Saskatoon

'Inadequate and insulting': Sask. family unhappy doctor not disciplined after boy burned during cast removal

A Saskatoon area couple whose son received second-degree burns while having a fibreglass cast removed is disappointed that the College of Physicians and Surgeons is not recommending mandatory training for doctors who perform the procedure.

Mother wants mandatory training for doctors using specialized saws

Elias McWalter's burn shown in February (left), and his scar shown in July. (Submitted by Sheri Wollf)

A Saskatoon area couple whose son received second-degree burns while having a fibreglass cast removed is disappointed that the College of Physicians and Surgeons is not recommending mandatory training for doctors who perform the procedure.

In February, Sheri Wollf spoke out after her son Elias McWalter was burned when a doctor used a specialized saw to remove a cast he had been wearing for a fractured thumb.

When Wollf took her son to their usual family doctor (who was not the same doctor that caused the burn) she said she was told Elias had suffered deep, second-degree burns in two areas, first-degree burns and two blisters.

Ian (left) and Elias McWalter and Sheri Wollf want mandatory training for doctors using specialized saws to remove casts after Elias was burned having one taken off. (Matthew Garand/CBC News)

Wollf complained to the College of Physicians and Surgeons of Saskatchewan, which investigated the incident before closing the file in May.

In a letter to Wollf outlining the outcome of its investigation, the college said the doctor responsible would have to attend a day of specialized training in application and removal of casts.

It also encouraged the doctor to attend a communications course in response to Wollf's complaint about the way the doctor handled the incident.

Wollf said the college's response was not enough.

"He's bearing some pretty serious scars because of [the doctor's] actions and I expected more than that," she said.

"What do I want? I want something more. I want something that feels like justice, because this feels inadequate and insulting."

Elias McWalter is relieved he can still do magic card tricks with his hands after he was burned while having a cast removed. (Matthew Garand/CBC News)

Elias's father, Ian McWalter, also thinks the doctor should have been disciplined for allowing his son to leave the clinic without further treatment for the burn.

"That's what I find to be really problematic," said McWalter, "because when they went to the pharmacy immediately after that, it was the pharmacist who said 'No, you can't leave here. You need to go back and have that dealt with. That's a big open wound.'"

Other similar cases 

Ambriel Roulette, 2, was left with burns and injuries on her arm after a traumatic cast removal on Feb. 8. Her mother took this photo on Feb. 9. (Lana Roulette)
The same February day Wollf spoke out about what happened to Elias, a Manitoba mom told CBC News that her two-year-old daughter had been burned the same way.

Wollf said other parents reached out to her directly to say their children had also received burns during the cast removal process. 

"There were a lot of people that responded through social media saying the same things had happened to them and to their children, so something needs to be done differently," she said.

"We cannot have children going in for cast removals and coming out with burns, lifelong scarring. That is not acceptable in 2017."

Saws can cause injury with improper technique

In February, a registered orthopedic technologist at Winnipeg's Grace Hospital said doctors in rural areas had to remove casts because there were rarely orthopedic technologists or surgeons in the area to do the job.

Jeff Lambkin said the oscillating cast saw has a vibrating instead of a rotating blade, which the skin can generally withstand without being cut, but injuries are possible with improper technique. He said the saw could cause burns if the user drags it instead of using an up and down motion, or if there is not enough cotton padding in between the cast and the skin.

"It's rare, but it does happen, particularly in rural communities," he said at the time.

Mandatory training 'inappropriate'

College of Physicians and Surgeons legal counsel Bryan Salte said the college could not justify recommending mandatory training if there is no indication it is needed by all Saskatchewan doctors.

"When you've identified a single instance where there was a problem with performance, to require 2,300 physicians in the province to take training when perhaps 2,299 of them don't require it, I think would be inappropriate," said Salte.

Salte said it was not possible for the college to set up training standards for all procedures that physicians might perform. Instead, he said there was an expectation that physicians would only perform procedures they are trained and capable of doing.

"If you're looking at it as a broader issue as to what is the mandatory requirements for physicians generally to engage in practice, that is something that would not customarily be something our college would do," said Salte.

"Our college is not particularly well-equipped to try to deal with general practices of the medical profession because it is so broad. There are specialty societies that set out expectations for the various things which specialists do."

No comment on lack of disciplinary action

Salte said the college would not comment on why disciplinary action was not taken against the doctor because the organization will not speak about individual cases unless a physician is charged with unprofessional conduct.

He said physicians will only be charged if their conduct is deemed unprofessional, not simply for making a mistake.

Wollf has written to Health Minister Jim Reiter in the hopes of arranging a meeting to discuss her concerns. 


ABOUT THE AUTHOR

Alicia Bridges is a former CBC Saskatoon reporter who is now working in Australia.

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