Dr. A. John Metzger – April 2017

THIS HEARING was held on April 24, 25, and 26, 2017 in Toronto, Ontario.

ON READING the Notice of Hearing, considering the evidence and hearing the submissions of counsel for the College of Optometrists of Ontario (the “College”):

A. THE DISCIPLINE PANEL FOUND

1. That Dr. A. John Metzger (the “Member”) is incompetent, as that term is defined in subsection 52(1) of the Health Professions Procedural Code of the Optometry Act, 1991, S.O. 1991, c. 35, as amended, in that his professional care of Patient A, Patient B, and Patient C, displayed a lack of knowledge, skill or judgment of a nature or to an extent that demonstrates that he is unfit to continue to practise or that his practice should be restricted.

2. That the Member committed an act or acts of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Optometry Act, 1991, S.O. 1991, c. 35, as amended, and defined in paragraph 1.14 of Ontario Regulation 119/94, in that, between approximately 2012 and 2015, he failed to maintain the standards of practice of the profession in relation to his care and management of Patient A, Patient B, and Patient C.

3. That the Member committed an act or acts of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Optometry Act, 1991, S.O. 1991, c. 35, as amended, and defined in paragraph 1.11 of Ontario Regulation 119/94, in that, he failed to refer Patient A to another professional whose profession is regulated under the Regulated Health Professions Act, 2001, when he recognized or should have recognized a condition of the eye or vision system that appeared to require such a referral.

4. That the Member committed an act or acts of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Optometry Act, 1991, S.O. 1991, c. 35, as amended, and defined in paragraph 1.39 of Ontario Regulation 119/94 in that, between approximately 2012 and 2015, he engaged in conduct or performed an act that, having regard to all the circumstances, would reasonably be regarded by members as unprofessional regarding his care and management of Patient A, Patient B, Patient C, and Patient D.

B. THE DISCIPLINE PANEL MADE THE FOLLOWING ORDER:

1. Requiring the Member to appear before the Panel to be reprimanded within two (2) months of the date this Order becomes final.

2. Directing the Registrar to suspend the Member’s Certificate of Registration until such time as the Member completes the remedial activities set out in paragraph 3(a), below.

3. Directing the Registrar to impose the following terms, conditions and limitations on the Member’s Certificate of Registration:

a. The Member must complete, at the member’s expense, a minimum of 35 hours of direct (one-on-one) learning sessions (the “Sessions”) with a practice coach, who has been preapproved by the Registrar. The total number of hours for the Sessions shall be determined by the practice coach, who, at the completion of the Sessions, shall submit to the Registrar a written report confirming that the Member has gained sufficient knowledge and skill to diagnose and manage patients with glaucoma or suspicion of glaucoma and to maintain patient records in accordance with the standards of practice of the profession. The subject matter of the Sessions shall focus on:

i. maintenance of accurate patient records in accordance with the standards of practice of the profession;

ii. improving the Member’s knowledge, skill and judgement in the assessment, diagnosis and management of patients with glaucoma, or a suspicion of developing glaucoma, and the indications for and performance of techniques and clinical applications and analysis of results in:

o stereoscopic optic nerve assessment under high magnification (by fundus biomicroscopy with 90D or 78D lens or other similar type of lens),
o applanation tonometry,
o gonioscopy,
o pachymetry, and
o specific visual field testing.

b. Following successful completion of the Sessions referred to in 3(a), above, the Member shall only practice under the direct supervision of another member of the profession (the “Supervisor”), pre-approved by the Registrar, until such time as the Supervisor provides a written report to the Registrar confirming that the Member has successfully incorporated his practice and is exercising appropriate judgement in relation to the subject areas identified in 3(a), above. Any expenses or costs associated with the Supervisor shall be borne by the Member.

4. Directing the Member to partially reimburse the College for its costs in relation to this proceeding in the amount of $75,000 according to the following schedule:
a. one cheque in the amount of $25,000 delivered to the College within two (2) months of the date this Order becomes final;

b. one cheque in the amount of $25,000 delivered to the College within seven (7) months of the date this Order becomes final; and

c. one cheque in the amount of $25,000 delivered to the College within twelve (12) months of the date this Order becomes final

Read the Notice of Hearing.

Read the full Discipline decision.