Committee: Discipline
Decision Date: 28 Apr 2020
Summary:
On February 24 and 25, 2020, on the basis of an Agreed Statement of Facts and Admission (Liability), and an Agreed Statement of Facts on Penalty the Discipline Committee held a hearing regarding liability and penalty with respect to Dr. Darryl Jordan Gebien (“Dr. Gebien”). The Committee reserved its decision, which was released on April 28, 2020 and is available to view on the College’s website
FACTS
Dr. Gebien is a 49-year-old physician who practised emergency medicine at Royal Victoria Regional Health Centre (“RVH”) in Barrie, Ontario. Dr. Gebien received his certificate of registration in Ontario in March 2009, subject to a practice restriction that Dr. Gebien may only practise emergency medicine under supervision. In February 2011, Dr. Gebien was issued an independent certificate of registration restricted to emergency medicine.
Dr. Gebien ceased practising medicine on November 1, 2014. On May 8, 2016, Dr. Gebien signed a cease to practise undertaking with the College that remains in effect.
OVERVIEW OF THE CASE
Beginning in approximately 2008, after experiencing a serious injury to his back, Dr. Gebien was prescribed Percocet by his family doctor and in time developed an addiction to opioids. By the summer of 2013, Dr. Gebien’s opioid addiction had developed to include the abuse of Fentanyl. By 2013, Dr. Gebien was recruiting other individuals to help him obtain drugs through fake prescriptions he wrote for them. He also forged colleagues’ signatures on RVH prescription pads in order to obtain Fentanyl. When a pharmacist called the hospital with questions about a forged prescription, Dr. Gebien’s scheme was uncovered. His privileges were suspended by RVH on November 1, 2014. Dr. Gebien subsequently resigned.
Dr. Gebien was arrested by the Barrie Police Service on November 3, 2014 and charged with six counts of making a forged document contrary to s.366(1)(a) of the Criminal Code of Canada and six counts of knowingly using a forged document contrary to s.368(1)(a) of the Criminal Code of Canada. In January 2015, Dr. Gebien was charged with trafficking in a substance included in Schedule 1 of the Controlled Drugs and Substances Act and five counts of possession of a substance included in Schedule 1 of the Controlled Drugs and Substances Act and six counts of possessing a substance included in Schedule 1 of the Controlled Drugs and Substances Act for the purpose of trafficking.
On December 12, 2016, Dr. Gebien pleaded guilty to a charge that, between August 10, 2013 and November 3, 2014, in Barrie, he knowingly used a forged document (a medical prescription) as if it were genuine, contrary to s. 368(1)(a) of the Criminal Code of Canada, R.S.C., 1985, c. C-46. He also pleaded guilty to a charge that, between the same dates, he trafficked in Fentanyl contrary to s. 5(1) of the Controlled Drugs and Substances Act, S.C. 1996, c. 19. Dr. Gebien was convicted on both counts and was subsequently sentenced to a two-year penitentiary term.
DISGRACEFUL, DISHONOURABLE OR UNPROFESSIONAL CONDUCT
As set out in detail in the Committee’s decision, Dr. Gebien’s disgraceful, dishonourable
or unprofessional conduct included:
- obtaining Fentanyl Through Fake Prescriptions
- Prescriptions forged in colleagues’ names
- Prescriptions to RVH Employees
- Prescriptions to Family/Friends
GUILTY OF AN OFFENCE RELEVANT TO SUITABILITY TO PRACTISE
On December 12, 2016, in the Ontario Court of Justice, Dr. Gebien pleaded guilty to one count of uttering a forged document, namely, a medical prescription, and one count of trafficking.
The Crown alleged and the defence conceded that those transactions where Dr. Gebien allowed individuals to keep Fentanyl patches in return for providing him with the remaining patches, constituted the offence of Trafficking in Fentanyl.
The Crown further alleged and the defence conceded that those transactions where Dr. Gebien forged prescriptions from other doctors to himself which were then filled by a pharmacist, constituted the offence of trafficking through the doctrine of innocent agency.
With respect to those transactions where Dr. Gebien wrote prescriptions to others in his own name as the prescribing doctor but received all of the Fentanyl, the Crown did not seek a judicial finding of trafficking but rather argued (and the defence conceded) that those transactions were aggravating factors given the fraudulent nature of the documents in that the real object of these prescriptions was for the Fentanyl to be returned to Dr. Gebien (which in fact it was) rather than to the person whose name was on the prescription.
On April 18, 2017, Dr. Gebien was sentenced by Justice B. Wilson of the Ontario Court of Justice to two years in custody on the count of trafficking and one year in custody, concurrent, on the count of uttering a forged document. Justice Wilson also ordered a period of three years’ probation, subject to terms and conditions outlined by the trial judge.
On December 17, 2017, Dr. Gebien was released on parole.
FINDINGS
The Committee found that Dr. Gebien has committed an act of professional misconduct in that he engaged in conduct or an act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional; and in that he has been found guilty of an offence that is relevant to his suitability to practise.
EVIDENCE ON PENALTY
ONTARIO MEDICAL ASSOCIATION’S PHYSICIAN HEALTH PROGRAM
On January 14, 2015, Dr. Gebien entered into a Substance Dependence Monitoring Contract with the Ontario Medical Association’s Physician Health Program (“PHP”). On June 22, 2016, Judi Platt, Clinical Coordinator with the PHP, wrote to the College to advise that, as per the Premature Termination Policy, the contract had been terminated. On December 14, 2018, Dr. Gebien entered into a PHP Moderate to Severe Substance Use Disorder Monitoring Contract. The contract was suspended on June 20, 2019.
Dr. Jake Bobrowski, Addiction medicine specialist, provided the PHP with an independent report regarding an addiction medicine assessment of Dr. Gebien. On November 25, 2019, Lisa Lefebvre, Associate Medical Director with the PHP, provided Dr. Gebien’s counsel with an update regarding Dr. Gebien’s status with the PHP. On February 19, 2020, Jordanna Graves, Clinical Coordinator at the PHP, provided Dr. Gebien’s counsel with an update regarding Dr. Gebien’s status with the PHP. On February 13, 2020, Dr. Chetan Mehta, Substance Use Service, Women’s College Hospital, provided the PHP with an update and summary of his care and treatment of Dr. Gebien.
Dr. Gebien is a member of a weekly online Caduceus group for healthcare professionals. Caduceus groups are voluntary peer support groups for physicians battling addiction.
BACK SURGERY
Dr. Gebien underwent back surgery in relation to his back pain on September 11, 2019.
PRIOR DISCIPLINE HISTORY
Dr. Gebien has no prior discipline history with the College.
CHANGING SCOPE OF PRACTICE AND RE-ENTRY
As Dr. Gebien has not practiced medicine for more than two years, he is subject to the College’s Change of Scope and Practice Re-Entry process outlined in the Policy, “Ensuring Competence: Changing Scope of Practice and/or Re-entering Practice”.
PENALTY
The Committee ordered (Note: please refer to the public decision for full details of the
Order):
-Dr. Gebien is to be reprimanded;
-The Registrar is to suspend Dr. Gebien’s Certificate of Registration for a period of 14
months;
-The Registrar is to impose terms and conditions and limitations on Dr. Gebien’s certificate of registration as set out in detail in the public decision available on the College’s website, to include: upon any return to practice, Dr. Gebien shall comply with the College Policy: Ensuring Competence: Changing Scope of Practice and/or Re- Entering Practice and shall enter into a PHP agreement. Dr. Gebien shall be subject to prescribing restrictions.
- Dr Gebien shall send a Prescribing Resignation Letter to Health Canada.
- Dr. Gebien is to pay costs to the College in the amount of $20,740.00 within 180 days of the date of this Order.