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The prosecution began its closing arguments Thursday by focusing on the charges of sexual abuse of a patient laid against a Sarnia dentist by Ontario’s regulator.
Kevin Bacchus, a 51-year-old second-generation dentist who practiced in Sarnia and Wallaceburg, is facing 18 allegations levied by the Royal College of Dental Surgeons of Ontario’s discipline committee including two counts of sexual abuse of a patient. Patients cannot give their consent to health professionals under provincial legislation making any sort of sexual contact or a relationship abuse.
Bacchus has pleaded not guilty to all of the college’s charges, stemming from five separate investigations during the past three years, while also planning his appeal for an unrelated criminal conviction of aggravated assault. He was sentenced last month to about two years of house arrest for stabbing a former patient.
The college’s discipline committee, meanwhile, has been hearing all five cases at once in a lengthy hearing that’s featured dozens of witnesses stretched across several months. The final witness was called in early April and, after lawyers on both sides handed over their written submissions, two days of oral arguments started Thursday.
College prosecutor Linda Rothstein, who spoke for most of the day, started by pointing out Bacchus’s defence of the sexual abuse of a patient charges were different in each case. In the first, from 20 years ago, he admitted to having an affair with a woman who later became his patient, but denied anything happened while he was her dentist. It’s the opposite situation in the other case from 2017, where he denied anything sexual took place between himself and another woman, who was his patient.
The names and identities of both women, along with all other patients in the five cases, are protected by a publication ban.
In the older case, the woman claimed she was Bacchus’s patient during their affair – she recalled getting fillings from him about three years before their six-month relationship started in 2003 – but there are no records due to a burglary at his Wallaceburg office in 2010. Rothstein said it’s an unusual situation due to the lack of records, but argued there’s overwhelming evidence she was a patient before the documentation starts in 2011.
Bacchus testified the woman was a patient of another dentist at the office and not his, but another witness agreed with the woman she was his patient. Rothstein pointed out the dentist-patient relationship is ongoing after it starts and doesn’t start and stop based on visits and treatments.
“We do not have clear, cogent evidence that there was any patient relationship,” Bacchus’s lawyer, Jasmine Ghosn, countered. “That’s what the records produced by the college identified.”
Ghosn just started her closing arguments by press time Thursday and had little time to make any responses beyond this area. But she also opened by saying she felt several of the prosecution’s arguments were made by raising speculation and reversing the onus to Bacchus to prove his innocence.
“And that’s not correct. The onus is on the college to prove with clear, cogent evidence,” she reminded the discipline panel.
As for the more recent charge of sexual abuse of a patient, Rothstein pointed out Bacchus couldn’t explain why the patient’s then-husband confronted and attacked him after allegedly walking in on him with his wife in what he believed was a sexual situation. The men had known each other for decades and there was no bad blood up until that point, she said.
“That just defies common sense and what would be likely in a situation like that,” Rothstein said.
She told the panel if they accept Bacchus’s evidence, the man is just a screwball with a temper-management problem.
“This account is completely implausible,” she said.
This woman has denied being sexually abused by Bacchus, but she also refused to testify at the hearing despite being summonsed. A brief statutory declaration she made to a lawyer has been included in the mountain of files.
Rothstein later shifted to the charge of disgraceful, dishonourable, unprofessional or unethical conduct linked to an alleged massage of a former employee’s shoulders at one of the offices, something Bacchus denied. The panel will have to decide that charge based on the former employee’s testimony as another ex-staffer called to corroborate the incident couldn’t recall it happening, Rothstein said.
Then, she turned her attention to charges linked to improper prescription practices. The prosecutor pointed out a patient allegedly called Bacchus complaining about a toothache and he immediately prescribed penicillin and Tylenol 3 without proper assessments or documentation.
Rothstein said that is evidence Bacchus pays no attention to the opioid prescription guidelines Ontario dentists are supposed to follow.
“No attention at all,” she reiterated.
Rothstein also brought up an alleged incident where he wrote five consecutive prescriptions for opioids in less than two months in 2018 to a patient who was on methadone and dealing with an opioid dependency.
“This is a very troubling story,” she said.
Bacchus had testified the woman was dealing with severe tooth pain due in part to a car crash, but Rothstein noted the maximum number of consecutive prescriptions a dentist can issue based on guidelines is three, regardless of the reason.
Ghosn argued the college could have called patients to testify about the opioid issue but chose not to.
“At a minimum, you need to bring the patients in as a witness and get their testimony,” she said.
Rothstein also argued the panel can assess Bacchus’s credibility as a witness based on his past discipline. He was found guilty in 2013 on seven college charges and was fined $5,000, suspended six months, reprimanded, had to take courses and had his practice monitored for two years.
The hearing will continue, and potentially wrap up, Monday.
If a dentist is found guilty of allegations by the discipline committee, penalties can include remediation, restrictions, suspensions, revoking licenses, fines up to $35,000, or any combination of those punishments.
Bacchus still has his licence while the latest allegations are outstanding and, despite recently selling his practices, wants to continue practicing part-time.
THE COLLEGE’S ALLEGATIONS
The college’s 18 allegations, arising from five separate investigations, include:
- Four counts of disgraceful, dishonourable, unprofessional or unethical conduct
- Two counts of sexual abuse of a patient
- Two counts of signing a certificate, report or similar document that contains false, misleading or improper statements
- Two counts of submitting a false or misleading account or charge
- Two counts of abuse of a patient
- Excessive or unreasonable fees
- Contravening a standard of practice or failing to maintain the standards of practice of the profession
- Failing to keep records as required by regulations
- Prescribing, dispensing or selling a drug for an improper purpose, or inappropriately using authority to prescribe
- Recommending or providing an unnecessary dental service
- Treatment without consent