OB/GYN Mistakes in Ontario Veiled in Secrecy

Just like the adage, “one bad apple spoils the bunch”, the wrongful actions of a few obstetricians have a costly effect on other OB/GYNs and the public. A Canadian investigation by the Toronto Star in conjunction with Ryerson University found that obstetrics is a unique field in which a relatively small number of doctors make serious mistakes but their mistakes are more impactful and tend to be committed repeatedly because the doctors are not caught.

The feature in the Canadian newspaper highlighted the stories of families coping with children who suffered birth injuries at the hands of doctors who had track records of negligent practices that their patients did not know about.

For example, one family’s baby allegedly had her skull crushed during a botched delivery performed by an OB/GYN who is the subject of 55 lawsuits alleging negligent medical care.

Malpractice insurance highest in obstetrics

According to the Canadian Medical Protective Agency (CMPA) – the Canadian national legal insurance fund for doctors – one third of all of the damages it pays to patients is due to obstetrical care. The practice of obstetrics carries the highest risk and accounts for the highest medical insurance premiums paid by doctors across Canada. In Ontario, obstetricians pay more than $72,000 per year in legal insurance to cover their risk.

Dr. John Kingdom, the chair of the University of Toronto’s Faculty of Medicine, explained to the Toronto Star why the settlements are higher in obstetrics than in other medical specialties: “Surviving is significantly more expensive than dying.” The surviving victims of birth injuries – newborn babies – often have a lifetime of specialized and intensive care ahead of them. This can be seen in the settlement figures.

Problem doctors tend to be repeat offenders

There are approximately 985 obstetricians and gynecologists actively practicing in Ontario and most have never faced discipline or court action. At least 40, however, are practicing while under investigation or after having received critical results in court or before the province’s medical overseer. According to a Toronto malpractice lawyer interviewed by the Star, obstetrics is unique among medical specialties in that so many so-called repeat offenders who see patients while being subject to disciplinary complaints and civil lawsuits.

The “repeat offenders” are aided by the secrecy in the process. Doctors do not need to report out-of-court settlements to the College of Physicians and Surgeons. Canadian professional rules also allow doctors to voluntarily restrict their practices with no need to explain why to patients. Experts say that these “voluntary” restrictions are often the product of deals that were reached behind the scenes as conditions to avoid public discipline hearings. One observer has noted that patients are not put on notice of doctors’ poor care until dozens of victims come forward in the media and connections can be drawn.

The secrecy of doctor complaints is a widespread problem. The College of Physicians and Surgeons – the self-regulating authority for Ontario doctors – does not release patient complaints unless the doctor faces disciplinary action.

Similar secrecy problems are inherent in the American medical system. For example, a Cincinnati newspaper recently reported that it can be two years after a patient complains to the state medical board of health before those complaints can become public.

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