Huebel, Stephen Charles (CPSO#: 59312)

Current Status: Suspended as of 07 Jun 2018

CPSO Registration Class: Restricted as of 19 Jan 2015

Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education:University of Toronto, 1988

Practice Information

Primary Location of Practice
Practice Address Not Available
View Professional Corporation Information

Professional Corporation Information

Corporation Name: Dr. Stephen C. Huebel Medicine Professional Corporation

Certificate of Authorization Status: Issued Date:  Jul 22 2014

Shareholders:
Dr. S. Huebel ( CPSO# 59312 )

Business Address:
2867 Ellesmere Road
Scarborough ON  M1E 4B9
Phone Number: (416) 898-0061

Hospital Privileges

Hospital Location
Rouge Valley Centenary Health Centre,Toronto Toronto
Scarborough Hospital,General Site Toronto
Scarborough Hospital-Birchmount Campus Toronto

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 13 Jun 1988
Transfer of class of registration to: Independent Practice Certificate Effective: 29 Jun 1989
Transfer of class of certificate to: Restricted certificate Effective: 19 Jan 2015
Terms and conditions imposed on certificate by Discipline Committee Effective: 19 Jan 2015
Terms and conditions amended by Inquiries, Complaints and Repo Effective: 03 May 2017
Terms and conditions amended by Discipline Committee Effective: 07 Jun 2018
Suspension of registration imposed: Discipline Committee Effective: 07 Jun 2018

Practice Restrictions

Registration Status: Suspended     Effective From: 07 Jun 2018


Imposed By Effective Date Expiry Date Status
Discipline Committee Effective: 07 Jun 2018 Active

Previous Hearings

Committee: Discipline
Decision Date: 07 Jun 2018
Summary:

On June 7, 2018 the Discipline Committee of the College of Physicians and Surgeons of Ontario 
(the College) found that Dr. Stephen Charles Huebel has committed an act of professional 
misconduct, in that he failed to maintain the standard of practice of the profession.  
 
Dr. Huebel failed to maintain the standard of practice of the profession in his care and treatment of 
patients in the seven cases described below. He also consistently failed to maintain the standard of 
practice of the profession in his documentation and charting, as demonstrated in 12 cases reviewed 
by the College. 
 
At the relevant times, Dr. Huebel practised emergency medicine at the Hospital. As a result of his 
certificate of registration being subject to interim terms and conditions since May 3, 2017, Dr. 
Huebel has not practised since July 31, 2017. 
 
Patient A 
 
In October 2016, the College received a complaint from Patient A’s family member regarding Dr. 
Huebel’s care of Patient A, who was a teenager at the time. Dr. Huebel attended to Patient A when 
she presented to the Hospital emergency department with shortness of breath. It was documented at 
triage that she also had a grossly elevated heart rate of 148. Dr. Huebel diagnosed her with an upper 
respiratory tract infection and discharged her home with a Flovent™ inhaler. Patient A was returned 
to the emergency department on the following day with a decreased level of consciousness and was 
diagnosed with acute severe Diabetic Ketoacidosis (DKA). 
 
An emergency medicine expert retained by the College opined that Dr. Huebel’s care of Patient A 
fell below the standard of practice, in that: 
 
 -  Dr. Huebel’s charting is mostly illegible, with minimal history and physical exam documented. 
    The standard of practice was not met in both the legibility and content of his charting; 
 -  Dr. Huebel should have recognized, assessed and addressed Patient A’s grossly elevated heart 
    rate. Even at the peak of flu season with upper respiratory tract infections being at the top of his 
    differential diagnoses, Dr. Huebel should have recognized that this heart rate was out of 
    keeping with his diagnosis and treatment plan for Patient A;  
 -  Given patient A’s high heart rate, Dr. Huebel should not have ordered medications that further 
    elevate the heart rate to treat the wheeze that he had heard in her respiratory exam; 
 -  Dr. Huebel did not address Patient A’s grossly elevated heart rate at all in his contemporaneous 
    patient records or narrative, despite him stating that he reviewed the triage vitals himself and 
    with the patient and her family member. 
 
The expert further noted that it is the standard of care in emergency medicine to assess, investigate 
and treat someone with an abnormal vital sign such as this prior to their discharge from the 
emergency department and that Dr. Huebel fell below that standard of care in both what he did and 
what he did not do. The expert concluded that Dr. Huebel’s clinical practice exposes his patients to 
harm as it clearly did so in the case of Patient A. 
 
Reassessment Pursuant to Discipline Committee Order 
 
On January 19, 2015,  the Discipline Committee imposed terms and conditions on Dr. Huebel’s 
certificate of registration, which required him to undergo a12-month period of supervision followed 
by two reassessments of his practice. The expert retained by the College to conduct the 
reassessment of Dr. Huebel’s practice reviewed 13 of Dr. Huebel’s patient charts. She opined that 
Dr. Huebel failed to meet the standard of practice of the profession in 11 of the 13 charts.  
 
Dr. Huebel’s charting and documentation failed to meet the standard of practice in 11 of the charts 
reviewed, the expert observed were largely illegible with minimal history and physical exam 
documented. In a response to the College dated April 5, 2017, Dr. Huebel conceded that his 
recordkeeping remains inadequate and requires improvement. Dr. Hubel’s care and treatment of 
patients fell below the standard of practice in the following six cases, which were included in the 
expert’s reassessment of his practice:  
 
 
Patient B  
 
Patient B, a man in his 90s, was transported by paramedics to the Hospital emergency department 
after falling down an unknown number of stairs. He was not placed on a board and collar. He had a 
hematoma on the side of his head that had been bandaged by paramedics and had a past medical 
history of a subdural hematoma requiring surgical removal. Dr. Huebel ordered a CT scan of Patient 
B’s head, read it as negative and discharged the patient home. Formal radiological interpretation of 
the CT scan the next morning indicated that Dr. Huebel had missed an acute subdural haemorrhage. 
 
The expert opined that Dr. Huebel’s care of Patient B fell below the standard of practice, in that: 
 
 -  although Dr. Huebel properly ordered the CT scan, he missed a very important diagnosis of an 
    acute subdural haemorrhage, when the patient had a history of same, making the index of 
    suspicion for this disease entity quite high; 
 -  there was no evidence on the chart that Dr. Huebel conducted a complete and systematic 
    trauma survey, which would be the standard in this case, given visible injuries such as a parietal 
    hematoma was indicated on the paramedic record; 
 -  Dr. Huebel’s charting is illegible, with minimal history and physical exam documented. 
     
Patient C  
     
Patient C, a woman in her 70s, presented to the Hospital emergency department with right hip pain 
radiating to her lower leg and calf. She had fallen onto her right hip three months prior and had x-
rays taken at that time, which were negative. She had visited the emergency department three times 
in the intervening period for the same pain. Dr. Huebel treated Patient C with medication, ordered a 
Doppler ultrasound of the right leg, and ordered a blood test for D-dimer, which assists in 
diagnosing Deep Vein Thrombosis (DVT). 
 
The expert opined that Dr. Huebel’s care of Patient C fell below the standard of practice, in that: 
 
-   the Doppler ultrasound ordered by Dr. Huebel was not the appropriate choice of imaging to rule 
    out DVT in Patient C given her age, history of trauma to the region and symptoms of this 
    duration. Rather, the CT scan ordered by a subsequent physician was more appropriate. Both 
    the ultrasound and CT scan revealed no acute findings. 
 -  Dr. Huebel’s assessment intentions were not indicated in his charting and his documentation of 
    the physical exam was incomplete for the consideration of DVT as a potential cause for the 
    patient’s pain.  
     
Patient D  
 
Patient D, a woman in her 20s, presented to the Hospital emergency department with suicidal 
thoughts and worsening depression, low mood, decreased sleep and daily use of marijuana and 
alcohol. She was seen by the crisis team and an on-call psychiatrist, who discharged her with a 
prescription for Cipralex and follow up with the Psychiatry outpatient clinic. She was then seen by 
Dr. Huebel, who documented her assessment time as 9:45 and her discharge time as 9:50.  
 
The expert opined that Dr. Huebel’s care of Patient D fell below the standard of practice, in that: 
 
 -  Dr. Huebel’s charting was illegible, with minimal history and physical exam documented; 
 -  there was no legibly documented justification for the assessment of depression or the statement 
    “medically clear”, which was written in the body of the chart; 
 -  there was no documentation of any medical issues that may have been considered, nor any 
    clinical toxicologic assessment given the patient’s daily use of drugs and alcohol, which is 
    standard for this patient group. 
     
     
Patient E  
 
Patient E, a man in his late 20s, was trauma patient who presented to the Hospital emergency 
department after he was involved in a motor vehicle accident on Highway 401. He complained of a 
headache, dizziness and mid-back/neck pain; he was ambulatory with normal vital signs. Dr. 
Huebel’s assessment time is documented as 01:55 and the discharge time is documented as 02:00. 
 
The expert opined that Dr. Huebel’s care of Patient E fell below the standard of practice, in that: 
 
 -  Dr. Huebel’s chart was illegible; 
 -  Dr. Huebel failed to clear Patient E for cervical spine injuries by applying a decision rule such 
    as the Canadian C Spine Rules to determine if imaging was necessary, despite the fact that neck 
    pain was included in the triage notes; 
 -  there was no documentation of the speed of the cars or assessment as to the degree of injury 
    predicted; 
 -  the patient was only seen for 5 minutes, and it is extremely difficult to conduct an appropriate 
    trauma assessment in that timeframe.  
 
Patient F  
 
Patient F, a man in his 50s, presented to the Hospital emergency department with heart palpitations, 
flushing and dizziness. His vital signs, EKG and blood work were normal, including levels of the 
cardiac enzyme troponin. Patient F was seen by Dr. Huebel at 22:05 and was discharged by him at 
22:15. Dr. Huebel never ordered a second blood test for troponin levels. 
 
The expert opined that Dr. Huebel’s care of Patient F fell below the standard of practice, in that: 
 
 -  Most of his chart was illegible, with minimal history and physical exam documented; 
 -  while appropriate bloodwork and an EKG were done, there was no legible documented 
    timeframe for the onset of the patient’s symptoms, which made it impossible to know whether 
    the appropriate time delay for testing of cardiac enzymes was met.  
       
Patient G  
 
Patient G, a man in his 80s, presented to the Hospital emergency department with bilateral shoulder 
aching pain. He had checked his blood pressure and heart rate at home and they were elevated. He 
had undergone an angiogram 2 weeks prior at a different facility but the Hospital did not have the 
results. Patient G was on an extensive list of medications and had a history of atrial fibrillation, 
hypertension and other comorbidities. He was placed on a cardiac monitor.  
 
Dr. Huebel ordered an EKG and bloodwork. The EKG showed atrial fibrillation. The bloodwork 
was drawn, but then had to be redrawn half an hour lated due to hemolysis. The blood showed 
elevated troponin levels, which necessitated a subsequent assessment of cardiac enzymes such as 
troponins after a prescribed interval of time to rule out cardiac ischemia.  
 
Dr. Huebel left the Hospital for several hours, assuming that Patient G would be transferred to 
another emergency physician and would receive an IV of Procainamide to encourage normal heart 
rhythm. Upon his return, he learned that Patient G had not been transferred to another physician in 
his absence. He was still in atrial fibrillation and had not yet received Procainamide. Dr. Huebel 
ordered an IV of Procainamide intended to convert the patient to a normal heart rhythm. 
Approximately an hour later, the nurses informed Dr. Huebel, who was working in a different area 
of the emergency department, that Patient G had converted to normal sinus rhythm. Dr. Huebel 
discharged Patient G home with a family member.  
 
The expert opined that Dr. Huebel’s care of Patient G fell below the standard of practice, in that: 
 
 -  Dr. Huebel’s chart was illegible; 
 -  a second set of cardiac enzymes (troponins) was never drawn in order to rule out cardiac 
    ischemia. Aching shoulder pain is recognized as a potential symptom of cardiac ischemia, 
    which should have been considered in a patient with a known cardiac history and recent 
    angiogram; 
 -  a post-cardioversion EKG to document Patient G’s return to normal sinus rhythm was not 
    completed before discharge;  
 -  after being told that he had converted to normal sinus rhythm, Dr. Huebel failed to personally 
    reassess Patient G before discharging him. 
  
The expert noted that it is highly unusual for an emergency physician to be working two shifts in 
different locations, such that he would need to leave and return a few hours later. 
 
Expert’s conclusion 
 
After reviewing the above cases in detail, the expert concluded that Dr. Huebel does not meet the 
standard of care expected of a competent physician practicing emergency medicine in the majority 
of cases; his poor documentation is not up to the standard expected of emergency medicine 
practitioners; and he displays a lack of knowledge and judgment with respect to the assessment and 
management of cardiac, trauma, psychiatric and toxicological patients. In the expert’s opinion, this 
combination has the potential to cause harm to his patients. 
 
Dr. Huebel’s Prior History with the College 
 
In 2004, the Complaints Committee of the College ordered Dr. Huebel to be cautioned in person 
regarding the importance of performing and documenting a thorough assessment in the emergency 
department of a patient with symptoms suggestive of myocardial ischemia.  
       
In 2006, the Complaints Committee ordered Dr. Huebel to be cautioned in writing regarding the 
importance of assessing patients thoroughly to justify his clinical decisions, documenting his 
assessments and treatment plan in the chart, and reassessing patients prior to discharge to answer 
questions and provide follow-up instructions.  
       
In 2008, following receipt of complaints regarding Dr. Huebel’s assessment and treatment of two 
patients in the emergency department, one of whom had suffered a cardiac event and the other was 
involved in a motor vehicle accident, the College commenced investigation. In the course of the 
investigation, Dr. Huebel completed the College’s record-keeping course. As a result of the 2008 
complaints and investigation, Dr. Huebel entered into an Undertaking with the College in 
September 2010 (“the 2010 Undertaking”), pursuant to which he was subject to supervision for a 
period of six months, followed by  reassessment. 
       
In October 2010, in response to a patient complaint, the Inquiries, Complaints and Reports 
Committee (the “ICRC”) issued a verbal caution to Dr. Huebel regarding his inadequate and 
cursory examination and making a referral too quickly before properly assessing the urgency level 
of the patient.  
 
On February 1, 2013, following the reassessment pursuant to the 2010 Undertaking, College 
inspector reviewed 27 charts selected from Dr. Huebel’s emergency medicine practice and reported 
that: 
 -  Dr. Huebel’s charting was illegible; 
 -  there was a consistent pattern of deficiencies in Dr. Huebel’s documentation of patient history, 
    physical exam, working or provisional diagnosis and reassessments prior to discharge; 
 -  significant results for investigations and lab tests were not documented; and  
 -  Dr. Huebel’s use of consultants was problematic as he relied on them to assume care of his 
    patients with no further management by him.  
As a result of this report, Dr. Huebel was subject to a preceptorship, with a preceptor acceptable to 
the College meeting with Dr. Huebel every one to two months to review charts selected by the 
Chief of Emergency Medicine and who would also supervise Dr. Huebel’s ongoing education. 
 
As a result of reassessment as well as a complaint received by the College in 2013 regarding 
“Patient AA”, the College commenced another investigation of Dr. Huebel’s Emergency Medicine 
practice. An expert retained by the College reviewed 21 charts selected from Dr. Huebel’s 
emergency medicine practice, observed Dr. Huebel’s assessment and treatment of 14 patients and 
conducted an interview of Dr. Huebel.  In his report, dated February 6, 2014, the expert found Dr. 
Huebel’s documentation regarding his clinical encounters to be “cursory and incomplete”, 
concluding that it did not meet the expectation for record keeping as set out in the College Policy on 
Medical Recordkeeping. The expert further opined that Dr. Huebel’s clinical handling of Patient BB 
did not meet the standard of practice of emergency medicine.  
 
In March and November 2014, allegations of failing to maintain the standard of practice of the 
profession with respect to Patient AA and Patient BB were referred to the Discipline Committee. In 
May 2014, Dr. Huebel entered into an undertaking with the College in lieu of an interim order of 
the ICRC and was subject to the undertaking from May 2014 until his discipline matter was 
disposed of in January 2015. Pursuant to this undertaking, Dr. Huebel retained a clinical supervisor 
who met with him once each month, and reviewed at least 10 charts selected by the emergency 
department Chief or his designate. Dr. Huebel also reviewed at least 50 questions that he had 
completed from the Emergency Medicine examination preparation handbook or similar web-based 
program.  
 
 
 
 
 
Prior Discipline Committee Finding 
 
On January 19, 2015, the Discipline Committee of the College found that Dr. Huebel committed an 
act of professional misconduct in that he failed to maintain the standard of practice of the profession 
in his care and treatment of two patients. The Discipline Committee found that: 
    -  Dr. Huebel failed to adequately investigate, diagnose and manage the care of Patient AA, 
       who presented with classical symptoms of aortic dissection, and who subsequently died. 
    -  Dr. Huebel failed to adequately evaluate and care for Patient BB, an insulin-dependent 
       diabetic woman who presented with hypoglycaemia and was seven months pregnant.  
    -  Dr. Huebel’s documentation with respect to Patient BB was cursory and incomplete; it did 
       not meet the standard of care for record-keeping.  
       
The Discipline Committee ordered a reprimand and directed the Registrar to impose the terms of 
the 2015 Undertaking as terms, conditions and limitations on Dr. Huebel’s certificate of 
registration, which provided that Dr. Huebel was to undergo a further period of clinical supervision 
for 12 months, to be followed by two reassessments of his practice. 
       
Subsequent Events 
 
The reports of the clinical supervisor who supervised Dr. Huebel over the following 12 months, 
meeting with him to review 10 charts selected by the emergency department Chief or his designate, 
and submitting quarterly reports to the College, were generally positive, though he did consistently 
note problems with illegibility and insufficient documentation. The clinical supervisor’s final report 
to the College was dated December 11, 2015. 
       
The misconduct currently at issue occurred between February and May 2016. It came to the 
College’s attention in late 2016 and was referred to the Discipline Committee on April 10, 2017. On 
May 2, 2017, the ICRC made an interim order imposing a number of terms, conditions and 
limitations on Dr. Huebel’s certificate of registration, pending this hearing. The Order required Dr. 
Huebel to engage a Clinical Supervisor who shall attend in person at all of Dr. Huebel’s encounters 
with patients and review all patient charts. Dr. Huebel retained a Clinical Supervisor, who 
supervised him from May 2017 until July 2017. Dr. Huebel has not practised medicine since July 
31, 2017.  
 
Disposition 
 
On June 7, 2018, the Discipline Committee ordered that:  
       
   -  the  Registrar  suspend  Dr.  Huebel’s  Certificate  of  Registration  for  a  period  of  three  (3) 
      months, effective immediately. 
   -  the  Registrar  impose  the  following  terms,  conditions  and  limitations  on  Dr.  Huebel’s 
      Certificate of Registration: 
       
      Practice Restrictions 
       -  Dr.  Huebel  shall  not  engage  in  the  practice  of  medicine  as  the  Most  Responsible 
          Physician for any patient(s) whatsoever. 
       -  The entirety of Dr. Huebel’s scope of practice shall be limited in the following ways: 
          -  He  shall  only  practise  medicine  in  a  hospital  setting  as  a  surgical  assistant  of  a 
             surgeon: 
               -  certified by the Royal College of Physicians and Surgeons or recognized as a 
                  surgical specialist by the College; and 
            -  who has been approved by the College,(collectively, a “Qualified Surgeon”); 
               and 
       -  for further clarity, but without limiting the generality of  the above: 
            -  Dr.  Huebel  shall  not  provide  any  pre-operative  or  post-operative  care 
               whatsoever; and 
            -  a Qualified  Surgeon  must  always  be  physically  in  attendance  when  Dr. 
               Huebel is engaging in practice as a surgical assistant. 
       - Dr. Huebel shall not engage in any practice of medicine that is not expressly and 
          specifically listed above. 
   Monitoring 
    -  Dr. Huebel shall inform the Collge of each and every location where he practices, in any 
       jurisdiction (his “Practice Location(s)”) within fifteen (15) days of this Order and shall 
       inform the College of any and all new Practice Locations within fifteen (15) days of 
       commencing practice at that location. 
    -  Dr.  Huebel  shall  submit  to,  and  not  interfere  with,  unannounced  inspections  of  his 
       Practice Location(s) and patient charts by a College representative for the purposes of 
       monitoring and enforcing his compliance with the terms of this Order. 
    -  Dr.  Huebel  shall  consent  to  the  College  making  appropriate  enquiries  of  the  Ontario 
       Health  Insurance  Plan  and/or  any  person  or  institution  that  may  have  relevant 
       information, in order for the College to monitor and enforce his compliance with the 
       terms of this Order. 
    -  Dr. Huebel shall consent to the College providing all Qualified Surgeon(s) and Chief(s) 
       of Staff with any information relevant to this Order and/or arising from the monitoring 
       of his compliance with the terms of this Order. 
    -  Dr. Huebel shall consent to any Qualified Surgeon and any Chief of Staff disclosing to 
       the College, and to one another, all information relevant to this Order and/or relevant for 
       the purposes of monitoring his compliance with the terms of this Order. 
   General 
    -  Nothing in this Order shall be construed as preventing Dr. Huebel from seeking to vary 
       this Order in the future. 
    -  Dr. Huebel shall be responsible for any and all costs associated with implementing the 
       terms of this Order. 
    
-  Dr. Huebel appear before the panel to be reprimanded. 
-  Dr.  Huebel  pay  to  the  College  its  costs  of  this  proceeding  in  the  amount  of  $10,180.00 
   within thirty (30) days from the date of this Order.

Decision: Download Full Decision (PDF)
Hearing Date(s): June 7, 2018


Committee: Discipline
Decision Date: 19 Jan 2015
Summary:

 On January 19, 2015, the Discipline Committee found that Dr. Huebel committed an act of 
professional misconduct in that he failed to maintain the standard of practice of the profession. 
Dr. Huebel admitted to the allegation.  
 
Patient A presented to the Emergency Department in August 2012 with back and chest pain and 
a history of some slurred speech. She was seen by an emergency physician, had some 
investigations done and was discharged with a diagnosis of TIA and chest pain not yet 
diagnosed. The blood work conducted that day at the Emergency Department was unremarkable.  
She was to have follow-up tests.  
 
Dr. Huebel saw Patient A when she returned two days later and documented her past medical 
history. He documented her history of a sudden sharp chest and mid-back pain that occurred two 
days prior with an episode of an altered state of consciousness. He noted that the CT head scan 
done at that time showed no acute abnormality and that the Troponin done at that visit was 
negative. There are scant details of a physical examination, which was essentially unremarkable.  
Dr. Huebel ordered blood work, a chest x-ray, a thoracic spine x-ray and a CT scan to rule out 
pulmonary embolism.  He also ordered medication, including Zofran and Toradol.    
 
Dr. Huebel’s documentation indicates that the patient returned from diagnostic imaging with a 
diagnosis of dissection of the carotid artery. The chart appears to contain a provisional diagnosis 
of probable thoracic degenerative spine disease/spasms/carotid dissection.  When the patient 
returned from the CT scan, a Code Blue was called. The patient could not be revived.  
 
Dr. X, Assessor for the College, was asked to provide his opinion on the care provided by Dr. 
Huebel to Patient A.  Dr. X stated that Dr. Huebel fell below the standard of care for a practising 
emergency physician in Ontario, among other things: 
 
When a patient with severe back pain radiating to the front presents with such a difference in 
blood pressures, the standard of care would be to consider an aortic dissection first and 
foremost above all other diagnoses and to order immediate investigations to rule out that 
possibility. Any delays by ordering other different types of tests would be inappropriate in the 
presence of such a classical presentation of an aortic dissection…the standard of care would 
have been to order an immediate ECG, and to arrange an immediate CT scan to rule out an 
aortic dissection… 
 
Patient B was an insulin-dependent diabetic female who was pregnant at the time Dr. Huebel saw 
 her in January 2013. She presented to the Emergency Department with an altered mental status.  
 Dr. Huebel provided Patient B with food to verify that she was PO tolerant and to give her a 
 more complex source of carbohydrates to prevent a relapse into hypoglycemia.  He discharged 
 Patient B with a final diagnosis of hypoglycemia.  
  
 Dr. Y, Assessor for the College, opined, among other things, that the evaluation and care of 
 Patient B and Dr. Huebel’s documentation were inadequate, and the risks posed to the unborn 
 fetus were not accurately considered and assessed.  Dr. Huebel failed to maintain the standard of 
 practice of the profession in his care and treatment of Patient B. 
  
On the basis of two complaints in 2008 and Dr. Huebel’s history with the College (Caution in 
person in 2004, Caution in writing in 2006), the College commenced an investigation of Dr. 
Huebel’s emergency medicine practice.   
 
In 2010, Dr. Huebel entered into an Undertaking with the College. That Undertaking provided 
that Dr. Huebel would be subject to supervision for a period of six months, after which he would 
be reassessed by the College. 
 
In her report to the College, Dr. Q, Assessor for the College, noted that Dr. Huebel’s charting 
was illegible, that there was a consistent pattern of deficiencies in Dr. Huebel’s documentation of 
patient history, physical exam, working or provisional diagnosis and reassessments prior to 
discharge, that significant results for investigations and lab tests were not documented, and that 
Dr. Huebel’s use of consultants was problematic as he relied on them to assume care of his 
patients with no further management by him.  
 
Commencing in 2013, Dr. Huebel has undertaken significant remedial and educational efforts to 
expand his knowledge base and improve his practice, which included: becoming a member of the 
College of Family Physicians of Canada, obtaining 198.3 CME credits from January 2013 to 
October 2014, and he applied for and was accepted into the Alternative Route for Certification 
(ARC) program, which is a practice eligible route to the CCFP Designation. 
 
In the context of its investigation of Dr. Huebel’s emergency medicine practice, the College 
retained Dr. Y to review Dr. Huebel’s practice. Dr. Y found Dr. Huebel’s clinical handling of the 
14 patient encounters he reviewed to be appropriate and that he met the standard of care expected 
by the profession and did not expose any of his patients to harm or injury. 
 
In March 2014, Dr. S, Chief of Dr. Huebel’s Emergency Department, advised the College of 
improvements to Dr. Huebel’s clinical practice over the past year.   
 
In May 2014, Dr. Huebel entered into an undertaking with the College, pending this hearing.  
Pursuant to the undertaking, Dr. Huebel retained Dr. T, Chief of Emergency Services, as a 
clinical supervisor. To date, Dr. T has expressed no concerns about Dr. Huebel’s care or 
treatment of patients. 
 
On January 13, 2015, Dr. Huebel signed an undertaking with the College requiring him to 
continue supervision with a Clinical Supervisor, continue in the ARC program, and submit to 
two reassessments of his practice. 
 
The Discipline Committee ordered and directed that:  
1. Dr. Huebel appear before the panel to be reprimanded. 
2. the Registrar impose the terms of Dr. Huebel’s undertaking with the College dated January 
   13, 2015, as terms, conditions and limitations on Dr. Huebel’s certificate of registration. 
3. Dr. Huebel pay costs to the College in the amount of $4,460.00 within 60 days of the date of 
   this Order. 
 

Decision: Download Full Decision (PDF)
Appeal: No Appeal
Hearing Date(s): January 19, 2015