Suspended doctor can practise again, but faces restrictions

A Sheet Harbour, N.S., doctor is free once again to practise medicine, but will need to adhere to restrictions.

On Monday, the College of Physicians and Surgeons of Nova Scotia announced it reached a settlement with Dr. Bradley Charles Atkinson.

Atkinson, who has long been under drug-prescribing restrictions, was suspended from practising medicine in 2016 after a woman complained to the college about his care of her grandmother during a visit to the outpatient department at Eastern Shore Memorial Hospital in 2015.

2015 complaint 

The woman said Atkinson declined to act on treatment recommendations for patients with cancer who are having or showing symptoms of a fever, despite the grandmother showing a card from her hematologist outlining what to do.

She said Atkinson did not make any changes to her grandmother's antibiotic regimen, despite clear failure of the initially prescribed therapy.

She said Atkinson didn't take appropriate steps to rule out other causes in her grandmother's symptoms, given that the grandmother was not improving on the original therapy prescribed.

And despite concern from the grandmother's family and the nursing staff regarding her respiratory status, she said Atkinson did not go back to the hospital to reassess the grandmother or transfer her to a place where she would get a more focused workup and therapy.

What are the restrictions?

In 2017, Atkinson and the college formed a remediation plan.

Once the remediation plan is over, Atkinson's practice will be restricted to office-based family medicine. He will not be allowed to practise in an emergency room, hospital clinic, nursing home or inpatient setting. Atkinson does have the option to apply to have those restrictions lifted.

Eastern Shore Memorial Hospital in Sheet Harbour has faced regular emergency room closures. So while Atkinson is able resume his work as a family doctor, his return means the emergency room will still be down a doctor and will likely continue to face regular closures.

The college said Atkinson can apply to have his existing prescription restrictions lifted only after a period of two years of practise.

Audit found poor record keeping

Through its investigation, the college's auditor found Atkinson kept poor records.

For example, the auditor noted there were "virtually no histories" recorded by Atkinson. The auditor said Atkinson relied heavily on the triage nurse report.

The auditor also found that medications prescribed "rarely" had dosages or quantities recorded unless noted by the nurse.

The college noted there were no other reports of "adverse outcomes" during its investigation, apart from the care of the grandmother.

Atkinson attended courses to improve his record keeping in March 2016, the college noted.

The auditor's findings, combined with the grandmother's case, were enough for the college's investigation committee to place an interim suspension on Atkinson's license on June 7, 2016.

Past complaints

The college noted five complaints were made against Atkinson between 1995 and the present. Three of the complaints "involved issues of clinical competence, two of which result in reprimands with consent."

Atkinson was also reprimanded by the college for continuing to write prescriptions for narcotics despite drug prescribing restrictions dating back to 2008.