Summerside doctor admits to professional misconduct

A Summerside gynecologist has admitted to professional misconduct related to a procedure he performed without a patient's consent in 2017. 

Dr. Henry Swart made the admission in an agreed statement of facts which was presented at a board of inquiry of the College of Physicians and Surgeons of P.E.I. in Charlottetown on Tuesday. 

Swart, 61, admitted to performing a cystotomy — an incision into the bladder — while a patient was under anesthesia for another procedure. He performed the cystotomy even though the patient had told him that she did not want any other surgery without her consent, and did not want him to touch her bladder.

Complications after previous surgery

The cystotomy was performed during a follow-up surgery after complications from a hysterectomy.   

The patient consented to certain procedures that could be done while she was under anesthesia, but she specifically said she did not want any other surgeries done without her consent.

According to facts read out at the hearing, Swart had some ideas of what might be causing the complications, but didn't mention all of them to the patient before she had the surgery.

He said it was only during the surgery that he found the cause, and performed a cystotomy in an attempt to fix the problem.

But the procedure was not successful. 

The patient told the investigator that she felt violated. She had to have a catheter until she had corrective surgery in Halifax several months later, and she used about 700 hours of sick leave from her job. 

Admits wrongdoing, says intentions were good

In the agreed statement of facts, Swart said he was wrong to do the cystotomy without the patient's consent and feels remorseful for unnecessary pain and suffering he may have caused.

He said he performed the additional surgery with good intentions in an effort to repair complications and avoid the need for additional surgery. He made the decision to perform the cystotomy during the course of the surgery, and felt it was a fairly minor procedure.

This is not the first time Swart has faced disciplinary measures. In 2009 and 2011, the college found Swart failed to demonstrate skills or judgment when treating a condition called cervical dysplasia. Swart no longer deals with patients with that condition.

Decision within 30 days

The lawyer for the college, Gordon MacKay, and Swart's lawyer Thomas Laughlin submitted a joint recommendation that Swart's medical licence be suspended for three months, that he complete a course at Dalhousie University related to consent and patient autonomy, that he pay a $5,000 fine to the college as well as up to $15,000 for costs associated with the investigation and proceedings. 

The board will make its recommendations within 30 days, and the council of the College of Physicians and Surgeons of P.E.I. will make the final decision after that.

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