Dr. Scott McLeod Registrar CPSA, Failure to Obtain Informed Consent
Home > Blog > Dr. Scott McLeod Registrar CPSA, Failure to Obtain Informed ConsentHAND DELIVERED
June 22, 2023
Dr. Scott McLeod, Registrar
College of Physicians and Surgeons Alberta 10020 100 St NW, Edmonton, AB T5J ON3
Dear Dr. McLeod:
We represent the Elder Advocates of Alberta Society.
We speak in defense of and advocate for the vulnerable and voiceless elderly.
COMPLAINT
Regulated members of the College of Physicians and Surgeons of Alberta, who subject, senior driver applicants to cognitive assessments, fail to obtain informed consent.
Regulated members of the College of Physicians and Surgeons of Alberta, collude with the Department of Transportation by referring cognitively intact, safe senior drivers to DriverCheck (Impirica) or elsewhere.
RELEVANT HISTORY
1) Regulated members of the College of Physicians and Surgeons of Alberta, who subject, senior driver applicants to cognitive assessments, fail to obtain informed consent.
2) The “medical assessment” referred to is most often the Simard MD (attached).
3) These physicians then notify the Department of Transportation of such testing.
4) Then whether the senior applicant scores well or poorly on such a test, the Department of Transportation may send them an unsigned registered letter (attached) which states that the Department of Transportation has
documented evidence that they are unfit to drive.
5) Whereupon the physician refers the senior to the private -for -profit $500 DriverCheck. Prior to DriverCheck, senior Applicants were referred for $250. DriveABLE test.
6) The senior may have been able to circumvent this unlawful protocol and obtaina second opinion from another physician, which grants him / her his license.
7) However when they attend at a Registry for the license, Transportation, has flagged the senior’s file, denying them their right to a driving license.
8) Essentially forcing the senior to attend at DriverCheck or whatever other difficult, unreasonable demands the Department of Transportation has made upon them, which are reinforced by the physician.
We ask your office to review this matter.
We would be grateful to be in receipt of your response by the 1st of July, 2023
Thank you
Yours truly
Elder Advocates of Alberta Society (1992)
Attached:
– Letter dated May 14, 2012
– Copy of Simard MD test
August 7, 2023.
Letter via email- registrar@cpsa.ab.ca
Dr. Scott McLeod, Registrar
College of Physicians and Surgeons Alberta
10020 100 St NW, Edmonton, AB T5J 0N3
Dear Dr. McLeod:
Further to our correspondence of June 22, 2023. (attached)
Our Hand Delivered complaint to you has been disregarded. The complaint concerned the failure of your regulated members to obtain informed consent when carrying out cognitive assessments of senior driving applicants.
Senior Albertans continue to be abused by their failure to adhere to policy.
Senior clients inform us that when they object to being subjected to a cognitive assessment, they are told such things as, Alberta Health Services requires it or it’s the policy of our clinic. Staff of one high profile central Alberta medical clinic arrogantly advise senior applicants that if they choose to refuse the cognitive assessment they just won’t get their (driving) license.
In the face of such blatant injustices by professionals, we are asking you to send a Directive to all your regulated members, informing them that they have a duty to obtain informed consent from senior clients prior to subjecting them to any assessments.
Thank you.
We would be grateful to be in receipt of your response by the 18th of September, 2023.
Yours truly
Elder Advocates of Alberta Society (1992)
CC. Honourable Minister of Transportation, Mr. Devin Dreeshen.
————————————————————————————————————
September 23, 2023
Letter via email- registrar@cpsa.ab.ca
Dr. Scott McLeod, Registrar
College of Physicians and Surgeons Alberta
10020 100 St NW, Edmonton, AB lT5J 0N3
Dear Dr. McLeod:
Further to our correspondence of August 7, 2023. (attached)
We have been reviewing our files and note that your office has failed to respond to our correspondence letter of September 19, 2023.
We have documented information that older Albertans continue to be abused by physicians who fail to of obtain informed consent when they assess their clients. They blindside their clients with cognitive tests.
Some clinics brazenly tell their elderly clients if you don’t take the test, you don’t get your license.
Please allow us to be in receipt of your response to our letter of August 7, 2023 concerning this urgent matter by October, 2023
Thank you.
Yours truly
Elder Advocates of Alberta Society (1992)
Procedural fairness. Procedural fairness concerns the rights of individuals affected by a decision to participate in that decision making process. These procedural rights flow from two principles of natural justice, the right to be heard (audi alteram partem) and right to be judged impartially (nemo judex in sua causa) …
CC. Honourable Minister of Transportation, Mr. Devin Dreeshen.
They come from another generation where decent people respected one and another’s rights. Recently, a physician was charged for failing to obtain a informed consent December 30 21
Attached:
– Letter dated August 7, 2023
—————————————————————————————-
September 27, 2023.
Letter via email- registrar@cpsa.ab.ca
Dr. Scott McLeod, Registrar
College of Physicians and Surgeons Alberta
Dear Dr. McLeod:
Reference Failure of regulated members to obtain informed consent from Alberta Seniors when conducting an assessment.
Further to your correspondence of June 29, 2023 (attached)
Indeed, Alberta seniors have been inappropriately assessed. There has been massive failure by regulated members of the College of Physicians and Surgeons to obtain informed consent prior to carrying out am assessment.
Across the province physicians are abusing senior Albertans by subjecting them to cognitive assessments but failing to first obtain informed consent.
We have documentation of such failure by the Moose and Squirrel Medical Clinic, Sundre, the Innisfail Medical Clinic, Innisfail, the Westfield Geriatric Centre, Stony Plain and hundreds of others.
We have been told by some driver applicants that when they attempt to object to a cognitive assessment, they are threatened in a mafiosi manner, Take the test or you won’t get your license.
We again ask you to address these injustices incurred by professionals. We are asking you to send a Directive to all your regulated members, informing them that they have a duty to obtain informed consent from senior clients prior to subjecting them to any assessment(s). Thank you.
We would be grateful to be in receipt of your response by the 10th of October 2023.
Yours truly
Elder Advocates of Alberta Society (1992)
CC. Honourable Minister of Health, Ms. Adriana, Lagrange
Honourable Minister of Transportation, Mr. Devin Dreeshen.
Honourable Minister of Seniors, Mr. Jason Nixon
Assistant Deputy Minister, Traffic Safety Service, Lynn Varty,
– Letter dated August 7, 2023
Obstetrician failed to explain to the patient the risks involved in C-section delivery
Canadian Lawyer
https://www.canadianlawyermag.com/practice-areas/medical-malpractice/doctor-who-failed-to-obtain-patients-consent-guilty-of-malpractice-alberta-court-of-kings-bench/373394
By Angelica Dino
02 Feb 2023
Share
The Alberta Court of King’s Bench has ruled that an obstetrician who failed to obtain the patient’s informed consent before delivering her baby breached the required standard of care.
In Smartt v Brar, 2023 ABKB 4, Filip Smartt was born in 2014 at the Foothills Hospital in Calgary. During a mid-forceps vaginal delivery, Filip’s shoulder got stuck behind the mother’s pubic bone, resulting in a brachial plexus injury. Filip’s left arm and hand were permanently paralyzed.
Filip’s parents, Morana Grba and Gairy Smartt, sued Dr. Kelly Albrecht, the obstetrician and gynecologist who performed Filip’s delivery. Grba and Smartt alleged that Dr. Albrecht did not properly inform them of the risks of mid-forceps delivery and that she refused to carry out a Caesarian section birth, even when asked by Grba to do so.
In a mid-forceps delivery, the doctor uses specifically designed forceps to reach into the birthing canal. She would affix the forceps such that they would grab each side of the head. Then, as the mother pushed during a contraction, the doctor would pull on the forceps to assist in getting the baby delivered.
Dr. Albrecht consistently maintained that she had fully discussed birthing options with Filip’s mother, explaining the benefits and risks of various forms of delivery. She said she even offered Grba the option to have a Caesarian section, but Grba chose the mid-forceps delivery. Dr. Albrecht asserted that she had properly performed the delivery without negligence.
No informed consent
The Alberta Court of King’s Bench noted that Dr. Albrecht would have obtained informed consent in a “complete textbook fashion” if she had discussed the risks and alternatives with Grba, offered her the option of a forceps delivery or a C-section, and Grba had then elected forceps delivery.
Grba testified that during delivery, Dr. Albrecht said, “we have to get this baby out now,” and explained that she would gently use forceps to deliver the baby. Grba then asked for a C-section, but Dr. Albrecht allegedly said it was “too late, the baby was too far down.”
On the other hand, Dr. Albrecht asserted that shortly before delivery, she performed a vaginal examination on Grba. Dr. Albrecht then spoke with Grba for five to 10 minutes about her delivery options and the risks involved.
The court observed that Dr. Albrecht’s delivery note did not indicate that she had obtained informed consent from Grba for the mid-forceps delivery. The court also found that the nurses’ notes record conflicted with the timing of Dr. Albrecht’s alleged five to 10-minute discussion with the patient.
The court gave more weight to the nurses’ notes, which show that Dr. Albrecht did not have a five to 10-minute discussion with Grba as she alleged. The court further found that during the forceps delivery, a difficult pull was involved and that Dr. Albrecht tried to downplay it at the trial.
The court found that the absence in Dr. Albrecht’s chart note of reference to obtaining informed consent was not adequately explained. The evidence Dr. Albrecht presented was an attempt to deflect blame and to record an informed consent discussion that never took place.
The court ultimately concluded that Dr. Albrecht did not properly inform Grba about the alternatives of either a mid-forceps delivery or a C-section. She failed to advise the patient about the risks of each alternative procedure to Grba and her baby. She did not obtain informed consent from Grba before performing the mid-forceps delivery. As a result, Dr. Albrecht breached the standard of care of an obstetrician in this situation.
Causal link
The court observed that when faced with the prospect of a forceps delivery, Grba immediately asked to have a C-performed. However, Dr. Albrecht did not offer that alternative, saying it was too late. The court said Dr. Albrecht knew that due to Grba’s age, weight, and health condition, there was a risk for shoulder dystocia to arise during a mid-forceps delivery, and the only way to avoid the injury was to deliver the baby by C-section.
The court was satisfied that if Grba had been informed of the risks to her baby from a forceps delivery compared to the risks to her baby from a C-section, she reasonably would have chosen the C-section.
The court emphasized that in a case with a lack of informed consent, the plaintiff does not have to show that the doctor performed the procedure negligently. They must only demonstrate that it caused the injury. In this case, the court was satisfied that, on a balance of probabilities, Dr. Albrecht caused Filip’s permanent paralysis.
——————————————————————————-
November 7, 2022
Letter sent via email president@albertadoctors.org
Letter sent via regular mail
Dr. Fredrykka Rinaldi – President Alberta Medical Association
#102 – 266 4th Street SW
Medicine Hat
T1A 4E5
Dear Madam:
REFERENCE: FAILURE TO OBTAIN INFORMED CONSENT
DISREGARD FOR ADMINISTRATIVE FAIRNESS / NATURAL JUSTICE
Alberta citizens, 75 years & older are required to have a medical exam by a physician in order to register for license renewal. Numbers of Alberta Physicians subject applicant seniors to cognitive testing.
Please be advised, that we have documented that these physicians –
1) frequently do not have evidence to support the decision to test the senior, they disregard the presumption of capacity,
2) fail to inform & advise the senior
a) of the purpose of the test
b) that a low score will result in a diagnosis of “dementia”,
c) that the diagnosis of “dementia” will be entered in his/her medical file.
d) a low score may result in termination of right to drive
e) fail to advise client of legal right to refuse testing.
3) fail to obtain informed consent.
These physicians have disregarded their duty to Administrative Fairness.
November 7, 2022
Page # 2
Administrative Fairness (procedural fairness) concerns the rights of individuals affected by a decision to participate in that decision making process. These procedural rights flow from two principles of natural justice, 1) the right to be heard (audi alteram partem) and 2) right to be judged impartially (nemo judex in sua causa).
We respectfully ask your office to address this matter.
Please allow us to be in receipt of your response by the 18th of November 2022.
Thank you.
Yours truly,
Elder Advocates of Alberta Society (1992)
—————————————————————————————–
—————————————————————————————–
From: Elder Advocates Of Alberta Society
Sent: Monday, March 20, 2023 8:52 AM
To: fred Rinaldi
I acknowledge that we are in receipt of your most recent correspondence, dated March
20, 2023, with the subject line: REGULATED MEMBERS FAIL TO OBTAIN INFORMED CONSENT. You have also shared the CPSA STANDARDS OF PRACTICE: Informed Consent, a document we are already quite familiar with and refer to regularly. Isee you have copied the CPSA as well.
In your letter, you ask that we “address the relevance of the standards as addressed in your correspondence of November 7, 2022,”a letter we replied to on November 17, 2022. In our reply, we advised that the matters of informed consent are not something the AMA has any jurisdiction over, and I asked you to direct your queries to the College of Physicians & Surgeons of Alberta.
Respectfully, I am not sure what you are requesting from the AMA in your latest correspondence. We have previously indicated that we would be open to working with you, CPSA and Alberta Transportation on some of the issues you have raised, but this does not seem to be what you are seeking. Let me reiterate that the AMA is a not-for-profit, voluntary member association of Alberta’s physicians, residents, and medical students and has no authority over physician conduct. The CPSA regulates the practice of medicine in Alberta.
Once again, I ask that you recognize that your correspondence to date deals with issues that are outside of the mandate of the Alberta Medical Association. Please direct any further inquiries about informed consent to the CPSA.
Regards,
fred Rinaldi, MD, CCFP, FCFP, LLB, MBA, MPA(HSA), BCom
President
Alberta Medical Association
12230 106 Ave NW
Edmonton AB T5N 3Z1
Phone: 587.579.1286
Fax: 780.482.5445
www.albertadoctors.org
Link to Article: “Failure To Obtain Informed Consent From Senior Drivers