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Wojcicki, Andrzej Tomasz

CPSO#: 64521

MEMBER STATUS
Expired: Resigned from membership as of 13 Mar 2020
CURRENT OR PAST CPSO REGISTRATION CLASS
None as of 12 Dec 2014

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English, Polish

Education: Bialystok University, 1977

Practice Information

Primary Location of Practice
Practice Address Not Available

Professional Corporation Information


Corporation Name: Andrew Wojcicki Medicine Professional Corporation
Certificate of Authorization Status: Inactive: Jul 24 2020

Specialties

Specialty Issued On Type
Internal Medicine Effective:06 Nov 1996 RCPSC Specialist

Postgraduate Training

Please note: This information may not be a complete record of postgraduate training.



University of Toronto, 01 Jul 1991 to 30 Jun 1992
Resident 1 - Geriatric Medicine

University of Toronto, 01 Jul 1992 to 30 Jun 1993
Resident 2 - Geriatric Medicine

University of Toronto, 01 Jul 1993 to 30 Jun 1994
Resident 3 - Internal Medicine

University of Toronto, 01 Jul 1994 to 30 Jun 1995
Resident 4 - Internal Medicine

University of Toronto, 01 Jul 1995 to 30 Jun 1996
Resident 5 - Internal Medicine

University of Toronto, 01 Jul 1996 to 30 Jun 1997
CF - Internal Medicine

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 23 Aug 1991
Transfer of class of registration to: Independent Practice Certificate Effective: 21 Nov 1996
Transfer of class of certificate to: Restricted certificate Effective: 12 Dec 2014
Terms and conditions imposed on certificate Effective: 12 Dec 2014
Terms and conditions amended by member Effective: 19 Feb 2016
Terms and conditions amended by Discipline Committee Effective: 22 Feb 2016
Suspension of registration imposed: Discipline Committee Effective: 22 Feb 2016
Suspension of registration removed Effective: 22 Apr 2016
Terms and conditions amended by member Effective: 02 Aug 2019
Expired: Resigned from membership. Expiry: 13 Mar 2020

Previous Hearings

Committee: Discipline
Decision Date: 22 Feb 2016
Summary:

On February 22, 2016, the Discipline Committee found that Dr. Andrzej Tomasz Wojcicki has committed an act of professional misconduct in that he failed to maintain the standard of practice of the profession and has engaged in an act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional. The Discipline Committee also found that Dr. Wojcicki is incompetent.

After receiving information from an anonymous source and from a physician, the College began a section 75(1)(a) investigation into Dr. Wojcicki’s practice.

Dr. X, an independent expert, provided an opinion on Dr. Wojcicki’s internal medicine practice and complementary and alternative medicine practice based on his care of 25 patients. Dr. X concluded that Dr. Wojcicki’s care did not meet the standard of practice of the profession in all of the 25 charts reviewed. In 24 of these charts, Dr. X also found that Dr. Wojcicki’s care reflected a lack of knowledge, skill and judgment and that his clinical practice is likely to expose many of his patients to a risk of harm or injury. The details of Dr. X’s concerns include:

- Dr. Wojcicki’s documentation practices do not meet the standard of practice of the profession. For example, he does not appear to use a Cumulative Patient Profile or similar instrument to document patient’s previous and current medical problems and treatment;
- Dr. Wojcicki makes a diagnosis without explaining his reasoning in the same chart note [which] is particularly problematic in light of the unconventional diagnoses (e.g., adult hormone deficiency syndrome) that [he] reaches;
- In many instances, Dr. Wojcicki makes a treatment recommendation without indicating clearly why he has chosen a particular course of action;
- In many instances, Dr. Wojcicki recommends that patients with atherosclerosis undergo chelation and “plaque therapy” which consists of intravenous administration of phospholipids and other agents. This treatment is not considered standard and … if offered should be done so in the context of an approved research study or under the auspices of the CPSO’s Complementary and Alternative Medicine Policy;
- ...in several instances, not only with regard to plaque therapy and intravenous chelation, but also in regard to bioidentical hormone replacement therapy… Dr. Wojcicki’s practice does not adhere to CPSO’s Complementary and Alternative Medicine Policy;
- Dr. Wojcicki recommends that patients with testosterone levels below the reference range be treated with testosterone creams, even in older adults (e.g., patients over the age of 65) who do not have symptoms and signs strongly suggestive of testosterone deficiency, and even in those with a history of prostate disease;
- Dr. Wojcicki recommends that patients with “adult hormone deficiency syndrome” or simply “hormone deficiency” be treated with growth hormone [and] in some cases this diagnosis is reached even when IGF-1 is within the reference range….the standard of practice is such that the diagnosis would generally be made or confirmed by an endocrinologist [and] treatment should also generally occur under the supervision of an endocrinologist;
- In many instances, Dr. Wojcicki appears to have ordered tests that are not indicated given the clinical circumstances – e.g., C-peptide levels, FSH and LH levels in women who are obviously post-menopausal, estradiol and progesterone in men, co-enzyme Q10, Vitamin A, mercury, various tumour markers, etc. … the ordering of these tests reflects a lack of knowledge and judgment and is inconsistent with the standard of practice;
- In one instance, Dr. Wojcicki treated a patient with a history of estrogen receptor positive breast cancer with estrogen. Such treatment is contra-indicated and… should only be offered in extremely unusual circumstances with the approval of a patient’s oncologist;
- Dr. Wojcicki treated post-menopausal women with estrogen. Because of the increased risk of cardiovascular disease, the standard of practice is that estrogen should only be used to treat severe menopausal symptoms, for a short period of time, and only after discussion of benefits and risks;
- In at least one instance, he treated a patient with newly diagnosed metastatic breast cancer with unconventional treatments without documenting a discussion regarding chemotherapy and without referring her to a medical oncologist; and
- In some instances, Dr. Wojcicki has provided care to patients with established medical diagnoses and has not treated these patients in a manner consistent with standard medical practice.

In response to the College expert’s report, Dr. Wojcicki retained Dr. Y, a practitioner of integrative-complementary/alternative medicine, to provide an opinion with respect to his care and treatment of patients at the Vivian Medical Spa. Dr. Y opined that “Dr. Wojcicki’s care, as demonstrated in the chart review, did not meet the standard of care expected of the profession. Dr. Wojcicki demonstrates a lack of compliance and understanding of the CPSO’s policy related to CAM Practice. He has displayed a lack of judgment in his care, and a failure to provide proper informed consent. His record-keeping is inadequate. Illustratively, Dr. Wojcicki demonstrated a lack of judgment in the prescribing of bio-identical estrogen replacement to a receptor positive breast cancer patient. The patient record does not contain any evidence of a consent discussion. Also of significant concern is the application of chelation therapy without fulsome assessment or proper informed consent, to a patient on whom he initiated intravenous chelation therapy by way of email correspondence. As teacher and Co-Chair for the Chelation Therapy workshop for ACAM, the world leader in chelation training and whose protocol was adopted for the TACT study, it is, in my view, below standard for a patient to begin the treatments in the manner that this individual did i.e. without examination by Dr. Wojcicki… Dr. Wojcicki’s [sic] has inaccurately described the study results in his correspondence and dialogue with his patients, given that the TACT subjects were an exclusive group, of specific age and clear cardiac history (not simply hypertensive or diabetic). It is imperative that standard therapies be discussed and documented in the patient chart prior to initiation of any CAM modality, according to the CAM policy of the CPSO. This fact is not consistently demonstrated by Dr. Wojcicki, nor is there sufficient evidence of robust discussion/ documentation of risks of therapies offered or denied. This would apply particularly to his management of dyslipidemia and “hormone deficiency syndromes.”

SECTION 75(1)(A) INVESTIGATION RE: HOSPITAL PRACTICE

The College commenced an investigation into Dr. Wojcicki’s hospital based internal medicine practice. The College retained an independent expert, Dr. Z, to opine on the 25 patients charts. Dr. Z stated that Dr. Wojcicki’s care and documentation fell below the standard of practice of the profession in 16 out of 24 charts.

Dr. Z found 4 instances that demonstrated Dr. Wojcicki’s lack of knowledge, including:

- In two cases a full dose of enoxaparin was ordered in a patient with severe renal insufficiency;
- An incorrect dose of IV Zantac was prescribed; and
- The wrong dose of Digoxin was prescribed.

 With respect to his lack of judgment, Dr. Z found that Dr. Wojcicki:

- Did not address elevated troponin and creatinine levels in testing done in the E.R. for one patient;
- Did not acknowledge or treat pneumonia perceived on chest x-ray done in the E.R. for one patient;
- Ordered triple anticoagulation for a patient without sufficient evidence it was needed;
- Ordered medications a patient was taking at home without regard for E.R. clinical status;
- Ordered anticoagulant and laxatives in a patient with bloody diarrhea; and
- Did not consider that a follow-up appointment was needed for patient to receive biopsy results.

With respect to lack of skill, Dr. Z stated: “There was consistent criticism of inadequate Consult Notes and Discharge Summaries. I felt that the Consult Notes were very brief and did not reflect the consultation that would be expected from an Internist. The Discharge Summaries generally did not provide a good picture of the events of the hospitalization.”

Dr. Z found that the following examples from the charts demonstrate that Dr. Wojcicki’s practice, behaviour or conduct exposes or is likely to expose patients to harm or injury:
- Triple anticoagulant therapy based on diagnosis of Acute Coronary Syndrome, without firm evidence to support this diagnosis;
- Two cases of prescribing a full prophylactic dose of enoxaparin when creatinine levels were, respectively, 1479 and 379;
- Ordering prophylactic anticoagulation in patient having bloody diarrhea and ordering NSAID in same patient with history of esophagitis and preplyoric ulcerations; and
- Ordering a dose of Digoxin 0.625 mg instead of 0.0625 mg.

 In response to Dr. Z’s opinion, Dr. Wojcicki provided an expert report by Dr. U dated July 16,2015. In summarizing her review of the same 25 charts that Dr. Z had reviewed, Dr. U noted: “In general, I do agree that Dr. Wojcicki’s notes tend to be quite brief and more complete notes would often be helpful. I would encourage him to be more complete in his note writing/dictation, perhaps following a template including all parts of a complete consultation letter. However, in general, I find his care to be appropriate. Occasionally I do find that I had to extrapolate based on the rest of the chart and other consult notes and orders. Overall documentation seems to be sparse, for example in admitted patients there are only progress notes seen. In someone admitted for a very short period of time, an admit note and discharge summary suffices as adequate; however when patients are admitted for longer durations I would expect to see more documentation from the MRP (Most Responsible Physician). This is likely to be a systems issue [at the hospital], given that Dr. Wojcicki is not generally the MRP and likely multiple other physicians serve this role, and in this sampling of 25 charts I found this to be a common issue. I understand that the system of writing discharge notes is often left to the weekend covering attending instead of the usual MRP. This is a system issue, which could use correction in the hospital…Similarly another easy careless error which can occur is a mistaken dose of medication. This should also have a system level backup, such as with an Electronic medical record or pharmacy, which should catch such dosing errors.”

ONTARIO HEALTH INSURANCE PLAN (OHIP) BILLING ISSUES

The College obtained OHIP billing information regarding care and treatment Dr. Wojcicki provided at the Vivian Medical Spa in the first section 75(1)(a) investigation, covering services provided between November 1, 2011 and December 31, 2012. The College concluded that Dr. Wojcicki billed OHIP on numerous occasions for services for which there is no documentation. In particular 21 of the patients whose charts were reviewed attended for intravenous treatment on a weekly or twice weekly basis, and Dr. Wojcicki never directly assessed these patients on many of these occasions. They were instead under supervision of nurses. Dr. Wojcicki would do ‘rounds’ with the nurses to discuss any issues with respect to individual patients. On these occasions, Dr. Wojcicki submitted claims to OHIP using billing codes such as A138, which is the internal medicine code for a partial assessment which requires direct examination of the patient, without assessing patients directly.

SECTION 37 INTERIM ORDER BY THE COLLEGE

On December 10, 2014, after referring allegations of professional misconduct to the Discipline Committee, the Inquiries Complaints and Reports Committee directed the Registrar to impose terms, conditions and limitations on Dr. Wojcicki’s certificate of registration pursuant to section 37 of the Code. The Order required that Dr. Wojcicki cease to engage in complementary / alternative medicine practice, among other things.



UNDERTAKING TO THE COLLEGE

As part of the resolution of the allegations referred to the Discipline Committee, Dr. Wojcicki executed an undertaking to the College on February 19, 2016. Dr. Wojcicki agreed to cease engaging in any CAM practice and has undertaken not to apply or reapply to practice CAM in Ontario. He must also post a sign indicating this restriction in all locations where he practices primary care.

ORDER

The Discipline Committee ordered and directed that:
- the Registrar suspend Dr. Wojcicki’s certificate of registration for a period of two (2) months, effective immediately.
- the Registrar to place the following terms, conditions and limitations on Dr. Wojcicki’s certificate of registration:

EDUCATION
(a) Dr. Wojcicki shall, at his own expense, participate in and successfully complete the following educational courses:
i. McMaster University Review Course in Internal Medicine (March 30, 2016 to April 1, 2016); and
ii. Canadian Cardiovascular Research Network course entitled “Gauging the Guidelines” (February 27, 2016);

OFFICE PRACTICE CLINICAL SUPERVISION
(b) Within thirty (30) days of the date of this Order, Dr. Wojcicki shall obtain a clinical supervisor acceptable to the College, who will supervise Dr. Wojcicki’s internal medicine office practice (the “Office Practice Clinical Supervision”) for a period of six (6) months, and who will sign an undertaking in the form attached hereto as Schedule “B” (the “Office Practice Clinical Supervisor”);
(c) The Office Practice Clinical Supervision shall be at a moderate level for a minimum of six (6) months, commencing on the date following the expiry of the suspension of Dr. Wojcicki’s certificate of registration. The Office Practice Clinical Supervisor will meet with Dr. Wojcicki bi-weekly and review ten (10) of Dr. Wojcicki’s patient charts, discuss Dr. Wojcicki’s patient care, treatment plan and follow-up, identify any concerns regarding the care, treatment plan and follow-up and make recommendations for improvement;
(d) After three (3) months, and only upon recommendation by the Office Practice Clinical Supervisor and approval of the College, the Office Practice Clinical Supervision may be reduced to a low level for the remaining three (3) months, such that the frequency of meetings and chart reviews by the Office Practice Clinical Supervisor shall be reduced to monthly;
(e) Within six (6) months after the completion of the Office Practice Clinical Supervision, Dr. Wojcicki will submit to a reassessment of his internal medicine office practice (the “Office Practice Reassessment”) by an assessor or assessors selected by the College (the “Office Practice Assessor(s)”). The Office Practice Reassessment may include a chart review, direct observation of Dr. Wojcicki’s care, interviews with colleagues and co-workers, feedback from patients and any other tools deemed necessary by the College. Dr. Wojcicki shall abide by all recommendations made by the Office Practice Assessor(s), and the results of the Office Practice Reassessment will be reported to the College and may form the basis of further action by the College;

HOSPITAL PRACTICE CLINICAL SUPERVISION
(f) Within thirty (30) days of the date of this Order, Dr. Wojcicki shall obtain a clinical supervisor acceptable to the College, who will supervise Dr. Wojcicki’s hospital practice (the “Hospital Clinical Supervision”) for a period of three (3) months, and who will sign an undertaking in the form attached hereto as Schedule “C” (the “Hospital Clinical Supervisor”);
(g) Hospital Clinical Supervision will commence on the date following the expiry of the suspension of Dr. Wojcicki’s certificate of registration. The Hospital Clinical Supervisor will meet with Dr. Wojcicki monthly and review charts for every patient where Dr. Wojcicki has been the Most Responsible Physician, discuss Dr.Wojcicki’s patient care, including documentation and record-keeping, treatment plan and follow-up, identify any concerns regarding the care, documentation, record-keeping, treatment plan and follow-up and make recommendations for improvement;
(h) Within six (6) months after the completion of the Hospital Clinical Supervision, Dr. Wojcicki will submit to a Reassessment of his hospital practice (the “Hospital Reassessment”) by an assessor or assessors selected by the College (the “Hospital Assessor(s)”). Hospital Reassessment may include a chart review, direct observation of Dr. Wojcicki’s care, interviews with colleagues and co-workers, feedback from patients and any other tools deemed necessary by the College. Dr. Wojcicki shall abide by all recommendations made by the Hospital Assessor(s), and the results of the Hospital Reassessment will be reported to the College and may form the basis of further action by the College;

COLLECTIVE CLINICAL SUPERVISION
(i) Dr. Wojcicki shall cooperate fully with the Office Practice Clinical Supervision and Hospital Clinical Supervision and abide by all recommendations of his Clinical Supervisor(s) with respect to practice improvements and education;
(j) Dr. Wojcicki shall consent to the disclosure by his Clinical Supervisors to the College, and by the College to his Clinical Supervisors, of all information the Clinical Supervisors or the College deems necessary or desirable in order to fulfill the Clinical Supervisors’ undertaking and to monitor Dr. Wojcicki’s compliance with this Order. This shall include, without limitation, providing the Clinical Supervisors with any reports of any assessments of Dr. Wojcicki’s practice in the College’s possession;
(k) If a Clinical Supervisor(s) who has given an undertaking in Schedule “B” and/or Schedule “C” to this Order is unable or unwilling to continue to fulfill its terms, Dr. Wojcicki shall, within twenty (20) days of receiving notice of same, obtain an
executed undertaking in the same form from a similarly qualified person who is acceptable to the College and ensure that it is delivered to the College within that time;
(l) If Dr. Wojcicki is unable to obtain a Clinical Supervisor in accordance with paragraphs 5(b), 5(f) or 5(k) of this Order, he shall cease practising medicine until such time as he has done so, and the fact that he has will constitute a term, condition or limitation on his certificate of registration until that time;
(m) Dr. Wojcicki shall co-operate with unannounced inspections and shall consent to the monitoring of his OHIP billings of his Office Practice and his Hospital Practice by a College representative(s), for the purpose of monitoring and enforcing his compliance with the terms of this Order;
(n) Dr. Wojcicki shall inform the College of each and every location that he practises or has privileges, including, but not limited to, hospital(s), clinic(s) and office(s), in any jurisdiction within fifteen (15) days of this Order, and shall inform the College of any and all new Practice Locations within fifteen (15) days of commencing practice at that location;
(o) Dr. Wojcicki shall be responsible for any and all costs associated with implementing the terms of this Order.
- Dr. Wojcicki to appear before the panel to be reprimanded.
- Dr. Wojcicki pay costs to the College in the amount of $5,000.00 within 30 days of the date of this Order.
 


Decision: Download Full Decision (PDF)
Appeal: No Appeal
Hearing Date(s): February 22, 2016

Concerns

Source: Member
Active Date: May 20, 2020
Expiry Date:
Summary:
Summary of the Undertaking given by Dr Andrzej Wojcicki Tomasz to the College of Physicians and Surgeons of Ontario, effective May 20, 2020:

College Investigations were conducted into whether Dr. Wojcicki failed to maintain the standard of practice of the profession and was incompetent, and with respect to his compliance with the Out of Hospital Premises Inspection Program. In the face of the Investigations and an unsatisfactory reassessment report received by the College on December 3, 2019, Dr. Wojcicki resigned from the College on March 13, 2020, and has agreed never to apply or reapply for registration as a physician in Ontario or any other jurisdiction.
Download Full Document (PDF)

 

Source: Inquiries, Complaints and Reports Committee
Active Date: September 7, 2016
Expiry Date:
Summary:
Caution-in-Person:

A summary of a decision of the Inquiries, Complaints and Reports Committee in which the disposition includes a "caution-in-person" is required by the College by-laws to be posted on the register, along with a note if the decision has been appealed. A “caution-in-person” disposition requires the physician to attend at the College and be verbally cautioned by a panel of the Committee. The summary will be removed from the register if the decision is overturned on appeal or review. Note that this requirement only applies to decisions arising out of a complaint dated on or after January 1, 2015 or if there was no complaint, the first appointment of investigators dated on or after January 1, 2015.

See PDF for the summary of a decision made against this member in which the disposition includes a caution-in-person:
Download Full Document (PDF)

 

Source: Member
Active Date: February 19, 2016
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Andrzej Tomasz Wojcicki to the College of Physicians and Surgeons of Ontario, effective February 19, 2016:

Allegations of professional misconduct and incompetence regarding Dr. Wojcicki were referred to a discipline hearing by the College. As a result, Dr. Wojcicki must not practise complementary and alternative medicine.

Dr. Wojcicki shall post a clearly visible sign in the waiting rooms of all his primary care Practice Locations, which states as follows: ''Dr. Wojcicki must not practise complementary and alternative medicine. Further information may be found on the College of Physicians and Surgeons of Ontario website at www.cpso.on.ca".

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