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Taniguchi, Alan

CPSO#: 59999

MEMBER STATUS
Suspended as of 10 May 2019
CPSO REGISTRATION CLASS
Restricted as of 19 Nov 2018
Flag: Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education:University of Alberta, 1988

Practice Information

Primary Location of Practice
Practice Address Not Available

Hospital Privileges

Hospital Location
Hamilton Health Sciences Centre McMaster & Childrens Hosp,McMaster & Children's Hospital Hamilton
Hamilton Health Sciences Corporation,St. Peter's Hospital Hamilton
Hamilton Health Sciences,Chedoke Hospital Site Hamilton
Hamilton Health Sciences,General Site Hamilton
Hamilton Health Sciences,Juravinski Hospital and Cancer Centre Hamilton

Specialties

Specialty Issued On Type
Family Medicine Effective: 12 Jun 1990 CFPC Specialist

Postgraduate Training

Please note: This information may not be a complete record of postgraduate training.



McMaster University, 01 Jul 1990 to 30 Jun 1991
Resident 3 - Family Medicine

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 01 Jul 1988
Transfer of class of registration to: Independent Practice Certificate Effective: 23 Apr 1991
Expired: Failure to Renew Membership Expiry: 11 Aug 2007
Subsequent certificate of registration Issued: Independent Practice Certificate Effective: 14 Aug 2007
Transfer of class of certificate to: Restricted certificate Effective: 10 May 2017
Terms and conditions imposed on certificate by Quality Assurance Committee Effective: 10 May 2017
Terms and conditions amended by Quality Assurance Committee Effective: 24 May 2017
Terms and conditions amended by Quality Assurance Committee Effective: 07 Jun 2017
Terms and conditions amended by Quality Assurance Committee Effective: 27 Feb 2018
Transfer of class of registration to: Independent Practice Certificate Effective: 09 May 2018
Transfer of class of certificate to: Restricted certificate Effective: 19 Nov 2018
Terms and conditions imposed on certificate by Inquiries, Complaints and Repo Effective: 19 Nov 2018
Terms and conditions amended by Inquiries, Complaints and Repo Effective: 19 Nov 2018
Terms and conditions amended by Inquiries, Complaints and Repo Effective: 23 Nov 2018
Terms and conditions amended by member Effective: 10 May 2019
Terms and conditions amended by member Effective: 10 May 2019

Practice Restrictions Flag: indicates a concern or additional information

Registration Status: Suspended     Effective From: 10 May 2019


Imposed By Effective Date Expiry Date Status
Discipline Committee Effective: 11 May 2019 Active

Previous Hearings Flag: indicates a concern or additional information

Committee: Discipline
Decision Date: 10 May 2019
Summary:

On May 10, 2019, on the basis of an Agreed Statement of Facts and Admission (Liability), the 
Discipline Committee found that Dr. Taniguchi committed an act of professional misconduct, in 
that he failed to maintain the standard of practice of the profession in his care of patients, and 
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. 
 
AGREED STATEMENT OF FACTS AND ADMISSION (LIABILITY) 
 
Dr. Taniguchi is 54 years old. He received his certificate of registration authorizing independent 
practice in 1991. He practices in Hamilton, Ontario in the area of palliative care. He previously 
also practiced in the area of long-term care medicine. 
 
In addition to his clinical practice, Dr. Taniguchi is an Assistant Clinical Professor at McMaster 
University, and the Program Director of McMaster’s Family Medicine Palliative Care Residency 
Program. At the time of the events at issue, in addition to his clinical duties, Dr. Taniguchi had 
significant teaching, academic, and administrative responsibilities. 
 
Failure to comply with SCERP 
On July 15, 2016, the Quality Assurance Committee of the College of Physicians and Surgeons 
of Ontario (“the College”) required Dr. Taniguchi to participate in a specified continuing 
education or remediation program (“SCERP”) consisting of: 
   -  a review and written summary of a College policy, and a section of the Practice Guide; 
   -  a period of clinical supervision, in which Dr. Taniguchi was required to meet with a 
      supervisor monthly for six months and review 10 charts at each meeting; and 
   -  a reassessment of his practice. 
Dr. Taniguchi was notified of the Committee’s decision on August 5, 2016.  He was required to 
retain a clinical supervisor within 30 days of receiving the decision. 
 
Dr. Taniguchi did not retain a clinical supervisor, or undergo a reassessment, pursuant to the 
SCERP. Dr. Taniguchi failed to respond to correspondence from the College on August 16, 
2016, November 22, 2016 and January 2, 2017 with respect to his compliance with the SCERP. 
Dr. Taniguchi submitted the required written summary on June 23, 2017. 
                                                                               
Breach of Order 
On May 10, 2017, the QAC made an Order imposing terms, conditions, and limitations on Dr. 
Taniguchi’s certificate of registration. Under the Order, Dr. Taniguchi was required to obtain a 
clinical supervisor acceptable to the College within 14 days of the Order, and meet with the 
clinical supervisor monthly to review 10 long-term care patient charts. The Order was to remain 
in effect until May 9, 2018. If Dr. Taniguchi was unable to retain a clinical supervisor as required 
by the Order, he was required to cease practicing long-term care until such time as he had done 
so. 
On May 25, 2017, Dr. Taniguchi proposed that Dr. David Chan be approved as his supervisor.  
On May 31, 2017, the College confirmed that Dr. Chan was approved. On June 7, 2017, the 
College advised Dr. Taniguchi that it had received Dr. Chan’s executed undertaking, and that Dr. 
Taniguchi was permitted to return to practice. 
Dr. Taniguchi had his first and only meeting with Dr. Chan on September 8, 2017: 
   -  there were “no deficiencies identified” in Dr. Taniguchi’s charts; and 
   -  “Dr. Taniguchi has made a lot of progress. His documentation is excellent and in my 
      opinion meets the standard of documentation in a [long-term care] setting”.  
Although Dr. Chan’s initial report was favorable, Dr. Taniguchi states that he felt overwhelmed. 
He failed to arrange follow-up meetings with Dr. Chan. Dr. Chan emailed Dr. Taniguchi twice 
after their first meeting to encourage Dr. Taniguchi to schedule their next meeting, but Dr. 
Taniguchi did not respond. 
On January 26, 2018, Dr. Taniguchi was notified that he was in breach of the Order, and was 
advised to meet with Dr. Chan and review 40 charts with him by February 8, 2018 to bring 
himself back into compliance. Dr. Taniguchi failed to do so. 
On February 12, 2018, Dr. Chan advised the College that he had not heard from Dr. Taniguchi, 
and withdrew as Dr. Taniguchi’s clinical supervisor. Dr. Taniguchi ceased practicing long-term 
care in February 2018. 
 
Section 75 Investigation 
In addition to making the Order described above, the QAC also disclosed to the ICRC Dr. 
Taniguchi’s name, as well as the allegations that he may have committed an act of professional 
misconduct, including but not limited to lack of governability, or that he may be incompetent or 
incapacitated. The Registrar appointed investigators to investigate whether Dr. Taniguchi, in his 
general medicine practice, including his long-term care and palliative care, had engaged in 
professional misconduct or was incompetent. 
 
Dr. Taniguchi was notified of the investigation on July 13, 2017. The investigator asked Dr. 
Taniguchi to complete a Physician Practice Questionnaire and an Electronic Records 
Questionnaire, and return them to the College within 10 business days. Dr. Taniguchi did not 
respond. The investigator sent several further requests for Dr. Taniguchi’s completed 
questionnaires between October 2017 and February 2018, to which Dr. Taniguchi did not 
respond. The College did not receive Dr. Taniguchi’s completed questionnaires. 
 
The College retained Dr. Benoit Robert to opine on Dr. Taniguchi’s care of 25 patients in both 
palliative care and long-term care practices. 
 
On April 16, 2018, the investigator wrote to Dr. Taniguchi advising him that Dr. Robert had 
requested to interview Dr. Taniguchi for the purposes of preparing his opinion. Dr. Taniguchi did 
not respond to this letter, and did not attend for an interview with Dr. Robert.  
 
With respect to Dr. Taniguchi’s palliative care practice, Dr. Robert opined: 
   -  Dr. Taniguchi’s pattern of documentation was consistent with a physician who practiced 
      “at a distance”. It was unclear from much of the documentation provided whether Dr. 
      Taniguchi had direct contact with patients. Although Dr. Taniguchi was a consultant in a 
      teaching setting, his charting pattern was suggestive of not being available on a consistent 
      basis; 
   -  Dr. Taniguchi’s documentation of encounters did not follow a “SOAP” format, or a 
      problem-based approach. His notes contained minimal subjective and objective data, and 
      his assessments and plans were cursory. There was limited evidence of physical 
      examinations; 
   -  Dr. Taniguchi demonstrated a significant lack of knowledge of appropriate 
      documentation. The paucity of charting and documentation interfered with Dr. Robert’s 
      ability to opine on Dr. Taniguchi’s knowledge with respect to palliative care. The lack of 
      documentation also precluded an accurate assessment of Dr. Taniguchi’s skill; and 
   -  Dr. Taniguchi was not readily available to assess patients in a timely fashion. While Dr. 
      Taniguchi’s clinical practice was unlikely to expose patients to harm or injury, this was 
      due to the rapid available backup by other qualified palliative care physicians on days on 
      which Dr. Taniguchi is not available. 
 
With respect to Dr. Taniguchi’s long-term care practice, Dr. Robert opined: 
      -  It was not clear from Dr. Taniguchi’s documentation in 2015 and 2016 that he was 
         performing admission physicals, nor was it clear that he was performing annual 
         physicals. There were a number of occasions on which these physicals were not 
         documented. Dr. Taniguchi’s extensive use of PRN orders in the order sets in some 
         charts also suggested that his approach to those residents’ care was not personalized; 
      -  There was a significant improvement in Dr. Taniguchi’s long-term care 
         documentation after mid-2017, with respect to his use of SOAP notes, and the 
         documentation of admission and annual exams, and care conferences; 
      -  Dr. Taniguchi’s knowledge and skill were difficult to ascertain from his charts. 
         However, there were instances in which Dr. Taniguchi’s charting suggested a lack of 
         knowledge and/or skill. In one case, Dr. Taniguchi failed to follow through on a 
         psychiatry note outlining the need for quarterly monitoring of the patient’s liver 
         function tests. In another case, Dr. Taniguchi failed to address rising creatinine levels 
         in an elderly patient who was prescribed Ramipril, and who later developed acute-on-
         chronic renal failure; and 
      -  Dr. Taniguchi was not readily available to assess his patient load, and his lack of 
         availability was concerning. His practice of attending on patients only every two 
         weeks allowed for conditions to aggravate between visits. It also appeared that he was 
         not available between visits. The use of email did not seem to expedite 
         communication. It also was not clear that the email channels used were secure, and 
         Dr. Taniguchi’s email correspondence at times comingled patients’ personal health 
         information. 
             
Section 25.4 Order 
On November 8, 2018, the Inquiries, Complaints and Reports Committee made an Order under s. 
25.4 of the Health Professions Procedural Code (“s. 25.4 Order”), requiring, among other things, 
that Dr. Taniguchi practice under the guidance of a clinical supervisor. 
 
On November 23, 2018, Dr. Anne Woods was approved as Dr. Taniguchi’s clinical supervisor.  
Since that time, Dr. Taniguchi has been fully cooperative with the College, and has been meeting 
with Dr. Woods on a regular basis to review patient charts from his palliative care practice 
pursuant to the s. 25.4 Order. Dr. Woods’s reports have been positive, and indicate that Dr. 
Taniguchi’s care has been appropriate. 
 
As Dr. Woods has noted in her reports: 
   -  “Once aware of the requirements for charting, Dr. Taniguchi's notes have met all 
      requirements, have addressed concerns raised in the previous audit, and reflect a care that 
      is exemplary.  I have made only one recommendation: ‘Ensure the documented physical 
      exam reflects all major concerns noted as issues that day.’” 
   -  “Dr. Taniguchi’s notes consistently reflect a high quality of care, supervision, education, 
      collegiality, and graciousness”; and 
   -  “Dr. Taniguchi has the reputation in the wider palliative medicine community as being 
      the doctor’s doctor, the one physicians would choose to have look after them. He is 
      known for his unremitting respect for other physicians, his knowledge, and his hard 
      work”. 
             
ADMISSION 
             
Dr. Taniguchi admits the facts above, and admits that, based on these facts, he engaged in 
professional misconduct under in that he failed to maintain the standard of practice of the 
profession; and engaged in acts or omissions relevant to the practice of medicine that would be 
regarded by members as disgraceful, dishonourable or unprofessional. 
             
AGREED STATEMENT OF FACTS (PENALTY) 
             
Dr. Taniguchi states that, between 2016 and 2018, he was feeling overwhelmed by his 
professional responsibilities, and was struggling to cope, and that this contributed to his failure to 
comply with the SCERP, and his failure to be responsive to the College. 
 
In order to address the issues that contributed to his conduct in this case, Dr. Taniguchi is 
working to reorganize his workload. He has stepped down from some of his academic 
responsibilities, and has recently moved to a lower-volume clinical environment. Dr. Taniguchi 
has also seen a counsellor, to help him develop his stress management and coping skills. 
 
On May 8, 2019, Dr. Taniguchi entered into an undertaking with the College by which he agreed 
to, among other things: 
   -  practise under the guidance of a Clinical Supervisor acceptable to the College for 6 
      months; 
   -  engage in professional education in professional responsibilities in post-graduate medical 
      education, and medical ethics; and 
   -  undergo a reassessment of his practice by an assessor selected by the College within 6 
      months of the end of the period of Clinical Supervision. 

DISPOSITION 

The Discipline Committee Ordered that: 
   -  Dr. Taniguchi attend before the panel to be reprimanded. 
   -  The Registrar suspend Dr. Taniguchi’s certificate of registration for a period of two (2) 
      months. 
   -  Dr. Taniguchi pay costs to the College in the amount of $6,000.00 within thirty (30) days 
      from the date of this Order.

Hearing Date(s): May 10, 2019 1:00 p.m. start time

Concerns Flag: indicates a concern or additional information

Source: Member
Active Date: May 10, 2019
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Alan Taniguchi the College of Physicians and Surgeons of Ontario, effective May 10, 2019:

Dr. Taniguchi was referred to the Discipline Committee on allegations of professional misconduct. In the face of these allegations, Dr. Taniguchi agreed to practise under the guidance of a Clinical Supervisor acceptable to the College for 6 months; to engage in professional education in professional responsibilities in post-graduate medical education, and medical ethics; and undergo a reassessment of his practice by an assessor selected by the College within 6 months of the end of the period of Clinical Supervision.


Source: QA Committee
Active Date: July 15, 2016
Expiry Date:
Summary:
Specified Continuing Education and Remediation Program:

Where the Quality Assurance Committee has made a decision on or after June 1, 2016 in which the disposition includes a Specified Continuing Education and Remediation Program (“SCERP”), the College By-laws require that the elements of the SCERP be posted on the register. A SCERP is one of the dispositions that the Quality Assurance Committee may make in connection with a matter before it, and this disposition requires the member to complete an education and remediation program specified for the member. A note will also be posted when all the elements of the SCERP have been completed.

See PDF for the summary of a decision made against this member in which the disposition includes a SCERP:
Download Full Document (PDF)