Brief Summary

The member examined a horse that had developed a growing mass in its right armpit, with significant local tissue swelling under the chest wall. Two samples of the mass were excised and sent to a laboratory for analysis. A couple days later, the mass ruptured and began to drain. The client bandaged the area and called the member to seek veterinary care.

The member saw the horse the next day. The laboratory results indicated the lump was a hair matrix tumor with secondary bacterial infection. The member recommended the tumour be excised and discussed options with the client. It was agreed the member would perform “field surgery” three days later.

The surgery, to excise the tumor, was performed in the barnyard. After excising the first mass, the member determined a second mass was deep and involved musculature. The member recommended transferring the horse elsewhere for intensive care due to concerns field sedation and anesthesia may not be adequate. However, the owner declined. The member proceeded to excise the second mass with attached muscle in the barnyard. The member closed the wound; however, in part due to inadequate anesthetic protocols given the unanticipated length of the surgery there was insufficient time to release further tension on the wound and the member elected to have the central portion of the wound heal by second intention. During the procedure, it began to rain. The member removed her surgical gloves as their surface had become slippery. Upon completion of the procedure, the member advised the client they would return the next week to examine the horse and assess its condition to determine if it required additional debridement and wound care.

The horse was seen by another veterinarian a couple days later and received further post-operative treatment for the wound. The horse had an uneventful recovery.

Allegations of Professional Misconduct

• proceeded with anesthesia that was inappropriate for the procedure
• removed gloves during the surgery
• failed to maintain a sterile environment during the procedure
• failed to maintain the standard of practice of the profession
• an act or omission relevant to the practice of veterinary medicine that, having regard to the circumstances, would be regarded by members as disgraceful, dishonourable or unprofessional

Decision

The member pleaded and was found guilty to the allegations of professional misconduct.

Penalty

• Reprimand
• The member shall not engage in the practice of equine veterinary medicine for two months, or until she has completed the assessments and mentorship.
• Required to complete a half-day assessment to evaluate the member’s knowledge of field medicine anesthetic protocols and maintaining a sterile field, as well as the exercise of professional judgment and client management
• Required to participate in a two-day mentorship with an equine practitioner on protocols for field medicine anesthetic, maintaining a sterile field, as well as guidance on using professional judgment and client management
• Participate in a half-day assessment to discuss learnings achieved through the mentorship
• Must pay costs to the College in the amount of $20,747.67

Panel's Reasoning

The member failed to live up to the standards of the profession and her conduct would reasonably be regarded by other members of the profession as unprofessional. The member did not exercise professional judgement in the face of pressure from a client. This resulted in continuing with a prolonged, complex procedure for which the anesthetic regime was inadequate. In addition, the member failed to maintain a sterile surgical field and removed her gloves during the surgery, falling below the accepted professional standard.

Reasons for Penalty Decision

The Panel was satisfied that a complete suspension from the practice of veterinary medicine was not necessary in this case. The reprimand and remedial terms ordered, together with the suspension from equine practice for a period of two months, will protect the public and does send a strong message of deterrence to the member and the profession.

The member runs a multi-species practice. The issue in the case involved only equine medicine and surgery. The penalty addresses this aspect of her practice while allowing her to continue to provide services to her clients with companion animals and exotic animals.