Previous Hearings
Committee: Discipline
Decision Date: 26 Mar 2018
Summary:
On March 26, 2018, the Discipline Committee found that Dr. Robert Stewart Cameron committed an act of professional misconduct, in that he has failed to maintain the standard of practice of the profession.
Dr. Cameron is a 65-year-old general physician who received his certificate of registration authorizing independent practice in 1978. At the relevant time, Dr. Cameron practised at a walk-in clinic in Windsor, Ontario.
Information from the Narcotics Monitoring System
In July 2016, the College received information from the Ministry of Health and Long-Term Care’s Narcotics Monitoring System regarding Dr. Cameron’s prescribing of controlled drugs, including narcotics, from January 1, 2015 to December 31, 2015 (the “NMS data”). The NMS data indicated that Dr. Cameron had been identified as a physician who, in 2015, prescribed eight or more patients at least 650 oral morphine equivalents per day and issued at least one prescription exceeding 20,000 oral morphine equivalents.
Investigation of Dr. Cameron’s Practice
The College retained an expert, a family physician, to opine on Dr. Cameron’s prescribing of controlled drugs including narcotics. The expert reviewed 24 charts, the NMS data, and interviewed Dr. Cameron. At the request of the College, the expert provided an addendum report to the College, containing individual patient reports of the charts he reviewed. The expert opined that Dr. Cameron’s care of his patients fell below the standard of practice of the profession in 18 of 24 charts and that Dr. Cameron’s care in 16 of 24 charts placed his patients at a risk of harm.
In particular, the expert noted that:
- Dr. Cameron had a tendency to prescribe narcotics at doses well in excess of those recommended in the relevant clinical guidelines, for chronic pain, over many years, with few physical exams or other evaluations of the patient’s pain or function;
- Dr. Cameron demonstrated questionable and at times very poor judgment in continuing to prescribe large doses of narcotics to patients who had repeatedly demonstrated aberrant behaviour, often at appointments over a period of years, and was too accepting of patients often questionable explanations for lost, stolen or damaged narcotics;
- Dr. Cameron failed to regularly conduct opioid risk assessments, implement narcotics contracts and/or conduct urine drug screening to address repeated aberrant behaviour;
- In respect of at least six patients, Dr. Cameron failed to refer patients to specialists, including pain and/or addiction specialists, where indicated;
- In respect of at least seven patients, Dr. Cameron failed to react to information from third parties about potential opioid abuse or to follow the advice of consultants who suggested decreasing or discontinuing opioid medications;
- Dr. Cameron continued to prescribe high doses of narcotics to patients who may have sustained accidents or injuries due to these prescriptions;
- Dr. Cameron prescribed benzodiazepines to patients to whom he was also prescribing high doses of narcotics;
- In respect of at least four patients, Dr. Cameron regularly prescribed narcotics to patients also prescribed methadone for addiction without appropriate consultation with the methadone prescriber.
Undertaking
On March 9, 2018, Dr. Cameron has entered into an undertaking with the College, whereby he undertook to resign from the College, effective April 30, 2018 and not to apply or re-apply for registration as a physician to practise medicine in Ontario or any other jurisdiction after the effective date.
Disposition
The Discipline Committee ordered that:
- the Registrar impose the terms of the Inquiries, Complaints and Reports Committee’s Order dated June 27, 2017 made pursuant to section 25.4(1) of the Health Professions Procedural Code (the “Code”), which is Schedule 2 to the Regulated Health Professions Act, 1991 (attached as Appendix “B” to the Order) as terms, conditions and limitations on Dr. Cameron’s certificate of registration.
- Dr. Cameron attend before the panel to be reprimanded.
- Dr. Cameron pay costs to the College in the amount of $10,180.00 within 60 days of the date this Order becomes final.
Decision: Download Full Decision (PDF)
Hearing Date(s): March 26, 2018
Committee: Discipline
Decision Date: 14 Jan 2013
Summary:
On January 14, 2013, the Discipline Committee found that Dr. Robert Stewart Cameron committed an act of professional misconduct, in that he has 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. Cameron admitted the allegation.
Between 2008 and 2010, Dr. Cameron worked with Ms AB, a Registered Practical Nurse, and made unwanted and inappropriate remarks of a sexual nature, including stories of sexual interactions with his girlfriend. Around February 2010, while Ms AB was working, Dr. Cameron put his arm around her hip and waist, with his hand resting on the upper part her left buttock. Ms AB ultimately reported the matter to the police.
Commencing in August 2009, Ms CD, a Registered Practical Nurse, worked with Dr. Cameron.
Dr. Cameron made unwanted, inappropriate and unprofessional comments of a personal nature regarding his ex-wife and his girlfriend and spoke unprofessionally regarding Ms CD to the father of a young patient. In early 2010, Dr. Cameron raised his voice at Ms CD in an irate fashion where patients were present.
In or about January 2010, in a conversation with Ms AB, Dr. Cameron made threatening remarks with respect to Dr. EF. Ms AB reported to Dr. EF and the police that Dr. Cameron stated he would like to meet EF in a dark alley with a baseball bat.
On March 3, 2010, Dr. Cameron was charged with sexual assault with respect to Ms AB and uttering threats with respect to Dr. EF. On June 18, 2010, the charges were withdrawn on the condition that Dr. Cameron enter into a peace bond for a one-year period. The conditions of the bond included not communicating with Ms AB and Dr. EF and not to be within a 50-metre radius of the Hospital.
The Discipline Committee ordered and directed that:
the Registrar suspend Dr. Cameron's certificate of registration for a period of three (3) months, to commence January 31, 2013 at 11:59 p.m.;
the Registrar impose the following terms, conditions and limitations on Dr. Cameron's certificate of registration:
a) Dr. Cameron shall, at his own expense, participate in and successfully complete a one-to-one course in boundary issues and communications approved by the College;
Dr. Cameron attend before the panel to be reprimanded; and
Dr. Cameron shall pay the College its costs in the amount of $3,650.00 within six months of the date of this Order.
Decision: Download Full Decision (PDF)
Appeal: No Appeal
Hearing Date(s): January 14, 2013
Committee: Discipline
Decision Date: 05 Dec 2011
Summary:
On December 5, 2011, the Discipline Committee found that Dr. Robert Stewart Cameron committed an act of professional misconduct, in that he engaged in 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. Cameron failed to see, assess, treat or respond to a two yearold boy while the boy was in the clinic and suffering from a life threatening anaphylactic reaction. Dr. Cameron was aware that the child was in the clinic, and yet did not leave his office at any time to attend to the child or to assist the paramedic while a medical emergency was occurring in the immediate vicinity. Fortunately for the child, the paramedic was immediately available and arrived and provided lifesaving measures within minutes of the receptionist placing the ambulance call.
The Discipline Committee ordered and directed that:
1. The Registrar suspend Dr. Cameron's certificate of registration for a period of one (1) month, to commence December 19, 2011;
2. The Registrar impose the following terms, conditions and limitations on Dr. Cameron's certificate of registration:
a) Dr. Cameron shall, at his own expense, participate in and successfully complete a onetoone educational program in medical ethics specifically tailored to the allegations in the Notice of Hearing organized and approved by the College;
3. Dr. Cameron attend before the panel to be reprimanded; and
4. Dr. Cameron shall within 160 days pay the College its costs in the amount of $7,300.00.
Decision: Download Full Decision (PDF)
Appeal: No Appeal
Hearing Date(s): April 4 and 5, 2011, December 5, 2011