A Doctor Secretly Induced Labor in His Patients So He Could Bill More

North York Hospital, where Dr. Shuen worked for nearly 30 years. Photo: Vince Talotta/Toronto Star via Getty Images

Paul Shuen was one of Toronto’s most highly esteemed surgeons and OB/GYNs, until nurses at the North York General hospital where he worked discovered that he had been inducing labor in pregnant women without their consent — seriously endangering mothers’ and babies’ lives — in order to bill more for the deliveries, Toronto Life reports.

Following his 2012 divorce, which he says left him in difficult financial straits, Shuen tried to maximize his income by increasing the number of procedures he performed. Although, due to government funding, North York capped the number of monthly deliveries at 50 per individual OB/GYN, Shuen flagrantly ignored this, averaging 58 deliveries per month in the 2015–2016 fiscal year. When his supervisor, who thought such a high volume of deliveries could lead to potentially unsafe conditions in the delivery ward, confronted Shuen, the doctor agreed to perform no more than 45 deliveries per month.

In order to maximize profit on those 45, however, he reportedly induced his pregnant patients without their knowledge so that they would deliver on weekends, when the hospital was generally short-staffed, and Shuen could charge more for his work (roughly $568 on a weekend versus $378 on a weekday). Officials later found that from 2015 to 2016, an astounding 46 percent of Shuen’s deliveries took place on weekends.

Nurses working on the weekends with Shuen noted that deliveries were often happening too fast, and dangerously. One Saturday in the spring of 2016, one of Shuen’s patients arrived at the hospital in rapid labor. A nurse examined her, and found a small white pill in her vagina. No mention was made of it in the patient’s chart, and she had no knowledge of it. Nurses had it tested. It was misoprostol, a medication originally developed to treat stomach ulcers, which also is known to soften the cervix, and is one of the two pills used in medical abortions.

Similar pills had been found in Shuen’s patients in 2013 and 2015. He had also crossed other lines of consent before. In 2008, one of his patient’s, who was induced early because her amniotic fluid was low, said Shuen was impatient with how slow her delivery was going, and performed an episiotomy (a surgical incision to enlarge the vaginal opening) on her without her knowledge or consent. She ended up with a third-degree tear of the perineum, and had to have surgery months later to repair the extensive damage.

In these instances, Shuen was spoken to and received cautions from hospital administrators, but it wasn’t until 2016 that hospital executives revoked his hospital privileges, and forbade him to speak to patients. He admitted to having induced labors with misoprostol, and announced his retirement shortly after.

He was also put under investigation by the College of Physicians and Surgeons’ discipline committee, which, in June 2018, ordered Shuen to pay more than $40,000 in costs and revoked his license to practice medicine in Ontario.

The reason we’re only hearing about Shuen’s misdeeds now, as Toronto Life reporter Michael Lista explained in his conclusion, is because of the long, convoluted process of getting the hospital to share its records. “It turns out that it’s easier to see the evidence against a murderer than the evidence against a doctor in Toronto.”

Read the full story here.

A Doctor Secretly Induced Labor in His Patients for Profit