The Case

The College received a complaint from a patient about the physiotherapy care she received at a family medical clinic. 

The patient indicated that the physiotherapist placed acupuncture needles in her neck and shoulders while she lay on a table in a private treatment room. The physio then left the room and closed the door.

Although she felt that significant time had passed, the patient initially assumed that the timing was part of the treatment plan. As she grew increasingly concerned that the physiotherapist had not yet returned, the patient yelled out for help, but nobody came.

After waiting for two and a half hours, the patient forced herself off the table while trying not to move her neck and shoulders. In the hallway she encountered another physiotherapist who removed the needles and told her that the physio who initially treated her had left the clinic. 

As a result of the incident the patient reported feeling “emotionally traumatized” as well as experiencing ongoing tenderness in her neck and shoulders and shooting pain in her arm.

The physiotherapist who had been treating the patient admitted that she forgot about the patient in the private treatment room when she learned of a family emergency and unexpectedly had to leave the clinic, neglecting to ask another PT to take over treatment. 

She acknowledged that the patient was left alone with the acupuncture needles in her neck and shoulders for approximately two hours. She said she called the patient on the same day of the incident to see if she needed to discuss any symptoms and implemented measures to prevent something similar from happening in the future. 

The Standards

The Essential Competency Profile for Physiotherapists in Canada says that physios are required to “perform physiotherapy interventions…in a safe and effective manner” and to “implement appropriate monitoring during specific physiotherapy interventions.” It further states that PTs are required to “maintain continuity of physiotherapy service delivery” via communication with other physiotherapists and health professionals by arranging substitute treatment as appropriate. 

The Decision

The Inquiries, Complaints and Reports Committee felt that the physiotherapist did not meet these professional expectations and, furthermore, left the patient in an unsafe situation for an extended period of time by forgetting that she was in the treatment room. 

While the Committee appreciated the fact that the physiotherapist left the clinic due to a family emergency, they did not believe it negated her responsibility to ensure that any patients undergoing care at the time were monitored by another health professional. 
As a result, the physiotherapist was required to appear before the Inquiries, Complaints and Reports Committee to be cautioned, the fact of which will permanently appear on the Public Register. 

The patient who made the complaint filed an appeal, but the decision was upheld.

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