An Ontario veterinarian has been suspended for four months and ordered to pay $5,000 in costs after admitting to professional misconduct, which included improperly prescribing a steroid to a cat that was subsequently euthanized and later falsifying the animal’s medical records1. The Discipline Committee of the College of Veterinarians of Ontario released its decision on January 13, 2025, detailing the findings against Dr. Nabeel Al-Azawi, who practised at locations including the Lakeshore Animal Hospital in Fort Erie. The panel found Dr. Al-Azawi’s conduct to be “disgraceful, dishonourable or unprofessional” and noted he had a prior disciplinary history for similar misconduct.
The matter proceeded by way of a hearing via video conference on December 17, 2024. At the outset, the panel was informed that Dr. Al-Azawi and the College had reached an agreement on the facts, his liability, the penalty, and costs. Dr. Al-Azawi pleaded guilty to the allegations of professional misconduct as set out in an Agreed Statement of Facts. The panel conducted a plea inquiry to ensure the plea was voluntary, informed, and unequivocal before accepting it. The College, in turn, withdrew one allegation related to signing or issuing a document that the member knows or ought to know is false.
The Agreed Statement of Facts, which formed the evidence for the hearing, outlined the events beginning on or about June 6, 2020. On that date, an individual identified as NK contacted the Fort Erie SPCA to adopt a cat, eventually expressing interest in an approximately eight-year-old male cat named Guiness. On June 12, 2020, NK took Guiness home for a “trial” period. NK was advised that Guiness was healthy, though he had some oily fur and dandruff. Once home, NK noticed that Guiness was constantly hungry but would not eat much food. She inquired with the SPCA about his diet but was assured Guiness was fine and required no special diet.
On Wednesday, June 17, 2020, NK called the SPCA again, suggesting Guiness’s ears be checked for suspected mites, as she had noticed some dark matter in his ears. A representative from the SPCA advised NK that Guiness’s ears had been cleaned recently and that he did not have mites. Later that same day, NK observed Guiness starting to fall when he would shake his head. She contacted the SPCA the following morning, June 18, and the SPCA arranged an appointment for Guiness with Dr. Al-Azawi at the Lakeshore Animal Hospital.
NK brought Guiness to see Dr. Al-Azawi later that day. After assessing the cat, Dr. Al-Azawi dispensed several items, including prednisone. The Agreed Statement of Facts explicitly noted this was done “despite the fact that Guiness displayed signs of diabetes.” Following this treatment, Guiness was later euthanized due to diabetic ketoacidosis. The case against Dr. Al-Azawi also involved serious issues discovered after the cat’s death. A subsequent medical records audit revealed that Dr. Al-Azawi had “significantly altered and rewrote many of his medical records long after they were originally created and long after the events occurred.” The audit also found that the nature of these revisions was not explained or documented.
Based on these facts, Dr. Al-Azawi admitted to several acts of professional misconduct. He admitted that he should not have prescribed or dispensed prednisone given Guiness’s condition. He also admitted to prescribing and dispensing the prednisone in the absence of the client’s informed consent. Finally, he admitted to altering and rewriting his medical records long after their creation and without documenting or explaining the nature of the revisions. These admissions constituted findings of professional misconduct under the Veterinarians Act regulations, including failing to maintain the standard of practice, failing to make or retain required records, falsifying a record, engaging in disgraceful, dishonourable, or unprofessional conduct, and conduct unbecoming a veterinarian.
In its reasons for the decision, the Discipline Panel accepted these admissions. The panel was satisfied that Dr. Al-Azawi’s decision to prescribe prednisone to Guiness, given the cat’s condition, fell below the standards of practice of the profession. It also found that his failure to obtain informed consent from NK amounted to professional misconduct on its own. The panel did acknowledge that it understood the member “was dealing with a significant caseload and an incomplete history from the SPCA regarding the cat,” but it firmly stated that “he should not have deviated from his professional obligations.”
The panel also addressed the alteration of records. It was satisfied that Dr. Al-Azawi’s decision to alter his medical records concerning Guiness’s treatment fell below the standards, was conduct unbecoming a veterinarian, and would reasonably be regarded by other members of the profession as disgraceful, dishonourable, or unprofessional. The panel stated, “It is a fundamental obligation of members of this profession to ensure that they keep accurate and timely records regarding the treatment of an animal. Failure to do so can result in mistakes, misdiagnosis, and potentially harm to the animal. Proper recordkeeping is a basic responsibility that this Member chose to ignore.”
The College and Dr. Al-Azawi’s counsel presented a joint submission on penalty and costs, which the panel ultimately accepted. The order requires Dr. Al-Azawi to appear before the Discipline Committee to receive a recorded public reprimand. His licence to practice veterinary medicine is suspended for a period of four months. He was also ordered to pay the College’s costs, fixed in the amount of $5,000, within one month of the order.
In addition to the suspension and costs, the panel imposed several conditions and limitations on Dr. Al-Azawi’s licence. These remedial terms require him to complete a one-day assessment by a College-selected assessor to evaluate his baseline knowledge regarding the issues raised in the case, with the costs paid for by the College. He must then complete a one-day mentorship, at his own expense, with a veterinarian other than the assessor. Dr. Al-Azawi is also required to complete, at his own expense, both a medical record-keeping course and an ethics course, both of which must be approved by the Registrar. Following the completion of the mentorship and courses, he must undergo a one-day follow-up assessment by the original assessor, paid for by the College, to evaluate how he will change his practice. Finally, upon his return to practice, he must complete up to four peer record reviews, each comprised of up to ten patient medical records, over a period of 24 months, with the costs to be paid by him.
During the penalty submissions, it was revealed to the panel that Dr. Al-Azawi had a previous history with the Discipline Committee. He had been disciplined in both 2014 and 2019 for conduct relating to “medication errors” as well as “misleading record keeping.” The panel was provided with the prior cases for its deliberation. The panel noted that it should not lightly depart from a joint submission unless the proposed order would bring the process into disrepute or be contrary to the public interest. Despite the member’s history, the panel was satisfied that the proposed order met this standard, noting the four-month suspension was consistent with similar cases and the remedial terms were appropriate.
However, the panel expressed significant concern over the member’s history. It stated it was “troubled to learn that the Member had engaged in similar conduct in 2014 and 2019, and that to date it appears that the remediation ordered in those earlier cases has not succeeded.” The panel wrote that it “remains concerned that previous attempts by this College at specific remediation regarding medication errors and inappropriate record keeping appear to have not been successful.” The panel concluded its reasons with a direct warning to Dr. Al-Azawi, encouraging him “to take this opportunity most seriously as, should he be unsuccessful, future panels of this College will be disinclined to consider further remediation as an option and instead will look to make decisions of a more punitive nature.” At the conclusion of the hearing, the member waived his right to appeal, and the panel delivered its reprimand.
