As from April 16th, 2024, the following are imposed as terms, conditions and limitations on the certificate of registration held by Dr. Cherie Ann Culic in accordance with an undertaking and consent given by Dr. Culic to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking") of
DR. CHERIE ANN CULIC
("Dr. Culic") 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. Culic, certificate of registration number 91597, am a member of the College.
(3) I, Dr. Culic, acknowledge that the College has received information regarding my standard of practice and is conducting an investigation, bearing File Number CAS-455239-T8F6Q2, into the information. I am aware of the College's concern about protecting the public.
(4) I, Dr. Culic, acknowledge that the College has accepted this Undertaking in lieu of making an Order under section 25.4 of the Code at this time.
(5) I, Dr. Culic, acknowledge that this Undertaking does not preclude the ICR Committee from making an order at a later date in accordance with the Code.
(6) I, Dr. Culic, acknowledge that this Undertaking continues in force until the matters currently being investigated are disposed of by a panel of the ICR Committee or Discipline Tribunal.
B. UNDERTAKING
(7) I, Dr. Culic, undertake to abide by the provisions of this Undertaking, effective immediately.
(8) Practice Restriction
(a) I, Dr. Culic, undertake that I will not discharge any patient brought to the Emergency Department by police services for the assessment of mental health issues, including for consideration of whether an application for psychiatric assessment under section 15 or 16 of the Mental Health Act, RSO 1990, c. M.7 should be made, prior to:
(i) obtaining a psychiatric consult through Health Sciences North;
(ii) documenting the advice provided by the consulting psychiatrist; and
(iii) following the recommendation of the consulting psychiatrist with respect to arranging admission for the patient to hospital or discharging the patient from the Emergency Department.
(b) I, Dr. Culic, undertake to maintain a log (the "Psychiatric Consult Log") of all patients for whom I obtain a psychiatric consult under section (8)(a) above, in the form attached hereto as Appendix "A".
(9) Clinical Supervision
(a) I, Dr. Culic, undertake to practise under the guidance of an emergency medicine clinical supervisor or emergency medicine clinical supervisors acceptable to the College (the "Clinical Supervisor") or "Clinical Supervisors"), ("Clinical Supervision").
(b) I, Dr. Culic, undertake to remain free of any conflict of interest with the Clinical Supervisor.
(c) I, Dr. Culic, acknowledge that I have reviewed the Clinical Supervisor's undertaking, attached hereto as Appendix "B", and understand what is required of the Clinical Supervisor. The Clinical Supervisor will, at minimum:
(i) Meet with me at my Practice Location, or another location approved by the College, once every two (2) weeks;
(ii) Review all entries in my Psychiatric Consult Log and the corresponding patient records to confirm that I have met the requirements of my Undertaking and that the discharge of any patient brought to the Emergency Department by a police service for the assessment of mental health issues was appropriate;
(iii) Discuss any concerns arising from the chart reviews;
(iv) 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;
(v) Submit written reports to the College at least once every month, or more frequently if the Clinical Supervisor has concerns about my standard of practice; and
(vi) Remain free of any conflict of interest with me.
(d) I, Dr. Culic, undertake to cooperate fully with the Clinical Supervision of my practice, conducted under the term of this Undertaking and Appendix "B" attached, and to abide by the recommendations of my Clinical Supervisor.
(e) I, Dr. Culic, undertake to ensure that Appendix "B" to this Undertaking, is signed and delivered to the College within ten (10) days of the date I execute this Undertaking.
(f) I, Dr. Culic, undertake that if a person who has given an undertaking in Appendix "B" to this Undertaking is unable or unwilling to continue to fulfill its provisions, I shall, within ten (10) 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.
(g) I, Dr. Culic, acknowledge that if I am unable to obtain a Clinical Supervisor on the provisions set out under sections (8)(e) and/or (f) above, I will cease practising medicine until such time as I have obtained a Clinical Supervisor acceptable to the College.
(h) I, Dr. Culic, acknowledge that if I am required to cease practise as a result of section (8)(g) 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.
(10) I, Dr. Culic, 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 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.
(11) I, Dr. Culic, undertake that I will submit to, and not interfere with, unannounced inspections of my Practice Locations and and to any other activity the College deems necessary in order to monitor my compliance with the provisions of this Undertaking.
(12) I, Dr. Culic, 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.
C. ACKNOWLEDGEMENT
(13) I, Dr. Culic, acknowledge that all appendices attached to or referred to in this Undertaking form part of this Undertaking.
(14) I, Dr. Culic, 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.
(15) I, Dr. Culic, acknowledge that I have read and understand the provisions of Undertaking and that I have obtained independent legal counsel in reviewing and executing this Undertaking, or have waived my right to do so.
(16) I, Dr. Culic, 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").
(17) I, Dr. Culic, 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.
(18) I, Dr. Culic, 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. Culic, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. Culic, 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. Culic's standard of practice and is conducting an investigation into the information. During the investigation and in the event of a referral to the Discipline Tribunal:
Prior to discharging any patient brought into the Emergency Department by police services for assessment of mental health issues, Dr. Culic must obtain a psychiatric consult and follow the recommendations of the consulting psychiatrist with respect to admission or discharge of the patient.
Dr. Culic must maintain a log of all psychiatric consults obtained in accordance with her Undertaking.
Dr. Culic must practise under the guidance of a Clinical Supervisor acceptable to the College, who will review all patients for whom a psychiatric consult was obtained.
D. CONSENT
(20) I, Dr. Culic, 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.
(21) I, Dr. Culic, acknowledge that I have executed the OHIP consent form, attached hereto as Appendix "C".
(22) I, Dr. Culic, give my irrevocable consent to the College to provide the following information to all Clinical Supervisors:
(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.
(23) I, Dr. Culic, 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.
(24) I, Dr. Culic, give my irrevocable consent to all Clinical Supervisors and Chiefs of Staff 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 "B";
(c) any information relevant for the purposes of monitoring my compliance with this Undertaking.
(d) any information relevant for the purposes of monitoring my compliance with this Undertaking.