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CMPA Malfeasance in Courtroom and Hospital

Canadian Medical Protective Association

Sask Judge Robert D. Laing:  CMPA Career Arc
1967 Robert Laing obtained LL.B. degree from the University of Saskatchewan.
1970 Laing articled with McKercher Law Firm in Saskatoon, Saskatchewan. That firm was (and still is) dedicated to the CMPA.
1976
circa
Laing became a full partner at McKercher, which was renamed McKercher McKercher Stack Korchin & Laing. His name on the letterhead means Laing wholly embraced the goals of the firm.
1970
to
1994
Laing worked at McKercher Law Firm for 24 years: In litigation he represented Defendant doctors on behalf of the CMPA.
1994 Laing was elevated to the bench of Sask Q.B. Court: Laing became a judge, but did not leave his CMPA loyalties behind.
2006 Laing was appointed Chief Justice of Queen's Bench Court in Saskatchewan.
2012 Laing stepped down as Chief Justice and elected supernumerary status with the Court of Queen's Bench.

Mocking the Historical Role of Judge

Without a qualm, Saskatchewan Q.B. Chief Justice Robert D. Laing swept an entire array of defence evidence off his desk. Without reading, glancing at, or alluding to this material, Judge Laing pretended the exhibits and proofs did not exist.

Judge Robert Laing decided the case in advance, before the parties ever appeared in court. Such conduct mocks the historical role of a Judge. The conduct is in keeping, however, with this man's lifelong career arc. Robert D. Laing began his legal career as a CMPA lawyer with the McKercher Law Firm in Saskatoon, Canada.

The CMPA – or Canadian Medical Protective Association – is the national organization which defends doctors in court in Canada, whether the proceedings are civil (such as a malpractice lawsuit) or criminal (such as charges of over-billing or assault).

The Canadian Medical Protective Association was founded in 1901, and incorporated in 1913. A few years later, the CMPA Annual Report of 1919 spelled out their goals in chilling language. For over a century the CMPA has pursued these goals, leaving in its wake a harsh but illustrative record.

  • One goal of the CMPA is Stacking the Judicial Bench, as described in the History booklet written by the CMPA in 2001 to commemorate its 100-year anniversary. That this goal has brazenly succeeded finds a concrete illustration in the events surrounding Judge Robert D. Laing.
  • Another CMPA goal is to Sway Silent Influence Against Litigants including gambits to exhaust the plaintiff's finances and spirit during a court case. Silent, insidious retaliation can extend to deficient hospital or clinic care toward a patient who has given evidence in a malpractice case. A concrete illustration is Dr. Peter Siemens at St. Paul's Hospital, Saskatoon.

CMPA Malfeasance in the Courtroom

Q.B. Chief Justice Robert Laing Mishandled Defence Evidence

The Registrar
Queen's Bench Court of Saskatchewan
520 Spadina Crescent East
Judicial Center of Saskatoon

Case Reference:  QBJ 5/07

Dear Queen's Bench Court:

The fiat of Judge Robert Laing, which was prepared on March 9, said:

[20]  Ms. Sil did not call defence evidence at the preliminary inquiry.

That is completely false.  In fact, the defence called considerable evidence:

Exhibits

The defence filed 24 defence exhibits marked D-1 through to D-24.

Statement

On July 6th in Court, I made a formal Defence Statement pursuant to CCC section 541(3) of the Procedure on Preliminary Inquiry. My Defence Statement covers 109 continuous pages of the Prelim Court Transcript. It starts on page #929 and runs to page #1037.

Witnesses

The defence called one witness, Insp. Allan Stickney, on November 20th. Although I needed to call other witnesses (such as Cst. Lee Jones), Judge Singer refused to allow more than one morning for the defence case at the Preliminary Inquiry.

The commentary by Judge Laing raises a concern about the integrity of the defence exhibits. I ask the Court Clerk or the Registrar to review the file and determine:

  • Where exhibits D-1 to D-24 are stored;
  • Where the Court Transcripts for July 6 and November 20 are; and
  • Whether the July 6 Transcript contains the pages #929 to #1037 encompassing my Defence Statement.

When my defence exhibits were filed in Court, they were listed on the Index page of the relevant Preliminary Inquiry Transcripts. The Index pages are enclosed. There is one exception: I could not locate a reference to exhibit D-15, though it was accepted by Judge Singer.

Also enclosed are the first and last pages of my Defence Statement.

Yours truly,
Georgena Sil

cc:  Jim Plemel, Regional Crown Prosecutor

CMPA Malfeasance in the Hospital

Treatment Withheld after Patient Gives Evidence in Malpractice Case

Plasmapheresis (plasma exchange to filter antibodies) is the only effective treatment known for Guillain-Barre Syndrome. Yet that treatment was withheld from me, and the Saskatoon medical community was not shy in telling me their vengeful reason: It was because I gave evidence in a malpractice lawsuit just one month before I developed the acute paralytic disease Guillain- Barre Syndrome.

𝁵 𝁵 𝁵 𝁵 𝁵

Guillain-Barre Syndrome is an autoimmune disease which attacks the myelin segments which wrap around and insulate the peripheral nerves. The myelin, and sometimes the axon or core of the peripheral nerve, dissolves. The patient is rapidly paralyzed.

The autoimmune process is triggered by antiganglioside antibodies. The acute phase of Guillain-Barre Syndrome lasts as long as anti-GM1 and other antibodies circulate in the bloodstream. When the antibody level falls, recovery begins.

Peripheral nerves re-grow at the (very slow) rate of one inch per month. Recovery is a long road back. What is worse: Guillain-Barre patients are often left with a residual deficit. There can be autonomic dysfunction, and profound muscle fatigue. The patient faces these limits for a lifetime.

Peripheral nerves undergo less damage if the acute phase is short. To artificially shorten that phase, neurologists normally order a procedure called plasmapheresis which filters the large-diameter antibodies out of the bloodstream. With plasmapheresis there is less initial nerve damage, and by extrapolation, fewer residual deficits long-term.

Guillain-Barre has two diagnostic criteria:  (1) A lumbar puncture must show elevated protein in the cerebrospinal fluid accompanied by a normal number of white-blood cells.  (2) Electrodiagnostic testing of peripheral muscles must show signs such as low signal amplitude, slow conduction velocity, absent F Waves, or conduction block. The ragged appearance of the Nerve Conduction Velocity graphs, when contrasted with the smooth fast sine waves of normal muscle, illustrate just how serious this disease is.

Deliberate Dereliction of Duty by a Physician

It would take an act of extraordinary malice from a neurologist to admit a patient into the hospital; to verify the diagnosis of Guillain-Barre by spinal tap and NCV tests; to know that plasmapheresis equipment was available locally; to have no medical reason why the treatment should not be used; but to withhold treatment anyway because the specialist has a retaliatory agenda.

𝁵 𝁵 𝁵 𝁵 𝁵

Background: In 1986 I reported Dr. Kenneth Blocka to the College of Physicians and Surgeons of Saskatchewan, the governing and disciplinary body for physicians. Dr. Blocka was a rheumatologist on staff at University Hospital in Saskatoon. The basis of my formal complaint was that Dr. Blocka botched a major, very expensive, referral to the Mayo Clinic where I attended for a week.

Of vital importance was my history of Nuclear Medicine Scans performed in Saskatoon over the previous years: all were positive, all were diagnostic. Dr. Blocka ignored these scans, and lost (or outright hid) the physical films in his office instead of forwarding them to the Mayo Clinic. Errors of information also existed in Dr. Blocka's chart.

When I asked Dr. Kenneth Blocka to correct his mistakes, he refused. Instead Blocka embarked on a prolonged, abusive backlash. The College took no action to stop the backlash. Therefore in 1987 I filed a Statement of Claim to initiate a malpractice lawsuit in Saskatoon Queen's Bench Court. The case was Q.B. #514/87.

After filing my Claim, the backlash from Dr. Blocka escalated. My family physician at that time, Dr. Roy Chernoff, saw my grief and explained the dynamics to me. Chernoff told me, in these precise words:

Dr. Blocka wants to find out all your sources of support, so he can turn them into sources of harassment.

If you bash anybody long enough, they are bound to break down.

Dr. Blocka hopes to make you break down before his malpractice suit goes to trial.

By 1989, after three years of intrusion with no let-up, I sought judicial intervention. I reported those comments, and many similar ones, to the Queen's Bench Court. The court ordered Dr. Blocka to sign a Restraining Order. Dr. Blocka's lawyer (Richard Elson) did not approve of his client's conduct, and promised the judge that he would lean on Dr. Blocka to sign the Restraining Order.

A month later, in September 1989, I developed Guillain-Barre Syndrome. Although I was hospitalized for two months, I did not receive plasmapheresis (plasma exchange) which is the only effective treatment that can shorten the course of Guillain-Barre.

Why was plasmapheresis withheld? My GP at the time, Dr. Hugh McKee, was negligent because he panicked in the face of a rare disease. But my neurologist Dr. Peter Siemens was criminally culpable. Literally: He knew about plasma-exchange; as a specialist he had perfect authority to order it; but he deliberately withheld it.

I can still recall his conversation with me in my hospital room. Dr. Peter Siemens raised the topic of plasmapheresis just once – in disparaging tones – then he added, You don't want that. I asked what the treatment was, and followed up with a couple of questions. At the end of the conversation Dr. Siemens uttered a clear threat, snarling, Go to University Hospital and see what happens to you!

The meaning of the threat: The city of Saskatoon owns one plasmapheresis machine, on site at Royal University Hospital. If a patient elsewhere needs plasmapheresis, then he or she is routinely transferred to University Hospital, at least temporarily. My location was St. Paul's Hospital (central to Saskatoon) but I was not transferred. No chart entry exists that mentions plasmapheresis at all for my case.

Dr. Kenneth Blocka, the physician of my past complaint, worked at University Hospital on the permanent staff. Dr. Blocka incited among his colleagues an attitude of targeted malice toward me, to the point where medical treatment was refused in an emergency. The brutal tactics from Dr. Blocka were condoned by the Canadian Medical Protective Association.

Ethical Flaws and Defects of Character

A Prescription for the Rogue Doctor

The journal Clinical Orthopaedics and Related Research published a two-part series entitled A Prescription for the Rogue Doctor. The abstract is frank:

A Prescription for the Rogue Doctor:  Part I – Begin With Diagnosis

Among the most serious problems a physician can have are those which result from a defect of character or a flaw in ethics. Unacceptable behavior patterns which may arise include dishonesty, intentionally harming a patient, sexual harassment, and substance abuse. For years, such doctors have been handled with kid gloves.

Typical protocols in response have been counseling, coaching, training, supervising, transfer to a less critical specialty, disciplinary warning, or offering an opportunity to resign. Traditionally, outright firing of doctors and residents has been relatively taboo and too radical for the medical profession.

Why has this been the case? Reasons include unwillingness to get involved or to deal with the stress of disciplining a colleague – an unwillingness often grounded in fears of retaliation. In a litigious society, fears of slander lawsuits may be all-too-real.

One must face a litigation trade-off:  In time, problem doctors may represent enormous liability for organizations that employ them. Protecting doctors' careers by preserving their professional status has an adverse impact on the well-being of patients. Part I of this series defines the problems that now exist, as a cornerstone for removing rogues from the system.

A Prescription for the Rogue Doctor:  Part II – Ready, Aim, Fire

Rogue doctors have serious sociopathic behavioral deficiencies. Unacceptable behavior is a certainty, yet only weak counter measures exist. In Part II we discuss a performance management system to remove rogues from the system.

When dealing with a rogue who has taken advantage of people and hurt them for years, the only way to get the rogue's attention is to keep the pressure on. We suggest this step-wise disciplinary action: a verbal reprimand; then a formal written reminder; then a paid 1-day decision-making leave. If expectations cannot be met, the rogue is given a choice to resign or be discharged.

One problem remains: The rogue will move on, but where to? To remove safe havens, organizations must be wary, especially where the MD's record shows a history of brief work locations, with no explanation. If everything does not check out, do not hire.

Employers must have a working knowledge of two concepts: just cause and due process. Just cause requires (1) Notice, (2) Reasonable rules and orders, (3) Investigation before accusation, (4) Fair investigation, (5) Proof of misconduct, (6) Equal treatment, and (7) Penalty in proportion to offence. Due process means the physician is confronted with evidence, given adequate time to prepare a defense, and opportunity to face accusers.

Georgena S. Sil
Saskatoon, Canada
Physicist & Technical Writer
Alumnus: University of British Columbia
TuumEstContact@protonmail.com

Copyright © 2008-2018 Georgena Sil. All Rights Reserved.