NEW GLASGOW – The College of Physicians and Surgeons of Nova Scotia has reprimanded a New Glasgow doctor for providing insufficient care for a patient with a severe head injury.
The College fined Dr. Marwan Tolba after evidence against him was deemed sufficient for a number of violations of medical practitioners regulations.
The Jan. 28 decision stems from an investigation of Tolba carried out by the College of Physicians and Surgeons in which he was found guilty of failing to appropriately diagnose, manage and reassess a patient with a significant head injury, and failure to document any clinical care provided to that patient in the emergency department for an extended period of time.
Tolba is a family physician who specializes in emergency medicine, and his practice is based in New Glasgow. The matter came to the attention of the College from a complaint letter that referenced care received by a patient on Dec. 22, 2016.
According to information from the College of Physicians and Surgeons released online, a complainant representing the patient said the patient struck his head on the sidewalk, and lost consciousness – and was eventually brought to the hospital by ambulance.
The complainant said the patient was brought to the hospital bleeding from the head and mouth, and was handcuffed to a stretcher for over eight hours with no medical treatment. There were minimal records kept on the status of the patient while at the hospital in New Glasgow.
According to information from the College, the patient was given a CAT scan, and it determined that he suffered what was described as “severe, traumatic, life-threatening brain injuries,” that required him to be airlifted to the QEII hospital in Halifax.
When in Halifax, the injuries on the patient’s wrists left deep scarring, and were so severe doctors found it difficult to believe the patient sustained the injuries while in a hospital. Doctors in Halifax were also concerned about the low standard of care the patient received.
The information from the College indicates that there were assumptions made about the condition of the patient that led to his head injury being overlooked. This resulted in the patient recovering over a long period of time in the hospital. Additional complaints included the unlikelihood that the wrist injuries occurred while in transit to the hospital, in New Glasgow, and the lack of soft restraints used for the patient.
Tolba responded to allegations, disputing the claim that the patient was handcuffed to a stretcher for eight hours, alleging he treated the patient within two minutes of being triaged.
Tolba described the patient as arriving at the hospital in New Glasgow drunk, “disruptive and agitated,” and not co-operating with police, after a fight in which he was knocked unconscious.
Tolba said he didn’t order that the patient be restrained, and that the patient was handcuffed because of aggression prior to his arrival at the Aberdeen Hospital, and it was his intention to “help (the patient), and alleviate pain and suffering, not cause it.”
According to Tolba, the patient was able to answer questions and didn’t have any neck, chest or abdominal pain. Tolba said the patient required medication to control his behaviour.
