News Release

2014 - 05 - 30 Discipline Committee Decisions

Dr. Ernest Eugene Hajcsar, Burlington; Dr. James Scott Bradley Martin, London; Dr. Behnaz Yazdanfar

May 30, 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. Ernest Eugene Hajcsar, Burlington.  On May 1, 2014, the Discipline Committee found that Dr. Hajcsar committed an act of professional misconduct, in that he engaged in disgraceful, dishonourable or unprofessional conduct. Dr. Hajcsar admitted to the allegation.

Dr. Hajcsar practises family medicine and offers cosmetic treatments in a clinic shared with his now ex-spouse. Dr. Hajcsar saw Patient A as a patient on numerous occasions including acting as her family physician when his ex-spouse, Patient A's primary family physician, was on maternity leave. Between approximately 2004 and January 2012, Dr. Hajcsar treated Patient A for a variety of health issues, including providing supportive psychotherapy and beginning in August 2011, cosmetic treatments.

Dr. Hajcsar inappropriately violated appropriate boundaries with Patient A on a number of occasions:

  • by commenting inappropriately on Patient A's physical appearance
  • sometimes brushing the back the front of Patient A's hair when speaking to her
  • kissing Patient A briefly while assisting her in putting on her coat when she was leaving the clinic on two or three occasions
  • touching Patient A's shoulder as she was leaving, in what she perceived as an affectionate manner
  • hugging Patient A from time to time or putting an arm around her shoulder, either in greeting or by way of reassurance, for example when she was going to receive an influenza vaccination

Patient A felt this behavior was confusing and odd.

In 2012, at the conclusion of a follow-up assessment of a cosmetic treatment, Dr. Hajcsar joked to Patient A, offering to "test" her "new lips."  He then kissed her on the lips.  It was not a long kiss, but Patient A described it as a "big kiss." Dr. Hajcsar then walked into the waiting area with Patient A and, in the presence of Patient A and the receptionist, joked that he "gave [Patient A]'s lips a test drive." Patient A heard laughter in the waiting room and was uncomfortable. This conduct violated the appropriate boundary between a physician and a patient.

The Discipline Committee ordered a public reprimand and directed the Registrar to suspend Dr. Hajcsar's certificate of registration for two months. Dr. Hajcsar was further ordered to pay to the College costs in the amount of $4,460.

Dr. James Scott Bradley Martin, London.  On May 20, 2014, the Discipline Committee found that Dr. Martin committed an act of professional misconduct, in that he failed to maintain the standard of practice of the profession. Dr. Martin admitted to the allegation.

Dr. Martin practises fertility medicine at the Southern Ontario Fertility Technologies Clinic.

In relation to an investigation into the care of 28 patients, Dr. X, an independent expert retained by the College, had significant concerns regarding Dr. Martin's lack of judgment and his standard of care. Dr. X found an excessive number of intrauterine insemination (IUI) treatment cycles in some cases, without adequate justification for a prolonged delay in moving to more effective treatments, such as in vitro fertilization (IVF), or intracytoplasmic sperm injection. In addition, important discussions regarding patients' treatment options and decisions that Dr. Martin claimed took place, including about moving to IVF and the patient(s) choosing to continue with IUI, were not documented in their charts.

In relation to Dr. Martin's care of Patient A between approximately 2001 and 2010, this complaint was triggered by Dr. Martin's decision to terminate Patient A's weekly counselling appointments for an eating disorder. Dr. Martin admitted that he is not specifically trained to counsel eating disorders and that he was outside of his scope in the five years he engaged in this counselling. He also admitted he erred in misrepresenting to Patient A the reason he stopped the counselling. In relation to Patient A's fertility treatment, Dr. Y, an independent expert retained by the College, opined that Dr. Martin failed to maintain the standard of care, in the following respects:

  • in his medical charting;
  • by proceeding with IUI despite a degree of hyperstimulation dangerous to patient health;
  • by failing to adjust treatment to reduce the risk of severe hyperstimulation; and
  • by repeatedly placing Patient A at extreme risk of multiple medical complications, including thrombosis, pulmonary emboli and stroke.

In relation to Dr. Martin's care of Patient B in August of 2009, Dr. Y concluded that Dr. Martin failed to maintain the standard of care, in the following respects:

  • he lacked knowledge regarding the diagnosis and management of an ectopic pregnancy;
  • the systems in place at the clinic failed to maintain the standard in terms of the organization and management of Patient B's care between the clinic's health-care providers; and
  • in the lack of adequate documentation and poor communication among health professionals at the clinic that put Patient B's life at risk.

The Discipline Committee ordered a public reprimand and directed the Registrar to suspend Dr. Martin's certificate of registration for two months. In addition, a number of terms, conditions and limitations are imposed on Dr. Martin's certificate of registration, which are summarized as follows:

  • Dr. Martin shall cease accepting new patients in his practice of fertility medicine;
  • Dr. Martin shall not counsel or advise patients regarding eating disorders or any other matter falling outside his permitted scope of practice;
  • Effective July 1, 2014, Dr. Martin shall restrict his practice exclusively to reproductive endocrinology and the interpretation of fertility-related ultrasound images. He shall be prohibited from practising fertility medicine in any respect, including, without limitation, the following:
  1. fertility-related assessment and investigations, including the performance or interpretation of fertility-related hysterosalpingograms, fertility treatment or fertility-related cycle-monitoring;
  2. artificial insemination;
  3. in vitro fertilization including oocyte retrievals and/or embryo transfers;
  4. counseling or advising patients regarding fertility treatments, artificial insemination, or any other matter relating to fertility medicine; and
  5. decision making of any kind regarding the care and treatment of patients undergoing fertility treatment, artificial insemination, in vitro fertilization or any other treatment or procedure associated with fertility medicine;
  • Within 30 days of the date of this Order, Dr. Martin shall obtain a clinical supervisor acceptable to the College, who will supervise Dr. Martin's interpretation of fertility-related ultrasound images;
  • If a clinical supervisor is unable or unwilling to continue in this capacity, Dr. Martin shall, within 20 days, obtain a similarly qualified person who is acceptable to the College.
  • If Dr. Martin is unable to obtain an acceptable clinical supervisor, he shall cease to interpret fertility-related ultrasounds until such time as he has done so, and the fact that he has ceased to practise shall be a term, condition and limitation on his certificate of registration until that time;
  • Dr. Martin shall abide by all recommendations of his clinical supervisor with respect to practice improvements and education;
  • Effective December 31, 2014, Dr. Martin shall be prohibited from interpreting ultrasound images and shall restrict his practice exclusively to reproductive endocrinology;
  • For an indefinite period of time, Dr. Martin shall submit to unannounced inspections of his practice location(s) and patient records by a College representative, and consent to the monitoring of his OHIP billings for the purposes of monitoring and enforcing his compliance with this Order;
  • Dr. Martin shall, at his own expense, participate in and successfully complete an educational program satisfactory to the College in Ethics, and in medical record-keeping;
  • Dr. Martin shall be responsible for any and all costs associated with implementing the terms of this Order.

Dr. Martin was further ordered to pay to the College costs in the amount of $40,140.

Dr. Behnaz Yazdanfar, (no practice address).   On May 26, 2014, the Discipline Committee found that Dr. Yazdanfar committed acts of professional misconduct, in that she failed to maintain the standard of practice of the profession, and she has engaged in disgraceful, dishonourable or unprofessional conduct. The Discipline Committee also found that Dr. Yazdanfar is incompetent with respect to her care of Patient A. Dr. Yazdanfar admitted to the allegations.

With respect to Patient A, in August 2009, the College received a letter of complaint about two liposuction procedures performed on her by Dr. Yazdanfar in February and April 2008. Dr. X, an independent expert retained by the College, concluded that Dr. Yazdanfar failed to meet the standard of practice of the profession and displayed a lack of knowledge, skill and judgment in her performance of large-volume liposuction on Patient A and by failing to appropriately recognize and respond to the complications that arose from the procedure.

With respect to Patient B, in July 2009, the College received a letter of complaint regarding a breast augmentation Dr. Yazdanfar performed on her in October 2007. Dr. X concluded that Dr. Yazdanfar failed to meet the standard of practice of the profession and displayed a lack of knowledge, skill and judgment in failing to appropriately respond to the unsatisfactory outcome of the breast augmentation procedure.

In addition, Dr. Yazdanfar engaged in disgraceful, dishonourable or unprofessional conduct in her communications with both patients post-operatively.

The Discipline Committee ordered a public reprimand; and imposed the following terms, conditions and limitations on Dr. Yazdanfar's certificate of registration for an indefinite period:

  • Dr. Yazdanfar is restricted from performing all surgery, except as a surgical assistant in a hospital based setting, provided that a member of the College of Physicians and Surgeons of Ontario who is approved by the College is in attendance and performing the surgery ("all surgery" includes but is not limited to any cosmetic surgical procedures);
  • Dr. Yazdanfar's practice is limited to that of a surgical assistant, as described above.
  • Dr. Yazdanfar shall cooperate with unannounced inspections of her practice and patient charts, conducted at her own expense, by a College representative(s), for the purpose of monitoring and enforcing her compliance with these terms, conditions and limitations; and
  • Dr. Yazdanfar shall publish the terms, conditions and limitations imposed on her certificate of registration in any advertisement of her clinic where she is referred to, including on her website, and shall post signage of these restrictions in a form acceptable to the College in the Toronto Cosmetic Clinic or any other clinic owned by her.

Dr. Yazdanfar was further ordered to pay to the College costs in the amount of $4,460.