Sudbury cardiologist loses bid to have hospital privileges restored

A prominent heart surgeon in Sudbury who brought a less invasive operating method to the north has lost his latest court battle to have his hospital privileges restored at Health Sciences North. (File)

A prominent cardiologist in Sudbury who brought a less invasive operating method to the north has lost his latest court battle to have his hospital privileges restored at Health Sciences North.

Dr. Dinkar Shukla made headlines in 2014 when he brought the transcatheter aortic valve implantation (TAVI) procedure to Sudbury. It allows the aortic valve to be replaced without first having to remove the old one.

While much less invasive, the operation is complex and requires a team of doctors.

“TAVI is a complicated procedure that carries significant risks for the patient,” said the transcript of the court case.

“It requires a team of physicians typically including nurses, technicians, a cardiologist, an anaesthetist, and a cardiovascular surgeon.”

Shukla has practised medicine in the city since 2008 and operates his own cardiac practise for his patients. In order to remain credentialed, surgeons have to perform a minimum number of the operations per year.

According to the court transcript, problems began in 2018 when two additional TAVI doctors arrived at HSN.

“The evidence before the hospital board suggests that Dr. Shukla enjoyed a collaborative and professional relationship with other medical staff until two new transcatheter aortic valve implanters arrived in 2018,” the transcript said.

“Within a few months of two additional TAVI doctors arriving at the hospital, conflicts developed. Those conflicts mushroomed into four-plus years’ worth of medical-legal proceedings over questions of interpersonal conflict, patient care, fairness, hospital leadership, respect for colleagues, reputation, and professionalism, with inevitable costs to the hospital, their colleagues and the community.”

In May 2020, HSN’s medical advisory committee informed Shukla that his hospital privileges were being revoked. That led to appeal hearings beginning in January 2021 by the hospital board, which heard evidence and submissions on Shukla’s case over 15 days.

When the board confirmed the decision, Shukla appealed to the Health Professions Appeal and Review Board to restore his hospital privileges.

When the board refused in July 2022, he applied for a judicial review of the decision. The judicial review hearing is scheduled for May 10, 2023.

At the same time, Shukla applied to the court to restore his hospital privileges while the judicial review is pending. His lawyer’s arguments included the fact that his medical competence wasn’t being called into question.

“Rather, Dr. Shukla was a senior member of a six-member interventional cardiologist team at Health Sciences North, where his skills can serve the community at a time where health care in Ontario is stretched,” the transcript said.

“Dr. Shukla continued to work in the hospital throughout the lengthy hearing before the hospital board. The emergency procedures could have been invoked if there were issues of risk to patients or competence.”

In response, HSN said there were broader issues at play.

'HEALTH SCIENCES NORTH DOES NOT AGREE'

“Health Sciences North does not agree,” the transcript said.

“It submits that after the hearing, the hospital board found that Dr. Shukla’s misconduct was related to the conflicts among the TAVI team, and that Dr. Shukla chose to mislead patients, colleagues and other doctors, rather than work honestly and collaboratively. This behaviour undermined his colleagues and put patient care and safety at risk.”

The court ruled that while many factors in the case will be adjudicated during the judicial appeal, HSN submits that patient care would be affected if Shukla’s privileges were restored.

“The hospital board found that patient care and safety was put at risk, given the strength and cohesiveness required in highly specialized, high-risk team environments such as the one to which Dr. Shukla formerly belonged,” the transcript said.

“However, there is also Dr. Shukla’s prior record for collegiality, professionalism and his competence and skill in interventional cardiology and TAVI procedures. It may well be that the findings and catalyst for these proceedings relate more to a combination of situational factors, unlikely to be replicated. However, that is not my decision to make.”

In addition to ruling in favour of HSN, Shukla was also ordered to pay the hospital’s legal costs of $45,000.

Read the full transcript here.