Toronto's Anorectal Doctor Loses Medical License Over 'Profound' Misconduct: Tribunal
A Toronto-based doctor has had his medical license revoked after a tribunal found him guilty of severe misconduct, including misdiagnosis, violation of consent, and performing unnecessary, non-evidence-based procedures that harmed patients.
The Ontario Physicians and Surgeons Discipline Tribunal made the decision on Wednesday, stating that Ashwin Rajan Maharaj is incompetent and exposed patients to harm through his proctology and gastroenterology practice. Maharaj pleaded no contest to the disciplinary charges, accepting the conviction without admitting guilt.
The tribunal detailed that Maharaj performed anorectal examinations that were unnecessary or contraindicated, including examinations under propofol anesthesia without proper justification. He misdiagnosed patients and proceeded to carry out unwarranted procedures, including treatments that are neither recognized, accepted, nor evidence-based. The tribunal also noted a lack of knowledge in his statements about anatomy and treatment options.
Furthermore, the tribunal found that Maharaj failed to obtain informed consent from his patients, obtaining 'blanket consent' before examination and diagnosis, then determining and performing procedures while patients were sedated, without obtaining consent for the specific treatment delivered. This approach fell short of the standard of practice and compromised patients' ability to make informed decisions about their healthcare. The documentation provided by Maharaj was also found to be inaccurate, incomplete, and not comprehensive, falling below the standard of practice.
Seven patients complained to the college about his assessment and treatment of various medical issues between 2019 and 2025. An independent expert, a colorectal surgeon, concluded that the care provided to these patients fell below the standard of practice and demonstrated deficiencies in knowledge, skill, and judgment, exposing or likely exposing them to harm. A subsequent investigation of 10 patient charts revealed similar issues, including misdiagnoses, unindicated and non-evidence-based procedures, and procedures performed under anesthesia without appropriate justification.
The tribunal stated that Maharaj's actions placed patients at an unacceptable risk of harm. They also found that he engaged in disgraceful, dishonorable, or unprofessional conduct by failing to properly store and destroy patient photographs, including sensitive and graphic images, and by sharing sensitive personal health information, including treatment videos, with another patient without consent. This behavior demonstrated a profound disregard for patients' sensitive personal health information and breached the college's policies on medical records, privacy, and professional conduct.
Additionally, the tribunal noted that Maharaj misrepresented insured services when offering uninsured services as an alternative, contrary to college policy. In April 2024, he undertook to stop performing procedures that were not evidence-based or consistent with the standard of practice, but later breached this undertaking by continuing to perform non-compliant procedures.
The tribunal also found that Maharaj contravened a regulation under the Medicine Act by misrepresenting his title and/or qualifications, holding himself out as a surgeon despite not being certified by the Royal College of Physicians and Surgeons of Canada in a surgical specialty or subspecialty.
Between 2003 and 2024, the College's Inquiries Complaints and Reports Committee addressed deficiencies in his documentation, informed consent, communication, and adherence to standards of practice. Maharaj was 'cautioned and counselled on multiple occasions' in 2013 and 2016 and required to complete specified continuing education programs to address consent and communication issues.
In 2024, four public complaints led to further cautions concerning non-evidence-based treatments, failures to obtain informed consent, inadequate history-taking and examination, and ethical concerns, which resulted in the April 2024 undertaking. Despite the ICRC's emphasis on the nature and importance of his professional obligations, Maharaj failed to ensure compliance.
The tribunal emphasized that patients are entitled to safe, evidence-based care grounded in sound clinical judgment, informed consent, accurate documentation, and respect for privacy. The tribunal stated that the breadth and severity of Maharaj's misconduct have resulted in the revocation of his certificate of registration, and they are confident that this severe sanction is necessary to protect the public.
On June 17, Toronto police criminally charged the 62-year-old former doctor with criminal negligence causing bodily harm. The status of these charges is not immediately clear. CTV News Toronto has reached out to Maharaj's lawyer but has not yet received a response.
