WATERLOO REGION - A local sleep medicine doctor was found incompetent by the College of Physicians and Surgeons of Ontario.

Dr. Wagdy Botros displayed a lack of knowledge, skill and judgment that demonstrates he's unfit to continue to practise or that his practice should be restricted, the college said in its decision released Friday.

Botros runs the Sleep Clinic, with locations in Kitchener, Cambridge and London.

A penalty hearing is yet to be scheduled.

The decision said Botros failed to maintain professional standards in his care and treatment of 22 patients in his practice between 2007 and 2010. The committee ruled his care of patients was lacking in general, and specifically in the care of four patients who had severe conditions and one patient who was inappropriately diagnosed and managed.

Botros also acted unprofessionally with the college investigators, according to the ruling, and interfered with their work during an office visit and made derogatory and demeaning comments. He also failed to comply with multiple requests for information within a reasonable time.

A message left Wednesday with a staff member at Botros' local number was not returned.

The findings are based on the evidence of expert witnesses and Botros's own testimony at the hearing, held over 2013 and 2014.

Failings noted in the decision include not triaging all patient referrals as required, prescribing inappropriate treatment, incorrectly or incompletely diagnosing five patients, and demonstrating poor knowledge of CPAP treatment, a standard therapy for sleep apnea in which a machine provides a steady stream of pressurized air through a mask worn while sleeping.

This is not Botros's first trouble with the college.

Later this month, he faces a penalty hearing for failing to complete a specified continuing education course in communications as required by the college.

Botros also will appear before the discipline committee starting in September on allegations of professional misconduct. It's alleged he was incompetent or failed to maintain the standard of practice in the care of four patients, and acted unprofessionally with the representative of a former patient seeking records.

Botros graduated from an Egyptian university in 1975 and registered in Ontario in 1990, according to the college's website. His specialty is listed as psychiatry.