On November 12, 2012, the Discipline Committee found that Dr. Heather Allison Larton committed acts of professional misconduct, in that she failed without reasonable cause to provide a report or certificate relating to an examination or treatment performed by her to her patient or her authorized representative within a reasonable time after the patient or her authorized representative requested such a report or certificate and she failed to respond appropriately or within a reasonable time to a written inquiry from the College; and in that she 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. Larton currently practises family medicine in Waterloo, Ontario. Between 1998 and 2008, Ms X was Dr. Larton's patient at her practice in Sudbury, Ontario. Commencing on April 15, 2004, Ms X, through her legal counsel, requested copies of Dr. Larton's clinical notes and records. Ms X's counsel required the clinical notes and records in furtherance of litigation related to two car accidents in which Ms X was involved. In total, Ms X's counsel sent Dr. Larton 14 requests of increasing urgency over the course of four years.
In 2008, Dr. Larton closed her practice in Sudbury. As Ms X had yet to obtain a copy of her clinical notes and records, she complained to the College. Ms X's new family physician could not complete her application for CPP Disability Benefits without Dr. Larton's clinical notes and records. In addition, litigation relating to the two car accidents was unable to proceed. Upon receipt of the complaint letter on August 20, 2008, College staff made attempts to contact Dr. Larton to secure the delivery of Ms X's patient records. Dr. Larton failed to respond to Ms X's records request or to her complaint letter, despite repeated requests by the College that she do so. On the eve of the Discipline hearing scheduled to commence on March 7, 2012, Dr. Larton retained counsel and requested an adjournment. She subsequently located and delivered the patient's chart to her.
The Discipline Committee ordered and directed that:
the Registrar impose the following terms, conditions and limitations on Dr. Larton's certificate of registration:
i. Dr. Larton shall obtain a clinical supervisor, being a Director, office manager or other person in a comparable role, at each location at which she practices ("Clinical Supervisor(s)"), who is acceptable to the College and who has signed an undertaking in the form attached to the Order as Appendix A. The Clinical Supervisor(s) shall report to the College on a quarterly basis in respect of Dr. Larton's office management, administrative, organizational and communications skills;
ii. Dr. Larton shall abide at her own expense with the Clinical Supervisor(s)'s recommendations with respect to her practice, including with respect to any practice improvements and/or ongoing professional development and/or education;
iii. If a Clinical Supervisor who has given an undertaking is unwilling or unable to continue to fulfill its terms, Dr. Larton shall, within 30 days, obtain an undertaking in the same form from a person who is acceptable to the College;
iv. If Dr. Larton is unable to obtain a Clinical Supervisor at a location at which she practices as set out in (i) or (iii) above, Dr. Larton shall cease to practice at that location immediately until such time as she has obtained a Clinical Supervisor at that location acceptable to the College; and
v. If, at any time after two years have passed since the Order, every one of Dr. Larton's Clinical Supervisor(s) is or are of the opinion that Dr. Larton's office management, administrative, organizational and communications skills are such that there is no further purpose to be served by clinical supervision, such clinical supervision shall be discontinued only upon:
(a) An assessment of Dr. Larton's practice at her primary practice location, undertaken by a College-appointed assessor at Dr. Larton's expense, the results of which are satisfactory to the College; and
(b) The approval of the College.
vi. Dr. Larton shall be solely responsible for all fees, costs and expenses associated with her compliance with the terms of this Order.
Dr. Larton attend before this panel to be reprimanded.
Dr. Larton pay costs to the College in the amount of $3,650.00 within 60 days of the date of this order.
Terms and conditions imposed on certificate by: Discipline Committee