Patients, treated in unsterile conditions, developed serious illnesses

The result of the above findings led to James’ suspension from the CPSO.

“Your care — or, better said, lack of proper care — and procedures you performed on these patients is, and was, simply unacceptable,” chair Dr. Marc Gabel told James last December after the committee handed down a 10-month suspension.

Although some patients had recently taken James to court in a certified class action lawsuit, Ontario law did not admit disciplinary findings against a health professional in civil court.

“I believe (the law) is there, in theory, so that doctors’ care can be questioned in order to improve quality without fear of being sued. But that’s not how it’s being used,” said plaintiffs’ lawyer Paul Harte.

“It’s used as a shield against the doctor, and requires the plaintiff to, in essence, re-invent the wheel. It also gives the doctor the opportunity to say one thing to the college and another thing in court…It just elongates a process that is ultimately all being done at the public’s expense.”

James, an anesthesiologist at the Rothbart Centre for Pain Care in North York, did not challenge to charges of incompetence and to disgraceful, dishonourable and unprofessional conduct relating to his treatment of 13 patients.

The hearing revealed how the patients became infected with potentially deadly Staphylococcus aureus bacteria in 2012.

According to health officials about 25 per cent of the population colonized with staph A. can become life-threatening if it enters the body through a wound or injection.

“The committee found that there were very serious breaches occurring over many months, and the consequences have been devastating,” says the disciplinary decision.

“The breaches affected people’s lives permanently, physically and emotionally, with significant effects for patients and their families. Dr. James’ breaches also undermined his patients’ trust in the medical profession.”

James, whose suspension was lifted on Oct. 15, had been working at Toronto Interventional Pain Specialists clinic in Richmond Hill, according to the CPSO’s public register.

Lawyers for Anne Levac, the representative claimant in the case believed they have enough evidence against James to forego a trial. These lawyers were in court this week to certify the class action lawsuit, which was granted.

None of the allegations had been proven in court.

Levac had developed an epidural abscess following a visit to the pain clinic and now lives with disabilities due to permanent nerve damage. Levac’s story was profiled in the Star in 2014.

James’ lawyers argued before Superior Court Justice Paul Perell on Thursday that before the full trial of some “genuine issues” summary judgment should not be granted.

“The plaintiff seeks summary judgment on the allegations that Dr. James breached the duty he owed to her and the putative class members by failing to utilize appropriate IPAC (infection prevention and control practice) measures while performing epidural steroid injections on them.”

James is also attempting find out results from a Toronto Public Health investigation in November 2012, which began after the agency learned some patients at the Rothbart Centre had come down with meningitis.

An audit conducted by TPH and Public Health Ontario at the time “identified a number of IPAC deficiencies associated with the clinic (Rothbart Centre) that were immediately brought to the attention of the clinic owner, the clinic nursing manager and the College of Physicians and Surgeons of Ontario,” TPH investigation reported.

James’ lawyers stated that TPH had observed him perform a mock epidural injection, but not on an actual patient and that the plaintiffs lacked evidence to back up its facts and conclusions.

James has submitted evidence countering any criticism “inferred from the final summary,” his lawyers argue in court documents.

“He has also adduced affidavits from two experts that explicitly endorse his IPAC practice as meeting the standard of care,” says the factum.

Justice Perell’s ruling on summary judgment is being considered.

(Reporting by Asha Bajaj)

Image: CPSO office Toronto where Dr. Stephen James case was heard