An assessment which falls below the minimum standard of care required, but does not lead to a misdiagnosis, may lead to a finding of veterenarian’s unprofessional conduct

Administrative law – Decisions of administrative tribunals – Veterinary Associations – Veterinarians – Disciplinary proceedings – Professional misconduct – Competence – Judicial review – Evidence –  Compliance with legislation – Standard of review – Reasonableness simpliciter

Karagic v. Alberta Veterinary Medical Assn., [2013] A.J. No. 481, 2013 ABCA 169, Alberta Court of Appeal, May 21, 2013, M.S Paperny, M.B. Bielby and B.C. O’Ferrall JJ.A.

The appellant, a veterinarian, was involved in the treatment of a dog with a broken leg. The appellant took one radiograph and diagnosed the dog with a fracture. He recommended to the owners that surgical intervention was necessary. Ultimately, the dog had three surgeries. This matter went before the hearing tribunal (“Tribunal”) of the Council of the Alberta Veterinary Medical Association (“Council”). In that hearing, expert evidence was led that a single radiograph was inadequate to determine the extent of the dog’s injury and that without two radiograph views and a diagnostic view of the joint, the appellant could not make a conclusive evaluation regarding potential future concerns and possible treatments. The Tribunal found the appellant guilty of two findings of unprofessional conduct on the basis that he failed to: (i) follow the appropriate standards for assessing a fracture by failing to take enough radiographs and (ii) maintain appropriate records. A written reprimand was issued.

The Tribunal’s decision was appealed to the Council. The Council concluded that the Tribunal’s findings were reasonable. The appellant then appealed the Council’s decision to the Alberta Court of Appeal. The Appeal Court dismissed the appeal on a standard of reasonableness.

The appellant argued that there was no evidence that the assessment was inaccurate or that more radiographic views would have changed the assessment. He argued that the diagnosis was uncontradicted and was confirmed by the Council’s expert evidence. The appellant also argued that because inaccuracy was not established, the Tribunal’s conclusion that the radiograph did not allow for conclusive evaluations was a decidedly different basis for professional discipline and fell outside the four corners of the citation.

The Appeal Court disagreed. The Court found that that the appellant’s submission rests on a narrow reading of the count equating diagnosing with assessing. The Court found no error in the Council’s conclusions and its reasons that failure to take additional views fell below the minimum standard. Regarding the appellant’s argument that departure from professional standards does not automatically constitute unprofessional conduct, under s.1 of Veterinary Profession Act, RSA 2000 c V-2, unprofessional conduct is defined as including “displaying a lack of knowledge or lack of skill or judgment in the practice of veterinary medicine.”  The Council expressly concluded that the failure to take additional radiographs constituted a lack of professional judgment; the Court found this reasonable.

Regarding the remaining count, failure to maintain appropriate medical records, the appellant did not document his discussion with the owners regarding the choice and reasons why the second surgery was going to be undertaken. The Tribunal found this was in breach of the Respondent’s Practice Inspection and Practice Standards Bylaws Small Animal Facility which required that the “medical and surgical record contain sufficient information to indicate the assessment of the patient, planned treatment and results of necropsy reports if applicable.”

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