Discipline Committee Decisions
Dr. Dhammika V. S. Amarasekera; Dr. Sami J.G. Karkanis; Dr. David Le
May 26, 2010
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 underDoctor Search.
Dr. Dhammika V. S. Amarasekera, Toronto. On April 28, 2010, the Discipline Committee found that Dr. Dhammika Amarasekera committed an act of professional misconduct, in that he failed to maintain the standard of practice of the profession with respect to his prescribing practices for chronic care patients. Dr. Amarasekera was prescribing large quantities and large doses of narcotics and controlled drugs. There were concerns regarding Dr. Amarasekera's overall treatment of chronic care patients, his prescribing practices, his management of potential addiction issues, and his record-keeping practices.
The Committee ordered a public reprimand, and that a number of specified terms and conditions be imposed on Dr. Amarasekera’s certificate of registration, including that he shall not prescribe any narcotic drugs, narcotic preparations or controlled drugs; he shall post a clearly visible sign in his waiting room indicating that he has relinquished his prescribing privileges with respect to narcotic drugs, narcotic preparations or controlled drugs; and he shall cooperate with unannounced inspections of his practice for the purpose of monitoring and enforcing his compliance with this order. Dr. Amarasekera was further ordered to pay costs to the College fixed in the amount of $3,650.
Dr. Sami J.G. Karkanis, Ajax. On January 27, 2010, the Discipline Committee found that Dr. Sami Karkanis committed an act of professional misconduct, in that he engaged in disgraceful, dishonourable or unprofessional conduct. Dr. Karkanis did not follow the College's Physician-Patient Dating guidelines, which were in effect in 2004 and which outlined the general rule that a period of one year should pass between the last professional contact and commencement of a personal relationship. In the circumstances of this case, the general rule should have been followed: there had been personal disclosures on the part of the complainant; Dr. Karkanis admitted that during the doctor-patient relationship feelings had developed; and Dr. Karkanis admitted to being infatuated. Dr. Karkanis knew that she was a vulnerable woman by her disclosures during the doctor-patient relationship. Dr. Karkanis initiated a personal sexual relationship in circumstances where he ought to have waited the full one year period before initiating such a relationship.
On April 29, 2010, the Committee ordered a public reprimand; a five-month suspension of Dr. Karkanis’ certificate of registration; and imposed a number of specified terms and conditions. These restrictions on Dr. Karkanis’ certificate of registration include that he shall not have any in-person professional encounters with female patients in his office practice, except in the presence of a female chaperone; he shall not perform any pelvic, rectal or breast examinations on any female patient in his hospital practice, except in the presence of a female regulated health professional employed by the hospital; and he shall successfully complete the College’s boundaries and medical ethics and informed consent course. Dr. Karkanis was further ordered to pay costs to the College fixed in the amount of $10,000.
Dr. David Le, Toronto. On May 4, 2010, the Discipline Committee found that Dr. David Le committed an act of professional misconduct, in that he has engaged in disgraceful, dishonourable or unprofessional conduct.
Dr. Le had been Patient 1's family physician since she was an infant. In 2007, when Patient 1 was 16 years old, she attended at Dr. Le's office. In the course of this visit, Dr. Le inappropriately conducted a rectal exam on Patient 1 without obtaining her informed consent to do so. Patient 1 felt violated and confused by this examination.
Dr. Le saw Patient 2 for the first time in 2000, when Patient 2 was 16 years old. In the course of this visit, Dr. Le inappropriately conducted a rectal exam on Patient 2 without obtaining her informed consent to do so. Following the examination, Patient 2 felt violated and confused.
Dr. Le admitted that he did not communicate clearly and adequately with Patient 1 and Patient 2 regarding the nature and purpose of the examination he was conducting, which resulted in the patients misunderstanding the purpose of those examinations and why he was conducting them. Dr. Le also acknowledged that it was inappropriate for him to assist Patient 1 and Patient 2 in disrobing.
The Committee ordered a public reprimand; a two-month suspension of Dr. Le’s certificate of registration; and imposed a number of specified terms and conditions. These restrictions on Dr. Le’s certificate of registration include that he shall successfully complete the College’s boundaries, medical ethics and informed consent, and communication courses; and an educational program in the conduct of intimate examinations. Dr. Le shall not perform intimate examinations of female patients, such as breast, pelvic or rectal examinations, unless in the presence of a female chaperone who shall be a regulated health professional; and he shall post a sign in his office waiting room and examination rooms stating that he shall not conduct unsupervised examinations. Dr. Le was further ordered to pay the College’s costs fixed in the amount of $3,650 and the results of the proceeding are to be included in the College’s public register.
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