News Release

2015 - 1 - 5 Discipline Committee Decisions

Dr. Olu Kayode Louis Victor Nicol; Dr. Andrew Paul Joseph Finnegan; Dr. Jennifer Margaret Armstrong

Jan 05, 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. Olu Kayode Louis Victor Nicol, Mississauga. On December 12, 2014, the Discipline Committee found that Dr. Nicol committed an act of professional misconduct, in that he has failed to maintain the standard of practice of the profession in his care and treatment of 26 patients. Dr. Nicol admitted to the allegation.

Regarding a complaint received in July 2011 regarding the care of Patient A, Dr. X, an  independent assessor retained by the College, opined that Dr. Nicol failed to maintain the  standard of practice of a general practitioner: in the manner in which he prescribed narcotics to  Patient A; in dealing with her underlying substance abuse problem and mood disorder; and, in the overall care of Patient A, including in the absences of history taking and physical exam as  well as failing to ensure that proper screening protocols were undertaken, such as a PAP test,  colon cancer screening and diabetes screening.

In July 2012, the College commenced a broader investigation into Dr. Nicol's practice and retained Dr. Y, an independent assessor, to opine on Dr. Nicol's care and treatment of 25 patients. Dr. Y opined that Dr. Nicol's record-keeping failed to maintain the standard of practice of medicine in each case. He also opined that Dr. Nicol's overall care of multiple patients failed to maintain the standard of practice including:

  • He failed to acknowledge test results or follow up on some results;
  • He appeared hesitant in making the diagnosis of diabetes when the diagnostic criteria were met and seemed hesitant to manage these patients in an effective manner;
  • With respect to pain management, he started patients on high-doses of narcotics and, in some cases, mixed varieties, without employing a slower, more cautious approach to the initiation of therapy. Initial screening steps and a clearer recording of functional abilities was lacking.  He did not consider drug interactions in his prescribing of medications;
  • He was not diligent in minimizing the use of benzodiazepines;
  • Being inconsistent in his lipid assessment and management;
  • He needlessly treated what seemed to be viral respiratory infections with antibiotics;
  • He displayed some lack of knowledge in the area of vaccines; and
  • He displayed a lack of knowledge with respect to screening recommendations for  mammography, PAP smears, colorectal screening and has not kept up to date with current  concepts in osteoporosis.

In January 2014, Dr. Nicol entered into an undertaking with the College pending the disposition of the discipline hearing. In accordance with the undertaking, Dr. Nicol has practiced under supervision. The College has received regular reports from Dr. Nicol's supervisor which indicate improvements in Dr. Nicol's practice. Some improvements in Dr. Nicol's practice were also noted by Dr. Y.

The Committee ordered a public reprimand and directed that a number of terms, conditions and limitations be imposed on Dr. Nicol's certificate of registration, which are summarized as follows:

  1. Dr. Nicol shall not issue new prescriptions or renew existing prescriptions for Narcotic Drugs; Narcotic Preparations; Controlled Drugs; Benzodiazepines/Other Targeted Substances (collectively referred to as the "Restricted Substances"); and all other Monitored Drugs.
  2. Dr. Nicol shall not take on any new chronic pain patients;
  3. Dr. Nicol shall refer patients who are diabetic or who have impaired glucose tolerance to a specialty clinic for assessment and treatment recommendations;
  4. Dr. Nicol shall post a clearly visible sign in his waiting room which sets out the terms noted above in (a), (b) and (c).
  5. Dr. Nicol shall retain a College-approved clinical preceptor. For a period of 12 months, Dr. Nicol may practice only under the supervision of the clinical preceptor and will abide at his own expense by all recommendations of his clinical preceptor with respect to his practice;
  6. If Dr. Nicol is unable to obtain a clinical preceptor, he shall cease practicing medicine until such time as he has obtained one acceptable to the College.
  7. For a period of 12 months, Dr. Nicol may practice only with a College-appointed clinical supervisor;
  8. Upon completion of this 12-month period, as described in paragraphs (e) and (g), within three months, Dr. Nicol shall undergo a re-assessment of his clinical practice by a College-appointed assessor. This re-assessment will include a review of Dr. Nicol's office charts and an interview with Dr. Nicol, and he shall abide by all recommendations made by the assessor.
  9. Two years after the completion of the re-assessment referred to above in paragraph (h), Dr. Nicol shall undergo a further re-assessment of his clinical practice by a College-appointed assessor, in addition to the re-assessment referred to in paragraph (h) above and, regardless of that re-assessor's recommendations. Dr. Nicol shall abide by all recommendations made by the College-appointed assessor.
  10. On an annual basis, Dr. Nicol shall meet and demonstrate to the College that he has met the annual continuing medical education requirements expected of  members of the College of Family Physicians of Canada;
  11. Dr. Nicol shall be responsible for any and all costs associated with implementing  the terms of this Order;
  12. Dr. Nicol shall consent to the sharing of information between the preceptor, supervisor and assessors as deemed necessary or desirable in order to fulfill their respective obligations; and
  13. Dr. Nicol shall cooperate with unannounced inspections of his office practice and  patient charts by the College for the purpose of monitoring and enforcing his compliance with the terms of this Order and shall provide his irrevocable consent to the College to make appropriate enquiries of the Ontario Health Insurance Plan, the Narcotic Monitoring Database and/or any person or institution who may have  relevant information for the purposes of monitoring and enforcing his compliance  with the terms of this Order.

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

Dr. Andrew Paul Joseph Finnegan, Toronto. On December 15, 2014, the Discipline Committee found that Dr. Finnegan committed acts of professional misconduct, in that he sexually abused a patient; and he has engaged in disgraceful, dishonourable or unprofessional conduct. Dr. Finnegan admitted to the allegations.

Patient A attended for psychoanalysis at Dr. Finnegan's office from December 1983 to April 1995. Between the fall of 1994 and April 1995, Dr. Finnegan and Patient A had a sexual relationship involving sexual intercourse on a regular basis, while still continuing their psychoanalytic relationship. Patient A ended the psychoanalytic relationship in April 1995. This relationship continued up until 2003 when Dr. Finnegan broke off the relationship with Patient A.

The Discipline Committee ordered a public reprimand and directed the Registrar to revoke Dr. Finnegan's certificate of registration effective immediately. Dr. Finnegan was also ordered to post an irrevocable letter of credit or other security acceptable to the College by January 15, 2015 in the amount of $16,060 in order to reimburse the College for funding provided to patients under the program required under section 85.7 of the Health Professions Procedural Code.

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

Dr. Jennifer Margaret Armstrong, Nepean. On December 15, 2014, the Discipline Committee found that Dr. Armstrong committed an act of professional misconduct, in that she has failed to maintain the standard of practice of the profession with respect to one patient. Dr. Armstrong admitted to the allegation.

Dr. Armstrong is a general practitioner with a special interest and additional training in environmental medicine. Patient A was 19 years old at the time Dr. Armstrong met and treated her.

Patient A first attended on Dr. Armstrong in December 2010. Dr. Armstrong noted that Patient A did not currently have a family doctor. In addition to a recent Form 1 stay at the hospital of which Dr. Armstrong was aware, Patient A's mother also reported Patient A's previous suicide attempts and hospitalisations. Patient A's mother also provided a summary of Patient A's medical history, including a history of cognitive decline and seizures and reported that Patient A had been treated by a physician practising environmental medicine in the past and had improved considerably.

Patient A attended on Dr. Armstrong on three occasions. On each occasion, in assessing Patient A, Dr. Armstrong failed to perform any mental health assessments. Dr. Armstrong recommended a regime of IV Vitamins which were administered between December 2010 and April 2011. Dr.  Armstrong also treated Patient A with minerals and amino acids and lowered Patient A's thyroid medication in response to tests.

Dr. Armstrong did not see Patient A again after April 2011.  In May 2011, Dr. Armstrong subsequently learned that Patient A committed suicide. The College received a report about Patient A's death from the Office of the Chief Coroner in September 2012, and commenced an investigation into Dr. Armstrong's care of Patient A.

Dr. Armstrong took no steps to investigate or treat Patient A's mental health issues. Nor did she take any steps to assist Patient A in finding a primary care physician or other specialist. Dr.  Armstrong did not refer Patient A to a psychiatrist, psychologist or other mental health professional. Patient A did not find a family physician.

The independent assessor retained by the College concluded that Dr. Armstrong's care and treatment of Patient A failed to maintain the standard of practice of the profession and opined as follows:

There were no conventional treatments offered or documented for her psychiatric symptoms. Patient was not treated for her psychiatric symptoms by another physician according to the chart. Dr. Armstrong did not refer this patient to another physician for the psychiatric symptoms or her seizures. The patient did not have a family physician.  Instead, Dr. Armstrong concentrated on giving vitamins, minerals and amino acids, which are not the standard of care. Her focus regarding this patient was on chemical sensitivities and metal toxicities.

The Committee ordered a public reprimand and directed that a number of terms, conditions and limitations be imposed on Dr. Armstrong’s certificate of registration, which are summarized as follows:

  1. Dr. Armstrong shall engage in clinical supervision and a reassessment of her practice in accordance with the terms of her undertaking;
  2. Effective immediately, Dr. Armstrong will require that all of her current patients have a family physician or certified specialist who will provide concurrent care and to whom she will send information about all treatment she initiates or she has initiated and any changes to that treatment that she provides to the patient. Dr. Armstrong will provide each of her current patients (i.e., patients of hers as of the date of this undertaking) with a period of 45 days to obtain care from a primary care physician or appropriate specialist, and will not take on any new patient who does not have a primary care physician or appropriate specialist. Dr. Armstrong will cease treating any of her current patients who have not  arranged concurrent care as set out above by January 31, 2015; and
  3. Dr. Armstrong shall post a sign in her waiting room and each of her examination rooms, in each of her practice locations, in a clearly visible location, that states: "I require that all of my current patients have a family physician or certified specialist who will provide concurrent care and to whom I will send information about all treatment I initiate or have initiated and any changes to that treatment that I provide to our shared patient. I will provide each current patient with a period of 45 days from December 15, 2014 to obtain care from a primary care physician or appropriate specialist, and will not take on any new patient who does not have a primary care physician or appropriate specialist. I will cease treating any current patient who has not arranged concurrent care as set out above by January 31 2015."

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