Suspension – Dr. Nicole Fancy

The College of Physicians and Surgeons of PEI received a complaint by Patient B in February 2020, against Dr. Nicole Fancy with regard to boundary violations of the physician -patient relationship in that Dr. Fancy inappropriately pursued a friendship with Patient B despite recently treating Patient B at a mental health clinic. Dr. Fancy voluntarily underwent a psychiatry/psychology evaluation.

The Council for the College accepted the Fitness to Practise Committee Report and Findings and adopted the Committee’s recommendations with some changes, on June 8, 2021, Ordered as follows:

… that whereas the Council of the College of Physicians and Surgeons of PEI confirmed the findings of the Fitness to Practise Committee of the College, regarding the complaint by Patient B against Dr. Nicole Fancy, that Dr. Nicole Fancy committed professional misconduct pursuant to subsections XI(1)(a) and (h) of the Medical Act Regulations:

-Failing to maintain accepted professional standards and procedures in the practice of medicine; and

-Engaging in conduct or an act relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by medical practitioners as disgraceful, dishonourable, or unprofessional,

and that Dr. Nicole Fancy is an incapacitated member pursuant to the Medical Act, Part 1, subsection 1(j), supported by the independent medical evaluation completed by a psychiatrist, and a psychologist, in December 2020.

“Incapacitated member means a member suffering from a physical or mental condition, emotional disturbance or excessive use of alcohol or drugs, of a nature and extent making it desirable in the interests of the public or the member that he no longer be permitted to practice or that his practice be restricted.”

It is Ordered that:

  1. Fancy be given a written reprimand.
  2. This Order includes a minimum of a 3 month suspension which is in addition to and which shall run consecutively with the suspension handed down this same date, in the Order pertaining to the matter self reported by Dr. Fancy.
  3. Fancy pay the College a fine of $5 000.00.
  4. Fancy pay the College a sum of $10 000.00, as payment of costs associated with the College’s investigation and disciplinary proceedings.
  5. Fancy be required to participate in and successfully complete within 6 months of the date this Order is received by Dr. Fancy, an individualized course in professional boundaries satisfactory to the College, at her own expense. Dr. Fancy shall provide to the College a report of successful completion of the course.
  6. Fancy be required to participate in and successfully complete within 6 months of the date this Order is received by Dr. Fancy, a course in the approach and management of patients with Borderline Personality Disorder for the general practitioner, that is satisfactory to the College, at her own expense. Dr. Fancy shall provide to the College a report of successful completion of the course.
  7. Fancy be suspended from practice for a minimum of 3 months, and until she is fit to practise in accordance with the following, and shall comply, with an undertaking for the following practice restrictions:
    1. Fancy shall remain under the care of her family physician and the Physician Health Program to ensure her mental health concerns are addressed, as well as any other physical or mental health problems are treated as they arise, with satisfactory quarterly reports submitted to the College office, from both the family physician and the Physician Health Program.
    2. Fancy shall complete a course of insight-oriented psychotherapy with a psychiatrist or psychologist, for a duration of no less than 12 months. Dr. Fancy will complete a minimum of 3 months of therapy before consideration of return to practice, with satisfactory quarterly reports submitted to the College office.
    3. Fancy shall enter into a Monitoring Agreement with the College and with the help of the Physician Health Program, where she agrees to abstain from the consumption of alcohol, cannabis, and other substances and to participate in a structured toxicology screening program for the duration of two years. Parameters of screening are set out by the Physician Health Program and will include random observed blood or urine collection utilizing chain of custody protocols no less than 36 times in the first year and 24 times in the second year.
    4. Fancy shall complete a minimum of 3 months of abstinence from alcohol, cannabis and other substances before considering a return to practice, with confirmation provided to the College by the Physician Health Program. Dr. Fancy is encouraged to access abstinence-based supports.
    5. Fancy be restricted from being the most responsible physician for patients with primary mental health issues.
    6. Fancy shall limit on-call demands where possible, and shall only practice within her core competencies as a family physician.
    7. Fancy will be restricted from working in a solitary family practice, but instead is to practice within an interdisciplinary team or group family practice to facilitate appropriate triaging of patients with mental health issues, and facilitate workplace supervision.
    8. Fancy shall live outside the community where she practices, unless Council orders otherwise, to promote work-life balance and professional boundaries.
    9. Fancy will practise with a workplace monitor to review her patient roster and provide direction and oversight regarding the appropriateness of the physician-patient relationship, with satisfactory quarterly reports submitted to the College office.
    10. Fancy will have no further contact either personally or professionally with Patient B.
  8. Fancy will release the Committee findings, College rulings and reports to her treating physicians.
  9. Council expects Dr. Fancy to participate in the psychotherapy program and to abstain from alcohol and drugs for an extended period of time so that her progress can be assessed, before she applies to have her license reinstated. After months of active treatment of insight-directed psychotherapy and months of abstinence in an abstinence program outlined above (both of which can happen concurrently), Dr. Fancy may choose to apply to return to practice, and must undergo a repeat independent medical evaluation of her fitness to practice by a psychiatrist or another qualified physician approved by the College to conduct the evaluation. Dr. Fancy shall arrange for the psychiatrist or physician to report findings and make a recommendation, and Council will review these before making a decision about return to practice.

Suspension – Dr. Nicole Fancy

Suspension – Dr. Nicole Fancy

The College of Physicians and Surgeons of PEI received a self-report from Dr. Nicole Fancy in early 2020,  that she had entered into a sexual relationship with Patient A at the time that  she had informed the patient that their physician -patient relationship had ended, which relationship then continued for months during the College investigation. Dr. Fancy voluntarily underwent a psychiatry/psychology evaluation.

The Council for the College accepted the Fitness to Practise Committee Report and Findings and adopted the Committee’s recommendations with some changes, on June 8, 2021, Ordered as follows:

… that whereas the Council of the College of Physicians and Surgeons of PEI confirmed the findings of the Fitness to Practise Committee of the College, with regard to the complaint by Council (Self Report) against Dr. Nicole Fancy, that Dr. Nicole Fancy committed professional misconduct pursuant to subsections XI(1)(a) and (h) of the Medical Act Regulations:

-Failing to maintain accepted professional standards and procedures in the practice of medicine; and

-Engaging in conduct or an act relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by medical practitioners as disgraceful, dishonourable, or unprofessional,

and that Dr. Nicole Fancy is an incapacitated member pursuant to the Medical Act, Part 1, subsection 1(j), supported by the independent medical evaluation completed by a psychiatrist, and a psychologist, in December 2020.

“Incapacitated member means a member suffering from a physical or mental condition, emotional disturbance or excessive use of alcohol or drugs, of a nature and extent making it desirable in the interests of the public or the member that he no longer be permitted to practice or that his practice be restricted.”

It is Ordered that:

  1. Fancy be given a written reprimand for boundary violations related to her relationship to Patient A.
  2. Fancy be given a further written reprimand for her professional misconduct and her attempts to avoid detection for these offences during an active investigation by the College and the Fitness to Practice Committee.
  3. This Order includes a minimum of a 9 month suspension which is in addition to and which shall run consecutively with the suspension handed down this same date, in the Order pertaining to the complaint made by Patient B.
  4. Fancy pay the College a fine of $5 000.00.
  5. Fancy pay the College a sum of $10 000.00, as costs associated with the College’s investigation and disciplinary proceedings.
  6. Fancy be required to participate in and successfully complete within 6 months of the date this Order is received by Dr. Fancy, an individualized course in professional boundaries satisfactory to the College, at her own expense. Dr. Fancy shall provide to the College a report of successful completion of the course.
  7. Fancy be required to participate in and successfully complete within 6 months of the date this Order is received by Dr. Fancy, a course in the approach and management of patients with Borderline Personality Disorder for the general practitioner, that is satisfactory to the College, at her own expense. Dr. Fancy shall provide to the College a report of successful completion of the course.
  8. Fancy be suspended from practice for a minimum of 9 months, and until she is fit to practise in accordance with the following, and shall comply with an undertaking for the following practice restrictions:
    1. Fancy shall remain under the care of her family physician and the Physician Health Program to ensure her mental health concerns are addressed, along with any other physical or mental health problems are treated as they arise, with satisfactory quarterly reports to submitted to the College, office from both the family physician and the Physician Health Program.
    2. Fancy shall complete a course of insight-oriented psychotherapy with a psychiatrist or psychologist, for a duration of no less than 12 months. Dr. Fancy will complete a minimum of 9 months of therapy concurrent with the requirement in the complaint by Patient B, before consideration of return to practice,     with satisfactory quarterly reports to be submitted to the College office.
    3. Fancy shall enter into a Monitoring Agreement with the College, where she agrees to abstain from the consumption of alcohol, cannabis, and other substances and to participate in a structured toxicology screening program for the duration of two years. Parameters of screening are set out by the Physician Health      Program and will include random observed blood or urine collection utilizing chain of custody protocols no less than 36 times in the first year and 24 times in the second year.
    4. Fancy shall complete 9 months of abstinence from alcohol, cannabis and other substances concurrent with the requirement in the complaint by Patient B, before considering a return to practice, with confirmation provided to the College by the Physician Health Program. Dr. Fancy is encouraged to access abstinence based supports.
    5. Fancy be restricted from being the most responsible physician for patients with primary mental health issues.
    6. Fancy shall limit on-call demands where possible, and shall only practice within her core competencies as a family physician.
    7. Fancy will be restricted from working in a solitary family practice, but instead is to practice within an interdisciplinary team or group family practice to facilitate appropriate triaging of patients with mental health issues, and facilitate workplace supervision.
    8. Fancy shall live outside the community where she practices, unless Council orders otherwise, to promote work-life balance and professional boundaries.
    9. Fancy will practise with a workplace monitor to review her patient roster and provide direction and oversight regarding the appropriateness of the physician patient relationship.
    10. Fancy will have no further contact with Patient A, either personally or professionally, and any communication required, such as regarding the repayment of the personal loan, can occur between Patient A and counsel for Dr. Nicole Fancy.
  9. Fancy will release the Committee findings, College rulings and reports to her treating physicians.
  10. Council expects Dr. Fancy to participate in the psychotherapy program and to abstain from alcohol and drugs for an extended period of time so that her progress can be assessed, before she applies to have her license reinstated. After months of active treatment of insight-directed psychotherapy and months of abstinence in an abstinence program outlined above (both of which can happen concurrently), Dr. Fancy may choose to apply to return to practice, and must undergo a repeat  independent medical evaluation of her fitness to practice by a psychiatrist or another qualified physician approved by the College to conduct the evaluation. Dr. Fancy shall arrange for the psychiatrist or physician to report findings and make a recommendation, and Council will review these before making a decision about return to practice.

Reprimand – Dr. Henry Swart

Whereas the Council of the College of Physicians and Surgeons of PEI confirmed the finding of the Fitness to Practise Committee of the College that Dr. Henry Swart was guilty of Professional Misconduct, pursuant to subsections XI(1)(a) and (h) of the Medical Act Regulations:

  • Failing to maintain accepted professional standards and procedures in the practice of medicine
  • Engaging in conduct or an act relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by medical practitioners as disgraceful, dishonourable, or unprofessional, and

Whereas Dr. Henry Swart violated the CMA Code of Ethics, section 20 (CMA Code of Ethics 2004):

  • Limit treatment of yourself or members of your immediate family to minor or emergency services and only when another physician is not readily available; there should be no fee for such treatment.

Whereas Dr. Henry Swart violated the College Policy on Treating Self and Family Members (August 2016 and previous version):

The Council for the College accepted the recommendations of the Fitness to Practise Committee and Orders that:

  1. Henry Swart be given a written reprimand.
  2. Henry Swart pay the College a sum of $3, 500.00, as costs associated with the College’s investigation and disciplinary proceedings.
  3. Henry Swart be required to participate in and successfully complete, within 6 months of the date of this Order, an individualized course in medical ethics satisfactory to the College, at his own expense. Dr. Swart shall provide to the College a report of successful completion of the course.

Reprimand – Dr. Paul Phelan

Whereas the Council of the College of Physicians and Surgeons of PEI confirmed the finding of the Fitness to Practise Committee of the College that Dr. Paul Phelan was guilty of Professional Misconduct pursuant to subsections XI(1)(a) Failing to maintain accepted professional standards and procedures in the practice of medicine, and (h) Engaging in conduct or an act relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by medical practitioners as disgraceful, dishonourable, or unprofessional; of the PEI Regulations.  Dr. Phelan has admitted to professional misconduct in failing to complete medical forms in a timely manner for a patient.

The Council accepted the recommendations of the Fitness to Practise Committee and Orders that Dr. Paul Phelan:

  1. be given a written reprimand,
  2. be fined $1000.00, and
  3. be required to attend a relevant course on appropriate and timely record keeping, such as the “Medical Records Keeping Course” offered online through Dalhousie University, or similar, as approved by the Registrar.

Suspension – Dr. Henry Swart

WHEREAS a Board of Inquiry constituted under the provisions of PEI Medical Act was held regarding the allegations that Dr. Henry Swart, a member of the College of Physicians and Surgeons of Prince Edward Island, has committed an act or acts of professional misconduct as per the PEI Regulations, XI-1(a) failing to maintain accepted professional standards and procedures in the practise of medicine, XI-1(h) engaging in conduct relevant to the practise of medicine that having regard to the circumstances would reasonably be regarded by Council as disgraceful, dishonourable or unprofessional and for XI-1(p) providing a professional medical service without the consent of the patient if consent is required by law;

And  WHEREAS Dr. Henry Swart admitted to professional misconduct;

And WHEREAS the Board of Inquiry has made a finding of guilt of professional misconduct and unanimously recommended the following action be taken by Council:

A.

  1. That Dr. Swart’s license to practise medicine be suspended for a period of three (3) months.
  2. That the following pre-conditions be placed on Dr. Swart’s return to practice following the three (3) months suspension:
      1. That he undertakes and successfully completes a course of continuing medical education to be provided at Dalhousie University in Halifax, Nova Scotia, and as approved by College Council, related to informed consent and patient autonomy, which is to be paid for by Dr. Swart, and which may consist of the following elements:
        1. Assigned readings on the topic of informed consent and patient autonomy;
        2. In person meetings at Dalhousie University in Halifax, Nova Scotia, and
        3. A reflective paper regarding the various aspects of informed consent and patient autonomy.
  3. That Dr. Swart pay a fine to the College in the amount of $5,000.00.
  4. That Dr. Swart pay the College the sum of $15,000.00, as costs associated with the College’s investigation and disciplinary proceedings.

 

 

B.

…that the Order of Council be effective June 3, 2019.

 

 

C.

… that the Costs and Fine are to be paid to the College office prior to reinstatement of Dr. Swart’s licence.

 

Council of the College of Physicians and Surgeons of Prince Edward Island adopts the recommendations of the Board and imposes the sanction outlined above as recommended by the Board of Inquiry.

Suspension – Dr. David Ashby

At a meeting of the Council of the College of Physicians and Surgeons of February 4, 2019, the following motion was passed:

WHEREAS Dr. David Ashby admitted to the following allegations of professional misconduct to wit:

under the Regulations and Act pursuant to Section 67 of the Act, Dr. Ashby did engage in conduct which constituted failure to maintain the standards of the practice of the medical profession by:

 a)    contrary to regulation xi-(i)(e) prescribing anti-anxiety and anti-depressant medication without proper diagnosis and being outside the scope of his medical practice and area of medical expertise;

 b)    contrary to regulation xi-i(h), engage in conduct relevant to the practice of medicine that having regard to all the circumstances would reasonably be regarded by medical practitioners as disgraceful, dishonourable, or unprofessional: by violating a doctor-patient boundary through the development of a personal and, later, sexual relationship with patient A, who had been a patient, which led to providing patient A with financial and other support and improperly prescribing anti-anxiety and anti-depression medications as outlined above.

 AND WHEREAS the Board of Inquiry made a finding of guilt of professional misconduct and unanimously recommended the following action be taken by Council:

 a) Dr. David Ashby’s license to practice medicine be suspended for a period of two (2) years;

b) The following pre-conditions be placed on Dr. Ashby’s return to practice following the two (2) year suspension:

i. That he undergoing counseling, and that his therapist confirms to the College that Dr. Ashby understands and appreciates the significance of his conduct;

ii. That he undertakes a course of continuing medical education approved by the College related to the issue of physician and patient boundaries;

iii. That upon his return to practice that he be restricted from prescribing medications and that his practice be restricted to that of a Surgical Assistant and

iv. That he not assume any position having responsibility for medical leadership;

c) That he pay a fine to the College in the amount of ten thousand dollars ($10,000);

d) That he pay to the College the sum of thirty thousand dollars ($30,000) as costs for the conduct of the College’s investigation and disciplinary proceedings; and

e) That in considering the foregoing, the College make note of whether Dr. Ashby ceased his medical practice as of December 21, 2018, being the date on which this Board of Inquiry recommended the same to Dr. Ashby pending the final decision of Council.

 Council of the College of Physicians of Prince Edward Island adopts the recommendations of the Board and imposes the sanction outlined above as recommended by the Board of Inquiry.

Reprimand: Dr. Douglas Carmody

(January 1, 2014)

The Council of the College of Physicians and Surgeons of PEI confirmed the finding of the Fitness to Practise Committee of the College that Dr. Douglas Carmody was found to have failed to meet the standard of care expected of a physician, a written reprimand be recorded on the Register, a letter of apology be forwarded from Dr. Carmody to Ms. A with a copy forwarded to our office, and Dr. Carmody be fined $3,000.00.