Committee: Discipline
Decision Date: 24 Jul 2014
Summary:
On July 24, 2014, the Discipline Committee found that Dr. Farazli committed acts of professional misconduct in that she has failed to maintain the standard of practice of the profession, she has contravened the Act, the Regulated Health Professions Act, 1991 or the regulations under either of those Acts and, she has 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. The Discipline Committee also found that Dr. Farazli is incompetent. Dr. Farazli pleaded no contest to the allegations.
This case comprises two s. 75(1)(a) investigations into Dr. Farazli's practice, as well as twenty patient complaints.
Dr. Farazli owned and operated an out-of-hospital premises where she conducted colonoscopies and gastroscopies. The premises were subject to inspection/assessment by the College's Out-of Hospital Premises Inspection Programme in May 2011. As a result of that inspection, largely on the basis of serious infection control concerns, the premises received a grade of "fail", which meant that Dr. Farazli could no longer perform procedures there as of early June 2011. After receiving this information from the College, Ottawa Public Health conducted a retrospective review, a "look-back", and notified several thousand of Dr. Farazli's former patients that they may have been exposed to Hepatitis C virus, Hepatitis B virus, or HIV and should be tested for these pathogens.
An expert retained by the College opined that Dr. Farazli failed to maintain the standard of practice of the profession and displayed incompetence in the unacceptable practice at the clinic, including in her infection control and instrument re-processing failures; the lack of training and certification of her staff; her failure to provide and maintain an adequate facility; and lack of emergency preparedness. Another expert opined that the care provided to the patients did not meet the standard of practice reasonably expected of a competent practitioner in the field of gastroenterology. In particular, Dr. Farazli did not consider it necessary to offer to patients and referring physicians reasonable options for management.
In respect to Patient A, Dr. Farazli engaged in disgraceful, dishonourable or unprofessional conduct in her interaction with the nurse and the patient in respect of Patient A's care and in exposing Patient A to potential infection. Patient A saw Dr. Farazli on four occasions between 1997 and 2010 for various procedures.
In respect to Patient B, Dr. Farazli failed to maintain the standard of care in proposing to engage a sales representative to assist her in a procedure when no nurse was available. Dr. Farazli engaged in disgraceful, dishonourable or unprofessional conduct in relation to Patient B in proposing to engage a sales representative to assist her in a procedure when no nurse was available, and in engaging in inappropriate and incomplete communications with Patient B. Patient B attended Dr. Farazli in about March 2010 for a colonoscopy.
In respect to Patient C, Dr. Farazli failed to maintain the standard of practice of the profession in relation to her care and treatment of Patient C. Dr. Farazli also engaged in disgraceful, dishonourable or unprofessional conduct in her communications with the patient including comments about pain management; in being rough and callous with the patient; and in exposing the patient to potential infection. Patient C attended Dr. Farazli's office for a procedure in January 2011, having been referred for a complaint of rectal bleeding and a family history of colorectal cancer, for a colonoscopy and removal of a polyp. The patient expressed that she was
experiencing extreme pain during the procedure.
In respect to Patient D, Dr. Farazli engaged in disgraceful, dishonourable or unprofessional conduct in her communications with Patient D, in persisting with the procedure despite the patient's request to stop due to unbearable pain, and in exposing the patient to potential infection. Patient D attended at Dr. Farazli for a colonoscopy and gastroscopy in 2003 or 2004. During the procedure, the patient experienced severe pain and asked Dr. Farazli to stop the procedure due to pain.
In respect to Patient E, Dr. Farazli engaged in disgraceful, dishonourable or unprofessional conduct in relation to Patient E in failing to provide the patient with enough sedation to be comfortable and in exposing the patient to potential infection. Patient E was referred to Dr. Farazli by her family physician for a colonoscopy in 2002 and experienced terrible pain during the procedure.
In respect to Patient F, Dr. Farazli engaged in disgraceful, dishonourable and unprofessional conduct in not providing the patient with enough sedation to be comfortable, and in being callous, unprofessional and disrespectful in her communication with the patient and in her pain management, and in exposing the patient to potential infection. Patient F was referred to Dr. Farazli by her family physician for a colonoscopy. During the colonoscopy, she experienced severe discomfort, but Dr. Farazli disregarded her complaints of pain.
In respect to Patient G, Dr. Farazli failed to maintain the standard of practice of the profession in relation to Patient G in her documentation. Dr. Farazli further engaged in disgraceful, dishonourable or unprofessional conduct in her callous and unprofessional communication with Patient G, and in failing to stop the procedure despite the patient complaining of unbearable pain and inadequate anaesthesia. Patient G underwent procedures by Dr. Farazli in about 2000 and 2001.
In respect to Patient H, Dr. Farazli engaged in disgraceful, dishonourable or unprofessional conduct in relation to Patient H in her callous, unprofessional, rough and hurried examination of the patient; in her communications with the patient; in continuing with the procedure when the patient was in excruciating pain; and in exposing the patient to potential infection. Patient H underwent a gastroscopy and colonoscopy by Dr. Farazli in March 2009.
In respect to Patient I, Dr. Farazli engaged in disgraceful, dishonourable or unprofessional conduct in relation to Patient I in her inappropriate communications with the patient; her failure to be responsive to the patient's complaints of lack of sufficient anaesthesia; and in exposing Patient I to potential infection. Patient I was treated by Dr. Farazli in about 2007 after a referral by her family physician for a gastroscopy and colonoscopy.
In respect to Patient J, Dr. Farazli failed to maintain the standard of practice of the profession and displayed incompetence in relation to Patient J by giving inadequate analgesic. Further, Dr. Farazli engaged in disgraceful, dishonourable or unprofessional conduct in relation to Patient J in her communications with the patient; in proceeding with an excruciating procedure despite the patient screaming in pain; and in exposing the patient to potential infection. Patient J was referred to Dr. Farazli by her family physician for a colonoscopy in about 2002.
In respect to Patient K, Dr. Farazli engaged in disgraceful, dishonourable or unprofessional conduct in relation to Patient K in her inappropriate and unprofessional communications with the patient; in failing to provide the patient with sufficient sedation; in charging the patient for a drug not administered; and in exposing the patient to potential infection. Patient K was referred to Dr. Farazli by her family physician in January 2002.
In respect to Patient L, Dr. Farazli engaged in disgraceful, dishonourable or unprofessional conduct in relation to Patient L in her callous and unprofessional communications with the patient; in her pain management; and in exposing the patient to potential infection. Patient L was referred to Dr. Farazli by her family physician in February 2000. She became very uncomfortable during the procedure, which was performed in March 2000.
In respect to Patient M, Dr. Farazli contravened the regulations made under the Medicine Act in relation to Patient M by failing to maintain records in accordance with the regulation. Dr. Farazli also engaged in disgraceful, dishonourable or unprofessional conduct in relation to Patient M in her callous, rough and unprofessional communications with the patient; charging for medications not needed for her procedure; and in exposing the patient to potential infection. Patient M was referred to Dr. Farazli by her family physician and underwent a procedure by Dr. Farazli in about April 2003. Patient M believed she saw Dr. Farazli again in 2010. Dr. Farazli did not have records of treatment for this patient.
In respect to Patient N, Dr. Farazli engaged in disgraceful, dishonourable or unprofessional conduct in relation to Patient N in her inappropriate and unprofessional communications with the patient; in proceeding with a procedure when the patient was in obvious distress from insufficient sedation; and in exposing the patient to potential infection. Patient N was treated by Dr. Farazli for a colonoscopy procedure in about July 2006.
In respect to Patient O, Dr. Farazli engaged in disgraceful, dishonourable or unprofessional conduct in relation to Patient O in her inappropriate and unprofessional communications with the patient; in proceeding with a procedure when the patient was in obvious distress from insufficient sedation; and in exposing the patient to potential infection. Patient O was seen by Dr. Farazli in 2004 and 2009. Patient O experienced extreme pain during the colonoscopy.
In respect to Patient P, Dr. Farazli engaged in disgraceful, dishonourable or unprofessional conduct in relation to Patient P in her unprofessional communications with the patient and in exposing the patient to potential infection. Patient P saw Dr. Farazli in September and November 2010. Dr. Farazli was unable to complete the procedure because she said she could not advance the scope.
In respect to Patient Q, Dr. Farazli demonstrated incompetence in relation to Patient Q in that she displayed a lack of knowledge, skill or judgment in not aborting the procedure. Further, Dr. Farazli engaged in disgraceful, dishonourable or unprofessional conduct in relation to Patient Q in being abusive in her communications with the patient. Patient Q was referred to Dr. Farazli by her family physician in July 1999. The patient underwent a gastroscopy by Dr. Farazli in November 1999. Dr. Farazli had difficulty gaining intravenous access and Patient Q was in terrible pain. Dr. Farazli yelled at her and shouted at the nursing staff to hold Patient Q down while Dr. Farazli attempted to insert the IV and to spray the throat anaesthetic. Dr. Farazli then herself roughly pulled Patient Q's head to the side and sprayed her throat while she was struggling. After the procedure, Dr. Farazli was yelling very loudly at the patient, about the patient needing the procedure and not being cooperative.
In respect to Patient R, Dr. Farazli engaged in disgraceful, dishonourable or unprofessional conduct in relation to Patient R in her inappropriate and unprofessional communications with the patient and in exposing the patient to potential infection. Patient R was referred to Dr. Farazli by her family physician and underwent procedures by Dr. Farazli in 2006.
In respect to Patient S, Dr. Farazli engaged in disgraceful, dishonourable or unprofessional conduct in relation to Patient S in her inappropriate and unprofessional communications with the patient; in proceeding with a procedure when the patient was in obvious discomfort and felt there was insufficient sedation; and in exposing the patient to potential infection. Patient S was referred to Dr. Farazli by his family physician, and was treated by Dr. Farazli in 2004. When Dr. Farazli asked him about his history, she behaved in an accusatory way toward him.
In respect to Patient T, Dr. Farazli engaged in disgraceful, dishonourable or unprofessional conduct in relation to Patient T in her inappropriate and unprofessional communications with the patient; in proceeding with a procedure when the patient was in obvious distress from insufficient sedation; and in exposing the patient to potential infection. Patient T saw Dr. Farazli on several occasions between 1997 and 2002. In 2002, the patient underwent a colonoscopy and was caused excruciating pain by the procedure.
Dr. Farazli has executed an undertaking never to engage in the practice of medicine again.
The Committee ordered and directed that:
" Dr. Farazli appear before the panel to be reprimanded.
" Dr. Farazli pay to the College costs in the amount of $4,460.00, within 30 days of the date of this Order.