On November 27, 2017, the Discipline Committee found that Dr. Mohan Krishnan Raja committed an act of professional misconduct in that he 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.
The allegations arose from the conduct of Dr. Raja during a number of clinical appointments when Patient A saw Dr. Raja for methadone treatment. The Committee found that in at least two examinations of Patient A, Dr. Raja had her raise her shirt above her bra, lifted the left side of her bra, and exposed her left breast. He then listened to her heart sounds in four areas, which included touching the periphery of her left breast with his stethoscope and pushing aside her breast for optimal skin contact. There was no evidence that Dr. Raja made any comments of a sexual nature.
The Committee found that while he did raise Patient A’s bra, there was no evidence that Dr. Raja touched her breast in a sexual manner. The Committee noted that there was no fondling, massaging of the breast, squeezing, or touching of the nipple. The Committee accepted that listening to the heart sounds in the four areas described by Dr. Raja was an acceptable focused cardiac examination. Examination of the heart in this manner with a stethoscope would involve placing the stethoscope close to the breast or at the periphery of the breast. In some cases, the breast would need to be pushed aside for optimal contact between the stethoscope and skin. The Committee found there was no sexual character to the examination as performed in this fashion. While Dr. Raja may have touched her breast while carrying out the examination of her heart, such touching of the breast in this context did not constitute a violation of sexual integrity. Dr. Raja’s approach appeared to have a mechanical quality, but was not of a sexual character.
In making a finding of disgraceful, dishonourable and unprofessional conduct, the Committee considered that:
• Dr. Raja failed to respect the privacy owed to his patient;
• The unanticipated exposure of her breast on its own constituted a significant
boundary violation;
• Dr. Raja was inconsiderate when he exposed Patient A’s breast;
• Dr. Raja did not understand or disregarded how his actions would make Patient A
feel;
• Dr. Raja’s explanation to Patient A of why he needed to repeatedly listen to her heart
sounds was unclear or nonexistent; and
• Patient A was a particularly vulnerable patient, which makes a lack of respect for her
dignity and privacy more egregious.
In failing to respect his patient’s privacy by not offering appropriate draping and by
unnecessarily exposing her left breast during examinations, the Committee held that Dr. Raja left his patient feeling uncomfortable and scared. She needed to understand why he was examining her. His explanations were superficial and left her wondering about his true motive. In his manner of examination, he had little regard as to Patient A’s sensitivity or the embarrassment she might experience.
On June 3-4 2016, Dr. Raja attended a one-and-a-half day course on Understanding Boundaries and Managing the Risks Inherent in the Doctor-Patient Relationship through the Western University’s Schulich School of Medicine and Dentistry.
On April 20, 2018, the Committee ordered and directed that:
- The Registrar suspend Dr. Raja’s certificate of registration for a period of two (2) months, to commence at 12:01 a.m. on May 18, 2018.
- Dr. Raja appear before the panel to be reprimanded.
- Dr. Raja pay to the College its costs of this proceeding in the amount of $22,000.00 within thirty (30) days from the date of this Order.
