Nfld. psychiatrist didn’t use standard mental status exams, document informed consent for off-label medication

A Newfoundland doctor who did not comply with conditions placed on his medical licence has been ordered to complete a professional development course on medical documentation and ordered to pay $10,000 in hearing costs. Dr. Hugh Mirolo, a St. John’s psychiatrist was found guilty by the Newfoundland and Labrador Adjudication Tribunal—the disciplinary arm for the College of Physicians and Surgeons of Newfoundland and Labrador—for failing to comply with conditions placed on his licence. Dr. Mirolo was found guilty of professional misconduct for not using standard examinations when testing patients and failing to document using standard medical terminology, among other conditions. The Quality Assurance Committee of the College—which assesses physicians and facilities to upkeep delivery-of-care standards—placed the conditions on Dr. Mirolo’s licence in December 2019. The conditions mandated that Dr. Mirolo must classify all patients’ disorders in accordance with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and document the same; use a standard mental status exam as part of patient examination; communicate with medical colleagues in a standard and comprehensive manner; and document both the clinical review and all off-label uses of medications, as well as the obtaining of informed consent from patients in respect of all off-label uses. Dr. Mirolo participated in a peer practice assessment in December 2020, which evaluated his practice for the period of July to December that year. “The assessor concluded that Dr. Mirolo did not comply with the conditions placed on his licence in December 2019,” wrote the tribunal. Dr. Mirolo also admitted that he did not comply with the conditions placed on his licence, including not using standard mental status exams as part of his examinations in his psychiatric practice. The tribunal accepted Dr. Mirolo’s guilty plea.According to the Tribunal, Dr. Mirolo’s professional misconduct was in violation of section the College By-Law No. 5: Code of Ethics, which it wrote is deserving of sanction under the Medical Act, 2011. The College prepared sanctions together with Dr. Mirolo and issued him a reprimand. The Tribunal ordered that Dr. Mirolo pay a fixed amount of $10,000—the hearing costs of the College. Along with the penalty, Dr. Mirolo was ordered to complete a professional development course on medical documentation and record-keeping. The Tribunal specified that the course must be approved by the College and completed within six months of the Order of the Tribunal.

Nfld. psychiatrist didn’t use standard mental status exams, document informed consent for off-label medication

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