SHOULD AN ADVERSE EVENT OCCUR IN ANY ONTARIO HOSPITAL, THE CITIZENS OF ONTARIO WILL BE ENSURED IT WILL BE COVERED UP BY ALL OF THOSE SEEN BELOW:

THE HOSPITAL --under jurisdiction of Liberal Minister of Health

THE CHIEF CORONER'S OFFICE--appointed by Liberal majority government and --under jurisdiction of Liberal Minister of Corrections

THE DEATH INVESTIGATIVE OVERSIGHT COUNCIL--appointed by Liberal majority government and --under jurisdiction of Liberal Minister of Corrections

THE COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO

THE HEALTH PROFESSIONS APPEAL AND REVIEW BOARD--appointed by Liberal majority government --under jurisdiction of Liberal Minister of Health

THE ONTARIO OMBUDSMAN--appointed by Liberal majority government

THE ONTARIO PATIENT OMBUDSMAN--appointed by Liberal majority government

THE ONTARIO PROVINCIAL POLICE--under jurisdiction of Liberal Minister of Corrections

THE INDEPENDENT POLICE REVIEW DIRECTOR--appointed by Liberal majority government and --under jurisdiction of Liberal Minister of Corrections

THE LIBERAL MINISTER OF HEALTH

THE LIBERAL MINISTER OF CORRECTIONS

THE LIBERAL PROVINCIAL PREMIER

WHEN IT COMES RIGHT DOWN TO IT, THE PRESENT LIBERAL GOVERNMENT SHOULD HAVE COME CLEAN TO PROTECT THE CITIZENS OF ONTARIO.

ALL OF THE ABOVE ARE IN "BREACH OF TRUST" AS THEY COVER EACH OTHERS' ASSES

A FATHER’S FAILURE

Without a doubt; a Conspiracy exists,
Self-protecting Officials; such hypocrites!

If you were a MPP’s daughter; it would cause a fit,
Because you’re mine; they don’t give a shit!

For years we have yearned for justice,
The lack of moral integrity merely disgusts us!

Government institutions that won’t expose,
The Medical negligence concealed by those!

Medical Immunity granted; regardless of guilt,
Preserving Ontario Health Care’s patchwork quilt!

So many individuals paid through our taxes,
Failing us all; what a bunch of asses:

Premier of Ontario --Premier Wynne, Premier McGuinty,

Ontario Minsters of Health --Dr. E. Hoskins, D. Matthews, Rick Bartolucci

Ontario Ministers of Corrections --Yasir Naqvi, Madeleine Meilleur

Ontario Members of Provincial Parliament --majority of them from 2006 to the present

CPSO -- Angela Bates Manager Committee Support Area Investigations and Resolutions, Sandra Keough Investigator

HPARB --Chair Janice Vauthier, Past Chair Linda Lamoureux, Lori Coleman Registrar, Third Appeal Chair Tom Kelly, Members Stephen Jovanoviorc and Brenda Petryna

Ontario Ombudsman --Paul Dube Ombudsman, A Marin-Ombudsman, Investigator Lorraine Boucher- Investigator, Fran Cappe-Investigator,

Humber River Hospital --CEO B. Collins, past CEO Rueben Devlin,

Ontario Chief Coroner’s Office --Dr. D. Huyer, Dr. A. McCallum, Dr. A. Lauwers

DIOC --Joseph C.M. James (Chair), Emily Musing (Vice-Chair), John Pearson (Vice-Chair), William (Bill) McLean, David Williams, Dorothy Cynthia (Cindy) Prince, Denise St-Jean, Fiona Smaill, Lidia Narozniak, Lori Marshall, Lucille Perreault, William (Bill) J Shearing, Michael Pollanen, Fiona Foster Manager of DIOC

Ontario Patient Ombudsman --Christine Elliott, Investigator Marie Claire Muamba

Ontario Provincial Police --Commissioner J.V.N. (Vince) Hawkes, Inspector Bradley McCallum

OIPRD -- Director Gerry McNeilly

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Terra Dawn Kilby
"An Angel In Our Lives"
April 22/78 to July 21/06

Linked 2612 Connections/Followers
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2,817

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DO YOU SMELL SOMETHING ROTTING WITHIN ONTARIO:
https://1drv.ms/w/s!ApBprmlxiUUnhHumD25kXQnNQ4f_

http://www.torontosun.com/…/why-did-woman-die-after-routine…

http://www.torontosun.com/2013/10/18/secret-medical-cautions

https://www.linkedin.com/…/ontario-patient-ombudsmans-offic…

https://www.linkedin.com/pulse/another-failure-arnold-kilby…

https://www.linkedin.com/…/death-investigation-oversight-co…

https://www.linkedin.com/…/terra-dawn-conspiracy-arnold-kil…

https://www.linkedin.com/…/help-bring-true-transparency-acc…

https://www.linkedin.com/…/breach-trust-chief-coroners-offi…

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https://www.linkedin.com/…/att-ontario-provincial-police-co…

https://www.linkedin.com/…/truth-kept-hidden-abusing-legisl…

READ ALL OF MY POSTS AS I ATTEMPTED TO BRING TRANSPARENCY AND ACCOUNTABILITY TO ONTARIO.

SCROLL DOWN FOR POSTS
--Look on right side under "Blog Archive" (oldest to newest)

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College of Physicians and Surgeons - Stories of Failure

What is especially interesting in this recent Star (last week Feb/2016)article is the following:

“We are not a public organization. . . Our accountability is to our members,” said the College’s executive director, Dr. Francine Lemire" CPSO

ONTARIO OMBUDSMAN'S OFFICE FAILS TO PROTECT CITIZENS FROM HPARB'S LACK OF PROCEDURAL FAIRNESS AND ADHERING TO THE PRINCIPALS OF NATURAL JUSTICE.

Mr Shanoff, (Toronto Sun Columnist) I don't know if you have done an article on the Ombudsman's Office, but you may wish to take this on as they are not questioning the contradictions. We already know the CPSO is corrupt and HPARB from your article where you stated "it looks like HPARB just threw up their hands and said we give up"

http://www.torontosun.com/2013/10/11/why-did-woman-die-after-routine-surgery

http://www.torontosun.com/2013/10/18/secret-medical-cautions

But for the Ombudsman's Office to swallow such garbage leaves the citizens of Ontario with no where to go.

Coalition For Physician and Surgeon Oversight is a group who has been harmed or had a loved one taken through negligence by a doctor/surgeon.


****************************************************

https://www.youtube.com/watch?v=_LFqWujTEVA&feature=youtu.be

Terra Dawn Kilby --- A Father's Memories
An Angel In Our Lives, Terra Dawn Kilby November 2014

A tribute to the life of my daughter who died due to the negligence of a surgeon at Humber River Regional Hospital, Toronto, Ontario, Canada. Covered up by Humber River Regional Hospital, the CPSO, HPARB, Chief Coroner's Office of Ontario, the DIOC, Ontario's Ombudsman and the entire Provincial Liberal Party!


TERRA DAWN KILBY April 22, 1978 - July 21, 2006. College’s Decision “The routine use of antibiotics prior to bowel surgery is an important aspect of care that was NEGLECTED by Dr. Klein in this case.”…
00:35:48

https://www.youtube.com/watch?v=lMof3T--zUY&feature=youtu.be


******************************************************
THE PATIENT FACTOR

http://thepatientfactor.com/canadian-health-care-stories/the-unholy-alliance-between-organized-medicine-and-government-a-fathers-quest-for-truth-and-justice-in-public-health-care/

HPARB's Decisions Kilby vs Laz Klein.
First Decision:
http://www.canlii.org/en/on/onhparb/doc/2010/2010canlii44390/2010canlii44390.html
Second Decision:

http://www.canlii.org/en/on/onhparb/doc/2012/2012canlii39837/2012canlii39837.html
Third Decision:
http://www.canlii.org/en/on/onhparb/doc/2013/2013canlii46625/2013canlii46625.html

The Letter I Sent to the Chief Coroner's Office Outlining My Numerous Concerns
Coroner's Comments.doc

Death Investigative Oversight Council's Decision

2 years after my initial request and after both Chief Coroner and Deputy Chief Coroner left the OCC.
DIOC Decision Aug 2013.doc


*********************************************************
The Chief Coroner's Office, the College of Physicians and Surgeons of Ontario, the Health Professions Appeal and Review Board, the Death Investigative Oversight Council, the Liberal government and Ms Deb Matthews and Premier Wynne apparently agree that it is perfectly within the accepted Standard of Care to:
--have open abdominal surgery without the mandatory antibiotic prophylaxis

--having not had the above, accepted that there was no need for antibiotics when the abdominal incision was oozing purulent liquid and was so infected that all staples were removed

--when test results showed "many gram negative bacilli", still it was quite acceptable to provide no antibiotics

ONTARIO CITIZENS----
And the College/HPARB totally ignored Dr. Andrew McCallum's letter to the College when he was Eastern Ontario Coroner. In it he states that infection was a contributing factor in Terra's death.
One must also wonder how on earth the Chief Coroner's death investigation failed to note the lack of antibiotics plus other issues contained within the hospital records and yet I have numerous pieces of correspondence from both Dr. Lauwers and Dr. McCallum stating they saw no issues with respect to the Standard of Care???
HOW DO YOU SPELL COVER-UP???



************************************
THE OMBUDSMAN'S OFFICE has allowed the College and HPARB to establish the above as precedence for future complaints/appeals made to both of them.
VERY DANGEROUS TO ALLOW THIS TO HAPPEN WITH REGARD TO PATIENT SAFETY AND CARE WITHIN OUR HOSPITALS.


********************************************************





http://thepatientfactor.com/canadian-health-care-stories/the-unholy-alliance-between-organized-medicine-and-government-a-fathers-quest-for-truth-and-justice-in-public-health-care/

https://plus.google.com/100940639342885447409/posts/YwvYaMn7eTw

http://www.yelp.ca/user_details?userid=BslEQAF9s6rUav3VSPqcWQ



**************************************************
Gan Reporter to appear this week before Tuesday, July 21, 2015
Terra Dawn Kilby
“An Angel In Our Lives”
April 22, 1978 – July 21, 2006


Tears still appear when we think of you.
Visits to your grave site we often do.
Loving memories convey serenity too!

Our precious daughter, Terra Dawn;
It’s been nine years since you’ve been gone.
Within our hearts you still belong!

July Twenty-first is a time of sorrow.
Additional years, I wish we could borrow.
Maybe then, we’d not feel hollow!

Today, messages guided to heaven above.
Channeled to you on the wings of a dove.
Expressing our heartfelt, everlasting love!


LOVE MOM, DAD AND BRANDY

Monday, 21 January 2013

No Accountability or Transparency in Ontario--Dr. Bert Lauwers/Dr. Andrew McCallum/Dr. Laz Klein--Part Thirteen

 A PRIMER ON THE LAW OF DEFAMATION IN ONTARIO
"Defamation is comprised of two subcategories between libel (libel refers to written defamatory statements)and slander(broadcasting of spoken defamatory words)

Proving a Claim in Libel and/or Slander
"the statement must be false!"

Defences to Actions in Libel and Slander
TRUTH--
"The first defence is the defence of truth. The defence can be made that the statement was truthful and therefore there was nothing false about the statement, meaning therefore, that the statement was not defamatory."


FAIR COMMENT--

"The second defence to an allegation of libelous statement is that the statements made were made as a fair comment. The defence of fair comment would be considered by the Court in situations where, by looking at the statement made, the facts and the situation, a conclusion can be made that the statements made were in actuality a fair commentary on the situation at hand and that the comments were fair and were not malicious."

QUALIFIED PRIVILEGE--
"The defence of qualified privilege arises normally in situations where the individual publishing these statements will escape any liability if it can be proven that the public good could be furthered in open debate. 

******************************************************************************
College of Physicians and Surgeons render yet a third decision.  Just as inept as the previous two.  So once again I have appealed to the Health Professions Appeal and Review Board.  This nonsense has been going on since 2007, now 7 years after Terra's Death.

The following statements regarding self-regulation are taken from the OCPS's own website:
"Physicians have been granted the privilege of self regulation. Society allows physicians to regulate themselves in return for the covenant that this regulation will occur in the public interest."
"Meeting these responsibilities requires efficient and appropriate governance and a reliable system of accountability. Fulfillment of this duty is essential to self-regulation."
"One important responsibility of the College of Physicians and Surgeons of Ontario is to respond to concerns and to investigate complaints from members of the public about doctors licensed to practice medicine in Ontario. In all that we do, the College must act first and foremost in the best interest of the public."
THEY CONTINUE TO FAIL! 

From their 3rd Decision!

Now really who is the following really for except to "SWEET TALK"  HPARB?
ROLE OF THE COMMITTEE
The College's complaints process provides a route for members of the public to raise concerns about a doctor's practice or conduct. The Regulated Health Professions Act requires the Committee to consider every complaint submitted to the College. The Committee, with the assistance of staff, conducts an investigation, then meets to review the written record of investigation and reach a decision.

The Committee cannot award financial compensation of any kind. Its process is not focussed on determining liability, or on punishing doctors. The Committee evaluates the investigative information available. It then determines what action, if any, is warranted, taking into account the seriousness and context of the concerns raised, the physician's insight into his or her practice, his or her capacity for remediation, and the physician's relevant College history, if any.
The Committee's role, broadly, is to protect the public by determining whether remedial action is necessary and, if so, what action would best enhance the quality of medical care of the particular physician, and the general quality of medical care in Ontario, by reinforcing the standards of practice.
The range of dispositions available to the Committee includes taking no further action, providing advice, cautioning a physician in writing or in person, or requiring a physician to complete a specified continuing education or remediation program.
In a small number of very serious cases, the Committee may refer a specified allegation of professional misconduct or incompetence to the College's Discipline Committee. The Committee will do this only where it believes that no alternative course of action could adequately protect the public interest, and that the available information has a reasonable chance of supporting a successful prosecution.
The Committee appreciates Mr. Kilby's action in bringing his concerns to the College's attention. Public engagement aids the College in protecting the public interest and improving the quality of physicians' care throughout the province. The Committee also acknowledges Dr. Klein for demonstrating professional accountability by providing a response.
Now, really, Is the above not just a bunch of Bull Shit!  They have proven over and over again that their first priority is to protect the surgeon, not Ontario patients or citizens.

Committee's Conclusion/Reasons
The Committee has determined that the appropriate disposition is to advise Dr. Klein to individualize the use of pre-operative prophylactic antibiotics for patients where it is warranted based on the evolving standard of practice. This is an educational disposition, designed to assist the physician in improving future practice.
In its July 2011 decision, the Committee issued a counsel to Dr. Klein on the timely documentation of discharge summaries, which the Board accepted as reasonable in its June 2012 decision. The Committee, therefore, includes this counsel to Dr. Klein as part of the current decision. A counsel [predecessor of the Advice disposition] is an educative disposition designed to guide a physician's future practice.
SUMMARY OF DISPOSITION
For the reasons set out above, the Committee advises Dr. Klein to continue to consider the use of prophylactic antibiotics at the time of conversion from laparoscopic procedure to open laparotomy based on the evolving standard of practice.
What a bunch of CRAP!
I have sent the following today to HPARB.

Attention: Ms Lori Coleman, Registrar


The Health Professions Appeal and Review Board

 I request that the College's third decision be reviewed by the Health Professions Appeal and Review Board.

I have attached a copy of their third decision.  You will note by reading it that they are presenting a new argument.  That being, that Dr. Klein was not aware of the possibility of a colon resection until he conducted the open abdominal surgery.  I have documented proof that he indeed did!

They are now trying to backtrack on their comment with respect to "Neglected" and "Oversight".

You will also notice that the College spend a considerable amount "kissing up to HPARB" by explaining their role in investigating a complaint from the public.  This was definitely not for my benefit!!!


You will also notice that they seem to alway referred to the unfortunate outcome, (Terra's death) when they make a statement with regard to her surgeon's actions.   The outcome is not a part of the complaint.  They do so to make their statements appear to be correct.   We are talking about the Standard of Care in 2006,   NOT 2007, 2008, 2009, 2010, 2011, 2012, or 2013.  Yes, a considerable amount of time as pass since the original complaint .
****************************************
From the College's Third Decision.
 

Although conversion to open surgery is always a possibility, his intention was that the surgery would be performed laparoscopically to remove a mesenteric cyst. However, during the surgery he determined it was necessary to immediately remove what he suspected was more concerning than a simple mesenteric cyst. He could not rule out sarcoma at that time, and it was not until after he converted to a laparotomy that it was clear that this cyst could not be removed without a bowel resection.
 


O AWKILBY’s ResponseThe above is pure BS.  He knew before he converted to a laparotomy!!
Note the following:  This proves that Dr. Klein was going to attempt laparoscopically a colon resection for a mesenteric mass.  This was before he converted to a laparotomy!!!
Note the Procedure Desc.

Laparoscopic Colon Resection Attempted For Mesenteric Mass”

The second Procedure Desc. indicates the laparotomy.
O AWKILBY’s ResponseThe College once again fails to thoroughly look at the Hospital Records.  OOPS or is it intentional---- My claim it is intentional--- three times they have studied the charts and still it is I who must point out the concerns substantiated by the records.  Dear HPARB panel, please don’t let them make cover up this neglect to the Standards of Care for a fourth time!

And from Dr. Taylors’(the College’s I.O)letter to Angela Bates
May 8th, 2011,
During the surgery on July 11 2006, Dr. Klein realized that the mass was not separable from the colon or retroperitoneum and obtained consultation with a colleague and went ahead with an open right colectomy. This is well documented in the operative note on page 48.”
OPERATIVE PROCEDURE        1-/  Diagnostic laparascopy 
                                                       2-/ Open right hemicolectomy and excision of mesenteric cyst.              
PROCEDURE;  O
At the time of laparoscopy, a large cyst could be seen in the mesentery of the right colon.  It was densely adherent to the bowel as well as densely adherent to the lateral abdominal wall.  It felt very solid and not at all in keeping with a simple mesenteric cyst.  We therefore made the decision to convert to an open procedure
AWKILBY’s Response:  So both proves Dr. Klein knew prior to conducting open abdominal surgery that a colon resection had to be performed.  Why did he go ahead without ensuring my daughter received the mandatory antibiotic prophylaxis! 
  
AWK Note:--- But when he discovered the mass could not be removed with the laparoscopic procedure, open abdominal surgery should not have gone ahead without the patient being properly prepared.  This was not an emergency surgery but day surgery!
WHY DOES THE COLLEGE NOT SEE THE ABOVE BUT THE COMPLAINTANT CAN.  --- THEY HAVE CLEVERLY DISMISSED ALL OF MY OTHER CONCERNS BY QUALIFYING THEIR STATEMENTS SUCH AS:
NOTICE HOW THEY SKIRT THE REAL ISSUES!
The IO provider set out the following information in an addendum to the IO report:
         The issue of antibiotic administration at the time of conversion to an open procedure is really not relevant to the outcome for this patient.
 AWKILBY’s ResponseThe outcome is not part of the complaint! ***************************************************************************************           
         Most general and colorectal surgeons administer antibiotics preoperatively prior to laparoscopic or open colorectal surgery, as they have been shown to reduce the incidence of wound infection. Antibiotics, however, have not been shown to decrease the incidence of anastomotic leak.
AWKILBY’s Response: Temporarily forget the anastomotic leak.  The above statement indicates the Standard of Care that was not followed by Dr. Klein.
         Many surgeons believe prophylactic postoperative antibiotics are unnecessary. They have very little impact on the incidence of wound infection.
 AWKILBY’s Response:  Antibiotics after?????-----but she didn’t have the preoperative antibiotics which means the need for post antibiotics is cleverly minimized by the College!!!
         The administration of antibiotics after the conversion to the open surgery would likely have been of little benefit in terms of preventing a postoperative wound infection and would only have had the potential of causing side effects, which included C. difficile colitis.
 AWKILBY’s Response: The conversion to open surgery should never have been done without antibiotic prophylaxis.  This surgery should have been postponed so that the patient could be properly prepared! 
Dr. Klein provided the following information in response to the addendum and subsequent information from Dr. Brian Taylor, the IO provider:
•     He agrees with the IO provider that:
o   The issue of antibiotic administration had no bearing on the outcome of this case,
o   The only benefit of pre-operative prophylactic antibiotics is to prevent a
postoperative wound infection,
o   Preoperative antibiotics have no preventative or beneficial effect for an anastomotic leak.
AWKILBY’s Response:  But she did have a post-operative infection!   And what about the many negative bacillia seen        
·        The routine use of antibiotics prior to bowel surgery is an important aspect of care that was neglected by Dr. Klein in this case. The Committee would suggest that Dr. Klein consider the routine use of antibiotics in such circumstances. Having said that, we do not consider this oversight to have contributed to the unfortunate outcome in this case.
 AWKILBY’s Response:  The outcome is not part of the complaint!
         In addition to the IO provider's views, the Committee notes that at this time there is no consensus in the medical community based on available research to support that antibiotics should be administered at the time of conversion from a laparoscopic procedure to an open laparotomy. As such, the Committee agrees with the IO that the administration of antibiotics at the time of the conversion would not be required to meet the standard of practice.
 AWKILBY’s Response:  The above is pure BS.  Gee what changed from your thorough examination done for the second complaint and your findings then?   “Neglect”  & “Oversight”
 Think about it,---a surgeon is going to make a 8 to 10 inch incision in your abdomen, spread it apart, move around some internal organs to get to the tumor, cut open a colon etc-----All done without antibiotic prophylaxis----I DON’T THINK THIS IS A STANDARD OF CARE AND IT CLEARLY IDICATES NEGLIGENCE!!  
Further to this clarification, the Committee notes that, as supported by Dr. Brian Taylor the IO, the lack of antibiotics in this case did not influence the unfortunate outcome, given there was no evidence of sepsis at the time of the discharge from the hospital.
 AWKILBY’s Response:  The outcome is not part of the complaint!  And there were numerous issues prior to her release that Dr. Klein ignored and the College supported this negligence.
*********************************
SUMMARY OF DISPOSITION
For the reasons set out above, the Committee advises Dr. Klein to continue to consider the use of prophylactic antibiotics at the time of conversion from laparoscopic procedure to open laparotomy based on the evolving standard of practice.
AWKILBY’s Response: 
This decision is BS --- “consider the use of…”. Prospective Patients should be able to look up the Surgeon’s Record and be able to access decisions made concerning complaints against this Surgeon!  If HPARB accepts this, the College could hide further or past complaints against this Doctor and Ontario citizens would never know.
What also concerns me is a statement Dr. Klein made when a nurse asked him if antibiotics should be prescribed for the infected incision after all the staples had been removed.   His response was “The Body Will Heal Itself.”  I think this explains a lot about his belief in using antibiotic prophylaxis and post operative antibiotics.  It would be extremely interesting to study the records of all patients undergoing surgery by Dr. Klein to see whether he has failed to use antibiotic prophylaxis and post operative antibiotics  when the standards clearly indicate so, and what the results are with respect to infections and perhaps deaths!!!  
Arnold Kilby          Terra Dawn Kilby
      "An Angel In Our Lives"

         April 22/78 to July 21/06
http://anangelinourlives-awk.blogspot.ca/