Committee: Discipline
Decision Date: 29 Oct 2018
Summary:
On October 29, 2018, Dr. Mohamed Salih Izzeldin entered a plea of no contest and the
Discipline Committee found that he has committed an act of professional misconduct in that: he engaged in sexual abuse of three patients (Patients A, K and O); and he engaged in 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.
FACTS
A. Background
1. Dr. Mohamed Salih Izzeldin (“Dr. Izzeldin”) is a 56 year-old physician who received his certificate of registration authorizing independent practice on August 10, 2005. He obtained certification from the College of Family Physicians of Canada on December 8, 2004.
2. At the material time, Dr. Izzeldin practiced family medicine at a Clinic in London,
Ontario (the “Clinic”).
B. Sexual Abuse and/or Disgraceful, Dishonourable and Unprofessional Conduct
(i) Sexual Abuse and Disgraceful, Dishonourable and Unprofessional Conduct re: Patient A
3. In 2005, Patient A began working at the Clinic. She was in her twenties at the time.
4. In addition to working with Dr. Izzeldin, Patient A was also his patient. Dr. Izzeldin treated Patient A for several illnesses, including colds, ear infections, and abdominal pain. He provided ongoing medical services for Patient A on multiple occasions, including issuing numerous prescriptions (including for controlled substances) over a four year period.
5. Commencing in 2006, Patient A began working at an after-hours walk in clinic with Dr. Izzeldin. In the evenings, they were often alone in the Clinic. No other staff members were present. At around this time, Dr. Izzeldin began making unwanted sexual advances to Patient A, and engaged in touching of a sexual nature of her breasts and buttocks, as set out below.
6. In the evening, during an after-hour clinic, Dr. Izzeldin approached Patient A while she was cleaning an examination room. He closed the door, approached her from behind, and embraced her in a hug. Without saying anything, Dr. Izzeldin inserted one of his hands underneath her shirt, underneath her bra, and groped her breast. Dr. Izzeldin kept his other arm wrapped around her in the hug. He nuzzled her ear with his nose.
7. Patient A did not say anything. She pushed herself out of his embrace, walked out of the room and continued to do her work.
8. Dr. Izzeldin engaged her in unwanted hugs from behind and groped her breasts on four or five occasions between 2006 and 2011.
9. On other occasions, while Patient A was sitting at the nursing station, Dr. Izzeldin took her hand and pulled her into an examination room. He shut the door behind her. He engaged her in long hugs from the front, and while doing so placed his hand on her bottom and rubbed her buttocks. Patient A froze on these occasions, unsure of what to do. She did not tell anyone what occurred. She was very embarrassed and continued to do her work.
10. Dr. Izzeldin also made inappropriate comments to Patient A. He asked her when she lost her virginity. Twice, while she was chaperoning female patients’ physicals, he asked (in front of the patient) inappropriate questions including when she had had her last physical or Pap test. He asked her whether it hurt to have a Pap done.
11. In 2011, Patient A stopped working at the evening after-hours clinic so she wouldn’t be alone with Dr. Izzeldin. She continued to work at the day clinic. In 2012, she went on leave. When she returned, she was assigned to a different clinic and did not work with Dr. Izzeldin again.
12. Dr. Izzeldin’s conduct described above constitutes sexual abuse of a patient and is disgraceful, dishonourable and unprofessional.
(ii) Disgraceful, Dishonourable and Unprofessional Conduct re: Ms. B
13. Ms. B started working at the Clinic. It was her first ever “career job”. Her work area was isolated from the rest of the Clinic, and she generally worked entirely alone.
14. Shortly after Ms. B started working at the Clinic, in or around October 2011, Dr. Izzeldin began hugging her. She thought it was unusual. He would frequently come to her office and ask her for hugs.
15. By around Christmas of 2011, Dr. Izzeldin’s conduct escalated to more frequent hugs of a sexual nature, as well as unwanted touching of a sexual nature, as set out below.
16. In around Christmas of 2011, Dr. Izzeldin began rubbing his leg against her in a sexual manner, while hugging her.
17. On many occasions, while embracing her in a hug, Dr. Izzeldin’s moved his hands down her back to her buttocks. On other occasions, Dr. Izzledin moved his hands up her sides and touched the sides of her breasts. Ms. B pushed his hands away and moved away from him.
18. On many occasions, while she was sitting at her desk, Dr. Izzledin leaned forward to hug her. On these occasions, he attempted to insert his hand down her shirt to touch her breasts. On some occasions he was successful, but on other occasions, Ms. B managed to block his hand with her hand, turn away and say “no”.
19. Dr. Izzeldin also attempted to kiss her on multiple occasions. He placed his lips near her cheek and then moved his face quickly so his lips were on her lips, with an open mouth. Ms. B pulled away.
20. Dr. Izzeldin repeatedly asked Ms. B to go out after work with her, to “party” or go for dinner. Ms. B repeatedly turned him down, but he persisted. She told him his conduct was inappropriate. She felt violated and uncomfortable.
21. Dr. Izzeldin also gave Ms. B gifts, including cash. Another time, after she had turned down his invitations several times, he offered to pay for Ms. B and her fiancé to go out for dinner.
22. She was initially anxious about complaining because it was her first career job, and she didn’t want anyone to think badly of her. She was new to the city, didn’t know many people, and didn’t want to make a bad name for herself.
23. Dr. Izzeldin’s conduct described above is disgraceful, dishonourable and unprofessional.
(iii) Disgraceful, Dishonourable and Unprofessional Conduct re: Ms. C
24. In 2013, Ms. C undertook a work placement at the Clinic. Later, she worked at the Clinic as a temporary worker. She was in her twenties at the time.
25. While at the Clinic, Ms. C was trained by Ms. B. She worked exclusively with Ms. B. However, after her work placement was completed, she worked alone in the work area.
26. Ms. C had minimal interaction with the doctors while working at the Clinic. The exception was Dr. Izzeldin, who touched her inappropriately and engaged her in unwanted hugs.
27. While working, Dr. Izzeldin came to Ms. C to have blood drawn. At the end of the encounter, he hugged Ms. C. He said to her, “hug me hard” or “hug me harder”. On at least two occasions, he hugged her tightly, and then moved his hand to her lower back/upper buttocks.
28. The hugging took place in her work area, which was far away from other parts of the Clinic. She was alone in this area of the Clinic when Dr. Izzeldin approached her to talk and to hug her.
29. Ms. C found these hugs awkward and was uncomfortable with Dr. Izzzledin’s conduct. Dr. Izzeldin’s conduct described above is disgraceful, dishonourable and unprofessional.
(iv) Disgraceful, Dishonourable and Unprofessional Conduct re: Patient I
30. Patient I was a patient of Dr. Izzeldin for nine years, at the Clinic. He was her family doctor, as well as the doctor for her then husband and children.
31. For her first five years as Dr. Izzeldin’s patient, Patient I’s visits with Dr. Izzeldin were infrequent. After she separated from her husband, her appointments were more frequent, as she was experiencing medical problems.
32. Dr. Izzeldin always shook hands and hugged her at appointments. The hugs typically lasted for two seconds. He would extend his hand to hers to shake it and then pull her into a hug.
33. After or around the time she separated from her husband, Dr. Izzeldin began to put his hand on her knee and on her arm while talking to her. Dr. Izzeldin knew that they were no longer together.
34. Around January 2014, she went to an appointment, and as usual Dr. Izzeldin shook her hand and pulled her up into a hug. This time, he hugged her tightly and did not let go until she pulled herself free. She felt trapped and panicked and did not know what to do. The hug lasted for approximately 15 seconds.
35. Dr. Izzeldin’s conduct described above is disgraceful, dishonourable and unprofessional.
(v) Sexual Abuse and Disgraceful, Dishonourable and Unprofessional Conduct re: Patient K
36. Patient K became a patient of Dr. Izzeldin’s shortly after she arrived in Canada. She was 15 years old when she was first treated by Dr. Izzledin in 2005.
37. In May 2006, Patient K reported to Dr. Izzeldin that she had stopped menstruating. She had not gotten her period for nine months. She reported anxiety and depression. Dr. Izzledin ordered a urine analysis. Dr. Izzeldin offered to prescribe birth control pill. She declined the prescription at that time.
38. Patient K continued to see Dr. Izzledin in follow up for her amenorrhea and depression. As set out below, Dr. Izzledin sexually abused Patient K on two occasions.
39. In July 2006, in a follow-up appointment with Dr. Izzeldin, Dr. Izzeldin embraced Patient K tightly in a close, body-to-body hug. This made Patient K extremely uncomfortable.
40. Dr. Izzledin then made Patient K sit on his lap. He brought her to his lap by pulling her towards him. While she sat on his lap, he whispered in her ear, and kissed her on the cheek. He fondled her breasts. She was alone during this visit. She was sixteen years old. She thought the situation was very strange and she was uncomfortable.
41. At a subsequent visit, when she was approximately 17, she was scheduled for a full checkup. Patient K was alone with Dr. Izzeldin during the appointment. No chaperone was present. The appointment started with Dr. Izzeldin pulling her into a full body-to-body hug that made her uncomfortable.
42. During the appointment, Dr. Izzledin told her he wanted to do a breast examination. He did not provide a gown. He left the room and waited for her to take off her shirt and bra.
43. When he returned, Dr. Izzledin proceeded to do what he purported was a breast examination. During the examination, he fondled her breasts sexually. Afterward, he remained in the room while she put on her shirt, depriving her of privacy.
44. In addition, Dr. Izzeldin again pulled Patient K to sit on his lap and whispered in her ear. Again, he kissed her cheek. This time, he inserted his hands down her shirt, under her bra and fondled her breasts. She felt numb. She was shocked.
45. He asked her if she wanted to have a Pap smear. He asked if she was sexually active. She said no, and refused the Pap smear. She did not want him to touch her.
46. This was Patient K’s final visit with Dr. Izzeldin. She never returned because she was terrified. She did not report what occurred to her parents or authorities. In the following two years, she developed an eating disorder, and eventually discussed what occurred with her therapist.
47. Dr. Izzeldin’s conduct described above constitutes sexual abuse of a patient and is disgraceful, dishonourable and unprofessional.
(vi) Disgraceful, Dishonourable and Unprofessional Conduct re: Patient L
48. Dr. Izzeldin was Patient L’s family doctor for about seven years, between the ages of 11 and 17. She suffered from depression as a teenager.
49. In 2013, Dr. Izzeldin prescribed Patient L psychotropic medications. She attended Dr. Izzeldin’s office frequently for prescription renewals which required a visit with the physician.
50. During several appointments in 2013, Patient L was seen alone by Dr. Izzeldin, while her mother or father waited in the waiting room. During these appointments, Dr. Izzeldin hugged her at the end of the appointment. The hugs were usually from the side, but occasionally they involved a full frontal hug. The hugs lasted for a few seconds and made Patient L uncomfortable.
51. During one appointment when she was alone, Dr. Izzeldin checked her breathing. He complimented her on her bra, saying “that’s a nice bra”.
52. At a certain point, Patient L told her mother that she was uncomfortable seeing the doctor alone. Her mother began accompanying her into the appointments. Her mother witnessed Dr. Izzeldin hugging her daughter, even after she began accompanying her.
53. In 2014, Patient L disclosed this information to a psychiatrist who assisted her to find another family physician.
54. Dr. Izzeldin’s conduct described above is disgraceful, dishonourable and unprofessional.
(vii) Disgraceful, Dishonourable and Unprofessional Conduct re: Patient M and Mr. N
55. Patient M came to Canada, after the war in the region where she was born. Patient M and her children became patients of Dr. Izzeldin in 2006. Patient M was diagnosed with post- traumatic stress disorder as a result of her experience during the war.
56. Patient M often attended appointments with her children. Her English is limited: sometimes, a translator was arranged. When there was no translator, her child translated during the appointments or she made do without. Patient M understands English better than she can speak it.
57. Patient M experienced pain in her left side and her back, and made frequent appointments with Dr. Izzeldin. At one appointment, Dr. Izzeldin asked why she came in so many times. Patient M told him she wanted to know what was going on with her health. Dr. Izzeldin said to her, “Come to my country, you will never be sick”. At another appointment he said to her, “Don’t be scared. I’m not sleeping with you.” He was examining her chest with a stethoscope when he made this comment.
58. At a subsequent appointment, in 2007, Patient M complained of breast pain. Dr. Izzledin told her to leave her children playing in the waiting room, and to come into his examination room. He instructed her to remove her top. During that appointment, no translator was present. She was alone with Dr. Izzeldin.
59. Prior to undertaking the breast examination, Dr. Izzeldin failed to:
(a) explain why the breast examination was appropriate in the circumstances;
(b) explain the steps involved in the examination, and why he would be required to palpate certain areas of Patient M’s breasts, with the result that he failed to obtain informed consent;
and
(c) ascertain whether Patient M was comfortable before or during the examination.
60. Patient M was extremely uncomfortable during the examination. Dr. Izzeldin pressed aggressively on her breasts. She asked him to explain why he was examining her and he replied it was because she was sick. During the examination, Patient M felt that he was pressing her breasts inappropriately. She experienced great discomfort during the examination.
61. Sometime after the appointment, Patient M started crying. She disclosed to her husband, Mr. N that Dr. Izzledin had said inappropriate things to her in previous appointments. Mr. N was not a patient of Dr. Izzeldin.
62. Mr. N was concerned with how Dr. Izzeldin had been treating his wife. In early 2008, he accompanied his wife to Dr. Izzeldin’s office. Mr. N confronted Dr. Izzeldin. Dr. Izzeldin grabbed Mr. N’s arm, pushed him, such that he hit the wall, and swore at him.
63. Dr. Izzeldin discharged Patient M from his practice following this encounter.
64. Dr. Izzeldin’s conduct described above in respect of Patient M and Mr. N is disgraceful, dishonourable and unprofessional.
(viii) Sexual Abuse and Disgraceful, Dishonourable and Unprofessional Conduct re: Patient O
65. Patient O became a patient of Dr. Izzeldin’s after she moved to London. She immigrated to Canada a few years earlier.
66. Patient O attended her first appointment with Dr. Izzeldin with her then-husband. Nothing unusual occurred. Dr. Izzeldin shook their hands.
67. In 2011, Patient O separated from her husband. She began attending appointments alone. At each of her appointments, Dr. Izzeldin greeted her by giving her his hand, as if to shake hands. He then grasped her hand and pulled her towards him tightly, into a body-to- body hug. Patient O felt him press his body against her breasts. These hugs lasted a few seconds. This made Patient O uncomfortable.
68. Following her separation, Patient O had trouble sleeping. She asked Dr. Izzeldin for a prescription to assist. At this encounter, she disclosed to Dr. Izzeldin that she had not had much sexual contact with her ex-husband. Dr. Izzeldin responded by saying he could not believe her husband didn’t want to have sex with her, because she was very “hot”. Patient O was surprised and felt his comments were inappropriate.
69. Patient O was experiencing pain in her feet and saw Dr. Izzeldin for a referral for an x-ray and to a specialist. At the appointment, he asked to see her feet. After examining her, he began rubbing her feet and leg, making her uncomfortable. As she was leaving, Dr. Izzeldin came up from behind her and hugged her from behind. His whole body came into contact with her back. She was very uncomfortable.
70. On multiple occasions, Patient O asked the receptionist to switch to a female physician. She was advised none were available.
71. Patient O was accustomed to going to the doctor for an annual physical examination. Because Dr. Izzeldin had made her uncomfortable, she told him she did not want him to give her a Pap test. Instead, she went to the women’s clinic for the Pap test and breast exam and then returned to Dr. Izzeldin’s for the rest of the examination.
72. When Patient O returned for the physical examination near the end of 2013, Dr. Izzeldin told her to remove her top and bra because he needed to listen to her heart. They were alone in the examination room. He began listening to her heart with the stethoscope and then asked her to lie on the examination table.
73. While Patient O was lying down, Dr. Izzledin started touching her breasts. She told him her breasts had been checked at the women’s clinic, but he insisted on conducting a breast exam. Dr. Izzeldin began touching her breasts and rubbing her nipples in a sexual manner. As he rubbed her nipples, he asked whether she was sensitive to his touch, and what she felt. He touched both nipples at the same time, in a sexual manner. Patient O was scared.
74. Patient O said she had to leave. Dr. Izzeldin stayed in the room while she put on her clothes and watched her get dressed. Before leaving, she asked Dr. Izzeldin for her blood test, and asked him to check for everything, including HIV. He said to her, “what do you mean, for everything? Are you having sex without condoms?” He wanted to talk with her in his office, but she refused.
75. Patient O did not return to see Dr. Izzeldin again.
76. Dr. Izzeldin’s conduct described above constitutes sexual abuse of a patient and disgraceful, dishonourable or unprofessional conduct.
DISPOSITION
On October 29, 2018, the Discipline Committee ordered and directed that:
- The Registrar revoke Dr. Izzeldin’s certificate of registration effective immediately.
- Dr. Izzeldin appear before the panel to be reprimanded.
- Dr. Izzeldin reimburse the College for funding provided to patients under the program
- required under section 85.7 of the Code, by posting an irrevocable letter of credit or other security acceptable to the College, within thirty (30) days of this order in the amount of $48,180.00.
- Dr. Izzeldin 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.
Hearing Date(s): third party records motion: July 12, 2018
Hearing dates: October 29, 2018