Doctor fined for no certificate

Dr. Clarence Charles was fined $500 on Monday for operating a healthcare facility without a certificate from the Health Practice Commission.

The facility was Rapha Medical Centre and the offense took place between March 31 and April 20, 2015.

Defense attorney Richard Barton pointed out that the period included the Easter holidays, so the actual number of days the center was open to patients was more like six, not 20.

Magistrate Valdis Foldats asked how many patients would have been seen during that period. After consulting with his client, Mr. Barton said the doctor would have seen no more than 10 patients per day.

The magistrate asked if there were any complaints of improper care. Crown counsel Scott Wainwright said no, not according to the summary of facts in the prosecution file.

He explained that the charge came about after police received a report from the Health Practice Commission that Dr. Charles was operating the Rapha Medical Centre with an expired certificate.

Dr. Charles had been advised that his certificate had expired and he attended the commission office the same day to speak to the facilities inspector. On April 20, 2015, he admitted that he had continued to treat patients after his certificate expired. He said he had not submitted the required documentation because his insurance had also expired.

A charge of operating a healthcare facility without adequate public liability insurance between Aug. 2, 2014 and April 13, 2015 was also laid against him. He was further charged with failing to have health insurance for himself, his spouse and one employee between Jan. 31 and March 31, 2015.

On March 1 this year, Dr. Charles pleaded guilty to operating his facility without a certificate and the Crown agreed to let the four insurance charges lie on file. The magistrate said this meant that if the four charges are not acted on within six months, they would no longer be considered by the court.

Mr. Barton explained that once Dr. Charles contacted the Health Practice Commission and had signed documentation with the chairman, in his mind he was being compliant. He accepted that, as owner of Rapha, he was responsible. “His attempts to rectify the situation should not be overlooked,” the attorney urged.

Mr. Barton argued that this case had to be distinguished from a rogue practitioner setting up in a nefarious way to do a rip-off.

The magistrate agreed that Dr. Charles was a sole practitioner, not part of four or five professionals billing at a high volume.

Mr. Barton said it was no secret that Dr. Charles, now 64, has been ill. His particular illness (which was not specified) was likely to have contributed to the situation in which he had found himself. It did not impair his clinical skills or judgment, but it seemed to have affected his ability to complete some of his administrative tasks.

Dr. Charles had ceased all operations after his arrest in April, 2015, and Rapha Medical Centre remained closed, Mr. Barton advised.

He said Dr. Charles’s career of 30 years had been unblemished until this incident. He had practiced in Jamaica, his native Guyana and in the U.K. before coming to Cayman in 2000. Several references were supplied to the court.

Mr. Barton asked that no conviction be recorded in this case, citing the defendant’s early guilty plea, cooperation and personal circumstances.

The magistrate pointed out that certification was a regulatory matter and it concerned public health. Medical clinics need to be properly licensed in all respects and this one was not, he said.

He agreed that individual deterrence was not a factor, but he had to impose a sentence that would be a general deterrence. “The court has to send a message – for all facilities, for all practitioners, there has to be a certificate.”

The penalties include a fine of $50,000 plus $10,000 for every day the offense continues, the magistrate noted. Those sums are a signal that once a facility does not have a certificate, it should not be operating, he said.

Speaking to Dr. Charles directly, the magistrate said, “For you, it is the conviction that is the penalty. You are impecunious. Your company is going to be bankrupt. The nominal fine is $500. Pay by the end of August.”