Winnipeg doctor censured for lack of care, poor judgment

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This article was published 23/11/2022 (516 days ago), so information in it may no longer be current.

A Winnipeg family doctor has been censured for his lack of care and management of a patient who was diagnosed with stage 4 metastatic breast cancer three years after tests indicated her cancer had likely returned.

The College of Physicians and Surgeons of Manitoba censured Dr. Berhanu Balcha, who was registered to practise in Manitoba on Aug. 28, 1986, on Nov. 17. The decision was made public this week.

“Dr. Balcha’s conduct is unacceptable and represents a significant breach of professional standards and reflects very poor judgment,” the college’s report says.

The report does not reveal the woman’s current state of health.

The college criticized the doctor for failing to refer the woman for yearly mammograms, as an oncologist had told him to do because of her history of breast cancer, and for failing to treat her conditions appropriately.

Balcha, who continues to work at the Primary Medical Clinic in the Superstore at 1385 Sargent Ave., said he wouldn’t comment, on the advice of his lawyer.

The patient, a woman born in 1950, had Balcha as her family doctor for years.

She had a history of breast cancer, which was diagnosed in 2008, and treated using surgery, radiation and chemotherapy. Her therapy was completed in 2013.

During her final appointment with her oncologist before that doctor retired in 2015, it was decided her family doctor would conduct followup appointments, with yearly mammograms until she turned 70, and routine blood work done annually.

Instead, the college report said the woman’s appointments with Balcha were about diabetes and hypertension monitoring in 2015 and 2016, until she complained of numbness on the right side of her face and right shoulder in October to December 2016. Her chart is silent about whether the doctor assessed those complaints at the time.

When the numbness continued in April 2017, Balcha referred her to a neurologist, who ordered an MRI and a CT/angiogram.

The testing showed “incidental pulmonary nodules;” the neurologist put an asterisk beside that finding in the report he sent to Balcha on July 11, 2017, as well as saying it was probably connected to her earlier cancer. As well, the neurologist recommended a CT scan be done of the woman’s thorax.

Despite that, Balcha didn’t order a CT scan until September 2017. Even though the Oct. 2 results likely showed “metastatic disease” and recommended a CT scan of her abdomen and pelvis, he was away when the report came in and didn’t return until after Nov. 29.

When Balcha next saw the woman on Dec. 6, 2017, he said the CT report wasn’t available and recommended she see him again in three months, at which time he ordered the CT of the woman’s abdomen and pelvis.

The CT test on March 26, 2018, showed signs of cancer, but Balcha referred the woman to a gastroenterologist instead of an oncologist.

When the woman saw Balcha again in August of that year, complaining of musculoskeletal pain, likely because the cancer was in her breast bone, he gave her Tylenol 3 and a sick note for work.

In August 2019, the woman complained of shortness of breath, but he didn’t refer her to a respirologist until she returned in October and reported she had the same symptom.

Finally, when a test done by the respirologist confirmed cancer in November 2019, a referral was made to CancerCare Manitoba.

“(The woman’s) oncologist has reviewed the… tests done in 2017 and confirmed that they are indicative of the return of stage 4/metastatic cancer,” the college report says.

“While the specifics of Dr. Balcha’s discussions with (the woman) are unknown, (she) has advised that she was unaware that there were concerns about a recurrence or spread of her cancer until she met with (the respirologist) in November 2019.”

Balcha graduated from Semmelweis University in Hungary in 1981. It’s not known when he came to Canada or arrived in Winnipeg.

According to Balcha’s physician profile on the college’s website, he is under no terms and conditions for his practice, he has never had any malpractice judgments against him, and the censure is the first disciplinary action taken against him.

Balcha was ordered to pay the $4,680 cost of the investigation.

In a statement, Dr. Anna Ziomek, the college’s registrar and CEO, said censures are a formal, public reprimand intended to serve as a deterrent to future misconduct.

“By accepting the censure, Dr. Balcha indicates he is in agreement with the facts and nature of the misconduct. Censures create a disciplinary record that may be considered in the future… when determining the action to be taken following an investigation or hearing,” Ziomek said.

kevin.rollason@freepress.mb.ca