March 29, 2012

BC HPRB: The adequacy of an investigation where assertions conflict

Health Professions Review Board
Inquiry and Investigations
Professional Regulation

An investigation may fail to be adequate where an Inquiry Committee fails to make inquiries addressing conflicting assertions of complainant and registrant, and instead simply accepts the assertions of the registrant, as illustrated in Complainant v. College of Physicians and Surgeons of BC, Decision No. 2010-HPA-0108(b).

In this case, a physician terminated a prescription for a drug, Lyrica, for an inmate in a correctional institution, and substituted other drugs. The complainant asserted that Lyrica best provided relief for his chronic back pain, and that the physician terminated the prescription by reference to a correctional service policy aimed at reducing prescription drug costs. The physician asserted that the prescription ended only because the Lyrica was no longer effective.

The inmate filed a complaint with the College that the physician terminated the prescription for no justifiable medical reason, failed to properly evaluate his condition or treatment needs, and breached professional ethics by terminating his prescription pursuant to a correctional service policy concerning prescription drugs for pain, rather than pursuant to the best interests of the patient. The College dismissed the complaint, but the HPRB remanded the matter to the Inquiry Committee, finding that the decision had been made by the Registrar yet was beyond the Registrar’s jurisdiction, [25-26] and that the investigation was also inadequate.

The HPRB determined that the College did not seek a copy of the correctional service guideline issued only two days before the physician terminated the prescription, [31] and did not interview the registrant to request an explanation for the differing assertions of the complainant and registrant. [36] The College “accepted the statement of the Registrant, presumably deeming the statement of the Complainant to lack legitimacy.” [36] The HPRB stated that, “The College cannot accept the response from the Registrant without enquiring of the Registrant what he has to say about the two positions and how it was that the Complainant had that view.” [38] Accordingly, the College remanded the matter back to the Inquiry Committee to interview the Registrant and to address specific, enumerated issues.

Complainant v. College of Physicians and Surgeons of BC, Decision No. 2010-HPA-0108(b)