(1 of 2)
As from July 9, 2023, the following are imposed as terms, conditions and limitations on the certificate of registration held by Dr. Balpreet Singh Brar in accordance with an undertaking and consent given by Dr. Brar to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. BALPREET SINGH BRAR
("Dr. Brar")
to
COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
(the "College")
________________________________________
A. PREAMBLE
(1) In this Undertaking:
"Code" means the Health Professions Procedural Code, which is Schedule 2 to the Regulated Health Professions Act, 1991, S.O. 1991, c. 18, as amended;
"Discipline Tribunal" means the Ontario Physicians and Surgeons Discipline Tribunal of the College;
"ICR Committee" means the Inquiries, Complaints and Reports Committee of the College;
"OHIP" means the Ontario Health Insurance Plan;
"Ontario Physicians and Surgeons Discipline Tribunal" means the Discipline Committee established under the Code;
"Public Register" means the College's register that is available to the public.
(2) I, Dr. Brar, certificate of registration number 92605, am a member of the College.
(3) I, Dr. Brar, acknowledge that I entered into an Undertaking with the College dated February 23, 2022 ("the February 2022 undertaking") in which I agreed to undergo remediation, including clinical supervision, education and a reassessment of my practice. As of the date of this Undertaking, the requirements of the February 2022 undertaking have not been completed.
(4) I, Dr. Brar, acknowledge that this Undertaking does not supersede or replace the February 2022 undertaking. For greater certainty, I, Dr. Brar, acknowledge that the February 2022 undertaking remains in force.
(5) I, Dr. Brar, acknowledge that the College has received information regarding my standard of practice in General Surgery and that the College is conducting an investigation, bearing File Number CAS-420483-Z3W5L4, into the information. I am aware of the College's concern about protecting the public.
(6) I, Dr. Brar, acknowledge that the ICR Committee has accepted this Undertaking in lieu of making an Order under section 25.4 of the Code at this time.
(7) I, Dr. Brar, acknowledge that this Undertaking does not preclude the ICR Committee from making an order at a later date in accordance with the Code.
(8) I, Dr. Brar, acknowledge that this Undertaking continues in force until the matters currently being investigated are disposed of by a panel of the ICR Committee or the Discipline Tribunal.
B. UNDERTAKING
(9) I, Dr. Brar, undertake to abide by the provisions of this Undertaking, effective immediately ("Effective Date").
(10) Practice Restrictions
(a) I, Dr. Brar, undertake to restrict my practice to diagnostic endoscopy and any clinically indicated biopsies required during endoscopy.
(11) Monitoring
(a) I, Dr. Brar, undertake to inform the College of each and every location at which I practice, delegate, or have privileges, including, but not limited to, any hospitals, clinics, offices, and any Out-of-Hospital Premises and Independent Health Facilities with which I am affiliated, in any jurisdiction (collectively my "Practice Location" or "Practice Locations"), within five (5) days of executing this Undertaking. Going forward, I further undertake to inform the College of any and all new Practice Locations within five (5) days of commencing practice at that location.
(b) I, Dr. Brar, undertake that I will submit to, and not interfere with, unannounced inspections of my Practice Locations and patient charts by a College representative for the purposes of monitoring my compliance with the provisions of this Undertaking.
(c) I, Dr. Brar, give my irrevocable consent to the College to make appropriate enquiries of OHIP, and/or any person or institution that may have relevant information, in order for the College to monitor my compliance with the provisions of this Undertaking.
(d) I, Dr. Brar, acknowledge that I have executed the OHIP consent form, attached hereto as Appendix "A".
C. ACKNOWLEDGEMENT
(12) I, Dr. Brar, acknowledge that all appendices attached to or referred to in this Undertaking form part of this Undertaking.
(13) I, Dr. Brar, acknowledge and undertake that I shall be solely responsible for payment of all fees, costs, charges, expenses, etc. arising from the implementation of any of the provisions of this Undertaking.
(14) I, Dr. Brar, acknowledge that I have read and understand the provisions of this Undertaking and that I have obtained independent legal counsel in reviewing and executing this Undertaking, or have waived my right to do so.
(15) I, Dr. Brar, acknowledge that the College will provide this Undertaking to any Chief of Staff, or a colleague with similar responsibilities, at any Practice Location ("Chief of Staff" or "Chiefs of Staff").
(16) I, Dr. Brar, acknowledge that, in the event of a referral to the Discipline Tribunal and in the event of an appeal of any order of the Discipline Tribunal, if the Discipline Tribunal has directed the Registrar to revoke, suspend, or impose terms and conditions on my certificate of registration, that order will take effect immediately despite any appeal.
(17) I, Dr. Brar, acknowledge that a breach by me of any provision of this Undertaking may constitute an act of professional misconduct and/or incompetence, and may result in a referral of specified allegations to the Discipline Tribunal.
(18) I, Dr. Brar, acknowledge that this Undertaking constitutes terms, conditions, and limitations on my certificate of registration for the purposes of section 23 of the Code.
(19) Public Register
(a) I, Dr. Brar, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. Brar, acknowledge that, in addition to this Undertaking being posted in accordance with section (19)(a) above, the following summary shall be posted on the Public Register during the time period that this Undertaking remains in effect:
The College has received information regarding Dr. Brar's standard of practice in General Surgery and is conducting an investigation into the information. During the investigation and in the event of a referral to the Discipline Tribunal, Dr. Brar has restricted his practice as follows:
Dr. Brar shall only perform diagnostic endoscopy and clinically indicated biopsies required during endoscopy.
D. CONSENT
(20) I, Dr. Brar, give my irrevocable consent to the College to provide all Chiefs of Staff with any information the College has that led to the circumstances of my entering into this Undertaking and/or any information arising from the monitoring of my compliance with this Undertaking.
(21) I, Dr. Brar, give my irrevocable consent to all Chiefs of Staff to disclose to the College, and to one another, any information relevant to this Undertaking and/or relevant for the purposes of monitoring my compliance with this undertaking.
(2 of 2)
As from February 23, 2022, the following are imposed as terms, conditions and limitations on the certificate of registration held by Dr. Balpreet Singh Brar in accordance with an undertaking and consent given by Dr. Brar to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. BALPREET SINGH BRAR
("Dr. Brar")
to
COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
(the "College")
A. PREAMBLE
(1) In this Undertaking:
"Code" means the Health Professions Procedural Code, which is Schedule 2 to the Regulated Health Professions Act, 1991, S.O. 1991, c. 18, as amended;
"Discipline Tribunal" means the Ontario Physicians and Surgeons Discipline Tribunal of the College;
"OHIP" means the Ontario Health Insurance Plan;
"Ontario Physicians and Surgeons Discipline Tribunal" means the Discipline Committee established under the Code;
"Public Register" means the College's register that is available to the public.
(2) I, Dr. Brar, certificate of registration number 92605, am a member of the College.
(3) I, Dr. Brar, am a general surgeon practicing at the Queensway Carleton Hospital (QCH). I also have privileges at Arnprior Hospital where I perform minor surgeries and endoscopies.
(4) I, Dr. Brar, acknowledge that the College conducted an investigation bearing File Number CAS-132365-F0V3S9 (previously 1112508) (the "Investigation") into my general surgery practice.
B. UNDERTAKING
(5) I, Dr. Brar, undertake to abide by the provisions of this Undertaking, effective immediately.
(6) Clinical Supervision
(a) I, Dr. Brar, undertake to practise at QCH under the guidance of a clinical supervisor or clinical supervisors acceptable to the College (the "Clinical Supervisor" or "Clinical Supervisors"), for at least six (6) months ("Clinical Supervision").
(b) I, Dr. Brar, acknowledge that I have reviewed the Clinical Supervisor's undertaking, attached hereto as Appendix "A", and understand what is required of the Clinical Supervisor. The Clinical Supervisor will, at minimum:
(i) Facilitate the education program set out in the Individualized Education Plan ("IEP"), attached hereto as Appendix "B";
(ii) Review the materials provided by the College and have an orientation session with me, including to discuss the objectives for the Clinical Supervision;
(iii) Meet with me at my Practice Location, or another location approved by the College, once every two (2) weeks for a minimum of two (2) months;
(iv) Directly observe my surgical practice for one day;
(v) After a minimum of two (2) months of Clinical Supervision, if my Clinical Supervisor recommends and the College approves a reduction in the level of supervision, my Clinical Supervisor will meet with me at my Practice Location, or another location approved by the College, once every month for a further four (4) months;
(vi) Review all surgical cases performed at QCH since the last meeting or up to twenty (20) of my patient charts at every meeting;
(vii) Discuss any concerns arising from the chart reviews;
(viii) Make recommendations to me for practice improvements and ongoing professional development and inquire into my compliance with the recommendations;
(ix) Perform any other duties, such as reviewing other documents or conducting interviews with staff or colleagues, that the Clinical Supervisor deems necessary to my Clinical Supervision; and
(x) Submit written reports to the College at least once every month for two (2) months or until the College approves a reduction in the level of supervision, and then once every two months or more frequently if the Clinical Supervisor has concerns about my standard of practice.
(c) I, Dr. Brar, acknowledge that in the event there are insufficient charts for my supervisor to review, the College may require an extension of the duration of the Supervision.
(d) I, Dr. Brar, acknowledge that the charts reviewed shall be selected by the Clinical Supervisor based on the educational needs identified in the IEP, attached hereto as Appendix "B", as well as the areas of concern identified in the Investigation, and concerns that may arise during the period of Clinical Supervision.
(e) I, Dr. Brar, undertake to cooperate fully with the Clinical Supervision of my practice, conducted under the term of this Undertaking and Appendix "A" to this Undertaking, and to abide by the recommendations of my Clinical Supervisor, including but not limited to, any recommended practice improvements and ongoing professional development.
(f) I, Dr. Brar, undertake to ensure that Appendix "A" to this Undertaking is signed and delivered to the College within sixty (60) days of the date I execute this Undertaking.
(g) I, Dr. Brar, undertake that if a person who has given an undertaking in Appendix "A" to this Undertaking is unable or unwilling to continue to fulfill its provisions, I shall, within thirty (30) 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.
(h) I, Dr. Brar, undertake that if I am unable to obtain a Clinical Supervisor on the provisions set out under sections (5)(e) and/or (f) above, I will cease practising medicine at QCH until such time as I have obtained a Clinical Supervisor acceptable to the College.
(i) I, Dr. Brar, acknowledge that if I am required to cease practise at QCH as a result of section (6)(h) above this will constitute a term, condition or limitation on my certificate of registration and that term, condition or limitation will be included on the public register.
(7) Professional Education
(a) I, Dr. Brar, undertake to participate in and successfully complete all aspects of the detailed IEP, attached hereto as Appendix "B", including all of the following professional education (the "Professional Education"):
(i) Medical Record-Keeping Course, University of Toronto:
(ii) Effective Team Interactions, Saegis
(iii) Leadership Begins with Self-Awareness, CMA-Joule
(iv) Review, reflection, and discussion with Clinical Supervisor of the following policies and other self-study:
1. ASA Physical Status Classification Guideline, CPSBC
2. The Practice Guide, CPSO
3. Medical Records Documentation, CPSO
4. Consent to Treatment, CPSO
5. Good practices: Informed discharge, CMPA
(v) any additional professional education recommended by my Clinical Supervisor.
(b) I, Dr. Brar, undertake to provide proof to the College of my successful completion of the Professional Education, including proof of registration and attendance and participant assessment reports, within one (1) month of completing it. I acknowledge that the College will determine, in its sole discretion, whether I have successfully completed the Professional Education.
(c) I, Dr. Brar, undertake to complete this requirement within six months or, if no satisfactory program is available by that time, by the first possible opportunity thereafter.
(d) I, Dr. Brar, acknowledge that a report or reports may be provided to the College regarding my progress and compliance with the Professional Education.
(e) I, Dr. Brar, acknowledge that if any of the programs listed above become unavailable, substitution requests will be reviewed by the College and the College will determine in its sole discretion whether substitution is appropriate.
(8) Reassessment of Practice
(a) I, Dr. Brar, undertake that, approximately six (6) months after the completion of the Clinical Supervision set out in section (5) above and Appendix "A" to this Undertaking, and the completion of the Professional Education set out in section (6) above, I will submit to a reassessment of my practice ("the Reassessment") by an assessor or assessors selected by the College (the "Assessor" or "Assessors"). I acknowledge that the Reassessment may include a chart review of a minimum of fifteen (15) charts, direct observation of my care, interviews with me, colleagues and co-workers, feedback from patients, and any other tools deemed necessary by the College.
(b) I, Dr. Brar, undertake to co-operate fully with the Reassessment, conducted under the term of this Undertaking.
(c) I, Dr. Brar, acknowledge that my Clinical Supervisor may receive and review the findings of the Assessor, and may discuss with the Assessor any issues or concerns arising from the Reassessment.
(d) I, Dr. Brar, acknowledge that the results of the Reassessment will be provided to me and reported to the College and the Reassessment may form the basis of further action by the College.
(9) Monitoring
(a) I, Dr. Brar, undertake to inform the College of each and every location at which I practice, delegate, or have privileges, including, but not limited to, any hospitals, clinics, offices, and any Out-of-Hospital Premises or Independent Health Facilities with which I am affiliated, in any jurisdiction (collectively my "Practice Location" or "Practice Locations"), within five (5) days of executing this Undertaking. Going forward, I further undertake to inform the College of any and all new Practice Locations within five (5) days of commencing practice at that location.
(b) I, Dr. Brar, undertake that I will submit to, and not interfere with, unannounced inspections of my Practice Locations and patient records by a College representative for the purposes of monitoring my compliance with the provisions of this Undertaking.
(c) I, Dr. Brar, give my irrevocable consent to the College to make appropriate enquiries of OHIP, and/or any person who or institution that may have relevant information, in order for the College to monitor my compliance with the provisions of this Undertaking.
(d) I, Dr. Brar, acknowledge that I have executed the OHIP consent form, attached hereto as Appendix "C".
C. ACKNOWLEDGEMENT
(10) I, Dr. Brar, acknowledge that all appendices attached to or referred to in this Undertaking form part of this Undertaking.
(11) I, Dr. Brar, acknowledge and undertake that I shall be solely responsible for payment of all fees, costs, charges, expenses, etc. arising from the implementation of any of the provisions of this Undertaking.
(12) I, Dr. Brar, acknowledge that I have read and understand the provisions of this Undertaking and that I have obtained independent legal counsel in reviewing and executing this Undertaking, or have waived my right to do so.
(13) I, Dr. Brar, acknowledge that the College will provide this Undertaking to any Chief of Staff, or a colleague with similar responsibilities, at any Practice Location ("Chief of Staff" or "Chiefs of Staff").
(14) I, Dr. Brar, acknowledge that a breach by me of any provision of this Undertaking may constitute an act of professional misconduct and/or incompetence, and may result in a referral of specified allegations to the Discipline Tribunal of the College.
(15) I, Dr. Brar, acknowledge that this Undertaking constitutes terms, conditions, and limitations on my certificate of registration for the purposes of section 23 of the Code.
(16) Public Register
(a) I, Dr. Brar, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. Brar, acknowledge that, in addition to this Undertaking being posted in accordance with section (16)(a) above, the following summary shall be posted on the Public Register during the time period that this Undertaking remains in effect:
A College investigation was conducted into Dr. Brar's general surgery practice. As a result of the investigation:
Dr. Brar will practise at Queensway Carleton Hospital under the guidance of a Clinical Supervisor acceptable to the College for six (6) months.
Dr. Brar will engage in professional education.
Dr. Brar's practice will be reassessed by an assessor selected by the College within six (6) months of the end of the period of Clinical Supervision.
(c) I, Dr. Brar, acknowledge that this Undertaking remains in effect until the College determines its terms are satisfied.
D. CONSENT
(17) I, Dr. Brar, give my irrevocable consent to the College to provide the following information to any person who requires this information for the purposes of facilitating my completion of the Professional Education and to all Clinical Supervisors, and/or Assessors:
(a) any information the College has that led to the circumstances of my entering into this Undertaking;
(b) any information arising from any investigation into, or assessment of, my practice; and
(c) any information arising from the monitoring of my compliance with this Undertaking.
(18) I, Dr. Brar, give my irrevocable consent to the College to provide all Chiefs of Staff with any information the College has that led to the circumstances of my entering into this Undertaking and/or any information arising from the monitoring of my compliance with this Undertaking.
(19) I, Dr. Brar, give my irrevocable consent to any persons who facilitate my completion of the Professional Education, and to all Clinical Supervisors, Chiefs of Staff and Assessors, to disclose to the College, and to one another, any of the following:
(a) any information relevant to this Undertaking;
(b) any information relevant to the provisions of the Clinical Supervisor's undertaking set out at Appendix "A" to this Undertaking;
(c) any information relevant to the Reassessment;
(d) any information relevant for the purposes of monitoring my compliance with this Undertaking; and/or
(e) any information which comes to their attention in the course of providing the Professional Education and which they reasonably believe indicates a potential risk of harm to my patients.