Nephrologists Appeal to End 3-Year Suspension Is Denied

Nephrologist Albert Kadri, MD, of Windsor, Ontario, Canada, has lost his appeal to have his 2018 suspension from Windsor Regional Hospital lifted, according to a decision by the Health Professions Appeal and Review Board, issued last month.

The board declined to lift the restrictions imposed by the Windsor Regional Hospital (WRH) Board of Directors, saying, “the suspension of the appellant’s privileges at WRH will continue pending the appellant exhausting his rights of appeal under the Public Hospitals Act.” Kadri had been a member of Windsor’s professional staff since 1998.

According to the summary of hearing status from the College of Physicians and Surgeons, allegations of professional misconduct against Kadri have been referred to the discipline committee of the College.

According to the Windsor Star, if Kadri is found guilty of any of the allegations, penalties could range from a reprimand to a fine of up to $35,000 or limitations on, suspension, or permanent revocation of his license.

Kadri Refused to Be a Team Player in New Model of Care

The same local newspaper details the history of the case.

“Windsor Regional, following a recommendation by its medical advisory committee, revoked Kadri’s hospital privileges in 2018 because he had repeatedly failed to comply with a new model of care for kidney patients,” their report notes. “The new program was based on the recommendations of an external review and was approved by the hospital and endorsed by the Ontario Renal Network, which leads kidney care in Ontario.”

The appeal board ruling says Kadri had told senior administrators, including hospital President and CEO David Musyj and now Chief of Staff Wassim Saad, MD, in March 2016 that he would be a “team player” and support the new program, but then refused to cooperate.

In the fall of 2016, according to testimony to the board, Kadri refused to refer patients to the hospital’s kidney clinic, as required. Then he began placing notes in patients’ charts instructing staff to call patients’ community-based nephrologists to discuss concerns or make appointments, stirring confusion among the kidney team members.

In other examples of not following protocols, Kadri refused to send patients who required dialysis to the hospital’s clinic for care before dialysis began, the Windsor Star reported.

“The evidence showed that some patients, who were referred to dialysis by the appellant, were not properly prepared to start dialysis because they had not had the benefit of the…clinic’s predialysis care and education,” the board stated.

The board found that Kadri’s actions:

  • Created stress and confusion among patients

  • Created “toxic relationships” with colleagues

  • “Exposed or were reasonably likely to expose patients to harm”

  • “[Have] been reasonably likely to be detrimental to patient safety or to the delivery of quality patient care”

  • Demonstrated inappropriate use of hospital resources

  • Showed failure to work and cooperate with others in a manner consistent with the hospital’s mission.

Windsor Regional Hospital declined to comment on the decision to Medscape Medical News. Neither Kadri, nor his attorney, responded to requests by Medscape Medical News for comment.

According to the appeal board ruling, “much of the evidence was uncontested, although the parties differed on the conclusions that ought to be drawn from that evidence.”

If Kadris Privileges Were Reinstated, it Would Be a Catastrophe

Asked what would happen if Kadri’s privileges were reinstated, hospital Chief of staff Saad testified before the board: “In a word, catastrophe. It would be a disaster.” He listed the names of two doctors who would leave if Kadri were reinstated.

Saad continued, “We would not be able to recruit; we would not be able to implement our model of care…it would be absolutely devastating. We would be decimated from a nephrology perspective, and I think it would take forever to recover from that.”

Additional testimony before the appeal board included that Kadri was invited to all meetings and discussions surrounding recommendations from an external review of the renal program and the model of care for the renal program, but according to the board report, “he withdrew from all consultative and planning opportunities with the two other nephrologists and the renal program team. He refused to attend or participate in meetings. He also stopped attending department meetings, even though [hospital bylaws require] professional staff members to attend 70% of meetings in the department of which he or she is a member.”

Also cited by the board: “On October 14, 2017, [Kadri] sent a video to the Minister and Deputy Minister [of the Ontario Ministry of Health and Long-Term Care], in which he accused the hospital of acting unethically.”

The video attacked the report and the model of care for the renal program as creating “a potential for more harm to patients due to a lack of consistent, longitudinal care and accountability to patients” and being “very clearly geared to help the administration cut costs.”

Kadri submitted in closing arguments that “the overarching issue is whether WRH acted in good faith.”

Kadri had said at the hearing: “The model of care is the bad faith.”

The board concluded in its decision: “We disagree.”

Marcia Frellick is a freelance journalist based in Chicago. She has previously written for the Chicago Tribune and and was an editor at the Chicago Sun-Times, the Cincinnati Enquirer, and the St. Cloud (Minnesota) Times. Follow her on Twitter at @mfrellick

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