Hamilton doctor suspended after he ‘knowingly endangered patients’ by performing nerve blocks at unapproved clinics

A Hamilton doctor has been handed a suspension by the College of Physicians and Surgeons of Ontario for professional misconduct and failure to maintain standard of practice.

Dr. Suneel Upadhye, a chronic pain and emergency medicine physician, was barred from practice for four months on Jan. 15.

The penalty came in the wake of a college investigation that revealed Upadhye performed thousands of nerve blocks at two free-standing clinics over a period of several months in 2013 and 2014.

Neither of the clinics were approved to perform interventional pain management by the college's out-of-hospital premises inspection program (OHPIP).

The college said in its decision issued April 9 that Upadhye knowingly endangered the public" when he failed to inform the college about the procedures and committed an ethical breach when he made false statements" to investigators about whether he conducted them.

By providing inadequate care to his patients, and intentionally avoiding the oversight of (OHPIP), which depends on physician honesty, Dr. Upadhye placed the public at risk of harm, and betrayed the trust of the public, the members and his regulator," the decision states.

Upadhye, who is also an associate professor of medicine at McMaster University, admitted to the allegation of professional misconduct.

He did not respond to The Spectator's request for comment.

The misappropriated pain procedures date back to at least 2011, according to the college's decision, when Upadhye worked at the Wellbeings Pain Clinic in Burlington and the Minerva Pain Management Clinic in Hamilton.

He became medical director of the latter in November 2013.

In March 2014, the decision states, Upadhye informed the college he was performing pain procedures at the Wellbeings clinic and sought approval from OHPIP.

But he did not do so for the Minerva clinic, where the same procedures were being performed without approval.

As the lead physician and medical director of the Minerva clinic, it was Dr. Upadhye's duty to inform OHPIP," the decision states. Not only did Dr. Upadhye choose not to inform OHPIP that the Minerva clinic had been providing (the) procedures in March 2014, he continued to provide the procedures himself at the location until July 2014."

The Wellbeings clinic failed an on-site inspection in July 2014 that revealed multiple deficiencies" at the practice. It was ordered to stop performing interventional pain procedures.

The college said Upadhye stopped performing nerve blocks after the Minerva clinic moved to 10 Ewen Rd. in May 2014.

Three years later, however, the college again received information that the clinic was providing unsanctioned pain procedures to patients.

Minerva failed an unannounced OHPIP assessment in November 2017.

That same month, the decision states, Upadhye wrote to the college that Minerva had no desire to pursue out-of-hospital premises (OHP) status as there has never been any interest in doing" nerve block procedures at the clinic and there will be none going forward ... we can reconfirm that we have not and will not be doing any OHP procedures in our facility."

This was clearly not true," the college said in its decision, pointing to the clinic's failed inspection.

The college also took issue with Upadhye's claim that Minerva had never conducted nerve blocks at its facilities.

Upadhye told the college through his counsel that, to the best of his knowledge, OHIP was never billed for nerve block services during his tenure at Minerva.

But OHIP billings tabled in the decision show Upadhye billed roughly $67,000 for more than 2,000 pain procedures at the clinic from Oct. 4, 2013 to July 17, 2014.

The college called Upadhye's hazy recollection of OHIP billings misleading at best" and said his conduct at the Minerva and Wellbeings clinics was disgraceful," dishonourable" and unprofessional."

A physician's lack of honesty can jeopardize public safety," the decision states. This is an ethical breach that stands in direct contrast to his duty as a physician to act in the best interests of his patients and provide them with safe care."

The failure to maintain standard of practice penalty in the decision stems from a June 2019 college review of five of Upadhye's patient charts at the Minerva clinic.

All of them failed to meet the standard of practice and revealed numerous highly concerning (and) serious deficiencies in Dr. Upadhye's care," the decision states.

This was not the first time Upadhye has fallen under the college's disciplinary purview.

In 2017, Upadhye was one of several Ontario doctors who were sanctioned after a collegewide crackdown on cyberbullying.

The sanction came after Upadhye referred to former Health Minister Dr. Eric Hoskins on a Facebook forum as Reichminister Hoskins," according to a past college decision.

Upadhye's recent suspension commenced on Feb. 1 and concludes June 1. He was also ordered to pay $6,000 in costs to the college.

Sebastian Bron is a Hamilton-based reporter at The Spectator. Reach him via email: sbron@thespec.com