Current Referrals
Practice Restrictions
| Imposed By |
Effective Date |
Expiry Date |
Status |
|
| Discipline Committee |
19 Dec 2012 |
|
Active |
View Details » |
Special Notices
Past Findings of the Discipline or Fitness To Practise Committee
View Details »
Committee: Discipline
Appeal Status: No Appeal Appeal Decision Date:
Hearing Date: 22 Mar 2012
Decision Date: 19 Dec 2012
On March 22, 2012, the Discipline Committee found that Dr. John Kenrick Pariag
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.
Pariag is incompetent. Dr. Pariag admitted to the allegations of professional
misconduct and incompetence, as follows:
Regarding a review of 35 patient charts from his surgical practice:
* improper placement of chest tubes in a CF patient;
* performing cholecystectomy in the presence of evidence that the common
bile duct was not clear;
* failure to protect an anastomosis with a stoma where appropriate;
improperly discharging 3 post-surgical patients with elevated white blood
cell counts and fevers;
* unnecessary transfusion of one patient;
* questionable decision to perform a targeted bowel resection in a patient
with rectal blood loss when the point of bleeding was unknown, and
failure to investigate a possible foreign body as indicated by x-rays of
the patient;
* incorrectly repairing a hernia, leading to recurrence;
* unnecessary removal of three healthy appendices;
* failure to obtain a right breast ultrasound despite a radiologist's
suggestion in a cancer patient;
* failed to give DVT [deep vein thrombosis] prohylaxis perioperatively to a
patient with known breast cancer;
* failure to properly control intraoperative bleeding;
* improperly performing surgery without first addressing the patient's
elevated INR;
* perforating a patient's bowel while removing two 0.25 cm polyps;
* improperly ordering blood transfusion of a 12-year-old with a haemoglobin
count of 108, which order was subsequently cancelled by another
physician, and failure to investigate percutaneous pelvic abscess
drainage before proceeding to perform a laparotomy on that patient;
* improperly performing an elective thyroidectomy without supervision when
Dr. Pariag had never performed such a procedure at the Hospital and had
not reviewed thyroid surgery during his residency; and
* dissecting a patient's portal triad during surgery to correct a bowel
obstruction, which error resulted in the patient's death due to
hemorrhagic shock.
Regarding patient A, who had surgeries for an intra-abdominal mass, later
identified as a sarcoma:
* failed to adequately document a differential diagnosis, treatment plan,
or informed consent discussions with Patient A; and,
* after the recurrence of the sarcoma, failed to solicit an opinion from
the Regional Cancer Centre where the patient had been seen in the past,
and improperly attempted to treat the sarcoma outside a multidisciplinary
care center.
On December 19, 2012, the Discipline Committee ordered and directed that:
1. the Registrar impose the following terms, conditions and limitations on
Dr. Pariag's certificate of registration for an indefinite period of
time:
a) Dr. Pariag is prohibited from engaging in any hospital-based
surgical practice save and except as a surgical assistant when a
College-approved certified surgeon is performing the surgery and is
in attendance. At no time shall Dr. Pariag be the most responsible
physician with respect to any patient in a hospital setting;
b) Dr. Pariag is prohibited from performing surgery in an office-based
setting save and except for minor surgical procedures under local
anaesthetic involving the skin and subcutaneous tissues;
c) At his own expense, Dr. Pariag shall undergo a comprehensive
practice assessment of the office-based practice described in
paragraph 3(b) of this Order by an assessor selected by the College
(the "CPA"). Dr. Pariag shall cooperate fully with the CPA,
including permitting the College's assessor to observe him in the
performance of any permitted procedures the assessor deems
necessary, provided it is possible to schedule the procedure in
question. Subject to paragraph 2(d) of this Order, the CPA shall be
completed within eight months of the date of this Order. Dr. Pariag
shall abide by any and all recommendations made as result of the
CPA; and
Dr. Pariag shall promptly notify the College should he cease
practising medicine before completion of the CPA. If he does cease
practising medicine prior to completion of the CPA, Dr. Pariag
shall provide the College with at least 45 days advance notice of
his intention to resume the practice of medicine. If this occurs,
the CPA shall be completed within eight months of Dr. Pariag's
resuming practice, in addition to any other requirements that may
apply at that time to physicians resuming the practice of medicine
following a leave of absence. Nothing in this order shall alter or
detract from Dr. Pariag's obligations pursuant to the College's
policy on Re-entering Practice, or such equivalent policies as may
apply to Dr. Pariag in the future.
2. The terms, conditions and limitations on Dr. Pariag's certificate of
registration under 1(a) and 1(b) of the Order be included on a written
form and the written form is to be presented to any patient before Dr.
Pariag sees the patient, and a copy signed by the patient is to be
included in the patient's chart;
3. Dr. Pariag attend before the Panel to be reprimanded, with the fact of
the reprimand to be recorded on the register; and
4. Dr. Pariag shall within 30 days of this Order pay the College its costs
of this proceeding in the amount of $3,650.00.
Member-reported Findings of Malpractice/Professional Negligence
No findings reported since June 4, 2009.