Intimate exams were 'not necessary', says expert at trial of ex-Kitchener neurologist

Warning: This story contains some graphic details.

The trial of former Kitchener, Ont. neurologist Jeffrey Sloka continued at the Waterloo Region Courthouse on Wednesday with health expert testimony on what type of procedures should be conducted during a neurological exam.

Sloka is facing 50 counts of sexual assault in connection to incidents dating back to 2010. The age of his alleged victims ranged from those in their teens to their fifties.

He is pleading not guilty.

On Thursday, Dr Vera Bril, a neurologist, shared her opinion on the notes Sloka had taken while examining and treating some patients.

All the patient cases discussed during the trial on Thursday had been referred to see Sloka to get treatment for recurring headaches and migraines.

In one case, a 17-year-old patient had come in to see Sloka for issues with light sensitivity, headaches and migraines.

The Crown told Dr Bril that Sloka allegedly proceeded to give the patient a breast exam, leaving her bare breasts exposed for several minutes. Dr Bril also heard how the patient was allegedly asked to lie down naked on the examination bed in a "frog-like position" with her knees pulled to her chest.

You have to twist your mind so much to understand the reason for these exams.​​- Dr Vera Bril said in court on Thursday

Sloka's notes from other female patients showed similar patterns. In some cases, it was alleged that a finger was inserted into the vagina of the patient, their buttocks were spread apart or the patient's breasts were cupped.

Dr. Bril determined that it was not medically reasonable to conduct a breast or skin exam to find the cause of recurring headaches and migraines. She noted that even when skin exams are necessary, as a standard practice the patient's genitalia is kept covered.

"You have to twist your mind so much to understand the reason for these exams," said Dr. Bril.

When it comes to breast exams, she said a neurologist must refer their patient to a physician. If the patient is worried about discharge coming from their nipples, the neurologist should do a blood test and order an MRI scan of the patient's brain.

In some of the cases discussed on Thursday, Dr. Bril said Sloka did not meet the standard of care because he had failed to write down his reasoning for conducting the skin exams.

Genital exams

Dr Bril said there is never a need for a neurologist to touch the genital areas of a patient. She said in rare cases, it may be appropriate to touch other parts of the body, for example, if the patient is 'morbidly obese' and the examiner needs to get a better look under larger folds of skin.

Sloka had a primary practice at Grand River Hospital but also had privileges at Guelph General Hospital and St Mary's General Hospital in Kitchener. 

He was put under restrictions in September 2017 due to the accusations. He was then stripped of his licence in May 2019 and arrested four months later in September.

Police announced multiple sets of charges against Sloka and by June 17, he faced 76 offences in connection with separate sexual assaults against women in Waterloo region. However, since that time several charges have been withdrawn at the request of the Crown.

The trial continues on Monday.

Read more about this trial and events leading up to it through CBC's coverage here: 

• Kitchener neurologist faces hearing over sexual abuse accusations
• Former Kitchener neurologist stripped of licence after patients sexually assaulted
• Former Kitchener, Ont., neurologist charged with 34 counts of sexual assault
• Former Kitchener neurologist faces new sexual assault charges
• Woman sues former Kitchener neurologist accused of sexually assaulting 63 patients
• Waterloo Regional Police lay 8 more sexual assault charges on former neurologist
• Trial of former Kitchener neurologist opens with summary of years of alleged sexual assaults
• Trial of ex-Kitchener neurologist continues as expert outlines standards for exams