On October 18, 2016, the Discipline Committee of the College of Physicians and Surgeons of Ontario found that Dr. Christopher Paul Brand committed an act of professional misconduct in that he 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.
Dr. Brand, a family physician who currently practices in Brechin, Ontario, was the medical director of the Leacock Care Centre, a Long-Term Care Home licensed by the Ministry of Health and Long-Term Care (“MOHLTC”) at the time of the incident described below.
One of the residents of the Centre, Patient A, was a man in his 70s with severe developmental delays since childhood and many serious behavioural challenges. Patient A is mostly nonverbal and has been in care for many years. Patient A often engaged in aggressive behaviour. This behaviour was described as being akin to “temper tantrums.” During these “tantrums,” he was observed to throw and bang on objects, throw himself on the floor, scream, yell and cry, and hit or kick out around him.
On a date in November 2014, staff had been attempting to cut Patient A’s beard, and Patient A refused. Staff asked Dr. Brand to assist because he had trimmed Patient A’s beard before.
When Dr. Brand approached, Patient A dropped to the floor and began kicking. Dr. Brand grabbed Patient A’s legs or feet and pulled him on the floor, up the hall to a conference room, which had previously been set aside as Patient A’s bedroom. Neither Dr. Brand nor Patient A suffered any injuries in this incident.
At the time of the incident, residents were attending for breakfast and other activities in the area.
The incident was observed by at least three staff members, including a nurse, as well as a compliance officer from the MOHLTC who happened to be in the building.
The nurse who observed the incident asked Dr. Brand to stop dragging the resident by his feet.
At that point, Dr. Brand had reached the door of the conference room. Dr. Brand was heard stating to Patient A, “you don’t want to get your hair cut,” as he pulled Patient A towards the conference room. Shortly after, Patient A exited the conference room, followed by Dr. Brand, who was holding hair clippers and an extension cord. Dr. Brand was heard to say, “guess the resident doesn’t want his hair cut then.” Shortly after the incident took place, the Administrator of the Centre informed Dr. Brand that this would not be tolerated. Dr. Brand replied by indicating it was Patient A they were talking about and that he had been Patient A’s doctor for many years.
Very soon after, however, Dr. Brand acknowledged to the Administrator of the Centre that he should not have dragged Patient A and that it was an error in judgment. He stated that, after Patient A fell to the floor, Patient A started kicking, and for that reason Dr. Brand grabbed his foot, “so he didn’t hurt anyone or me.” At the time, Dr. Brand had recently undergone an abdominal surgery, and was concerned that Patient A’s kicking might injure Dr. Brand. He therefore decided to restrain Patient A’s feet and return him to his room.
Dr. Brand was terminated by the Leacock Care Centre on December 2, 2014.
PENALTY
On October 18, 2016, the Discipline Committee ordered and directed that:
- Dr. Brand appear before the panel to be reprimanded.
- The Registrar suspend Dr. Brand’s certificate of registration for a two month period, to commence at 12:01 a.m. on October 19, 2016.
- The Registrar impose the following as terms, conditions and limitations on Dr. Brand’s certificate of registration:
- At his own expense, Dr. Brand shall participate in and successfully complete, within 6 months of the date of this Order, individualized instruction satisfactory to the College and with an instructor approved by the College (the “Instructor”), on professional behavior and managing difficult patients. The Instructor shall provide a summative report to the College including his or her conclusion about whether the instruction was completed successfully by Dr. Brand; and
- Prior to commencing individualized instruction, Dr. Brand shall engage in self study in medical ethics, which shall include a literature review with a written report to be presented to, discussed with and reviewed by the Instructor.
- Dr. Brand pay to the College its costs of this proceeding in the amount of $5,000.00 within thirty (30) days from the date of this Order.