On June 2, 2015, the Discipline Committee found that Dr. Sim committed an act of professional misconduct, in that he failed to maintain the standard of practice of the profession with respect to 24 patients, and in his infection control practices and instrument reprocessing. The Committee also found that Dr. Sim engaged in acts or omissions relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional, including: inadequate supervision of members of his staff; improper delegation of responsibilities to his staff; inappropriate electronic communications with patients; inappropriate billing to the Ontario Health Insurance Plan; and his failure to refer Patient A for a second opinion. Dr. Sim admitted to the allegations.
Regarding Patient A, she expressed concerns about the sanitary conditions of Dr. Sim’s office, as well as him pressuring her to have an endometrial biopsy in the office for $20 when she advised that she wished to have it performed elsewhere. A Medical Inspector retained by the College concluded that the main problem in relation to the issues raised in the complaint was a “lack of proper communication”. Dr. Sim “showed a lack of judgement in that he did not refer [Patient A] to another obstetrician/gynecologist for a second opinion concerning her endometrial biopsy and whether it should be performed in an office setting or in a hospital with a hysteroscopy and D&C.”
In May 2011, the clinic at which Dr. Sim engaged in a therapeutic abortion practice was inspected by the Premises Inspection Committee (PIC) and received a “fail”. Accordingly, Dr. Sim was prohibited from performing any “procedures”, including therapeutic abortions, at his clinic. Among the reasons cited in the report for the “fail” was the clinic’s non-compliance with infection control standards set by the Out of Hospital Premises Standards.
The PIC brought concerns to the attention of the College’s Registrar regarding the standard of patient care, infection control and the overall function of the premises in relation to Dr. Sim’s abortion practice. Following an investigation, the Inquiries, Complaints and Reports Committee (“ICRC”) decided that Dr. Sim should undertake in writing to undergo a re- nspection of his practice, as well as a re-assessment regarding record keeping and documentation. Additionally, the ICRC counseled Dr. Sim to ensure he practised within his scope of practice.
In accordance with terms set out in that undertaking, College compliance monitors attended at Dr. Sim’s office in May 2013 to conduct an “infection control inspection of the office premises. A re-assessment of Dr. Sim’s practice took place in the summer of 2013. The results of the re-assessment and infection control inspection led the ICRC to commence another investigation of Dr. Sim’s practice.
In January 2014, the College received a report prepared by a Medical Inspector retained to investigate infection control issues pertaining to Dr. Sim. The Medical Inspector found that Dr. Sim did not meet the standard of practice in infection control practices and instrument reprocessing. Additionally, she found that Dr. Sim’s infection control and reprocessing practices may put patients at significant risk for harm in terms of transmission of infectious microorganisms, including antibiotic-resistant organisms and blood borne pathogens.
Between July 2013 and November 2014, the College received several reports from another Medical Inspector who was retained to opine on Dr. Sim’s obstetrical and gynecological practice. The Medical Inspector found that Dr. Sim’s practice did not meet the standard of care for the practice of the profession, and that he is still performing surgical procedures that should not be performed in an office setting. He found that Dr. Sim’s “practice of medically induced therapeutic abortions is of harm and danger to the patients because he converts many of these into surgical abortions if they do not succeed initially” and “[f]or this reason, [that] Dr. Sim should cease from performing medical or surgical therapeutic abortions in an office setting.”
As of May 21, 2014, the following term, condition and limitation was imposed on Dr. Sim’s certificate of registration, pursuant to an undertaking made in lieu of a section 37 order: Dr. Sim shall not perform any surgical or medical abortions and shall not engage in any aspect of surgical or medical abortions. All patients seeking termination of pregnancy shall be referred to another physician or facility where Dr. Sim does not practice. The undertaking also required Dr. Sim to adhere to specific infection control practices.
On May 29, 2015, Dr. Sim signed an undertaking to resign from the College effective June 30, 2015, and not to apply or re-apply for registration as a physician to practise medicine in Ontario. Pursuant to this undertaking, he agreed to be subject to the terms of the May 21, 2014 undertaking until his resignation becomes effective on June 30, 2015.
Having regard to this May 29, 2015 Undertaking, the Committee ordered and directed that:
- Dr. Sim attend before the panel to be reprimanded, with the fact of the reprimand to be recorded on the Register.
- Dr. Sim pay to the College costs in the amount of $4,460 by June 30, 2015.
Terms and conditions imposed on certificate by: Member