As from January 25, 2017, the following is imposed as terms, conditions and
limitations on the certificate of registration held by Dr. Miah Hahn, in
accordance with an undertaking and consent given by Dr. Hahn to the College of
Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. MIAH HAHN
("Dr. Hahn")
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;
"ICR Committee" means the Inquiries, Complaints and Reports Committee of
the College;
"OHIP" means the Ontario Health Insurance Plan;
"Public Register" means the College's register that is available to the
public.
(2) I, Dr. Hahn, certificate of registration number 59311, am a member of the
College. The College has received information regarding my standard of
practice.
(3) I, Dr. Hahn, acknowledge that the College initiated an investigation
bearing File Number 7214935 (the "Investigation") into whether I engaged
in professional misconduct and/or am incompetent in my pediatric
orthopedic surgery practice.
B. UNDERTAKING
(4) I, Dr. Hahn, undertake to abide by the provisions of this Undertaking,
effective immediately.
(5) Practice Restriction
(a) I, Dr. Hahn, undertake that I will not engage in any of the
following areas of practice:
(i) Operative treatment of children for Developmental Dysplasia
of the Hip ("DDH surgery").
(6) Clinical Supervision
(a) I, Dr. Hahn, undertake to practise under the guidance of a clinical
supervisor(s) acceptable to the College (the "Clinical
Supervisor(s)"), for twelve (12) months ("Clinical Supervision").
(b) I, Dr. Hahn, acknowledge that I have reviewed the Clinical
Supervisor(s)'s undertaking, attached hereto as Appendix "A", and
understand what is required of the Clinical Supervisor(s). The
Clinical Supervisor(s) will, at minimum:
(i) Facilitate the education program set out in the
Individualized Education Plan ("IEP") attached as Appendix
"B";
(ii) High-level supervision: For a period of four (4) weeks, the
Clinical Supervisor will engage in a period of high-level
supervision, during which time:
i. I shall not be the Most Responsible Physician ("MRP")
for any patient; and
ii. the Clinical Supervisor will directly observe my
performance of all procedures.
(iii) The Clinical Supervisor shall reconsider the need for
high-level supervision after the first four (4) weeks of my
Clinical Supervision, and at the beginning of every month
thereafter for so long as the period of moderate supervision
continues. If the Clinical Supervisor believes that I am
ready to practise under moderate supervision, he/she shall
provide the College with a report addressing the practise
concerns raised in the report of the Medical Inspector,
received July 27, 2016. The College must agree to the
transition to the next phase, based on the reports of the
Clinical Supervisor;
(iv) Moderate-level supervision: For a period of a further eleven
(11) months, the Clinical Supervisor will engage in a period
of moderate-level supervision, during which time the Clinical
Supervisor will meet with me at my Practice Location, or
another location approved by the College, on a monthly basis
to;
i. review a minimum of fifteen (15) to twenty (20) of my
patient records and discuss any issues or concerns
arising therefrom; and
ii. discuss any concerns the Clinical Supervisor may have
arising from the chart reviews or the direct
observations.
(c) I, Dr. Hahn, acknowledge that the charts reviewed shall be selected
by the Clinical Supervisor(s) based on the educational needs
identified in the IEP set out at Appendix "B" to my Undertaking, as
well as the areas of concern identified in the report of the
Medical Inspector, received July 27, 2016, and concerns that may
arise during the period of Clinical Supervision.
(d) I, Dr. Hahn, undertake to cooperate fully with the Clinical
Supervision of my practice, conducted under the term of this
Undertaking and Appendix "A" attached, and to abide by the
recommendations of my Clinical Supervisor(s), including but not
limited to, any recommended practice improvements and ongoing
professional development.
(e) I, Dr. Hahn, undertake to ensure that Appendix "A" to this
Undertaking, is signed and delivered to the College within thirty
(30) days of the date I execute this Undertaking.
(f) I, Dr. Hahn, 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
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.
(g) I, Dr. Hahn, agree that if I am unable to obtain a Clinical
Supervisor on the provisions set out under sections (6)(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. Hahn, agree that if I am required to cease practise as a
result of section (6)(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.
(7) Professional Education
(a) I, Dr. Hahn, 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) ProBE: Ethics & Boundaries Program - Canada;
(ii) Individualized one-on-one instruction satisfactory to the
College, with respect to the issues of concern raised in the
report of the Medical Inspector, received July 27, 2016, with
an instructor selected by the College; and
(iii) any additional professional education recommended by my
Clinical Supervisor(s).
(b) I, Dr. Hahn, 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. Hahn, acknowledge that a report or reports may be provided
to the College regarding my progress and compliance with the
Professional Education.
(d) I, Dr. Hahn, undertake to complete this requirement by within three
months of executing this undertaking, or, if no satisfactory
program is available by that time, by the first possible
opportunity thereafter.
(8) Reassessment of Practice
(a) I, Dr. Hahn, undertake that, approximately three (3) months after
the completion of the Clinical Supervision set out in section (3)
above and Appendix "A" attached, I will submit to a Reassessment of
my practice ("the Reassessment") by an assessor or assessors
selected by the College (the "Assessor(s)"). I acknowledge and
agree that the Reassessment may include a chart review, direct
observation of my care, interviews with colleagues and co-workers,
feedback from patients and any other tools deemed necessary by the
College.
(b) I, Dr. Hahn, undertake to co-operate fully with the Reassessment,
conducted under the term of this Undertaking, and to abide by those
recommendations of the Assessor(s) that are approved by the ICR
Committee.
(c) I, Dr. Hahn, acknowledge and agree that my Clinical Supervisor(s)
may receive and review the findings of the Assessor(s), and may
discuss with the Assessor(s) any issues or concerns arising from
the Reassessment. I also acknowledge that the results of the
Reassessment will be provided to me and reported to the College and
the report may form the basis of further action by the College.
(d) I, Dr. Hahn, understand and agree that if I am of the view that any
of the Assessor(s)'s recommendations are unreasonable, I will have
thirty (30) days following my receipt of the recommendations within
which to provide the College with my submissions in this regard. I
further understand and agree that thereafter, the ICR Committee
will consider my submissions and make a determination regarding
whether or not the recommendations, or any of them, are reasonable
and if so, whether they, or any of them, constitute limitations or
restrictions on my practice, and that decision will be provided to
me.
(e) I, Dr. Hahn, undertake that, following the decision referenced in
section (8)(d) above, I will abide by those recommendations of the
Assessor(s) that the ICR Committee has determined are reasonable.
(f) I, Dr. Hahn, hereby consent to any of the following being included
on the public register as terms, conditions or limitations on my
certificate of registration, for the purposes of section 23 of the
Code:
(i) any recommendations of the Assessor(s) which are terms,
conditions or limitations on my practice;
(ii) any recommendations of the Assessor(s) which the ICR
Committee has identified in its decision referenced in
section (8)(d) as terms, conditions or limitations on my
practice.
(9) Monitoring
(a) I, Dr. Hahn, undertake to inform the College of each and every
location that I practise or have privileges, including, but not
limited to, hospital(s), clinic(s) and office(s), in any
jurisdiction (collectively my "Practice Location(s)"), 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. Hahn, undertake and agree that I will submit to, and not
interfere with, unannounced inspections of my Practice Location(s)
and patient records by a College representative for the purposes of
monitoring my compliance with the provisions of this Undertaking.
(c) I, Dr. Hahn, 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. Hahn, acknowledge that I have executed the OHIP consent
form(s), attached hereto as Appendix "C".
C. ACKNOWLEDGEMENT
(10) I, Dr. Hahn, acknowledge that all appendices attached to or referred to
in this Undertaking form part of this Undertaking.
(11) I, Dr. Hahn, 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. Hahn, 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. Hahn, acknowledge that the College will provide this Undertaking
to any Chief of Staff, or a colleague with similar responsibilities, at
any Practice Location ("Chief(s) of Staff").
(14) I, Dr. Hahn, 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 Committee of the College.
(15) I, Dr. Hahn, 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. Hahn, acknowledge that, during the time period that this
Undertaking remains in effect, this Undertaking shall be posted on
the Public Register.
(b) I, Dr. Hahn, acknowledge that, in addition to this Undertaking
being posted in accordance with section (15)(a) above, the
following summary shall be posted on the Public Register during the
time period that this Undertaking remains in effect:
Dr. Hahn was the subject of a College investigation into
whether she engaged in professional misconduct and/or is
incompetent in her pediatric orthopedic surgery practice. As
a result of the investigation:
* Dr. Hahn will practise under the guidance of a Clinical
Supervisor acceptable to the College for 12 months.
* Dr. Hahn will engage in professional education in
ethics and boundaries, and areas of clinical concern.
* Dr. Hahn's practice will be reassessed by an assessor
selected by the College within 3 months of the end of
the period of Clinical Supervision.
D. CONSENT
(17) I, Dr. Hahn, 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 set
out in section (6) above 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. Hahn, give my irrevocable consent to the College to provide all
Chief(s) 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. Hahn, give my irrevocable consent to any person who facilitates my
completion of the professional education set out in section (6) above,
and to all Clinical Supervisors, Chiefs of Staff and Assessors, to
disclose to the College, and to one another, any information:
(a) relevant to this Undertaking;
(b) relevant to the provisions of the Clinical Supervisor's undertaking
set out at Appendix "A";
(c) relevant to the Reassessment;
(d) relevant for the purposes of monitoring my compliance with this
Undertaking; and/or
(e) which comes to his or her attention in the course of providing the
professional education set out in section (6) above and which he or
she reasonably believes indicates a potential risk of harm to my
patients.