DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO
PANEL: Michael Hogard, RPN Chairperson Grace Fox, NP Member Terry Holland, RPN Member Mary MacMillan-Gilkinson Public Member Cathy Ward Public Member
BETWEEN:
COLLEGE OF NURSES OF ONTARIO ALYSHA SHORE for College of Nurses of Ontario
- and -
NANCY E. LANE Registration No. 7918063 MEAGHAN THOMAS for Nancy E. Lane
Heard: October 4, 2016
DECISION AND REASONS
This matter came on for hearing before a panel of the Discipline Committee (the “Panel”) on October 14, 2016 at the College of Nurses of Ontario (“the College”) at Toronto.
The Allegation
The allegation against Nancy E. Lane (the “Member”) as stated in the Notice of Hearing dated August 29, 2016 is as follows.
IT IS ALLEGED THAT:
- You have committed an act of professional misconduct as provided by subsection 51(1)(a) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, in that on June 4, 2015, you were found guilty of an offence relevant to your suitability to practise nursing, as follows:
a. on or about the 8th day of October in the year 2009 in the Town of Athens, in the Province of Ontario, you did commit manslaughter of [the Victim], contrary to section 234 of the Criminal Code.
Member’s Plea
The Member admitted the allegation set out in paragraph 1(a) in the Notice of Hearing. The Panel received a written plea inquiry which was signed by the Member. The Member was not present at this hearing but was represented by Counsel. Member’s Counsel assured the Panel that the plea inquiry was voluntary, informed and unequivocal, as set out in the written plea inquiry. Further, the Member’s Counsel advised that she had reviewed the plea inquiry verbally with the Member, and the written plea inquiry was witnessed by the lawyer who deals with the Member’s parole issues.
Agreed Statement of Facts
Counsel for the College and the Member advised the Panel that agreement had been reached on the facts and introduced an Agreed Statement of Facts, which reads as follows.
THE MEMBER
Nancy Lane (the “Member”) obtained a diploma in nursing from St. Lawrence College in 1978.
The Member registered with the College of Nurses of Ontario (the “College”) as a Registered Nurse (“RN”) on January 1, 1979.
The Member was employed as a staff nurse at Brockville Mental Health Centre from November 25, 2003 until her employment was terminated with cause effective June 4, 2015.
INCIDENT RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT
Finding of Guilt of Manslaughter on June 4, 2015
On August 23, 2011, the Member was charged with first degree murder of her husband [the Victim] who died on October 8, 2009.
The Member pled not guilty and a trial was held in the winter and spring of 2015.
Midway through the trial, the Member entered a guilty plea to the lesser charge of manslaughter. In support of the plea, the Member signed an Agreed Statement of Facts (“ASF”). The Member admitted the following in the ASF:
a. She was a registered nurse.
b. She was intimately aware of the medical issues her husband was suffering from, including:
i. Heart disease;
ii. Diabetes;
iii. Colostomy; and
iv. High blood pressure.
c. She was aware that he was prescribed and/or had various medication to address some of these medical issues, including:
i. Metoprolol;
ii. Hydromorphone;
iii. Mirtazapine;
iv. Insulin; and
v. Diphenhydramine.
d. She witnessed her husband’s declining health on October 7-8, 2009 (he was growing steadily weaker, dizzy, clammy and cold and he was physically ill).
e. Her husband slipped into medical distress that she described to her co-worker as a coma.
f. She believed her husband had ingested some of his prescription medications.
g. She never called 911 or attempted to get medical assistance for her husband.
h. She never attempted to provide medical assistance to her husband.
In addition, the Member admitted that “with proper medical attention [the Victim] may have been resuscitated when he suffered the ventricular fibrillation” and that “it was possible he would have survived had medical attention been sought” on October 8, 2009.
Finally, the Member admitted that “she had a legal duty to provide the necessities of life to [the Victim] and that duty was engaged sometime prior to him slipping into medical distress that she described as a coma” on October 8, 2009.
On June 4, 2015, the Member pled guilty to manslaughter in connection with the death of [the Victim]. She was sentenced to eight years (less three years for the time she spent on bail awaiting trial). The sentence was a joint submission between the Member and the Crown.
ADMISSIONS OF PROFESSIONAL MISCONDUCT
On June 2, 2015, the Member’s counsel sent a letter to the College explaining that the Member entered a guilty plea and would accept responsibility and cooperate with the College.
The Member admits that she was found guilty of manslaughter on June 4, 2015, and that the finding of guilt is relevant to her suitability to practise.
The Member admits that she committed the acts of professional misconduct as described above in paragraphs 3 to 9, and as alleged in paragraph 1(a) in the Notice of Hearing.
Decision
The Panel finds that the Member committed an act of professional misconduct as alleged in paragraph 1(a) of the Notice of Hearing.
Reasons for Decision
The panel considered the Agreed Statement of Facts and the Member’s plea and finds that this evidence supports findings of professional misconduct as alleged in the Notice of Hearing.
Allegation #1 (a) in the Notice of Hearing is supported by paragraphs 3, 4, 5, 6, 7, 8, and 9 in the Agreed Statement of Facts. There is no issue that the Member was found guilty of the offence of manslaughter. This offence is relevant to her suitability to practise because the conduct falls well below the standards of the profession. It casts serious doubt on the Member’s moral fitness and inherent ability to discharge the higher obligations the public expects nursing professionals to meet. Human life is precious and needs to be respected, protected and treated with consideration. Health care professionals need to make reasonable efforts to preserve human life.
Penalty
Counsel for the College and the Member advised the Panel that a Joint Submission on Order had been agreed upon. The Joint Submission requests that this Panel make an order directing the Executive Director to immediately revoke the Member’s certificate of registration.
Penalty Submissions
Submissions were made by College Counsel. The Member’s Counsel indicated that she agreed with those submissions.
The parties agreed that the mitigating factors in this case were that the Member has cooperated with the College, accepts responsibility for her actions, and agrees with the revocation.
The aggravating factors in this case were the seriousness of the allegation. The Member had intimate knowledge of her spouse’s medical condition. She failed to give medical assistance or call for assistance, causing a delay in medical treatment contributing to his death.
The proposed penalty provides for general deterrence as it sends a clear, strong message to the profession that this conduct is very serious and not acceptable. Publication of this decision to the public and the profession carries this message. Specific deterrence is not applicable in this case as the Member will not be practicing nursing. Overall, the public is protected because the Member will not practice nursing in the future.
Counsel submitted cases to the panel to demonstrate that the proposed penalty fell within the range of similar cases from this Discipline Committee. In CNO v. Keida (Discipline Committee, 2015) the member’s registration was revoked for a second degree murder conviction; and in CNO v. Philp (Discipline Committee, 2012) the member’s registration was revoked following an attempted murder conviction. Member’s Counsel agreed in principle but suggested that the presented cases were much more serious in nature than the manslaughter conviction of the Member.
Penalty Decision
The Panel accepts the Joint Submission as to Order and accordingly orders:
- The Executive Director is directed to immediately revoke the Member’s certificate of registration.
Reasons for Penalty Decision
The Panel understands that the penalty ordered should protect the public and enhance public confidence in the ability of the College to regulate nurses. This is achieved through a penalty that addresses specific deterrence, general deterrence and, where appropriate, rehabilitation and remediation. The Panel also considered the penalty in light of the principle that joint submissions should not be interfered with lightly.
The Panel concluded that the proposed penalty is reasonable and in the public interest. The Member has co-operated with the College and, by agreeing to the facts and a proposed penalty, has accepted responsibility. The Panel finds that the penalty satisfies the principles of general deterrence and public protection. The penalty is in line with what has been ordered in previous cases.
I, Michael Hogard, RPN, sign this decision and reasons for the decision as Chairperson of this Discipline panel and on behalf of the members of the Discipline panel as listed below:
Chairperson Date
Panel Members:
Michael Hogard, RPN, Chairperson
Grace Fox, NP
Terry Holland, RPN
Mary MacMillan-Gilkinson, Public Member
Cathy Ward, Public Member