File # 21-CRV-0064  
HEALTH PROFESSIONS APPEAL AND REVIEW BOARD  
PRESENT:  
Bonita Thornton, Designated Vice-Chair, Presiding  
Cathy Loik, Board Member  
Mitchell Toker, Vice-Chair  
Review held on March 29, 2022 in Ontario (by teleconference)  
IN THE MATTER OF A COMPLAINT REVIEW UNDER SECTION 25(3) of the  
Veterinarians Act, R.S.O. 1990, c. V. 3, as amended  
B E T W E E N:  
CARMIE DI GIACOMO  
Applicant  
and  
SHAWN MIDDLETON, DVM  
Respondent  
Appearances:  
The Applicant:  
The Respondent:  
For the College of Veterinarians of Ontario:  
Carmie Di Giacomo  
Shawn Middleton, DVM  
Cindy Rose  
DECISION AND REASONS  
I.  
DECISION  
1.  
The Health Professions Appeal and Review Board confirms the decision of the  
Complaints Committee of the College of Veterinarians of Ontario to state its expectation  
that veterinarians conduct themselves in a professional and respectful manner in all  
interactions with clients no matter how challenging and its expectation that veterinarians  
conduct discussions about euthanasia with sensitivity and compassion given that end of  
life decisions are challenging and emotionally stressful for pet owners, and to take no  
further action.  
2.  
This decision arises from a request made to the Health Professions Appeal and Review  
Board (the Board) by Carmie Di Giacomo (the Applicant) to review a decision of the  
Complaints Committee (the Committee) of the College of Veterinarians of Ontario (the  
College). The decision concerned a complaint regarding the conduct and actions of  
Shawn Middleton, DVM (the Respondent). The Committee investigated the complaint  
and decided to state its expectations, as set out above, and to take no further action.  
II.  
BACKGROUND  
3.  
In August 2018, when the Applicant’s German Shepherd, Frank, was five years old, he  
started to experience numerous medical issues, including an issue with his right front  
paw. Frank was treated with anti-inflammatories by a veterinarian at the Foster  
Veterinary Service (FVS), a house call service, where the Applicant was cautioned that  
the paw was a location where tumours were often found.  
4.  
By July 2019, the Applicant was concerned that Frank had a urinary tract infection and he  
was vomiting. The Applicant brought Frank to the Dundas Animal Hospital (DAH)  
which owned FVS and where the Respondent worked as a veterinarian. Over the next  
two months Frank was prescribed Clasepetin, Cerenia, Sucralfte, Pepcid AC and  
Cartrophen, an injectable medication with anti-inflammatory and anti-arthritic properties.  
The Applicant returned with Frank for additional visits at DAH and ongoing treatment;  
however, Frank’s condition continued to deteriorate.  
5.  
6.  
On August 24, 2019, the Applicant phoned DAH and requested intravenous penicillin for  
Frank. The Respondent phoned the Applicant back, at which time a disagreement over  
Frank’s diagnosis, treatment and next steps occurred.  
Sadly, Frank passed away within a few days later.  
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The Complaint and the Response  
The Complaint  
7.  
The Applicant complained that the Respondent failed to provide professional and  
appropriate veterinary care and services to the Applicant and Frank, and as a result,  
Frank’s health deteriorated, and he passed away. Specifically, the Applicant complained:  
a)  
When the Respondent contacted the Applicant by telephone in response to  
her calling DAH seeking intravenous (IV) penicillin for her dog Frank, as  
the Applicant was of the opinion that Frank had an infection in his paw,  
the Respondent was verbally abusive, aggressive, explosive, assaulting,  
hostile, and was yelling and screaming. He could not control his emotions  
or rage/anger towards the Applicant. He then hung up the telephone while  
the Applicant was attempting to get medical help for Frank.  
b)  
c)  
The Respondent refused to provide IV penicillin for Frank even though he  
had previously sold the Applicant a bottle of Cartrophen.  
The Respondent made unsubstantiated assumptions about Frank’s health  
(i.e., claimed that Frank had cancer even though he had never performed  
any diagnostic testing).  
d)  
Despite being on call for Frank’s regular veterinarian, the Respondent  
refused to provide veterinary help to Frank, knowing that without timely  
veterinary intervention, Frank could become septic, and this would result  
in death. The Respondent did not want to see Frank.  
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e)  
f)  
On July 16, 2019, the Respondent made a medication error when he  
dispensed the incorrect amount of pills that he prescribed and also  
provided incorrect instructions (i.e., he told the Applicant to give 1 pill 3  
times a day, when the bottle said 3 pills once a day).  
When Frank was presented to the Respondent on August 16, 2019, the  
Respondent failed to treat Frank for the infection by dispensing antibiotics  
as requested by the Applicant, but instead, performed an x-ray which the  
Applicant did not request. The Respondent did not perform any tests to  
establish what type of infection Frank had, nor did he suggest obtaining a  
second opinion.  
g)  
h)  
i)  
The Respondent was uncompassionate, cruel, callous and cavalier when  
he told the Applicant to euthanize Frank.  
The Respondent failed to contact the Applicant by telephone or by letter to  
apologize for his unprofessional behavior towards her.  
The Respondent failed to show remorse or take responsibility for his  
behaviour towards the Applicant or his failure to provide appropriate  
veterinary services to Frank.  
j)  
The notes in the Respondent’s medical record for Frank were self-serving  
and did not accurately reflect the facts of the incidents nor did they reflect  
the Respondent’s unprofessional conduct.  
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The Response  
8.  
In a letter to the College, the Respondent provided an overview of his care of Frank and  
addressed the Applicant’s concerns by indicating that:  
The Applicant telephoned DAH on Friday August 23, 2019, to request injectable  
antibiotics as she felt Frank’s issues were related to an infection. Dr. D, another  
veterinarian who had treated Frank, noted in Frank’s medical record that there  
was an injectable antibiotic that might be used for the skin, but that it was highly  
unlikely that there was an infection, and noted that Frank was on clindamycin (an  
oral antibiotic) and duoxo pyo spray (a topical antiseptic spray). The Applicant  
was informed that another clinic veterinarian, Dr. F, would be at the clinic on  
Monday, and further advised the Applicant to go to Hamilton Region Emergency  
Veterinary Clinic if the situation persisted over the weekend.  
The Applicant telephoned DAH again on Saturday, August 24, 2019, requesting  
injectable penicillin. The Respondent telephoned back to discuss the issue and  
explained that Frank was already on antibiotics and it would not be prudent to use  
injectable antibiotics given that Frank had a bone tumour, and that Frank should  
be seen immediately for an examination or further care. The Applicant did not  
accept the advice and started to verbally attack the Respondent.  
The Respondent decided not to dispense the IV penicillin due to the fact that  
Frank was already on clindamycin (orally) and duoxo pyo spray (topically), and  
had previously been on clavaseptin and sulfa-trethoprim in the past few weeks.  
The use of antibiotics would not have been prudent and the underlying cause of  
Frank’s pain was the bone tumour, not an infection.  
Frank’s diagnostic radiograph showed severe bone lysis and was highly indicative  
of osteosarcoma (a bone tumour), or other aggressive lytic process.  
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Every time the Applicant phoned DAH they responded with a call back or made  
an appointment to see Frank. The house-call schedule was fully booked when the  
Applicant phoned on August 23, so they offered to see Frank at DAH, which the  
Applicant declined.  
With respect to the concerns with some of Frank’s medications, Omepraxole was  
dispensed in July and the instructions on the label stated to give three tablets  
orally once daily. On July 29, another veterinarian with the clinic, Dr. F, made a  
house call and noted that the Applicant was giving Frank omeprazole 20mg  
tablets three times daily instead of three tablets once daily.  
The Applicant phoned on August 16 for a house call re-check. The Respondent  
explained that a radiograph was needed before dispensing any further medications  
so that they could make a diagnosis and rule out bone involvement, but  
radiographs could not be done at house calls. The Applicant and her son assisted  
Frank into the clinic that afternoon and a radiograph was completed.  
The results of Frank’s radiographs were discussed with the Applicant and they  
were informed that there was severe bone lysis and that was indicative of  
osteosarcoma, and not an infection, and that a referral to an oncologist would be  
needed. The Applicant declined the referral.  
The Respondent had discussions with the Applicant on previous visits about  
quality of life and the Respondent explained that tough decisions were going to  
need to be made if Frank was unable to walk on this own. At the August 16 visit  
Frank’s leg was swollen and he was unable to stand on his own. Frank was also  
suffering paresis in the hind end from his spinal disease and this, combined with  
what was seen on the radiographs, indicated that Frank was suffering. The  
Respondent dispensed tramadol for Frank’s pain before he was taken home.  
The Respondent denied acting unprofessionally during any of the visits. The  
Respondent stated that he advocated in the best interest of Frank.  
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After the August 16 visit, Dr. F went on another house call to see Frank and  
dispensed antibiotics and discussed euthanasia or a surgery referral for Frank with  
the Applicant.  
The notes in the medical records reflect the conversations and treatments as they  
occurred.  
The Committee’s Decision  
9.  
The Committee investigated the complaint and decided to state its expectations, as noted  
above, and to take no further action.  
10.  
In reaching its decision, the Committee indicated that it considered the details of the  
Applicant’s complaint and the information in the response from the Respondent. The  
Committee addressed the Applicant’s concerns as follows.  
The Respondent was verbally abusive, aggressive, explosive, assaulting, hostile, and was yelling  
and screaming and could not control his emotions or rage/anger towards the Applicant, and he  
hung up the telephone while the Applicant was attempting to get medical help for Frank.  
11.  
The Committee stated that it was presented with conflicting accounts of this conversation  
and was not in a position to establish credibility by preferring one version of events over  
the other. The Committee noted that the Applicant indicated that the Respondent was  
verbally aggressive towards her and the Respondent asserted that the Applicant began  
verbally attacking him when he declined to dispense injectable antibiotics. The  
Committee decided to take no further action, while stating its expectation that  
veterinarians conduct themselves in a professional and respectful manner in all  
interactions with clients no matter how challenging.  
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12.  
The Committee commented that the situation appeared to have been emotionally taxing  
given that the Applicant feared for Frank’s well-being and she was concerned about the  
pain Frank was experiencing. The Committee stated however that it was the  
Respondent’s prerogative to exercise clinical judgement in the best interest of the patient  
and to not dispense the injectable antibiotic.  
13.  
The Committee also observed that when a veterinarian is not in a position to meet a  
client’s demand that does not in and of itself reflect anger on the part of the veterinarian.  
The Committee noted the Applicant’s comment that a veterinarian’s duty is to do no  
harm, and the Committee stated that it appeared that the Respondent was endeavoring to  
avoid harm to Frank by not prescribing what was likely an ineffective antibiotic, and to  
recommend that Frank be taken to the emergency hospital.  
The Respondent refused to provide IV penicillin for Frank even though he had previously sold  
the Applicant a bottle of Cartrophen.  
14.  
The Committee indicated that it did not consider it was reasonable to compare dispensing  
a bottle of Cartrophen to dispensing injectable antibiotics and stated that Cartrophen is  
used in dogs as an adjunct treatment for arthritis, given once weekly for four weeks, then  
once monthly, and has few to no side effects or contraindications. The Committee added  
that the issue of antibiotic resistance must be taken into consideration when considering  
administering antibiotics in treatment. The Committee noted that there had also been a  
concern that Frank was vomiting and that this was possibly caused by antibiotic use.  
15.  
In reference to intravenous penicillin, the Committee stated that veterinarians do not  
dispense antibiotics to be given at home intravenously to small animals and that it would  
not have been medically responsible to dispense the medication to Frank even if it had  
been available. The Committee noted that the medical record confirmed that Frank was  
already on clindamycin, another antibiotic, and the Committee stated in its opinion there  
would have been no medical benefit to add penicillin. The Committee concluded that it  
appeared the Respondent exercised appropriate clinical judgement.  
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The Respondent made unsubstantiated assumptions about Frank’s health (i.e., claimed that  
Frank had cancer even though he had never performed any diagnostic testing).  
16.  
The Committee noted the Respondent’s differential diagnosis for the results of the  
radiograph of Frank’s front leg was osteosarcoma and that this was a diagnostic test. The  
Committee stated that the only other confirmatory test would have been a biopsy,  
however the Committee agreed that osteosarcoma was a reasonable conclusion, and that  
there was no other condition in Ontario that would obliterate bone in the way Frank’s  
distal radius and ulna were destroyed. The Committee stated that these conditions would  
not have been responsive to antibiotics.  
Despite being on call for Frank’s regular veterinarian, the Respondent refused to provide  
veterinary help to Frank, knowing that without timely veterinary intervention, Frank could  
become septic, and this would result in death. The Respondent did not want to see Frank.  
17.  
The Committee indicated that, in addition to the information from the Applicant and the  
Respondent, it reviewed statements from several witnesses who confirmed the Applicant  
was offered an appointment at DAH, which she declined, and that she was advised that  
she could take Frank to an emergency hospital. The Committee stated that offering an  
appointment and suggesting a referral fulfills the requirements to provide veterinary  
services. The Committee stated that it was satisfied that these were reasonable and  
appropriate recommendations and that a mechanism was in place at DAH to adequately  
serve the clients in these circumstances.  
The Respondent made a medication error when he dispensed the incorrect amount of pills that  
he prescribed and also provided incorrect instructions.  
18.  
The Committee indicated that it reviewed a computerized copy of the original medical  
label for the Omeprazole which indicated that three tablets were to be given once daily.  
The Committee stated that as this information was provided to the Applicant in writing in  
the form a label on the medication bottle, no dispensing error appeared to have been  
made.  
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The Respondent failed to treat Frank for the infection by dispensing antibiotics as requested by  
the Applicant, did not perform any tests to establish type of infection, and did not suggest  
obtaining a second opinion.  
19.  
The Committee noted that the Respondent took radiographs of Frank’s leg and showed  
the Applicant the radiographs and explained that there was severe bone lysis indicative of  
osteosarcoma, and not an infection. With respect to the issue of an infection in Frank’s  
leg, the Committee stated that a temperature may have been unreliable because Frank was  
on steroids. The Committee noted that there was no indication in the medical records to  
make it suspicious of the presence of an infection and stated that signs of heat, redness  
and swelling may be confused with infection. The Committee stated that the radiographic  
results were supportive of a diagnosis of neoplasia, and that this was consistent with the  
prolonged history of Frank’s front leg.  
The Respondent was not compassionate, and was cruel, callous and cavalier when he told the  
Applicant to euthanize Frank.  
20.  
The Committee indicated that there were no unbiased third-party witnesses to the  
Respondent’s conversations with the Applicant about Frank’s quality of life. The  
Committee indicated it agreed that the radiographic findings indicated osteosarcoma in  
the front-right leg, a very painful condition, and stated that Respondent’s  
recommendation of euthanasia was made in Frank’s best interest, in particular given  
Frank’s mobility issues. The Committee decided that it would take no further action but  
stated it expected veterinarians to conduct discussions about euthanasia with sensitivity  
and compassion given that end of life decisions are challenging and emotionally stressful  
for pet owners.  
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The Respondent failed to apologize to the Applicant, and the Respondent failed to show remorse  
for his behaviour toward the Applicant or his failure to provide appropriate veterinary services.  
21.  
The Committee stated that the Respondent provided appropriate care to Frank in the  
circumstances. The Committee noted that the Applicant did not agree with the  
Respondent’s course of action and made demands on the Respondent that he was not in a  
position to fulfill. The Committee indicated while veterinarians should always be  
respectful in communicating sensitively with clients, they are expected to use their  
professional knowledge and judgement when deciding on how to treat patients and it is  
their prerogative to refuse to agree to clients’ demands if the treatment requested is  
inappropriate. The Committee stated that there did not appear to be any reasons to  
apologize to the Applicant for his actions.  
The Respondent’s notes in the medical record were self-serving and did not reflect the facts or  
reflect the Respondent’s unprofessional conduct.  
22.  
The Committee stated that Frank’s medical records appeared to be factual and consistent  
with the information in the billing records and the various witness statements provided to  
the Committee and did not appear to be self-serving or fail to accurately reflect events as  
they occurred. The Committee noted the timeline in the entries made by the Respondent  
were consistent with the recommendations for treatment and with another veterinarian’s  
clinical notations. The Committee stated that the Respondent’s medical records included  
appropriate details about history, physical examination, a description of Frank’s lesion,  
an assessment and recommendations, and the treatment provided. The Committee noted  
that the records also documented communications with the Applicant and the Committee  
stated that this was an integral component of medical records. The Committee concluded  
that the Respondent maintained appropriate medical records with respect to the care  
provided to Frank.  
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23.  
The Committee concluded that while it acknowledged the Applicant’s concerns about the  
Respondent, there did not appear to be sufficient evidence to indicate that that  
Respondent failed to provide professional and appropriate veterinary care and services  
III.  
REQUEST FOR REVIEW  
24.  
In a letter dated February 9, 2021, the Applicant requested that the Board review the  
Committee’s decision.  
IV.  
POWERS OF THE BOARD  
25.  
After conducting a review of a decision of the Committee, the Board may do one or more  
of the following:  
a) confirm all or part of the Committee’s decision;  
b) make recommendations to the Committee;  
c) require the Committee to take such action or proceeding as the Committee is  
authorized to undertake under the Veterinarians Act.  
26.  
The Board cannot recommend or require the Committee to do things outside its  
jurisdiction, such as make a finding of misconduct or incompetence against the member  
or require the referral of specified allegations to the Discipline Committee that would not,  
if proved, constitute either professional misconduct or incompetence.  
V.  
ANALYSIS AND REASONS  
27.  
Pursuant to section 25(11) of the Veterinarians Act, the mandate of the Board in a  
complaint review is to consider either the adequacy of the Committee’s investigation, the  
reasonableness of its decision, or both.  
28.  
The Board has considered the submissions of the parties, examined the Record of  
Investigation (the Record), and reviewed the Committee’s decision.  
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Adequacy of the Investigation  
29.  
An adequate investigation does not need to be exhaustive. Rather, the Committee must  
seek to obtain the essential information relevant to making an informed decision  
regarding the issues raised in the complaint.  
30.  
The Committee obtained the following information and documents:  
the letter of complaint from the Applicant and subsequent correspondence and  
responses, including confirmation of her complaint;  
the letter advising the Respondent of the complaint and College guidelines from  
the Committee investigator;  
the letter of response to the complaint from the Respondent and subsequent  
correspondence and responses;  
Frank’s medical records from the Respondent;  
Frank’s radiographs and laboratory results;  
information from clinic staff;  
information from additional treating veterinarians;  
information from the Applicant’s sister and brother-in-law;  
additional comments from the Applicant following receipt of the Record of  
Investigation (the Record); and  
the Respondent’s College profile and prior decisions.  
31.  
The Applicant submitted that the investigation was not adequate.  
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32.  
The Applicant submitted that she had requested that the Committee interview her, as well  
as her sister, her brother-in-law and her son. The Applicant submitted that they witnessed  
the events with the Respondent, but instead the Committee “did not bother” to speak with  
her family. The Applicant submitted that “this led to a process that was not fair or  
impartial and was weighed heavily in favour of the Respondent, and that the statements  
obtained by the Committee from staff at the Clinic were libelous statements about her and  
made in order to defend the indefensible, and that the staff members had a vested  
interest”. The Applicant requested that a new and impartial investigation be conducted.  
Along with the Applicant’s written submission, the Board received correspondence from  
the Applicant’s sister and brother-in-law about this matter.  
33.  
The Respondent submitted that both parties were able to make submissions to the  
Committee. The Respondent added that the witnesses who provided statements to the  
Committee investigator were staff members and that the Committee was following a  
process in interviewing staff.  
34.  
35.  
The Board finds that the investigation was adequate.  
With respect to the Applicant’s submission that the Committee should have interviewed  
members of the Applicant’s family, the Board finds that the Committee’s decision to not  
interview the family did not render the investigation inadequate. The Board observes that  
the Committee received the detailed description of the events and concerns from the  
Applicant over the course of the investigation. In addition, the Committee wrote to the  
Applicant’s sister, brother-in-law and son requesting they “provide a summary of their  
involvement in this matter” and the Committee received a letter in response from the  
Applicant’s family members. In addition, the correspondence from the Applicant’s sister  
and brother-in-law to the Board did not contain any new information that was not already  
before the Committee. The Board finds that there is no indication that the Applicant or  
her family members had additional information that would have affected the decision had  
subsequent interviews had been conducted.  
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36.  
The Applicant submitted that the Committee’s investigation process was not fair or  
impartial and favoured the Respondent, noting her concerns with the statements from the  
Respondent’s staff members. The Board observes from the information in the Record that  
the letters sent from the Committee investigator to the Respondent’s staff contained the  
same wording as the letter sent to the Applicant’s sister and brother-in-law. In addition,  
the Board received no compelling information that the responses to the Committee by the  
staff were false. The Board finds that there is no indication that the process the  
Committee used to obtain witness information was unfair or impartial.  
37.  
The Board notes that the Committee had the Applicant’s detailed complaint and the  
Respondent’s letter addressing each complaint. The parties had ongoing opportunities to  
provide further information and responses. In addition, the Committee obtained the  
relevant veterinary records and radiographs, including medical notes from other  
veterinarians who provided care for Frank, and information from the Respondent’s staff  
and the Applicant’s family members.  
38.  
The Board finds the Committee’s obtained essential information relevant to making an  
informed decision regarding the issues raised in the complaint. There is no indication of  
further information that might reasonably be expected to have affected the decision,  
should the Committee have acquired it. Accordingly, the Board finds that the  
Committee’s investigation was adequate.  
Reasonableness of the Decision  
39.  
In determining the reasonableness of the Committee’s decision, the question for the  
Board is not whether it would arrive at the same decision as the Committee. Rather, the  
Board considers the outcome of the Committee’s decision in light of the underlying  
rationale for the decision, to ensure that the decision as a whole is transparent, intelligible  
and justified. That is, in considering whether a decision is reasonable, the Board is  
concerned with both the outcome of the decision and the reasoning process that led to  
that outcome. It considers whether the Committee based its decision on a chain of  
analysis that is coherent and rational and is justified in relation to the relevant facts and  
the laws applicable to the decision-making process.  
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Submissions from the Parties  
40.  
The Applicant provided detailed submissions to the Board and submitted that she  
disagreed with the Committee’s decision and reiterated the concerns she raised in her  
correspondence with the Committee. The Applicant’s submissions included the following  
points.  
41.  
The Applicant disagreed with the Committee’s conclusion that the Respondent made no  
medical errors. The Applicant noted that she had not asked for an x-ray, however tests  
that she had asked for, such as blood and urine tests, were not done by the Respondent.  
The Applicant stated that a biopsy was not conducted on Frank and submitted that the  
Respondent was just guessing that Frank had cancer. The Applicant also submitted she  
now has concerns about the use of miloxcam and its possible side effects on Frank.  
42.  
43.  
The Applicant submitted that the Committee did not address the screaming and abuse by  
the Respondent in its decision. The Applicant submitted that she saw nothing to absolve  
the Respondent of that conduct so the decision was therefore unreasonable.  
The Applicant noted that the Committee stated in its decision that it did not want to take  
sides; however, the Applicant submitted that the Committee was not impartial. The  
Applicant submitted that the Committee did not address what was said by other credible  
witnesses, but instead only referred to the comments from the Respondent’s staff, who  
had maligned the Applicant. The Applicant concluded that she felt re-victimized and that,  
in her view, the Committee did not take her concerns seriously and they just defended the  
Respondent.  
44.  
The Respondent submitted that the Committee’s decision was reasonable and that the  
medical notes in the Record were accurate.  
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The Board’s Analysis  
45.  
The Board will review the Committee’s decision, under the following categories:  
treatment, records and communications.  
Treatment, Medication and Diagnosis  
Re: The Respondent refused to provide IV penicillin for Frank even though he had previously  
sold the Applicant a bottle of Cartrophen –and-  
The Respondent made unsubstantiated assumptions about Frank’s health (i.e., claimed that  
Frank had cancer even though he had never performed any diagnostic testing – and-  
The Respondent made a medication error when he dispensed the incorrect amount of pills that  
he prescribed and also provided incorrect instructions –and-  
The Respondent failed to treat Frank for the infection by dispensing antibiotics as requested by  
the Applicant, did not perform any tests to establish type of infection, did not suggest obtaining a  
second opinion  
46.  
With respect to these four aspects of the Applicant’s complaint regarding the medical  
care, medications and treatment the Respondent provided to Frank, the Board finds that  
the Committee’s decision to take no further action is reasonable.  
47.  
The Board observes that in reaching its conclusions, the Committee made frequent and  
specific references to the information in the Record including the contemporaneous  
medical records and Frank’s radiographs. For example, the Committee referred to the  
medical notes on Frank’s medication and that there was no indication in the medical  
record of the presence of an infection.  
48.  
The Board notes that the circumstances of this complaint required the Committee, which  
included professional members, to rely on its professional knowledge and expertise  
related to the expected standards of the profession in assessing the Respondent’s conduct.  
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49.  
The Board sees no information to support the Applicant’s submission that additional  
testing should have been conducted or to support the Applicant’s submission that Frank  
did not have cancer. The Board finds that it was reasonable for the Committee to rely on  
its knowledge of the expected standards of the profession in considering the treatment  
decisions for Frank, including the Respondent’s choice of medication, and to reach a  
conclusion that osteosarcoma was a reasonable diagnosis for Frank.  
Re: Despite being on call for Frank’s regular veterinarian, the Respondent refused to provide  
veterinary help to Frank, knowing that without timely veterinary intervention, Frank could  
become septic, and this would result in death. The Respondent did not want to see Frank.  
50.  
The Board finds that the Committee’s decision is reasonable regarding this concern. The  
Board notes that in reaching its conclusion on this aspect of the complaint, the Committee  
referred to the response by the Respondent and the information provided by staff  
members, which confirmed that the Applicant was offered an appointment at DAH. The  
Committee relied on its knowledge of the expected standards of the profession to  
conclude that offering an appointment and suggesting a referral fulfilled the requirements  
for the provision of veterinary services. The Board sees nothing to support the  
Applicant’s concern that the Committee did not consider the information in the Record in  
an impartial manner. The Board finds that the Committee’s determination to take no  
further action is reasonable and supported by the information in the Record.  
51.  
In conclusion, the Board finds that the Committee’s determinations with respect to these  
concerns relating to treatment, medication and diagnosis are supported by the information  
in the Record and are reasonable.  
Records  
The Respondent’s notes in the medical record were self-serving and did not reflect the facts or  
reflect the Respondent’s unprofessional conduct  
52.  
The Board finds that the Committee’s decision to take no further action on the  
Applicant’s concerns with the Respondent’s medical notes is reasonable.  
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53.  
The Board notes that the medical record provides a contemporaneous record of the care  
provided by the Respondent and other treating veterinarians made prior to the  
commencement of the complaint and, in the absence of compelling information to the  
contrary, the medical record is a reliable source of information as to what occurred during  
the veterinarian treatments. The Board observes that in its decision the Committee  
reviewed Frank’s records and the Committee relied on its knowledge of the expected  
standards of the profession to conclude that the Respondent’s medical records included  
appropriate details and descriptions of Frank’s condition and diagnosis, and documented  
communications with the Applicant. The Board finds that the Committee’s decision to  
take no further action on this aspect of the complaint is reasonable.  
Interactions and Communications  
Re: The Respondent was verbally abusive, aggressive, explosive, assaulting, hostile, and was  
yelling and screaming and could not control his emotions or rage/anger towards the Applicant,  
and he hung up the telephone while the Applicant was attempting to get medical help for Frank.  
– and -  
The Respondent was not compassionate, and was cruel, callous and cavalier when he told the  
Applicant to euthanize Frank  
54.  
55.  
With respect to the interactions and communications between the parties, the Board finds  
that the Committee’s decision to take no further action with regard to these aspects of the  
complaint is reasonable.  
The Board notes that the Committee had to address competing perspectives of the  
interactions between the Applicant and the Respondent, including the differences in  
perspectives from the Applicant’s family and the Respondent’s staff. The Board observes  
there was nothing in the Record or any other information advanced that might have  
assisted the Committee in preferring one account to the other. Given there was  
insufficient information for the Committee to prefer one version of the events to the  
other, the Board finds that the Committee’s decision to state its expectation that it  
expected veterinarians to conduct discussions about euthanasia with sensitivity and  
compassion and to take no further action is reasonable.  
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Re: The Respondent failed to apologize to the Applicant and the Respondent, and failed to show  
remorse for his behaviour toward the Applicant or for his failure to provide appropriate  
veterinary services.  
56.  
The Board finds the Committee’s decision to take no further action with respect the  
Applicant’s concern that the Respondent did not apologize or show remorse is  
reasonable. In considering this concern, the Committee acknowledged that the Applicant  
did not agree with the Respondent’s course of action for Frank. The Committee however  
stated that the Respondent had provided adequate care for Frank, for the reasons  
discussed above, and determined that there did not appear to be any reasons for the  
Respondent to apologize to the Applicant. The Board observes that the Committee relied  
on its knowledge of the expected standards of the profession to state that while  
veterinarians should always be respectful in communications, they are expected to use  
their professional knowledge and judgement in deciding how to treat a patient. The Board  
finds that the Committee’s decision to state its expectation as indicated above and to take  
no further action regarding this aspect of the Applicant’s complaint is reasonable.  
Conclusion  
57.  
The Board finds that the Committee’s investigation was adequate and its decision is  
supported by the information in the Record and is reasonable. The Board acknowledges  
that the Applicant is dissatisfied with the Committee’s decision. However, the Board  
finds that the Committee’s decision as a whole is transparent, intelligible and justified  
and the Committee based its decision on a chain of analysis that is coherent and rational  
and justified in relation to the relevant facts and the laws applicable to the decision-  
making process.  
58.  
The Board extends its condolences to the Applicant.  
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VI.  
DECISION  
59.  
Pursuant to section 27(1) of the Veterinarians Act, the Board confirms the Committee’s  
decision to state its expectation that veterinarians conduct themselves in a professional  
and respectful manner in all interactions with clients no matter how challenging and its  
expectation that veterinarians conduct discussions about euthanasia with sensitivity and  
compassion given that end of life decisions are challenging and emotionally stressful for  
pet owners, and to take no further action.  
ISSUED July 6, 2022  
Bonita Thornton  
___________________________  
Bonita Thornton  
Cathy Loik  
___________________________  
Cathy Loik  
Mitchell Toker  
__________________________  
Mitchell Toker  
Cette décision est aussi disponible en français. Pour obtenir la version de la décision en français, veuillez contacter  
[email protected]  
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