General surgeon argued that he had 'unblemished' history
In order to maintain the standards and preserve the public’s faith in the medical profession, the Manitoba Court of Appeal recently agreed to suspend a surgeon who refused to operate on a patient.
In Dhalla v College of Physicians and Surgeons of Manitoba, 2022 MBCA 7, Dr. Sonny Surej Dhalla was the on-call physician when a patient suffering from gastric volvulus — an abnormal rotation of the stomach — was admitted. Dr. Dhalla performed a surgery to untwist the gastric volvulus, but the patient’s condition remained severely unstable.
The patient experienced significant bleeding over the following days. However, Dr. Dhalla decided that it was neither necessary nor advisable to operate on him again. Another doctor expressed concerns about the patient’s ongoing blood loss and even requested Dr. Dhalla to postpone another patient’s scheduled medical procedure in order to attend to the patient’s massive bleeding. Dr. Dhalla refused, and eventually another physician stepped in to perform the surgery. Several days after the surgery, however, the patient died because of multi-organ failure.
Suspension for professional misconduct
An inquiry panel of the College of Physicians and Surgeons of Manitoba found that Dr. Dhalla had committed an act of professional misconduct by failing to provide appropriate assistance to a patient who was in urgent need of medical care. The panel said that the “appellant’s decisions were deliberate and conscious, and not the result of a flawed exercise of professional discretion.”
The panel imposed a reprimand and a two-month suspension. The panel said that the penalties were required to achieve the objectives of specific and general deterrence and to maintain the standards of the medical profession.
Dr. Dhalla questioned the penalty of suspension. He argued that the “panel placed too much weight on the principles of specific and general deterrence and that it failed to give the appropriate weight to the severity of a reprimand.”
Specific deterrence
Dr. Dhalla argued that he had an “unblemished” history as a competent general surgeon with no discipline record in the 26 years that he had been practicing, so it was not necessary for the panel to give considerable weight on specific deterrence.
While the court agreed that a lack of prior discipline history was relevant to the consideration of specific deterrence, it was not the only factor that the panel relied upon. The court found that the panel strongly considered the serious and deliberate nature of the doctor’s conduct in determining the issue of specific deterrence.
General deterrence
Dr. Dhalla also argued that the panel committed an error in its consideration of general deterrence because there was no evidence of any prevailing or ongoing issue in the medical community that required prevention.
The court ruled, however, that there was no need for the panel to find an ongoing concern in the medical community in order to emphasize general deterrence.
In the end, the court was satisfied that the panel carefully considered and balanced the objectives of specific and general deterrence in determining that a mere reprimand would not represent adequate punishment in order to maintain the standards of the medical profession and preserve the public’s faith in it. The court dismissed the appeal and upheld the penalties issued by the panel.
