Our Response to 2012 Infection Control Incidents and Media Articles

Dear Patient,

At the Rothbart Centre for Pain Care, we strive to deliver the highest standard of healthcare for our patients in a safe and hygienic environment. As the largest and first pain clinic of its kind in Ontario, our team of 14 anesthetists and chronic pain specialists have managed over 800,000 patient visits since 1987. Our entire team takes the safety of your healthcare very seriously. We want to thank you, our patients, for entrusting us with your care.

Recently, you may have read about an infection prevention and control (IPAC) incident that occurred at our Centre, which affected several of our patients. We have great sympathy for the affected patients, the health complications they have experienced and the impact this has had on their families.

We’re writing this letter to share with you the facts of how this infection occurred, inform you of our infection control procedures and answer many of the questions you may have.

What are the facts around this occurrence at the Rothbart Centre?

Toronto Public Health (TPH) informed our Centre in December 2012, that nine patients with Staphylococcus aureus bacteria (also known as S. aureus or staph aureus) infection had been linked to one of our staff physicians, Dr. Stephen James.

We were deeply distressed to learn that these patients had become ill. Upon learning of the problem, our staff immediately began working closely with TPH to help them investigate the situation and communicate with any other patients deemed at risk.

Prior to this incident, the College of Physicians and Surgeons of Ontario (CPSO) inspections identified no deficiencies in Rothbart Clinic procedures and the Centre maintained a “Pass” status. Dr. James himself had no symptoms of staph aureus infection and was unaware he carried this bacteria until being tested by health authorities. The Centre, the doctors and nurses working with Dr. James, and even his own family did not know that he was a carrier.

Which patients were impacted by this incident?

TPH determined the staph aureus occurrence was limited to a small number of Dr. James’ patients who were treated by him with injectable medications prior to December of 2012. Of the original nine patients of which TPH notified us, we know that several have developed meningitis and other health complications. Some of these individuals have entered into legal proceedings against the Centre. These are all patients we cared for. We sincerely regret the pain and health impact that they have experienced as a result of this unforeseeable incident.

What did the Rothbart Centre do about this incident?

Once the Centre was notified of the occurrence by TPH, we responded proactively and co-operated fully with them and with the CPSO, always with the goal of protecting patients, our workforce, and the community. We worked closely with TPH to make sure any affected patients were notified. As well, we managed the complete sterilization of the premises where patients were treated. It has since been declared safe by health authorities. Dr. James was asked and agreed to stay off work while receiving antibiotic treatment as recommended by Toronto Public Health. Dr. James was regularly tested for staph aureus, and after six weeks he was no longer infected and was able to return to work.

How are the College of Physicians and Surgeons of Ontario (CPSO) and Toronto Public Health (TPH) involved?

As an Out-of-Hospital Premises, we are regulated and inspected routinely by the CPSO. Shortly after notifying us of the occurrences, TPH and CPSO performed a comprehensive IPAC audit at our clinic and made a number of recommendations. We immediately implemented an enhanced IPAC regimen, maintained and monitored daily by our nurses on staff. The Centre was recently re-inspected by CPSO and given “Pass” status with no conditions. You can view our current CPSO “Pass” standing anytime on the College of Physicians and Surgeons of Ontario website.

Dr. James remains on staff at the Rothbart Centre. As of January 2013, he was tested and found to be free of staph aureus and is not a risk to any patients. Dr. James remains an active member and licensed physician with the CPSO.

Am I receiving safe, hygienic health care at the Rothbart Centre?

Yes, you are safe coming to the Centre and continuing to receive your pain treatment here. Our Centre has in place robust and comprehensive IPAC policies and procedures that are supervised closely by both our own staff and with regular oversight by public health authorities. These IPAC procedures govern all aspects of the environment and work performed at our clinic; from hand hygiene and clinical attire to medical device handling, staff training and operating room procedures.

Both our clinic and our infection control protocols have received a “Pass” by the CPSO as of September 2014, indicating no deficiencies exist. To maintain this status, our current sterile techniques and procedures fully comply with Public Health Ontario best practices to maintain cleanliness, hygiene and infection control for reducing health risks and protecting patient safety. All medical staff are trained in the Centre’s infection control procedures and clinicians involved in patient care are provided with additional on-going training in this area. You can read the Rothbart Centre’s full infection control policies and procedures on our website at: http://www.rothbart.com/infection-control/

I have some concerns or further questions about this situation. Who should I talk to?

We understand this is an upsetting situation and that you and your family may have additional questions. Should you want to discuss your concerns or believe you may have been affected, we are here to help. Please call 416- 512-6407 ext. 219 for an appointment with one of our doctors or email us at nursemanager@rothbart.com.

How can I learn about further updates?

We are dedicated to providing you with transparency into our regulatory standing and infection control practices here at the Centre – so you have the information you need to make the right healthcare decisions for you and your family. We will be voluntarily providing information about our clinic’s regulatory status and IPAC procedures on our website and a new communication board to be installed in the patient reception area. You can check anytime at: http://www.rothbart.com/infection-control/ 

We sincerely apologize and regret that this situation has occurred and any stress this may have caused you. All of us here at the Rothbart Centre chose our careers because we are dedicated to helping people. Pain and distress caused to our patients is a great source of sadness for us too. We will continue to provide high quality pain care and remain committed to safeguarding our patients and healthcare staff, now and in the future.

Yours sincerely,


Peter Rothbart, MD

Medical Director

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The Rothbart Centre is no longer in operation. The "Silver Medical Group Centre for Pain Care" (CPC) is now open at the same location and is currently accepting new patients as well as continuing care for former Rothbart patients. Please visit the CPC clinic website to learn more or to schedule an appointment.