On July 4, 2016, the Discipline Committee of the College of Physicians and Surgeons of Ontario found that Dr. Douglas Earl Brooks committed an act of professional misconduct in that he has engaged in conduct or 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.
Dr. Brooks, a general practitioner in Sault Ste Marie, also works as an investigating coroner. He maintains a family practice at the Group Health Centre and hospital privileges at the Sault Area Hospital.
Patients A and B had a close personal connection to Dr. Brooks and his wife.
The family physicians of Patients A and B practised at the Group Health Centre, which maintained patient medical records in an electronic medical records system. Patients A and B also had medical records from hospital visits that were maintained in the Hospital’s electronic medical records system.
Patient A, who suffered from mental health and addictions issues, died by suicide in 2014. Dr. Brooks was the investigating coroner on call at the time of Patient A’s death and attended at the scene. Due to his connection to Patient A, arrangements were made to have the case transferred to another coroner. Dr. Brooks accordingly did not act as the coroner in the investigation of Patient A’s death.
After Patient A’s death, her relatives, concerned about potential unauthorized access to their records by Dr. Brooks, requested audit reports of access to Patient A and Patient B’s electronic medical records from both the Group Health Centre and the Hospital.
PRIVACY BREACHES
Dr. Brooks accessed Patient A’s electronic medical records from the Group Health Centre on six dates between September 2005 and March 2014. Dr. Brooks accessed Patient A’s electronic medical records from the Hospital on eight dates between August 2011 and August 2014. Multiple records were accessed on each of the above dates.
Dr. Brooks accessed Patient B’s electronic medical records from the Group Health Centre on eight dates between April 2003 and October 2006. Multiple records were accessed on each of these dates.
Dr. Brooks’ access to the electronic records was unauthorized because he did not have the consent of Patient A and Patient B to access their medical records. Further, there was no medical reason for Dr. Brooks to access the records.
The medical records that were accessed by Dr. Brooks included information related to general family medicine care, as well as highly personal information of a very sensitive nature.
PATIENT B’S PREGNANCY
In 2006, after a period of estrangement, during the first trimester of Patient B’s pregnancy, Patient B initiated contact with Dr. Brooks’ wife. The attempt at reconciliation was unsuccessful.
Subsequent to this contact, Dr. Brooks accessed Patient B’s electronic medical records at the Group Health Centre six times during the remainder of her pregnancy.
PATIENT A’S HOSPITALIZATION
In 2011, Patient A was admitted to the Mental Health Inpatient Unit at the Hospital. During this time, Dr. Brooks accessed Patient A’s records almost daily over a period of seven days, with additional access during the week after her discharge.
PATIENT A’S FATHER SOUGHT DR. BROOKS’ AND HIS WIFE’S ASSISTANCE
In 2014, Patient A was struggling and refusing access to crisis care. Patient A’s father reports that when he asked Patient A if there was anything he could do to help, Patient A requested that he seek out Dr. Brooks’ wife to meet with her. Patient A’s father went to Dr. Brooks’ home, requesting Dr. Brooks and his wife join him in an intensified effort to help Patient A. At that time, he also asked Dr. Brooks’ wife if she would meet with Patient A the next day.
Later that day, Dr. Brooks’ wife discussed this with Dr. Brooks. He expressed concern to her that it was not safe to meet Patient A where she was living. Dr. Brooks’ wife then called Patient A’s father in the evening and told him that she would not be able to meet Patient A the next day. That same evening, Dr. Brooks accessed Patient A’s medical records.
Dr. Brooks and his wife had no further contact with Patient A from this point forward.
CONFIDENTIALITY AGREEMENT
On November 24, 2003, Dr. Brooks signed a Confidentiality Agreement with the Hospital, confirming that except where he was legally authorized or required to do so, he would not inspect or receive paper or electronic patient-related information from Health Records or from notes, charts, and other material related to patient care. The Hospital’s policy stated that it was a breach of confidentiality to access patient or health information when not required to provide care to a patient or in the performance of duties.
PENALTY AND COSTS
The Committee ordered and directed that:
1. Dr. Brooks appear before the panel to be reprimanded, with the fact of the reprimand to be recorded on the register.
2. The Registrar suspend Dr. Brooks’ certificate of registration for a period of five (5) months commencing from the date of this Order.
3. The Registrar impose the following term, condition and limitation on Dr. Brooks certificate of registration:
a. Dr. Brooks will participate in and successfully complete, within 6 (six) months of the date of this Order, individualized instruction in medical ethics with an instructor approved by the College, with a report or reports to be provided to the College regarding Dr. Brooks’ progress and compliance.
4. Dr. Brooks pay to the College costs in the amount of $5,000.00 within 30 (thirty) days of the date of this Order.
Terms and conditions imposed on certificate by: Discipline Committee