discipline Committee found that with respect to Mr. X, Dr. McIntyre engaged in
disgraceful, dishonourable or unprofessional conduct by failing to maintain appropriate
professional boundaries with Mr. X during the doctor-patient relationship (by engaging in
a close friendship) and after the doctor-patient relationship, by commencing a sexual
relationship with him approximately twelve months after the end of the doctor-patient
relationship.
Sexual Abuse and Disgraceful Dishonourable and Unprofessional Conduct regarding
Ms Y
The Committee found that Dr. McIntyre engaged in boundary violations with her patient,
Ms Y, in that a close personal relationship existed between the two. Dr. McIntyre allowed
herself to become a close friend of Ms Y, often involved in her personal and financial
affairs, including helping her with loans, financial issues and her bank account. Ms Y often
travelled with Dr. McIntyre and her children, which included Dr. McIntyre and Ms Y
sharing a bed. Dr. McIntyre engaged Ms Y in caring for her children and performing
household chores. Dr. McIntyre was found in bed together with Ms Y, both partially
unclothed and in the nude on separate occasions. The Committee also found that Dr.
McIntyre sexually abused Ms Y by engaging in a romantic kiss with her in November or
December 2010, while Ms Y was Dr. McIntyre’s patient. Ms Y was a vulnerable patient.
She had been a patient of Dr. McIntyre for many years and the doctor took advantage of
her position of power to become involved with her socially and ultimately, sexually.
Penalty and Costs
On March 22, 2016, the Discipline Committee ordered and directed that:
1. The Registrar revoke Dr. McIntyre’s certificate of registration, effective
immediately.
2. Dr. McIntyre appear before the panel to be reprimanded. The reprimand should be
scheduled within three (3) months from the date the Order becomes final.
3. Dr. McIntyre reimburse the College for funding provided to patients under the
program required under section 85.7 of the Code, and post an irrevocable letter of
credit or other security acceptable to the College to guarantee payment of such
amounts within sixty (60) days of the date this Order becomes final, in the amount
of $16,060.00; and
4. Dr. McIntyre pay costs to the College in the amount of $13,380.00 within sixty
(60) days of the date this Order becomes final.
Appeal
On August 5, 2015, Dr. McIntyre appealed the decision on finding of the Discipline
Committee to the Superior Court of Justice (Divisional Court). On January 17, 2017, the
Divisional Court dismissed the appeal. Therefore, the decision of
the Discipline Committee remains in effect.
On February 1, 2017, Dr. McIntyre filed a motion for leave to appeal the decision of the
Divisional Court to the Court of Appeal. On July 7, 2017, the Court of Appeal denied Dr.
McIntyre’s motion for leave to appeal. Therefore, the decision of the Discipline
Committee remains in effect
Decision: Download Full Decision (PDF)
Appeal: Notice of Appeal
Hearing Date(s): February 2, 4,5,6, February 17-18, 2015. Penalty hearing: December 11, 2015.