News Release

2015 - 2 - 25 Discipline Committee Decisions

Dr. Michel Ronald Prevost; Dr. Mile Savic

Feb 25, 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. Michel Ronald Prevost (no practice address). On February 2, 2015, the Discipline Committee found that Dr. Prevost committed an act of professional misconduct, in that he failed to maintain the standard of practice of the profession with respect to 28 patients. The Committee also found that Dr. Prevost is incompetent in his practice of obstetrics and gynecology. Dr. Prevost admitted the allegations.

In response to concerns brought to the attention of the College, the College commenced an investigation into Dr. Prevost’s practice.

In the course of the College’s investigation, Dr. Prevost voluntarily entered into an undertaking with the College signed January 23, 2013, to cease to prescribe Methotrexate and/or Misoprostol for the purpose of terminating pregnancies. Upon referral of the allegations to the Discipline Committee, Dr. Prevost entered into an undertaking with the College signed November 20, 2013, in lieu of the imposition of an Order under s. 37 of the Health Professions Procedural Code to cease to practice obstetrics and gynecology.

A medical inspector retained by the College opined that in his care and treatment of 28 patients, Dr. Prevost did not meet the standard of practice of the profession and lacked knowledge, skill or judgment. The medical inspector identified a number of specific concerns pertaining to Dr. Prevost’s obstetrics and gynecology practice. These concerns were found by the Discipline Committee to amount to incompetence and professional misconduct, in that he failed to maintain the standard of practice of the profession.

With respect to cases pertaining to medical terminations, Dr. Prevost’s care fell below the standard of practice of the profession in failing to comply with The Society of Obstetricians and Gynecologists of Canada Induced Abortion Guidelines (SOGC Guidelines). He displayed a lack of judgment and patients were exposed to harm or injury in his failure to properly screen patients for medical terminations, in his failure to calculate doses of Methotrexate on the basis of his patients’ respective body surface areas, and in his failure to follow up with patients including when he was aware that patients had on-going gestations after the administration of Methotrexate. In the cases of on-going gestations, the patients’ fetuses were exposed to risk of harm in that they were exposed to Methotrexate and Misoprostol. There were documented fetal abnormalities in two pregnancies that went to term. Whether or not the abnormalities were caused by the medications administered for the purpose of terminating the pregnancies was not the subject of the College’s investigation because it was not necessary for proof of the allegations set out in the Notice of Hearing. 

Additionally, the Discipline Committee found Dr. Prevost breached the standard of practice of the profession and lacked judgment in the following areas:

  1. obtaining weights and urine dips in his pre-natal patients;
  2. charting pre-operatively and post-operatively;
  3. obtaining or documenting informed consent;
  4. obtaining appropriate pre-operative medical and/or anesthetic consults when indicated;
  5. following up appropriately and in a timely manner in his gynecological and obstetrical practice; and
  6. communicating with physician and nursing colleagues about his availability and/or lack of availability and/or when he was or was not taking responsibility for his patients who presented at or were admitted to hospital.

On February 2, 2015, Dr. Prevost signed an undertaking to resign from the College and not to apply or re-apply for registration as a physician to practice medicine in Ontario. In addition, Dr. Prevost has undertaken never to practice obstetrics or gynecology in any jurisdiction. This undertaking was taken into consideration by the Discipline Committee in determining the appropriate penalty.

Accordingly, the Committee ordered a public reprimand and directed that the results of this proceeding be included in the register. Dr. Prevost was further ordered to pay the College costs in the amount of $4,460.

Dr. Mile Savic, Belleville.  On February 19, 2015, the Discipline Committee found that Dr. Savic committed an act of professional misconduct, in that he has failed to maintain the standard of practice of the profession; he had a conflict of interest; and he has engaged in disgraceful, dishonourable or unprofessional conduct. Dr. Savic admitted the allegations.

In 2008, allegations of professional misconduct against Dr. Savic were referred to the Discipline Committee and were withdrawn on the basis of an undertaking dated November 22, 2010. The undertaking included terms requiring Dr. Savic to practice under the guidance of a clinical supervisor and to abide by the recommendations of the clinical supervisor.  

Dr. X acted as Dr. Savic’s clinical supervisor from November 22, 2010 until approximately April 2012. Dr. X made recommendations to Dr. Savic for practice improvements. Dr. X advised the College, through his reports, that Dr. Savic was not complying with his recommendations. Dr. Savic admits that he failed to adequately implement the recommendations of Dr. X during the period that Dr. X acted as clinical supervisor and that he engaged in disgraceful, dishonourable and unprofessional conduct by breaching this term of his undertaking.

Following receipt of patient complaints and supervision reports from Dr. X, the College commenced an investigation into Dr. Savic’s practice. Dr. Z provided an independent opinion to the College regarding Dr. Savic’s care and treatment of patients. Dr. Z concluded that Dr. Savic did not meet the standard of practice of the profession that would be reasonably expected of a competent practitioner in his field of practice. Of the 25 charts reviewed, Dr. Z found 20 charts were deficient in documentation; in 12 charts, Dr. Z was unable to determine if the standard of care was met due to documentation deficiencies; and 7 charts had significant care concerns. The standard of care was met in 5 charts and partially met in 2 charts.

Since approximately April 2012, Dr. Y has been Dr. Savic’s clinical supervisor. In his reports to the College, Dr. Y has reported that Dr. Savic now meets the standard of care, including with respect to documentation in charts. Dr. Y has advised the College that Dr. Savic is complying with his recommendations.

Dr. Savic admits that he placed himself in a conflict of interest in that he ordered diagnostic testing for some of his patients, to be performed at his clinic, and failed to disclose his proprietary interest. As of March 1, 2013, Dr. Savic voluntarily ceased performing diagnostic testing at his clinic in circumstances where he had a conflict of interest. Dr. Savic signed an undertaking dated November 6, 2013, in which he agreed not to refer his patients for diagnostic testing in a facility in which he had a proprietary interest and agreed to refer his patients to another physician when there is a conflict of interest.

The College and Dr. Savic agreed to additional facts in respect of penalty including that, in 2007, the Inquiries, Complaints and Reports Committee of the College ordered Dr. Savic to be cautioned in writing regarding the importance of performing and documenting a thorough physical examination of patients. In 2008, the Chief of Hospital 1’s emergency department notified the College of concerns regarding Dr. Savic’s prescribing practice. Allegations of professional misconduct were referred to the Discipline Committee and withdrawn on the basis of an undertaking signed by Dr. Savic on November 22, 2010, one of the terms of which was the resignation of narcotics prescribing privileges. This term, condition and limitation remains on Dr. Savic’s certificate of registration.

The Discipline Committee ordered a public reprimand; and a two-month suspension of Dr. Savic’s certificate of registration. The Committee further directed that the Registrar impose terms, conditions and limitations on Dr. Savic’s certificate that are summarized as follows:

  1. Dr. Savic, at his own expense, is to submit to a comprehensive practice assessment of his practice, by an assessor selected by the College, immediately following the completion of the Individualized Educational Plan, which is now in progress, and which is expected to be completed by July 31, 2015;
  2. Dr. Savic shall abide by reasonable recommendations made by the assessor. The College will determine whether any recommendations constitute terms, conditions or limitations on Dr. Savic’s practice, in which case they will be included on the public register.
  3. Dr. Savic shall, at his own expense, successfully complete College-facilitated instruction in ethics no later than one year from the date of this Order;
  4. Dr. Savic shall not delegate to any other person any Controlled Act as that term is defined in the Regulated Health Professions Act, 1991;
  5. Dr. Savic shall not conduct or interpret echocardiograms or exercise stress tests, nor shall he permit his patients to undergo such testing at a facility owned by him, a member of his family, or a corporation wholly, substantially, or actually owned by him or a member of his family, and he shall promptly refer all patients requiring such testing to another physician.
  6. Dr. Savic shall keep a log  of all prescriptions for Tremadol, Tramacet, Tidural or any other synthetic narcotic, which will include at least the following information:
    1. the date of the prescription;
    2. the name of the patient with chart/file number;
    3. the name of the medication prescribed;
    4. the medication dosage;
    5. the quantity prescribed;
    6. the clinical indication for use and patient direction; and
    7. physician initials.
  7. Dr. Savic will ensure that his prescription pads are kept in a secure location at all times; and
  8. Dr. Savic shall keep a copy of all prescriptions he writes for all synthetic narcotics, in the corresponding patient chart.

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