News Release

2015 - 1 - 30 Discipline Committee Decisions

Dr. Jordan Kirkwood Mzoma Achiume; Dr. Roger Cyril Wales; Dr. Bruce Gordon Minnes; Dr. Stephen Charles Huebel; Dr. Kwame Attuah

Jan 30, 2015

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. Jordan Kirkwood Mzoma Achiume, Cambridge.  On December 18, 2014, the Discipline Committee found that Dr. Achiume committed an act of professional misconduct, in that he engaged in disgraceful, dishonourable or unprofessional conduct. Dr. Achiume admitted to the allegation.

On January 13, 2010, the Inquiries, Complaints and Reports Committee (“ICRC”) issued a decision regarding an investigation. The Committee concluded that it had “significant concerns regarding Dr. Achiume’s record-keeping”. It ordered Dr. Achiume to complete a specified continuing education or remediation program (SCERP) in medical record-keeping between June and December 2010.

Letters from the College sent on November 15, 2013 and January 26, 2014, advised Dr. Achiume that he had still not complied with the January 2010 SCERP order, and had not provided any explanation for his failure to do so.  He was informed that the matter could result in a referral to the Discipline Committee.

As of February 19, 2014, Dr. Achiume had not completed a medical record-keeping course approved by the College.  Accordingly, the ICRC referred the matter to the Discipline Committee. As of the date of this hearing [December 18, 2014], Dr. Achiume has completed the in-class portion of the medical record-keeping course.  He is scheduled to complete the practical component of the course by January 30, 2015.

On March 4, 2014, terms and conditions requiring Dr. Achiume to obtain a clinical supervisor were placed on his certificate of registration by order of the College’s Quality Assurance Committee, which remains in effect until March 4, 2015, unless rescinded or varied by the Quality Assurance Committee. The Discipline Committee ordered a public reprimand and directed the Registrar to suspend Dr. Achiume’s certificate of registration commencing January 15, 2015, until the later of:

  1. February 15, 2015; or
  2. until Dr. Achiume has provided to the College proof of his compliance with the Specified Continuing Education and Remediation Program in medical record-keeping directed by the Inquiries, Complaints and Reports Committee in its January 13, 2010 decision.

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

Dr. Roger Cyril Wales, Napanee.  On January 14, 2015, the Discipline Committee found that Dr. Wales committed an act of professional misconduct, in that he failed to maintain the standard of practice of the profession. The Committee also found that Dr. Wales is incompetent.

Dr. Wales is a general practitioner (GP) refractionist in solo practice in the Kingston area.

The findings of professional misconduct and incompetence pertain to the following areas of Dr. Wales’ practice:

  • his measuring intraocular ‎pressure by touching the eye with his finger (finger tonometry) instead of using an applanation tonometer to measure numerically;
  • his failure to measure intraocular ‎pressure in certain age groups (under 40);
  • his failure to dilate pupils to look at the fundus/posterior eye; and
  • his failure to use cycloplegia ‎in children to obtain proper refraction. 

Dr. Wales’ deficiencies in his care and treatment of patients demonstrated a lack of knowledge, skill and judgment of such a nature and to an extent that he is unfit to continue to practise or that his practice should be restricted. The Committee found that the deficiencies Dr. Wales displays are current.

A penalty hearing is yet to be scheduled.

Dr. Bruce Gordon Minnes, Toronto. On September 29, 2014, the Discipline Committee found that Dr. Minnes committed professional misconduct, in that he has engaged in disgraceful, dishonourable or unprofessional conduct.

Findings in Relation to Conduct at the Hospital

The Committee found that Dr. Minnes failed to observe appropriate boundaries in the hospital setting with respect to numerous workplace colleagues over an extended period of time.

Regarding nurse B, Dr. Minns would, on occasions in 2008 without explanation, put his arm on her shoulder. In early 2009, while she was on the phone, Dr. Minnes placed his hands on her head and leaned in to kiss the top of her head; on an occasion the following month, Dr. Minnes came up behind her and massaged her neck and back. On another occasion, in early 2009, while she was sitting down charting, Dr. Minnes put his hand on her shoulder.

Dr. Minnes also behaved in an inappropriate and unprofessional manner with clinical manager D. In the early 2000's, Dr. Minnes approached D with a smile, wrapped his arms around her tightly and lifted her off the ground.

Regarding nurse C, on one occasion, Dr. Minnes came up behind her and started massaging her shoulders. He also pointed to or gently touched her collar area to make her look down and then he flicked his fingers up to touch her chin. She found this touching very annoying and uncomfortable and witnessed him do this to a new nurse in the department in the fall of 2011. On another occasion, Dr. Minnes took nurse C's hand and kissed it. She told him this was inappropriate and not to touch her again in any way. He called the next day to apologize and stopped touching her hand and doing the finger flicking trick. However, nurse C continued to witness Dr. Minnes touch other staff on the back, shoulders and doing the "finger flicking" routine.

Nurse F, who began work in the department in approximately 2003, witnessed Dr. Minnes giving back rubs to female staff and in the past, saw Dr. Minnes play the finger flicking game with female staff. These interactions with Dr. Minnes made it uncomfortable for staff to work with him.

In March 2009, Chief of the Department of Paediatrics and other staff, met with Dr. Minnes to discuss nurse B's complaint. In the context of discussing personal boundary issues, Dr. Minnes said that he recognized that at times he had difficulty exercising appropriate self-control and that at times colleagues had told him they were uncomfortable with his behaviour so he stopped. At that meeting, he acknowledged that he had been previously spoken to in October 2003 about complaints received about his inappropriate behaviour, including touching nurses in a manner that could be considered inappropriate and that he had been asked at that meeting to refrain from such action. At the hospital's direction, Dr. Minnes took certain steps to try to address these concerns.

Dr. Minnes admitted that the facts agreed to with respect the hospital allegations support a finding of disgraceful, dishonourable or unprofessional conduct against him.

Findings in Relation to Conduct as a Camp Physician

These findings pertain to Dr. Minnes' actions in relation to Ms A, a 17-year-old counsellor at a camp, where Dr. Minnes was volunteering as the camp physician, in the summer of 2007.

The Committee found based on the evidence that there was no doctor-patient relationship between Dr. Minnes and Ms A. She was not his patient on the date in July 2007.

The Committee found that there was sexual contact between Dr. Minnes and Ms A in Dr. Minnes' living quarters attached to the infirmary. Ms A had informally approached Dr. Minnes with respect to a foot injury. Dr. Minnes told her to drop by the infirmary. A few days later Ms A encountered Dr. Minnes on what turned out to be his last day at camp. After casual conversation, he invited her to come to his cabin that evening to look at her foot and to have a glass of juice. Ms A attended the infirmary; Dr. Minnes was in his living quarters.

Ms A entered his living quarters. Dr. Minnes made progressively intrusive advances towards her, enquiring about her sexual activities with her boyfriend, inviting her to sit on the couch beside him, putting his arm around her shoulder, placing her hand on his genitals over his pants, removing her shirt, fondling her breasts, rubbing himself against her buttocks, removing her shorts and attempting to remove her underwear. When Dr. Minnes attempted to remove her underwear, Ms A told him she had to leave as it was late and she had responsibilities and left the cabin.

The Committee found that the brief informal conversation about Ms A's foot did not establish a doctor-patient relationship. While Dr. Minnes, as camp physician, was responsible for providing medical service to both children and staff at the camp, he did not provide any medical services to Ms A. She did not follow his initial advice to come to the infirmary prior to the date in July 2007, and did not attend that evening out of concern for her foot (which was getting better). Dr. Minnes never properly examined her foot, he gave no medical advice and did not prescribe treatment and no record was made of Dr. Minnes' brief discussion with Ms A about her foot.

While the Committee has found that there was no doctor patient relationship, Dr. Minnes was nevertheless the camp doctor and 47 years old and Ms A was a 17-year-old camp counsellor, and he was in a position of authority vis-à-vis Ms A.  The Committee finds on the evidence that Dr. Minnes' conduct with Ms A, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable, or unprofessional.

On January 19, 2015, the Committee ordered a public reprimand, and directed the Registrar to revoke Dr. Minnes’ certificate of registration, effective immediately.

Dr. Stephen Charles Huebel, Scarborough.  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 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. R to review Dr. Huebel’s practice. Dr. R 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 a public reprimand and directed that the terms of Dr. Huebel’s undertaking dated January 13, 2015, be imposed as terms, conditions and limitations on his certificate of registration.

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

Dr. Kwame Attuah, (no practice address).  On January 21, 2015, the Discipline Committee found that Dr. Kwame Attuah committed an act of professional misconduct, in that he engaged in disgraceful, dishonourable, or unprofessional conduct. Dr. Attuah admitted to the allegation.

On November 12, 2012, Dr. Attuah entered into an undertaking to practise under the guidance of a clinical supervisor acceptable to the College, and to provide a signed undertaking of an approved clinical supervisor by December 12, 2012, in order to continue to practise medicine in Ontario.

As of December 12, 2012, Dr. Attuah had not obtained a clinical supervisor. Accordingly, as of December 13, 2012, he was required to cease practising medicine in Ontario.  Instead, Dr. Attuah treated 57 patients over 33 days in February and March 2013 without being under clinical supervision, including writing prescriptions for patients. Therefore, this constituted a breach of his undertaking with the College.

On December 19, 2014, Dr. Attuah signed an undertaking to resign from the College effective immediately and never re-apply to practise medicine in Ontario or any other Canadian jurisdiction.

The Committee ordered a public reprimand, and Dr. Attuah is to pay the College costs in the amount of $4,460.