Quarterly report of all closed conduct files from May 1, 2023 – July 31, 2023.
Disclaimer: Decisions may vary depending on the circumstances. The reasons for a decision must be considered in light of the evidence and the actual issues pertaining to the allegation.
Case 1
Allegation
The physiotherapist received two suspensions from their employer due to failing to comply with procedures and policies regarding taking sick time and attending scheduled work hours.
Investigation
It was determined that although the physiotherapist’s alleged behavior is not what is expected from any employee, in particular a regulated professional, this matter is a human resources concern. This matter did not warrant an investigation.
Decision
Pursuant to section 55(2)(f) of the Health Professions Act the complaint was dismissed.
Case 2
Allegations
- The patient sustained injury and various symptoms because of the physiotherapist’s IMS treatments.
- The physiotherapist failed to provide the patient with a complete copy of the patient record when requested.
- The physiotherapist submitted "false" reports to WCB. The clinical record does not reflect clinical care received.
Investigation
The complaint was investigated. The evidence did not support that the IMS treatment provided by the physiotherapist was the cause of the patient’s various ongoing symptoms or newly reported symptoms. There was evidence that there was a lack of communication between all parties involved, the physiotherapist, WCB, and the patient regarding the complainant’s presenting condition and the overall plan. The physiotherapist failed to consider the patient’s position regarding the chronicity of their condition, lack of substantive improvement over time, and the patient’s relationship and reliance on WCB.
The evidence supported that the clinic, on behalf of the physiotherapist, was prepared to provide the complete patient record following the Personal Information Protection Act. There was no evidence that the patient record was actually provided to the patient, but the clinic was prepared to do so.
The evidence does not support the allegation that the physiotherapist submitted “false” reports to WCB or that the clinical record did not reflect clinical care received. The report centered on the current condition which the physiotherapist was specifically treating. The evidence supported that the WCB report did not comprehensively reflect the patient’s current condition, including preexisting and current complaints, or a realistic long-term plan.
Decision
The complaint was dismissed. There was insufficient presenting evidence of unprofessional conduct to refer this matter to a hearing; however, the physiotherapist was provided with the following recommendations to read and consider:
- Power and the Therapeutic Relationship: Considerations for Physiotherapists
- Good Practice: Effective Communication to Improve Therapeutic Relationships
- Client Centered Care Standard of Practice
https://www.cpta.ab.ca/docs/129/Client-Centered_Care.pdf
- Code of Ethical Conduct
https://www.cpta.ab.ca/for-physiotherapists/regulatory-expectations/code-of-ethics/
- WCB Physiotherapy Contract Reference Guide
https://www.wcb.ab.ca/assets/pdfs/providers/PTContractReferenceManual.pdf
Case 3
Allegation
The patient’s symptoms significantly worsened as a result of the physiotherapy assessment and treatment on August 23, 2022.
Investigation
The Investigation findings were as follows:
- Review of the clinical treatment notes supports that the physiotherapist undertook an appropriate and adequate assessment of the patient’s cervical spine on August 21, 2022.
- Review of the clinical treatment notes supports that the patient had a positive response to the initial treatment.
- The clinical treatment notes indicate that several additional techniques were added to the patient’s treatment on August 23, 2022. However, the additional components were not unreasonable additions to the patient’s treatment plan.
Decision
There was insufficient evidence of unprofessional conduct to refer this matter to a hearing. The complaint was dismissed. The degree of the patient’s reported exacerbation was significant and not expected given the type of treatment provided and their positive response to the initial treatment; however, it is plausible that the physiotherapy treatment and exercises were the cause of the exacerbation. The Complaints Director recommended that the physiotherapist undertake introductory manual therapy levels in the Canadian Physiotherapy Association, Orthopedic Division, Advanced Integrated Musculoskeletal Physiotherapy Program (https://www.orthodiv.org/education/) to strengthen skills and improve future patient treatment outcomes.
Case 4
Allegation
Failure to meet Documentation and Record Keeping Standard of Practice resulted in termination of employment.
Investigation
As part of the investigation, the investigator undertook a random audit of 10 charts. The audit was based on the College’s Documentation and Record Keeping Standard. 75% of the documentation requirements were met.
Decision
The evidence specific to the investigated allegation did not ensure that there was a reasonable prospect of establishing the facts necessary to support a finding of unprofessional conduct by a hearing tribunal. This matter was not referred for hearing and the complaint was dismissed; however, a formal caution was given to the physiotherapist that a future complaint of a similar nature may result in referral to a hearing.
It was strongly suggested that the physiotherapist undertake each of the following recommendations to improve practice.
- Review the Documentation and Record Keeping Standard of Practice
- Read the following:
- Complete any or all the following courses through the University of Alberta Faculty of Rehabilitation Medicine:
Case 5
Allegation
The physiotherapist failed to provide the patient or their legal representative with the treatment record upon request in a timely manner.
Investigation
The Investigation revealed that the physiotherapist failed to meet components in each of the following Standards of Practice.
- Documentation and Record Keeping
- Provides a copy of the complete clinical and financial record to the client or their authorized representative upon request and appropriate consent.
- Fees and Billing
- Maintains current knowledge of funding sources for physiotherapy services and complies with funding requirements, policies, and procedures.
- Legislative Responsibilities
- Is knowledgeable of and complies with all relevant legislative and regulatory requirements in Alberta (Diagnostic and Treatment Protocol Regulation & Health Information Act).
Decision
The evidence specific to the investigated allegation did not warrant referral of this matter to a hearing. However, the evidence collected did support there were significant concerns with the physiotherapist’s professional practice. It was recommended that the physiotherapist review the following documents to improve their practice.
- Documentation and Record Keeping Standard of Practice
- Fees and Billing Standard of Practice
- Diagnostic Treatment Protocols Regulation Interpretive Guide
- The physiotherapist’s clinic Policy and Procedures to ensure that the CPTA Standards of Practice are consistently being met and that all staff are aware of all clinic procedures regarding the management of patient records.
Case 7
Allegations
- On or between December 2019 and March 2020, Scott Sherman failed to maintain appropriate boundaries during their therapeutic relationship with client SB by meeting with SB on one or more occasions in a personal capacity for coffee.
- Scott Sherman engaged in sexual abuse toward patient SB the particulars of which include:
- Scott Sherman provided physiotherapy treatment to SB on a number of occasions between February 5, 2014 – September 3, 2019;
- On or about March 17, 2020, Scott Sherman commenced a sexual relationship with SB and engaged in conduct of a sexual nature with SB while SB was still a “patient” as defined in Physiotherapy Alberta’s Standard of Practice for Physiotherapists in Alberta: Sexual Abuse and Sexual Misconduct;
- Scott Sherman provided further treatment to SB on or between October 7, 2020 to November 23, 2020, while continuing to engage in a sexual relationship with SB and when SB was still a “patient”.
- Further or in the alternative to allegations #2, Scott Sherman’s conduct in engaging in an intimate and/or sexual relationship with SB constitutes an inappropriate boundary violation.
Investigation
The evidence obtained during the investigation supported referral of this matter for a hearing.
Findings
The Hearing Tribunal found that Allegation 1 was not proven on a balance of probabilities. The evidence did not establish, on a balance of probabilities, that Scott Sherman failed to maintain appropriate boundaries with SB between December 2019 and March 2020. The act of having coffee with a client/patient is not in itself sufficient to establish that there is a failure to maintain appropriate boundaries in breach of the Boundary Standard or Code of Ethical Conduct. Allegation 1 is dismissed.
Allegation 2 is proven on a balance of probabilities. The conduct is a breach of the Sexual Abuse Standard and constitutes unprofessional conduct and sexual abuse, as that term is defined in section 1(1)(nn.1) of the HPA, as “the threatened, attempted or actual conduct of a regulated member towards a patient that is of a sexual nature and includes any of the following conduct: sexual intercourse between a regulated member and a patient of that regulated member.”
With respect to Allegation 3, this Allegation was in the alternative to Allegation 2. The Hearing Tribunal found that the September 3, 2019 appointment was not episodic care under the Sexual Abuse Standard. Allegation 2 was proven and the Hearing Tribunal found the conduct constituted unprofessional conduct and sexual abuse under the Sexual Abuse Standard. [210] Given the Hearing Tribunal’s findings on Allegation 2, Allegation 3 is dismissed.
Orders
In accordance with section 82 of the HPA, the Hearing Tribunal hereby orders:
- Decision of the Hearing Tribunal on allegations (posted March 2, 2023)
- Decision of the Hearing Tribunal on sanctions (posted June 20, 2023)
Case 8
Allegations
- The patient fell off the treatment table, which had been raised during their May 17, 2021 treatment with the physiotherapist, resulting in a fractured hip.
- The physiotherapist failed to act professionally following the patient's fall on May 17, 2021 by providing no follow-up contact after the incident.
Investigation
This matter was investigated.
Regarding the first allegation, all accounts support that the patient fell off a treatment table when dismounting following a physiotherapy appointment with the physiotherapist on May 17, 2021, causing a right hip fracture that required a total hip replacement on May 18, 2021. The evidence supports that the physiotherapist raised the table while mobilizing the patient’s shoulder, left the cubicle, did not lower the table prior to leaving the cubicle, and did not warn the patient that the table was raised. The evidence does not support that the physiotherapist intended any harm to the patient.
Following the fall, the patient was transported to the hospital via ambulance.
The evidence supported that the physiotherapist did not communicate with the patient following the accident and the physiotherapist provided several reasons why they did not contact the patient following the accident.
Decision
The evidence does not support that the physiotherapist was guilty of unprofessional conduct to a level that would support referral of this matter to be heard before a hearing tribunal. However, a future complaint of a similar nature may result in a referral to a hearing. The physiotherapist was provided with the following recommendations to improve practice:
- Adopt routine practice, for every patient, to:
- Ensure the treatment table is lowered to chair height prior to leaving the treatment cubicle.
- Ensure the patient is made aware of the height of the treatment table if being treated on a standard fixed height table.
- Read the College of Physiotherapists of Alberta: Managing Challenging Situations Guide
- Watch the College of Physiotherapists of Alberta Webinar: Now what? Responding When Things Don’t Go As Planned
