ONTARIO AUDIOLOGISTS AND SPEECH-LANGUAGE PATHOLOGISTS DISCIPLINE TRIBUNAL
BETWEEN:
College of Audiologists and Speech-Language Pathologists of Ontario
College
- and -
Meghan Palangio
Registrant
FINDING AND PENALTY REASONS
Heard: January 21, 2025, by videoconference
Panel:
David A. Wright (Tribunal Chair)
Tina D’Agnillo (speech-language pathologist)
Bonny Li (public)
Appearances:
Enniael Stair and Bernard C. LeBlanc, for the College
Adrienne Anderson, for the registrant
RESTRICTION ON PUBLICATION
Pursuant to Rule 2.2.2 of the HPDT Rules of Procedure and ss. 45-47 of the Health Professions Procedural Code, no one shall publish or broadcast the names of clients or any information that could identify clients or disclose clients’ personal health information or health records referred to at a hearing or in any documents filed with the Tribunal. There may be significant fines for breaching this restriction.
The Ontario Audiologists and Speech-Language Pathologists Discipline Tribunal is the Discipline Committee established under the Health Professions Procedural Code.
Introduction
1With the advent of electronic health records, health professionals have access to many people’s personal health information. They must use that access only for the provision of health care services and only with consent. To do otherwise is to breach patients’ trust in providing their most private information. When a professional accesses information without a legitimate purpose, it causes significant harm, whether or not the information is disclosed to others. It harms the patients whose privacy was violated, the public’s confidence that they can trust the health-care system with their information, and the reputation of the profession and of all health professions.
2Meghan Palangio is a speech-language pathologist who worked at Health Sciences North (the hospital) for nearly 11 years. During that time, she accessed medical records of over 100 patients, including at least one former co-worker. She accessed many of these patients’ records multiple times, including one that she accessed over 20 times during a two-month period. In a separate act of misconduct, she misled her employer by claiming she was working when she wasn’t. She tapped into the hospital’s timekeeping system before arriving for her shift.
3The parties agreed on the facts and the registrant admitted misconduct. The College and Ms. Palangio made a joint submission that the penalty should be a three-month suspension, requirements that she advise all present and future employers of this decision, obtain coaching on her professional obligations and have her access to personal health information monitored. She must also provide proof to the Registrar that she has repaid the hospital for her time theft. The parties also agreed on costs of $2,000.
4We must implement a penalty agreed upon by the parties unless this would bring the administration of the professional discipline system into disrepute. The proposed order reflects the general range in other cases and includes appropriate steps to protect the public. We therefore made the order the parties requested.
Findings of Misconduct
5Section 1 of Ontario Regulation 749/93 under the Audiology and Speech-Language Pathology Act, 1991, SO 1991, c. 19, sets out various categories, or heads, of misconduct. When the registrant improperly accessed health records, she:
failed to maintain a standard of practice of the profession, contrary to para. 2. It is self-evident to meet the standards of any health profession, registrants must respect patient privacy and not use information technology privileges except for authorized purposes.
contravened a provincial law, contrary to para. 32.The Personal Health Information Protection Act, 2004, SO 2004, c. 3, Sched. A, s. 37 restricts the uses that can be made of personal health information and s. 72(1)(a) makes it an offence to use or disclose health information in contravention of the act.
engaged in conduct or performed an act, relevant to the practice of the profession, that would reasonably be regarded as disgraceful, dishonourable or unprofessional, contrary to para. 37.
6When the registrant claimed time she did not work, she:
issued a document she knew contained a false or misleading statement contrary to para. 22.
submitted a charge for services she knew was false or misleading, contrary to para. 23.
engaged in conduct or performed an act, relevant to the practice of the profession, that would reasonably be regarded as disgraceful, dishonourable or unprofessional, contrary to para. 37.
Penalty
7The parties’ agreement on penalty must be implemented unless it is so “unhinged from the circumstances” that implementing it would bring the administration of the College’s professional discipline system into disrepute: R. v. Anthony-Cook, 2016 SCC 43; Bradley v. Ontario College of Teachers, 2021 ONSC 2303(Div. Ct.); College of Audiologists and Speech-Language Pathologists of Ontario v. Dame, 2023 ONCASPD 3.
8We must “accept and implement a joint submission in all but the most exceptional circumstances”: at para. 6. This is because when the parties have a high degree of confidence the Tribunal will implement an agreement, there are benefits to the public, the registrant and other participants in the process. As stated in Dame at para. 11:
Deciding whether a penalty meets the test is about the forest, not the trees. Neither the parties' arguments nor the panel's reasons need identify every consideration that a panel would apply if it were deciding what penalty to impose without an agreement. What is important are the key penalty factors that place this misconduct at a general point along the spectrum of potential penalties. Comparing the penalty factors with those in other cases and their results helps the panel determine if the penalty is so far removed from what would be expected that it meets the high bar to consider rejection of the joint submission.
9In College of Nurses of Ontario v. Twance, 2021 CanLII 152559 (ON CNO) the registrant improperly accessed the psychiatric records of a patient who was an acquaintance 10 times. She was suspended for two months, required to meet with an expert for coaching and to notify employers of the decision for 12 months. In another Nurses case, College of Nurses of Ontario v. Fazzari, 2022 CanLII 136847 (ON CNO), the registrant accessed the records of 57 patients, including acquaintances and relatives. She was suspended for three months, required to attend coaching sessions and to notify employers of the decision for 18 months.
10The College also provided us with two cases dealing with time theft. College of Nurses v. Kartisch, 2000 CanLII 50746 (ON CNO), resulted in a suspension of 60 days and College of Nurses of Ontario v. Pellechia-Clarke, 2000 CanLII 50753 (ON CNO) resulted in a suspension of three months, which would not have to be served if the registrant took a course and made a charitable donation. Given that these cases are nearly 25 years old, they are of less weight. We doubt that today a panel would find it appropriate that there be effectively no suspension in a case of fraud as in Pellechia-Clarke.
11The jointly proposed penalty sends a strong message to the registrant and other members of the profession about the importance of respecting patients’ privacy and of honesty and integrity in their relationships with their employer. In addition to the suspension, the requirement to provide employers with this decision indefinitely, the monitoring and the coaching protect the public. The donation to the hospital compensates it for the time she was paid but did not work. The suspension and the indefinite requirement for notice to employers will also deter the registrant and others from engaging in this type of misconduct. The coaching and monitoring are aimed at rehabilitating the registrant so she does not commit misconduct again once she returns to practice. The costs agreed are also reasonable.
12There is nothing about this proposal that would bring the administration of the professional discipline system into disrepute. We therefore made the order requested.
Order
13We ordered:
The Tribunal requires the registrant to appear before the panel to be reprimanded.
The Tribunal directs the Registrar to:
a. suspend the registrant’s certificate of registration for a period of three (3) months commencing on the date that this Order takes effect.
b. immediately place the following terms, conditions and limitations on the registrant’s certificate of registration, all of which shall be fulfilled at the expense of the registrant and to the satisfaction of the Registrar:
i. The Registrant shall advise all of her employers of the results in this case forthwith, including providing a copy of the final reasons for decision once they are available. This requirement will remain in place indefinitely.
ii. The Registrant must attend four (4) sessions with a Regulatory Expert, or a practice mentor approved by the College to:
a. discuss professional and ethical obligations regarding confidentiality of personal health information, and the Code of Ethics (session 1); and
b. monitor the Registrant’s access of personal health information for a period of six (6) months (sessions 2-4).
iii. The Registrant must provide proof to the Registrar that she has donated $163.07 to Health Sciences North, to address the time she improperly claimed for work that she did not perform, within 30 days of this order taking effect.
Costs
- The Tribunal requires the registrant to pay the College costs in the amount of $2000 within two (2) months of the end of the suspension of her certificate of registration.