Ont. surgeon suspended for 18 months after directing female X-ray tech to examine his genitals: disciplinary tribunal

An Ontario surgeon's licence has been stripped for 18 months after a disciplinary tribunal found that he directed a female colleague to perform an exam on his genitals for the second time in his more than 30-year career.

In a decision published by the Ontario Physicians and Surgeons Discipline Tribunal (OPSDT) Friday, Dr. Biagio Innantuono, a general surgeon in Bracebridge, Ont., was found to have engaged in serious misconduct after initiating inappropriate” interactions with an X-ray technician at a hospital in January 2022.

According to the ruling, Innantuono asked the woman, referred to in the documents only as 'Ms. X,' to perform exams on his genital region without proper requisition. 

Finding him to have engaged in "serious and disturbing" conduct, the panel suspended Innantuono's licence until February 2025 -- a penalty they called "significant."

Their reasoning, in part, was that last year's incident wasn't the surgeon's first time being disciplined for such behaviour -- in 2008, he was found to have engaged in "remarkably similar" misconduct with a nurse working in his office.

"The significant penalty [...] is intended to deter Dr. Iannantuono and other members from similar conduct," the College wrote in its decision, "and to express the profession’s rejection of his behaviour."

When reached for comment, a legal representative for Innantuono said they do not have any comment at this time. According to the College of Physicians and Surgeons of Ontario's website, Iannantuono resigned his hospital privileges to Muskoka Algonquin Healthcare in March 2022.

'NOT THE ROLE' OF AN ULTRASOUND TECH

In January 2022, Innantuono visited his family doctor, complaining of testicular swelling, the documents read. In doing so, he acquired a lab requisition form directly from his physician, rather than the usual practice of having it faxed to the lab and then the imaging center.

“Typically, ultrasound requisitions were submitted directly to the hospital’s Diagnostic Imaging Department, and then ultrasounds were booked with a technician who happened to be available,” the decision reads.

About five days later, Innantuono asked the X-ray technician to perform a “sensitive exam” on him.

She agreed to perform the exam and began to explain the procedure to Innantuono, the document states. Before she could leave the room to give Innantuono time to undress, the surgeon removed his bottoms, exposing himself to the woman, it reads.

“This startled Ms. X,” the document reads. She then asked the surgeon to cover himself, which he did not do, the ruling states. Instead, it says Ms. X moved to cover the man’s genitals herself using a towel, which he soon removed.

According to the decision, Innantuono then requested Ms. X perform an exam that was not indicated on his requisition form – an inguinal hernia exam – which is done in the groin area, near the pubic bones.

The surgeon then asked the woman to palpate him for hernias, "although that is not the role of an ultrasound technician," the ruling reads.

However, “because of Dr. Iannantuono’s position as a senior surgeon in the hospital, she felt compelled to be cooperative and deferential,” it continues.

As Ms. X examined one side of his groin, Iannantuono once again removed a towel placed over his genitals, grabbed Ms. X’s hand to reposition it and in doing so, caused her to touch his penis. The ruling states he did the same on the other side, and then for a third time, after making her repeat the first side.

Before leaving, Iannantuono stood from the table, allowing the towels to drop to the floor and once again exposing himself to the woman, the tribunal found.

Within her victim impact statement, Ms. X painted a picture of a staff member “who had little choice but to go along with the wishes of a surgeon she described as ‘the top of the food chain,’” the ruling reads.

"She provided details of the immediate effects, including being intimidated, shaking, freezing up, and feeling disgusted with herself for not having stopped the exam and exited the situation,” it continues.

After the incident, the ruling states Ms. X sought emergency medical care and was off work for several months, experiencing anxiety, and receiving weekly therapy.

NOT THE FIRST TIME: TRIBUNAL

The 2022 incident was not the first instance in which Iannantuono was reprimanded for inappropriate conduct.

More than 15 years ago, the OPSDT issued a warning to the surgeon over “remarkably similar behaviour” to that of which he displayed to Ms. X.

According to the committee, between 2004 and 2008, Iannantuono used his office nurse to do post-operative examinations on patients, including hernia repair patients.

In 2008, the committee said he offered to “assist her in learning proper examination techniques, suggesting that she do a scrotal examination on him.

The nurse was “clearly uncomfortable” and rejected the offer, the tribunal found – after which, Iannantuono told her “no one needed to know about it.”

Previous to this incident, another nurse employed by the surgeon also performed a practice scrotal examination on him.

In this case, the tribunal suspended Iannantuono’s licence for one month – from December to January 2010  – and ordered to pay the college $3,650 in costs.

HIT WITH SUSPENSION

Iannantuono admitted to the panel that he had engaged in professional misconduct and that he failed to maintain appropriate boundaries, the documents show. Still, it found his actions to be “serious and disturbing, involving an abuse of his authority as a senior member of the health care team at the hospital.”

As the 2023 incident marked the second time the OPSDT had to discipline Iannantuono for inappropriate behavior, they handed down what they called a "significant" penalty, an 18-month suspension of his license. It also mandated the surgeon receive individualized instruction in professionalism and ethics and therapy with a College-approved mental health professional.

Since the incident, Iannantuono has completed a professional ethics course through the Centre for Personalized Education for Professionals, receiving an unconditional pass, the committee noted in its reasonings.

When he returns to practice, he must submit to “continuous observation” by another appointed healthcare professional, who will submit monthly logs of patient encounters to the College. In his office, a notice must be displayed informing patients of the circumstances.

He was ordered to pay $6,000 in costs.