In the matter of Seerattan v Ohayon, 2022 CanLII 122507 (ON HPARB), a female patient complained to the RCDSO’s Inquiries, Complaints and Reports Committee (the “Committee“) about the actions of Dr. Adam Ohayon (the “Dentist“). Specifically, the complaints were that the Dentist:
- removed her implant without her consent (especially if the implant could have been saved with bone grafting). She even claimed it wasn’t her signature on the informed consent document.
- refused to meet with the Patient with her to review the results of her CBCT scan;
- used a lot of pressure during the procedure, which caused her pain;
- used a mix of human and cow for the bone graft (which violated her religious beliefs) and
- charged her $4,271 vs. the estimate submitted of $3,892.
The Committee reviewed the facts and used common sense to conclude that NO ACTION needed to be taken. Specifically, the Committee found:
- There WAS informed consent. Specifically, the Dentist had two treatment planning sessions with the Patient to finalize the plan (which included a discussion of risks) and outline the steps (there was a signed consent and the Dentist’s charting noted that the Patient reviewed and signed the form). In addition, the Dentist’s assistant even came into the operatory, provided the Patient with the consent and observed the Patient reviewing the consent form before signing (the assistant even asked the Patient if she had questions).
- The Dentist Did NOTHING WRONG re: the CBCT Scan. There was nothing to suggest that the Patient had requested a meeting with the Dentist about their CBCT scan or that the Dentist had refused to do so. Furthermore, dentists are NOT required to review the results of CBCT scans with a patient in the absence of significant findings.
- NO PROOF that Excess Pressure Was Used. As such, the Committee concluded that it was unable to determine with reasonable certainty exactly what happened and took no further action.
- The Patient WAS INFORMED about Bovine material being used and CONSENTED. Both the Dentist and their Assistant explained, and the Committee believed, that the source of bovine is xenograft material and human allograft combination to the Patient and the Patient’s informed consent was obtained. Further, per the Dentist, which the Committee found credible, if the Patient had objected based on their religious beliefs, the Dentist would not have used the bovine source material.
- The Fees Charged were REASONABLE and SUPPORTED by the Clinical Notes. The Committee noted that occasionally unforeseen treatment procedures might arise, resulting in additional fees. The Committee reviewed the ledger and concluded that the fees charged regarding the procedure were reasonable and supported by the clinic notes.
Key Takeaways: DENTISTS NEED COMPREHENSIVE NOTES and HAVE AN ASSISTANT BACK YOU UP!
It’s not what you did or what you know… It’s What You Can Prove! And having good records and a corroborating witness won the day for the Dentist!
P.S. the Patient wasn’t happy with the Committee’s Decision to do nothing, so they APPEALED to the Health Professions Appeal and Review Board (the “Board“). Luckily, that Board reviewed and re-confirmed the Committee’s decision and stuck by it (i.e. it took no action).
It’s worth mentioning that the treatments were on September 26, 2018. The complaint was filed on December 28, 2018. The Health Professions Appeal and Review Board rendered its decision (a review of the Committee’s decision) on December 29, 2022. That’s FOUR (4) Years after the complaint! What did it cost the Patient? Likely nothing or not much. They didn’t even make submissions when they appealed the Committee’s decision to the Board! What did this fiasco cost the Dentist? Years of worrying about the treatment they provided, hiring lawyers to defend them and their license. What did it cost the RCDSO? More time was spent on lawyers to defend their actions when the matter was appealed. This is a broken system my friends: decisions need to be made much quicker/cheaper without compromising due process for legitimate patient claims based on facts and have a reasonable chance of success.