A disciplinary hearing for a PEI psychiatrist accused of professional misconduct heard Wednesday that he would order staff to lock up a patient with Huntington’s disease for hours at a time.
The College of Physicians and Surgeons of PEI is considering allegations made against Dr. Arvind Singh at a series of hearings that began Wednesday in Charlottetown.
The woman at the center of the case is 40-year-old Laurel Hurst, who was under Singh’s care at Prince County Hospital in Summerside, PEI The substance of the complaint is that Singh’s treatment was inappropriate given the nature of her condition.
Hurst was 26 when she was diagnosed with Huntington’s disease, a hereditary and degenerative disease that causes a breakdown of the nerve cells in the brain. Her mother died of it at age 53; her older sister also developed it.
Stephen Hurst says his daughter Laurel once lived and worked as a hairdresser in London, England.
Now, he says his daughter’s Huntington’s presents like that of a patient with three diseases: Parkinson’s, which causes shaking; Alzheimer’s, which causes dementia; and schizophrenia, which causes behavioral issues.
As a result, her father says she has the mental abilities of a four-year-old and an inability to control her self-destructive actions. Before her hospitalization, she also struggled with drug and alcohol addiction, and antisocial behavior including theft, gross indecency and aggression toward others.
We became increasingly more and more upset with his treatment of her.—Stephen Hurst
For nearly 15 months starting in January 2017, she was an inpatient at the psychiatric ward of Prince County Hospital in Summerside after she became too difficult for her father and stepmother to care for safely.
“We knew there was no way we could control or direct the behavior of someone with Huntington’s disease,” said Hurst. “You can’t change the behavior. There’s a piece of the brain missing … all you can do is figure out the person’s hot buttons and stay away from them.”
Eventually, she was released from hospital in June 2018. Shortly afterward, Hurst filed a complaint about his daughter’s care while at the Prince County Hospital, accusing Singh of using inappropriate treatments that were unnecessary, ineffective and harmful.
Singh denies allegations
Singh has practiced psychiatry in Summerside for more than a decade.
His lawyer, Tom Laughlin, told the hearing that his client vigorously denies all the allegations.
Laughlin says his client regrets his choice of words when talking with Laurel Hurst’s father, but he points out that the mental health unit at Prince County Hospital was overcrowded, and Singh was not successful in his efforts to have Hurst transferred out.
The lawyer also says the witnesses who will speak in support of the complainant are basing their testimony on hearsay and second-hand information.
If the three-person panel finds the complaint well-founded, Singh could face a fine and/or restrictions on his practice.
Daughter ‘locked up,’ father says
But Hurst says he personally witnessed what happened with his daughter’s care.
“We became increasingly more and more upset with his treatment of her. He continuously, relentlessly practiced behavioral modification techniques and continuously ordered the staff to restrict our daughter by locking her in a safe room,” Hurst said Wednesday in an interview with CBC News outside the hearing room.
At other times, she wouldn’t be allowed a magazine unless she improved her attitude, Hurst said.
“She was locked up for hours at a time and she was told that she would be allowed out if she changed her behavior,” he said.
Laurel became more verbally and eventually physically abusive to staff as this treatment continued, her father tested at the hearing.
Stephen Hurst told CBC such lack of control over emotions is typical of Huntington’s patients.
“Their filtering system is broken, and to control rage is almost an impossible thing to do,” he said.
Witnesses begin testing
At least 10 witnesses will speak at the 10-day hearing. Dr. Heather Keizer was the first to speak on Wednesday.
She was the province’s chief of mental health and addictions when Stephen Hurst approached her in 2018 with issues about Singh’s care of Laurel. They met in October of that year and she was concerned enough to arrange for an outside doctor, Curt Peters, to review the case.
Peters is also expected to testify at the hearing.
Keizer told the hearing that the contents of Peters’ report were disturbing and “unfortunately consistent with other reports” she had received about Singh’s care.
In response, she suspended Singh’s admission privileges to the Prince County Hospital, and signed a letter of complaint to the College of Physicians and Surgeons.
‘You need to stand up’
Laurel Hurst is now a long-term resident of Wedgewood Manor in Summerside, which her stepmother Janet-Rose Hurst says is a “very safe and nurturing environment” where Laurel is doing well. Stephen Hurst said the manor assured him staff do not use behavioral modification therapy on dementia patients — and that is part of how his daughter’s condition presents.
Hurst was on the national board of directors for the Huntington Society of Canada for several years and said he is very familiar with how the disease affects people and families.
“Our only goal is to see that no other persons are mentally harmed with behavior modification techniques that are wrong for their illness,” Hurst said. “Because we can’t undo what has been done.
“If your medical care that you’re getting isn’t what you expect or what you need or you feel it’s wrong, you need to stand up and tell the system that you’re going to push back.”