Conduct Matters: August 2026

Hearing Tribunal Decision

June 17, 2026

On September 10, 2024, the Complaints Director referred a matter involving Surya Gadgerao to the Hearing Tribunal for a hearing.

A hearing on allegations was held on April 28 - 30 and May 1, 2025, by videoconference. A hearing on sanctions was held on March 31, 2026, by videoconference.

Findings

In its decision dated September 4, 2025 ("Merits Decision"), the Hearing Tribunal found the following allegations proven:

1. On or about May 15, 2023, while providing physiotherapy treatment to patient C.R., Mr. Gadgerao failed to obtain adequate informed consent before touching patient C.R.’s buttocks under her clothing;
2. On or about May 26, 2023, while providing physiotherapy treatment to patient C.R., Mr. Gadgerao failed to obtain adequate informed consent before touching patient’s C.R.’s inner thigh and/or groin area over her clothing;

Orders of the Hearing Tribunal

Prior to re-registration with the College (if applicable), Mr. Gadgerao shall:

• Complete the College of Physiotherapists of Alberta’s Informed Consent Module
• Review and reflect on the Code of Ethics;
• Review and reflect on the following Standards of Practice (Assessment, Diagnosis, Treatment; Boundary Violations; Informed Consent)
• Submit a Reflection Paper
• Gadgerao must provide notification of the Merits Decision and the Sanction Decision to any employer for a period of twelve (12) months following re-registration
• Payment of costs

Summary of the Hearing Tribunal Decision on allegations and sanctions (posted June 9, 2026)

Is It Clear Who Is Providing Physiotherapy Services?

June 23, 2026

Allegation

The patient attended twenty physiotherapy appointments at a clinic and self-discharged after experiencing increased symptoms following the use of shockwave by a physiotherapy support worker (“PTSW”).

The College investigated two allegations:

1. On a specific date, the physiotherapist assigned the application of the physiotherapy intervention, shockwave, with the patient to a PTSW, a task that did not fall within the PTSW's competence, and this resulted in an exacerbation of the patient’s condition not expected by the physiotherapist or the patient.
2. On a specific date, the physiotherapist assigned the provision of physiotherapy services, specifically the intervention shockwave, to a PTSW without the patient’s consent.

Investigation

The investigation collected evidence of the following:

• Two physiotherapists provided physiotherapy services at the clinic, PT1 and PT2.
• PT1 was the physiotherapist responsible for the provision of physiotherapy services with the patient.
• The patient had attended 20 times with PT1. Shockwave was utilized as an intervention 13 times. Six times a PTSW administered the shockwave intervention.
• On the date in question, two PTSWs were employed by the clinic.
• A PTSW administered shockwave as a physiotherapy intervention on the date in question.
• The patient was accustomed to a certain degree of soreness following the application of shockwave.
• On the date in question, the patient experienced a greater symptom increase than normal and also noted bruising in the treatment area, another unexpected result.
• The patient submitted their complaint to the College regarding PT2’s conduct.
• PT2 was not present in the clinic on the date in question. This was confirmed by PT2, PT1, and the two PTSWs.
• PT2’s name and registration number were not documented in the physiotherapy record.

Decision

The patient was certain that PT2 was involved in their care on the date in question.

Four people informed the investigation that PT2 was not present at the clinic on the date in question.

As there was strong evidence that PT2 was not in the clinic on the date in question and PT2’s name and registration number were not documented in the physiotherapy record, there was no evidence to support the allegations.

The complaint was dismissed.

Key Message

The Supervision Standard of practice states that patients “…can expect that they are informed of the role of supervisees, have consented to services being provided by supervisees, and that the services provided by supervisees are supervised by the physiotherapist.”

Ensuring that patients are introduced to supervisees and informed of their role in the delivery of physiotherapy services should be standard practice. However, in this and other cases, the Complaints Director is aware that patients do not always know who is providing their physiotherapy care. This lack of clarity is concerning. Physiotherapists who utilize PTSWs are expected to reflect on their practices and ensure that patients are fully aware of the identities and roles of all individuals involved in their care.

Consent and The Safe Use of Dry Needles In Practice

June 23, 2026

Allegation

The patient attended physiotherapy for three sessions. Dry needling was utilized as a physiotherapy intervention on two occasions. The patient reported a reduction in leg pain but an increase in low back pain following the use of dry needling as a physiotherapy intervention. The patient alleged that the physiotherapist did not obtain informed consent for the use of dry needling and that the physiotherapist did not perform dry needling safely and effectively.

Investigation

After obtaining written submissions and conducting interviews with the patient and the physiotherapist, the investigation focused on the documentation surrounding informed consent and the physiotherapist’s rationale and description of the dry needling intervention they performed.

Decision

The patient and the physiotherapist agreed that informed consent discussions occurred prior to the use of dry needling as a physiotherapy intervention. The depth and level of understanding of those discussions was disputed between the two parties.

The physiotherapy record contained a written consent form that was initialed and signed by the patient. The patient identified that the physiotherapist went over the form with the patient, but the patient stated that they did not have their glasses and was not able to read or fully comprehend the benefits and risks sections of the consent form. The physiotherapist confirmed that they sat with the patient and reviewed the consent form and believed the patient provided informed consent.

The physiotherapy record also documented that general and specific consent for treatment and the use of dry needling as an intervention was obtained on both dates that dry needling was utilized.

The physiotherapist provided a description of safe and effective dry needling techniques that was further supported by documentation in the physiotherapy record.

There was no evidence to support the allegations and the complaint was dismissed.

Key Message

Physiotherapy records are foundational documents in professional conduct cases. Records are meant to be an accurate description of the events of a given date.

In this case, the physiotherapist’s documentation supported their version of events and led to a dismissal of the complaint.

Does your documentation support your version of events? Is there enough detail within that documentation to refute patient complaints of unprofessional conduct?

Termination by Employer

July 7, 2026

Allegation

The College received an Employer Mandatory Reporting Form from the physiotherapist’s employer.

As per section 57 of the Health Professions Act, the employer reported the termination of the physiotherapist’s employment for the following general reasons that the employer determined to be unprofessional conduct:

• “…repeated instances of disparaging management and colleagues in common clinic areas that have harmed the clinic practice's integrity…”
• “…hostile communication and has threatened meritless regulatory complaints against the clinic directors/partners on…rather than following professional conflict-resolution standards.”

Any report made under section 57 must be treated as a complaint.

Investigation

The Complaints Director, under the authority of section 55(2)(f) of Health Professions Act, had to decide whether to conduct an investigation or, if he was satisfied, there was insufficient or no evidence of unprofessional conduct relative to the College’s Standards of Practice and Code of Ethical Conduct, to dismiss the complaint.

In order to determine the next steps available to the Complaints Director under section 55 (2) (f), the Complaints Director requested that the employer provide specific evidence of the general reasons they provided via their mandatory report.

Decision

The employer did not provide any further evidence for the Complaints Director to consider.

The Complaints Director exercised the option under the authority of section 55 (2) (f) to dismiss the complaint without an investigation due to no or insufficient evidence of unprofessional conduct.

The complaint was dismissed.

Key Message

The College is clear in the educational material provided to the public, including employers, about the need for specific evidence in order to conduct an investigation into a complaint.

Not all matters reported to the College meet this threshold.

This is an example of an employer fulfilling their requirements under section 57 of the Health Professions Act and the College managing the complaint without the need for an investigation.

Sensation Testing, Consent and Interferential Current

July 8, 2026

Allegation

The patient attended physiotherapy services and as part of the physiotherapy services, the modalities interferential current (“IFC”) and heat packs (“HP”) were utilized.

After two appointments, the patient noted skin injuries to both ankles which the patient attributed to the IFC and HP applications.

The College investigated the following allegation:

• The physiotherapist failed to safely and effectively apply a therapeutic modality, and this resulted in skin injuries to both of the patient's ankles.

Investigation

The investigation revealed that the patient had attended physiotherapy services with the physiotherapist for two distinct episodes of care approximately six months apart.

The patient recalled being informed of the risks and benefits of IFC and HP during the first episode of care. The patient did not recall being informed about the risks and benefits of IFC and HP during the second episode of care.

The physiotherapist described their normal practice when providing patients with education about the modalities and described the method in which the modalities were applied. In this case the modalities were applied by a physiotherapy support worker (“PTSW”).

The patient and the physiotherapist had different recollections regarding the management of the adverse event, specifically whether any aftercare advice was given by the physiotherapist.

The physiotherapy record was examined to provide evidence regarding education and consent discussions surrounding the use of IFC and HP.

Education and consent were documented throughout the record. No specific mention was made of IFC and HP.

Both the patient and the PT agreed that the IFC and HP was applied by a PTSW. This was not documented in the record nor was consent for the involvement of a PTSW in the provision of physiotherapy services documented in the record.

No response to treatment was documented in the record.

No sensation testing was documented in the record despite there being sections within the record for it.

The skin injuries and the physiotherapist’s advice regarding the injuries was documented in the record and on an internal incident report.

Decision

Ultimately, the Complaints Director determined that there was insufficient evidence that unprofessional conduct occurred in this case and the Complaints Director did not refer this matter for a hearing.

The Complaints Director considered the physiotherapist’s rationale for using IFC and HP, the education about the modalities, informed consent for the use of the modalities, the actual physical application of the modalities, and the physiotherapist’s response once learning the adverse events occurred.

After analyzing the submissions of the patient and the physiotherapist, and reviewing the available evidence, the Complaints Director believed that there was insufficient evidence that the skin injuries sustained by the patient were the result of the physiotherapist “…displaying a lack of knowledge of or lack of skill or judgment in the provision of professional services.”

While it was reasonable to conclude that the IFC applied to the patient’s ankles resulted in skin injuries the Complaints Director believed that the evidence and submissions demonstrated that this was an unexpected event and did not occur as a result of a lack of knowledge, skill, or judgment on the part of the physiotherapist.

Despite dismissing the complaint, the Complaints Director had several recommendations for the physiotherapist to reflect on to improve their practice and reduce the risk of future adverse events:

• Given the adverse event experienced by the patient, the Complaints Director recommended that the physiotherapist reflect further on the education provided to patients when a significant period occurs between episodes of care (as occurred in this matter).
• The physiotherapist identified that they regularly chart by exclusion and the Complaints Director recommended that the physiotherapist reflect on this practice to determine if this approach meets the physiotherapist performance expectations of the Documentation Standard of Practice.
• While the physiotherapist provided evidence that all the IFC modalities at the Clinic were inspected annually, the physiotherapist did not detail any measures taken to ensure the IFC used on the patient was performing safely after the adverse event experienced by the patient. The Complaints Director recommended that the physiotherapist reflect on whether this approach was the appropriate course of action and whether the physiotherapist fulfilled the physiotherapist performance expectations of the Risk Management and Safety Standard of Practice in this case.
• The physiotherapist review and reflect on the Supervision Standard of Practice to ensure that the physiotherapist is meeting the following physiotherapist performance expectations:
  • Communicates to clients the roles, responsibilities, and accountability of support workers participating in the delivery of physiotherapy services.
  • Obtains clients’ informed consent for the delivery of physiotherapy services by support workers.
  • Monitors documentation of physiotherapy services by support workers to confirm that the documentation is consistent with regulatory standards.

Key Message

The Health Professions Act in section 1(1) (pp) defines unprofessional conduct as “…displaying a lack of knowledge of or lack of skill or judgment in the provision of professional services.”

Patients encounter risk of harm each time they seek health-care services. Some risks are directly related to assessment procedures and interventions, while others relate to environmental factors. All physiotherapists are required to:

• Be familiar with the risks and harms associated with the assessment and treatment interventions they employ, including common and mild side effects and rare, severe harms.
• Communicate risks and potential harms in a meaningful way when obtaining patient informed consent for assessment or treatment.

Some risks are expected and are mitigated through assessment, education, and consent discussions. Despite thorough assessment, education, and consent discussions, unexpected events, including injury and/or harm, may occur during the provision of physiotherapy services.

Not all adverse events occur because of unprofessional conduct; they are unexpected. An unexpected event must be distinguished from unskilled practice that arises from a lack of knowledge of or lack of skill or judgment in the provision of physiotherapy services.

If you are involving PTSWs in the provision of physiotherapy services, ensure you are meeting the physiotherapy performance expectations of the Supervision Standard of Practice.

Consider whether documenting by exclusion will support your version of events in the professional conduct process.

Getting Workplace Relationships Just Right

July 21, 2026

Allegation

A workplace investigation and subsequent termination of an employee for what the employer determined was unprofessional conduct led to a complaint of unprofessional conduct under section 57 of the Health Professions Act. The Health Professions Act directs that when notice is given under section 57, the Complaints Director must treat the notice as a complaint and the employer as the complainant.

The College investigated the following allegation:

• Over a three-month period, the physiotherapist failed to meet the performance expectations of the Professional Boundaries Standard of Practice (2017 version).

On January 1, 2025, the Professional Boundaries Standard of Practice was renamed the Boundary Violations Standard of Practice. Given that the alleged events occurred prior to January 1, 2025, the Professional Boundaries Standard of Practice (2017 version) and its physiotherapist performance expectations were applied in this matter.

Investigation

The physiotherapist was given the opportunity to respond to the allegation by the Complaints Director and provided a fulsome response.

The Complaints Director relied on the employer’s investigation into this matter for the following reasons:

1. Significant time had passed between the allegations and the College’s investigation. The Complaints Director felt that this would impact the recollections of events of the involved parties.
2. One of the involved parties requested that they not be involved further in any investigations. The Complaints Director considered this request and, following the College’s commitment to trauma-informed practices, decided, along with the above decision, not to conduct further interviews into this matter.
3. The employer’s investigation was thorough and there were opportunities for the Complaints Director to independently analyze the evidence provided by the employer. The Complaints Director did not rely on the opinion of the employer when making his decision.

Decision

After reviewing the evidence and the submissions of the parties, the Complaints Director determined that, while there was evidence that the physiotherapist erred and showed poor judgement in their interactions with a physiotherapy student and with their colleagues, the behaviour did not rise to the level of unprofessional conduct as defined by the Health Professions Act to warrant referral to a hearing.

In Moll v College of Alberta Psychologists, 2011 ABCA 110 (“Moll”), the Alberta Court of Appeal distinguished errors of judgment from unskilled practice stemming from a lack of knowledge, noting that errors of judgment involve the application of professional standards in circumstances where reasonable practitioners may differ in the application of those professional standards.

The Complaints Director believed that Moll applied in this case. The physiotherapist erred and showed poor judgement in their interactions with other professionals. However, the physiotherapist admitted to these errors and poor judgement, provided an explanation for why they behaved the way they did, and apologized for their actions. Further, when the physiotherapist became aware that their behavior was not welcome in the case of one colleague, the physiotherapist adjusted their behavior and maintained a professional relationship with this colleague. There was no evidence that the second colleague asked the physiotherapist to adjust the behavior and that the physiotherapist persisted in unwelcome behavior towards the second colleague.

Given the above, the Complaints Director did not believe that he could fully establish for a hearing tribunal that unprofessional conduct warranting sanctions from the hearing tribunal occurred in this matter.

The Complaints Director issued a formal caution to the physiotherapist and provided the following recommendations to the physiotherapist to improve their future practice:

• Review and reflect on the Boundary Violations Standard of Practice as it has replaced the Professional Boundaries Standard of Practice.
• Listen to and reflect on the College podcast: Episode 72: Getting Workplace Relationships ‘Just Right’.

Key Message

Although employers are responsible for creating safe and respectful working conditions, physiotherapists also have a professional obligation to consider how they conduct themselves in practice, including in their interactions with students and colleagues.

Physiotherapists should:

• Be aware of power and power imbalances in workplace relationships.
• Act with trust, respect, and professionalism in all interactions.
• Avoid comments or conduct that may be discriminatory or contrary to human rights.

Workplace friendships can be a positive and rewarding part of professional life. This case highlights the importance of understanding and respecting boundaries. One person may view a relationship as close or informal, while the other may not share that understanding. Physiotherapists must be attentive to those differences and ensure their conduct remains appropriate and professional.

When the Chart Tells the Story

July 21, 2026

Allegation

The College investigated two allegations based on the patient’s written complaint.

1. The physiotherapist did not safely and effectively use manual therapy as a physiotherapy intervention with the patient, and this resulted in an adverse event for the patient.
2. The physiotherapist did not disclose the adverse event to the Workers' Compensation Board (the "WCB").

Investigation

The physiotherapy record, including reporting to WCB was the primary piece of evidence in this investigation.

The investigator also collected submissions from both the patient and the physiotherapist. The recollections of the parties were quite different. Thus, the physiotherapy record was relied upon for an accurate representation of the physiotherapy services provided.

There was evidence to support an increase in symptoms on the date in question.

There was no evidence to support that this increase in symptoms related to any physiotherapy services provided on the date in question. In fact, the physiotherapy record supported the fact the no manual therapy was performed on the date in question.

The physiotherapy record also supported the fact that the physiotherapist reported the increase in symptoms experienced by the patient to WCB.

Decision

The complaint was dismissed as there was no evidence to support either allegation.

The physiotherapy record documented the dates on which manual therapy was utilized. The physiotherapy record was reliable in that all entries were signed contemporaneously and contained unique data.

Further, the physiotherapy record documented multiple instances of symptom increase for the patient and consistently documented the reason for the symptom increase.

This made the Complaints Director’s decisions in this matter straightforward as the decisions were supported by documentary evidence.

Key Message

When your version of events require clarification in a professional conduct matter, the physiotherapy record is the primary piece of evidence the Complaints Director will turn to. Are you documenting sufficient information to accurately represent what occurred during the provision of physiotherapy services? If not, you should be, as this is the minimum performance expectation of the Documentation Standard of Practice and it will be your primary defense in a Professional Conduct Matter.

No Evidence of Sexual Abuse

July 21, 2026

Allegation

The College received a complaint from a patient alleging that, during an assessment, the physiotherapist reached under the patient’s clothing and touched their breast.

The College investigated whether the physiotherapist touched the patient’s breast without a clinical reason while providing physiotherapy services.

Investigation

The College requested a written response to the allegation, and the physiotherapist responded promptly.

The investigator attempted to involve the patient in the investigation; however, the patient did not respond to the investigator’s requests.

The physiotherapist was interviewed and provided their account of the services delivered on the date in question.

The physiotherapy record was reviewed as documentary evidence of the events on the date in question.

Decision

Because the patient did not participate further, the College could not explore the patient’s account beyond the written complaint.

The physiotherapist’s written and verbal accounts were fully supported by the physiotherapy record.

The physiotherapist provided a sound rationale for the assessment procedures and interventions used, and the Complaints Director determined they were appropriate for the patient’s presentation.

The physiotherapist acknowledged placing their hand under the patient’s shirt, with informed consent, to perform a scapular mobilization technique.

The physiotherapist stated that, as a result of this matter, they have modified their informed consent process and now obtain written consent for this technique.

The complaint was dismissed, as there was no evidence to support a finding of unprofessional conduct.

Key Message

Reports of sexually inappropriate conduct are difficult and stressful for everyone involved, including the patient, the physiotherapist, and the College’s Conduct Department.

The College responds to these complaints promptly and as efficiently as possible.

When the College receives a complaint involving sexual abuse or sexual misconduct, it reviews the available information and usually requests an immediate response from the physiotherapist. This allows the College to consider both accounts and determine appropriate next steps. The College recognizes that allegations of this nature can be extremely difficult for physiotherapists and encourages them to access available supports during the professional conduct process.

Even a skilled, trauma-informed physiotherapist who understands patient vulnerability and how their actions may be perceived can become the subject of a complaint.

Clear documentation can help support a physiotherapist’s account in a professional conduct matter. This includes documenting informed consent, unusual or unexpected patient responses, time offered before providing services that may be perceived as sensitive, and any follow-up when services do not proceed as planned or expected.

These matters often turn on two accounts of the same events: the patient’s and the physiotherapist’s.

Because interactions between a patient and physiotherapist are not usually recorded in real time, there is often no documentary evidence the College can obtain to support or refute the allegations.

As a result, the investigator’s findings may rely heavily on the parties’ submissions, which can amount to competing accounts that cannot be independently verified.

In these circumstances, complaints are often addressed by hearing tribunals, which have broader authority than the Complaints Director to assess the credibility of the parties.

Ask yourself: does your documentation support your version of events so that there is documentary evidence to support the physiotherapy services you provided?

Does The Chart Tell The Story?

July 21, 2026

Allegation

This was an Employer Mandatory Report made by an employer under the authority of section 57 of the Health Professions Act. The Health Professions Act directs that when notice is given under section 57, that the complaints director must treat the notice as a complaint and the employer as the complainant.

The employer received a patient complaint about inappropriate contact by the physiotherapist during the provision of physiotherapy services.

The employer fulfilled their obligations under section 57 of the Health Professions Act by reporting the patient complaint to the College.

The College investigated one allegation based on the employer mandatory report: While providing physiotherapy services, the physiotherapist’s genitalia made contact with the patient.

Investigation

The investigation involved submissions from and interviews with employer and the physiotherapist.

The College attempted to engage the patient in the investigation, but the patient declined to participate.

The physiotherapy record was reviewed as it always is in College Professional Conduct matters.

Decision

The lack of patient participation in the investigation limited the direct, first-hand information available for the Complaints Director to consider.

The physiotherapist provided a sound rationale and description of the manual therapy technique used during the provision of physiotherapy services that led to the complaint.

The physiotherapy record was incomplete and was not a reliable piece of evidence in this matter.

Given that the incomplete physiotherapy record did not support the physiotherapist’s rationale for the manual therapy technique chosen and the fact that the physiotherapist did not met the physiotherapist performance expectations of the Boundary Violation Standard of Practice, the Complaints Director had to consider whether these errors on the part of the physiotherapist were simply errors or a lack of judgement or were these errors made because of unskilled practice arising from a lack of knowledge.

In this case, the Complaints Director, after considering the available submissions and evidence, determined that the physiotherapist made an error in judgment and that their conduct did not rise to the level of unprofessional conduct that warranted referral for a hearing. The error in judgment occurred when the physiotherapist failed to document a discussion with the patient regarding the potential for a boundary issue to arise in relation to the manual therapy intervention provided. While this represented a lapse in documentation and professional judgment, it did not rise to the level of unprofessional conduct warranting referral for a hearing.

The complaint was dismissed.

However, given the evidence collected, specifically the incomplete physiotherapy record, the physiotherapist was provided with the following recommendations to improve their practice:

• Review and reflect on their documentation practices surrounding possible boundary violations, whether initiated by the physiotherapist or the client, by discussing inappropriate behaviour and attempting to resolve issues.
• Review and reflect on the following Standards of Practice in relation to their current practice:
  • Assessment, Diagnosis, Treatment
  • Informed Consent
  • Supervision
  • Documentation

The physiotherapist was also reminded that, under section 56 of the Health Professions Act, the Complaints Director, when aware of unprofessional conduct, has the authority to “treat the information…as a complaint and act on it under section 55.”

Key Messages

1. Document when unexpected events occur in your practice and the conversations you have with your patients when something unexpected does occur.
2. A common theme of Conduct Matters – does your documentation support the physiotherapy services provided to your patients on a specific date?

Page updated: 04/08/2026