A well-known Sudbury cardiologist has lost an appeal in the Ontario Divisional Court of the Superior Court of Justice to have his hospital privileges restored at Health Sciences North in Sudbury.
Details of the decision were revealed in public court documents on Jan. 17. The case was actually heard in court on Dec. 9, 2022.
This follows a previous decision by HSN's medical advisory committee to deny hospital privileges to Dr. Dinkar Shukla based on conflicts that arose between himself and other physicians who were part of a specialized team that performed a procedure known as transcatheter aortic valve implants, also known as the “TAVI procedure”.
It is a procedure that replaces a diseased heart valve without requiring cardiac surgery, the court was told.
Shukla appealed the decision on several levels, including at the Divisional Court where he challenged the decision of the HSN board of directors and the Health Professions Appeal and Review Board.
Evidence presented to the hospital board suggested that Dr. Shukla had enjoyed a "collaborative and professional relationship with other medical staff" until two new TAVI physicians arrived in 2018, said the court documents.
In order to stay current with their credentials, TAVI physicians must carry out a minimum of three of the procedures each year.
"Against this backdrop, within a few months of two additional TAVI doctors arriving at the hospital, conflicts developed," said the documents presented in court.
"Those conflicts mushroomed into four-plus years’ worth of medical-legal proceedings over questions of interpersonal conflict, patient care, fairness, hospital leadership, respect for colleagues, reputation, and professionalism, with inevitable costs to the hospital, their colleagues, and the community." said the documents.
Things reached a head on Nov. 18, 2020, when the HSN medical advisory committee took action.
"The Medical Advisory Committee recommends to the Board of Directors that Dr. Dinkar Shukla’s appointment and privileges at Health Sciences North be immediately revoked and that his re-application for appointment and privileges at Health Sciences North for the years 2020 and 2021 be denied."
Shukla appealed. There were several days of in-house presentations of evidence and submissions that began in January of 2021 and continued until March of 2022.
The College of Physicians and Surgeons of Ontario (CPSO) was notified last spring that Shukla's privileges at the Sudbury hospital were revoked.
"On March 31, 2022, Health Sciences North notified the College that Dr. Shukla’s hospital privileges were revoked and Dr. Shukla’s application for appointment and privileges was rejected, due to alleged misconduct, incompetence and/or negligence," said a notice posted on the CPSO website.
Shukla's lawyers argued that his privileges should be reinstated because the hearing is not about his competence and that his services are still valuable to the community.
"Health Sciences North does not agree," said the court. "It submits that after the hearing, the hospital board found that Dr. Shukla’s misconduct was related to the conflicts among the TAVI team, and that Dr. Shukla chose to mislead patients, colleagues and other doctors, rather than work honestly and collaboratively. This behaviour undermined his colleagues and put patient care and safety at risk.”
Part of the legal proceedings included arguments put forward by Shukla's lawyers that the proceedings were moving too quickly; that Shukla was not being given enough time and that his hospital privileges were revoked before he had gone through a full appeal process. The court did not agree.
There was also a ruling on costs, against Shukla.
"Costs are not being sought for or against the Appeal Board. As between Dr. Shukla and Health Sciences North, given the hospital’s success on this motion, costs are ordered to be paid by Dr. Shukla to Health Sciences North in the sum of $45,000," said the court documents.
The case was heard by Justice Janet Leiper of the Ontario Superior Court of Justice.
The complete transcript of the hearing is on the Canlii.org website.
Len Gillis covers health care and mining for Sudbury.com.