News Release

Discipline Committee Decisions

Dr. Leona Constance Rudinskas, Weston; Dr. Roland C.K. Wong, Toronto.

Jan 28, 2014

The College of Physicians and Surgeons of Ontario (“the College”) released the results of its most recent disciplinary hearings. The College is the licensing and disciplinary body for physicians in Ontario. Hearings are held to review allegations of professional misconduct and incompetence, and are open to the public. The following are brief summaries of recent discipline hearing results. The Discipline Committee’s full decisions and reasons for decisions are posted on the College’s website as they become available. Full decisions are located by entering the doctor’s name in the Doctor Search section of the College’s website at www.cpso.on.ca.

Dr. Leona Constance Rudinskas, Weston. On December 9, 2013, the Discipline Committee found that Dr. Rudinskas committed an act of professional misconduct, in that she failed to maintain the standard of practice of the profession. Dr. Rudinskas admitted the allegation. She practises oncology, haematology and internal medicine in Toronto, Ontario.

Patient A
Dr. Rudinskas failed to perform appropriate assessments; round at an appropriate hour; review in a timely manner patient's condition and test results, and respond in a timely manner to information about her condition; appropriately assess her following a haemoglobin drop; order a CT scan on a 'stat' basis; review results of abdominal x-rays demonstrating the existence of a bowel obstruction in a timely manner; diagnose a bowel obstruction in a timely manner; and communicate in a timely manner with the patient's family.

Patient B
Patient B, an infant, died of known cardiac congenital abnormalities. In her role as Coroner, Dr. Rudinskas attended at the hospital and communicated in an insensitive and unprofessional manner with the patient's parents immediately after his death in the course of communicating to them about the policy of the Coroner’s office regarding co-sleeping.

Patient C
Dr. Rudinskas failed to conduct her first patient encounter with Patient C at an appropriate hour; conduct a physical examination during the eight days for which she was his most responsible physician; communicate in a timely and professional manner with the patient and his family, including by failing to adequately discuss her plan of care with him; terminate the physician-patient relationship in accordance with College policy; and accurately document her reason for termination. In terminating the relationship, Dr. Rudinskas communicated with the patient's daughter in an insensitive and unprofessional manner.

Patient D
Dr. Rudinskas communicated additional information confirming the patient's cancer diagnosis to her in an inappropriate manner and at an inappropriate hour and failed to document an appropriate discussion of the risks and benefits of treatment.

Patient E
Dr. Rudinskas failed to document in patient's chart the rationale for a treatment decision, an appropriate discussion regarding the same, and an appropriate discussion regarding the use of a taxane regime. She also failed to make a physician-to-physician transfer when the patient moved to another city to complete her treatment.

Patient F and Patient G
Dr. Rudinskas failed to document in the patients' charts an appropriate discussion of the risks and benefits of treatment.

Patient H
Dr. Rudinskas failed to consider additional steps to investigate a differential diagnosis for this patient's anemia.

Patient I and Patient M
Dr. Rudinskas failed to document in the patients' charts appropriate physical examination and appropriate discussion regarding the risks of benefits of treatment.

Patient J
Dr. Rudinskas failed to document appropriate assessment of Patient J when she presented complaining of gait instability and failed to document the treatment plan in the patient's chart.

Patient K
Dr. Rudinskas failed to document in the patient's chart the reasons for her decision to administer a seventh round of chemotherapy and appropriate discussion regarding the risks and benefits of doing so.

Patient L
Dr. Rudinskas failed to make appropriate inquiries to identify the patient's treating physician(s) in order to communicate the existence of a fistula, which could result in renewed sepsis or other issues.

On January 25, 2010, Dr. Rudinskas entered into an interim undertaking, to remain in effect until the allegations in this hearing had been disposed of by the Discipline Committee. Among other things, Dr. Rudinskas agreed to complete routine rounds of all patients before 10:00 pm each evening and engage a supervisor acceptable to the College to review all aspects of both her hospital and office practice and to meet with her to discuss any issues or concerns. Pursuant to Dr. Rudinskas' interim undertaking, she engaged a clinical supervisor. She also completed Medical Record-Keeping for Physicians in October 2010, pursuant to the interim undertaking.

The Discipline Committee ordered a public reprimand and directed the Registrar to suspend Dr. Rudinskas' certificate of registration for three months, commencing January 15, 2014. In addition, the Committee ordered terms, conditions and limitations on Dr. Rudinskas' certificate of registration, which are summarized as follows:

  • Dr. Rudinskas shall attend, and successfully complete, an education program satisfactory to the College in Communications, which will involve multiple one-on-one sessions with a College-approved instructor, incorporating counseling, guided reflection, tailored feedback, and/or other modalities, with a report(s) to be provided to the College regarding her progress and compliance. This term, condition and limitation shall be removed upon completion of this requirement.
  • Dr. Rudinskas shall attend, and successfully complete, an educational program satisfactory to the College in Ethics, with a report(s) to be provided to the College regarding her progress and compliance. This term, condition and limitation shall be removed upon completion of this requirement.
  • Dr. Rudinskas shall undergo an assessment of her hospital and office practice conducted by a College-appointed assessor. Dr. Rudinskas shall cooperate fully with the assessment, including providing access to her patient records, consenting to disclosure of relevant information by the College or any hospital at which she practices to the assessor, permitting the assessor to directly observe her provision of patient care, and participating in or facilitating interviews of other persons with the assessor. Dr. Rudinskas shall abide by the recommendations of the assessor.
  • Dr. Rudinskas shall comply with all policies at any hospital where she practices regarding the frequency and timing of patient rounds and complete routine rounds of all patients before 10:00 p.m. each evening. This term, condition and limitation shall remain on Dr. Rudinskas' certificate of registration for an indefinite period of time.
  • The chief of staff, chief of medicine, director, office manager or other person who is acceptable to the College (i.e., a “reporting director”) at any hospital or facility at which Dr. Rudinskas practices, not including Dr. Rudinskas’ office, shall provide quarterly reports notifying the College of any concerns that have arisen with regard to Dr. Rudinskas' conduct, patient care, communications or collegiality.
  • If a reporting director is unwilling or unable to continue in this capacity, Dr. Rudinskas shall, within 30 days, identify another reporting director who is acceptable to the College. If Dr. Rudinskas is unable to obtain a reporting director at a hospital or facility at which she practices, she shall cease to practise at that location immediately until such time as she has obtained one at that location.
  • Upon successful completion of the assessment, and upon receipt of satisfactory quarterly reports from the reporting director(s), the quarterly reports may be reduced to one further report to be delivered after one further years’ time. If that further report is deemed satisfactory, no further reports shall be required.
  • Dr. Rudinskas shall consent to the monitoring of her OHIP billings and cooperate with inspections of her practice and patient charts by College representative(s) for the purpose of monitoring and enforcing her compliance with the terms of this Order.

Dr. Rudinskas was further ordered to pay to the College costs in the amount of $55,000.

Dr. Roland C.K. Wong, Toronto. On December 12, 2012, the Discipline Committee found that Dr. Wong committed an act of professional misconduct, in that he failed to maintain the standard of practice of the profession with respect to:

  • his completion of the Special Diet Allowance (SDA) forms, in that he did not take the necessary steps to satisfy himself that the 15 patients, whose records were before the Committee, had the conditions reported on the forms;
  • his record-keeping, in that his documentation in the 15 charts reviewed supporting confirmation of each condition varied from minimal to non-existent;
  • his OHIP billing, in that he did not obtain sufficient information to attest to the various medical conditions which he confirmed on the SDA forms. Consequently, he did not meet the requirement of taking a reasonable history of the reported condition prior to billing OHIP for a partial assessment in the 15 charts reviewed.

In addition, he engaged in unprofessional conduct by confirming diagnoses on SDA forms, without first satisfying himself that the patient had the specified condition.

A contested penalty hearing proceeded in July 2013. On January 22, 2014, the Discipline Committee ordered a six-month suspension of Dr. Wong’s certificate of registration; a public reprimand; a fine of $35,000 payable to the Minister of Finance and Dr. Wong shall provide proof of payment to the College; and terms, conditions and limitations are imposed on Dr. Wong’s certificate of registration, which are summarized as follows:

  • Dr. Wong shall successfully complete a preceptorship in medical record-keeping and in the completion of special diet allowance forms for one year, and abide by all recommendations of his preceptor with respect to practice improvements and professional development. The preceptor shall provide reports to the College.

  • Dr. Wong shall retain a copy of all special diet allowance forms which he will submit to his preceptor along with the corresponding patient chart on a monthly basis. The preceptor will review and co-sign every copy of a special diet form and will report any irregularity to the College. (To clarify, the special diet forms need not be co-signed before they are given to the patient).
  • Within 12 months of completing the preceptorship, Dr. Wong shall undergo reassessment with regard to medical record-keeping and his completion of special diet allowance forms by a College appointed assessor and shall abide by all related recommendations.
  • Dr. Wong shall cooperate with inspections of his OHIP billings and their supporting chart entries at approximately 3, 6, 9 and 12 months from the date of Dr. Wong's return to practice.
  • Dr. Wong shall cooperate with unannounced inspections of his practice and patient charts by a College representative for the purpose of monitoring and enforcing his compliance with the terms of this order.
  • Dr. Wong shall be responsible for any and all costs associated with implementing the terms of this order.

Dr. Wong was further ordered to pay the College costs in the amount of $26,360.