Nahri, Dolly Teresa (CPSO#: 65603)

Current Status: Active Member as of 01 Jul 2015

CPSO Registration Class: Restricted as of 25 Nov 2014

Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Female

Languages Spoken: Arabic, Creole, English

Education:Dalhousie University, 1992

Practice Information

Primary Location of Practice
4100 Albion Rd
Gloucester ON  K1T 3W1
Phone: (613) 822-7800
Fax: (613) 822-9800
Electoral District: 07
View Professional Corporation Information

Professional Corporation Information

Corporation Name: D. Nahri Medicine Professional Corporation

Certificate of Authorization Status: Inactive: Mar 19 2007


Corporation Name: Dolly Nahri Medicine Professional Corporation

Certificate of Authorization Status: Issued Date:  Nov 29 2017

Shareholders:
Dr. D. Nahri ( CPSO# 65603 )

Business Address:
4100 Albion Road
Gloucester ON  K1T 3W1
Phone Number: (613) 822-7800

Postgraduate Training

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

The University of Western Ontario, 01 Jul 1993 to 30 Jun 1994
Resident 2 - Family Medicine

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 15 Jun 1992
Transfer of class of registration to: Independent Practice Certificate Effective: 29 Jun 1993
Transfer of class of certificate to: Restricted certificate Effective: 25 Nov 2014
Terms and conditions imposed on certificate by Discipline Committee Effective: 25 Nov 2014
Suspension of registration imposed: Executive Committee Effective: 01 Jan 2015
Suspension of registration removed Effective: 01 Jul 2015

Practice Restrictions

Imposed By Effective Date Expiry Date Status  
Discipline Committee Effective: 25 Nov 2014 Active View Details [+]

            As from November 25, 2014, by order of the Discipline Committee of the College
            of Physicians and Surgeons of Ontario the following terms, conditions and
            limitations are imposed on the certificate of registration held by Dr. Dolly
            Teresa Nahri:


                  (a)   Dr. Nahri shall successfully complete by June 2015 a one-on-one
                        educational
                        program in ethics acceptable to the College, in accordance with the
                        portion of the
                        Individualized Education Program attached hereto at Schedule "B"
                        that relates to Dr. Nahri's educational needs related to her role
                        as Professional.
                  
                  (b)   Dr. Nahri shall, before June 1, 2015, retain aCollege-approved
                        clinical supervisor,
                        who will sign an undertaking in the form attached hereto as
                        Schedule "A," and
                        whose role shall be guided by the Individualized Education Program
                        attached heretoat Schedule "B." Commencing on the day that Dr.
                        Nahri resumes practice following her suspension, Dr. Nahri may
                        practice only under the supervision of the ClinicalSupervisor and
                        will abide by all recommendations of her Clinical Supervisor
                        withrespect to her practice, including but not limited to her
                        recordkeeping, practice improvements, practice management, and
                        continuing education. Dr. Nahri shall nolonger be subject to this
                        term, condition and limitation after a period of at least twelve
                        (12) months, and shall be released therefrom only upon receipt of
                        satisfactory reports) from her Clinical Supervisor and approval, in
                        its sole discretion, by the College.
                  
                  (c)   If Dr. Nahri fails to retain a Clinical Supervisor as required
                        above or if, prior to the completion of the required period of
                        supervision above, Dr. Nahri's Clinical
                        Supervisor is unable or unwilling to continue in that role, Dr.
                        Nahri shall retain a new College-approved Clinical Supervisor who
                        will sign an undertaking in the form attached hereto as Schedule
                        "A" within twenty (20) days, failing which she shall cease to
                        practice until such time as she has retained aCollege-approved
                        Clinical Supervisor.
                  
                  (d)   Approximately twelve (12) months following the completion of the
                        required period of supervision, Dr. Nahri shall undergo a
                        reassessment of her practice by a College appointed Assessor. The
                        assessment shall include a review of Dr. Nahri's patient charts,
                        direct observations, and interviews with staff and/or patients. Dr.
                        Nahri shall abide by all recommendations made by the Assessor, and
                        the Assessor shall reportthe results of the assessment to the
                        College.
                  
                  (e)   Dr. Nahri shall consent to sharing of information among the
                        Assessor, the Clinical Supervisor, the College and the provider of
                        the educational program in ethics as any of them deem necessary or
                        desirable in order to fulfill their respective obligations.
                  
                  
                  
                  
                  
                  
                  (f)   Dr. Nahri shall inform the College of each and every location where
                        she practices, in any jurisdiction (her "Practice Locations)")
                        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, until the report of
                        the assessment of her practice have been reported to the College.
                  
                  (g)   Dr. Nahri shall cooperate with unannounced inspections of her
                        practice and patient charts by a College representatives) for the
                        purpose of monitoring and enforcing her compliance with the terms
                        of this Order.
                  
                  (h)   Dr. Nahri shall consent to the College making appropriate enquiries
                        of the OntarioHealth Insurance Plan and/or any person who or
                        institution that may have relevant information, in order for the
                        College to monitor her compliance with this Order.
                  
                  (i)   Dr. Nahri shall be responsible for any and all costs associated
                        with implementing the terms of this Order.

Previous Hearings

Committee: Discipline
Decision Date: 25 Nov 2014
Summary:

On November 25, 2014, the Discipline Committee found that Dr. Nahri committed an act of 
professional misconduct in that she has failed to maintain the standard of practice of the 
profession, and in that she has engaged in conduct or 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. Dr. Nahri admitted to the allegations. 
 
In March 2007, Dr. Nahri acquired her own clinic where during the material time she provided 
family physician services, including walk-in services. Dr. Nahri's staff included international 
medical graduates who were not Ontario licensed physicians, who were directly involved in 
patient care. Dr. Nahri inadequately supervised these individuals and did not delegate care to 
them appropriately.  While delegation is permissible under College policy if certain criteria are 
met and procedures are followed, Dr. Nahri failed to familiarize herself with her professional 
obligations in this regard. 
 
In October 2010, the College received a complaint from Patient A, a patient in Dr. Nahri's family 
practice who saw Dr. Nahri once regarding her pregnancy and received further pregnancy-related 
care from a staff member on three occasions in 2010. Dr. Nahri was not present in the office for 
any of the appointments between the staff member and Patient A. Dr. Nahri reviewed Patient A's 
chart and discussed Patient A's care with the staff member during this time period, but this was 
not documented. Patient A believed that the staff member was a registered physician. 
 
The staff member had never been registered to practise medicine in Ontario. Initially Dr. Nahri 
accompanied her into the examination room to see patients, but over time came to receive 
minimal direct supervision, including while performing controlled acts. Dr. Nahri did not provide 
medical directives, but did review the staff member's care and orally approve or correct it. The 
staff member identified herself to patients as "Dr.," as did Dr. Nahri's staff. Services performed 
by her were billed to the Ontario Health Insurance Plan under Dr. Nahri's billing number. The 
fees received were shared between Dr. Nahri and the staff member who received a 35% share. 
 
The College retained an independent expert who opined that the clinical outcome experienced by 
Patient A was not adversely affected by the care provided by the staff member. However, Dr. 
Nahri demonstrated lack of knowledge regarding appropriate delegation, lack of skill in 
appropriately obtaining patient consent and providing appropriate supervision, and lack of 
judgment with respect to the use of stamped prescription pads. Harm or injury might occur in 
light of the degree to which Dr. Nahri was delegating roles and responsibilities in a clinical 
setting without appropriate supervision.    
 
In September 2010, the College initiated a broad investigation into Dr. Nahri's practice. Private 
investigators posed as patients seeking care and were seen at Dr. Nahri's clinic by individuals 
who were not registered physicians.  College investigators interviewed workers and learned that 
Dr. Nahri had left pre-signed prescription pads, requisition pads, and consultation requests for 
use by staff providing patient care, and that office staff billed the Ontario Health Insurance Plan 
using Dr. Nahri's billing number for services provided by staff members.  Information was 
provided that supervision was sometimes provided by telephone.  The College retained the 
independent expert as a Medical Inspector to evaluate the care provided by Dr. Nahri, including 
with respect to her supervision of and delegation to staff. Dr. X reviewed information obtained 
during the investigation, as well as the charts of 28 patients (including those of the private 
investigators retained by the College who attended at Dr. Nahri's clinic). Dr. X found, among 
other things: 
-     Supervision of staff and delegation of controlled acts fell below the expectations and the 
            standards of the profession. Dr. Nahri's clinical practice, behaviour and conduct in 
      this regard exposed her patients to potential harm or injury.   
-     It was difficult to determine from the charts who was providing the care, as notations 
            were not signed. Charting was below the standard of practice of the profession. 
      Dr. Nahri failed to document patient consent to be examined and treated by a staff 
      member. In many cases management of continuity of care was below the standard of 
      practice.  
 
Dr. Nahri cooperated throughout the College investigation. In her response to Dr. X's report, Dr. 
Nahri acknowledged that she had not provided adequate supervision and delegation to the 
individuals working in her clinic during the period in question. She stated that as a result of the 
College investigation she had "made many positive changes in her practice," including reducing 
the size of her practice and ceasing to provide walk-in care. In addition, she described 
improvements made to her record-keeping, including with regard to completion of cumulative 
patient profiles, diabetic flow sheets, well baby growth charts, and immunization records.   
 
After investigators attended at the clinic in November 2010, Dr. Nahri agreed to enter into an 
interim undertaking with the College to protect patients while the College investigation was 
ongoing, or until any allegations against her were finally determined by the Discipline 
Committee. As a result, Dr. Nahri ceased to employ international medical graduates or other 
unregulated workers to provide patient care.   
 
The interim undertaking obliged Dr. Nahri to review the records of all patients who had received 
patient care directly from staff members, and to document having done so. Dr. Nahri did 
undertake such a review as required. However, initially she failed to adequately document her 
review, in breach of her undertaking. After being alerted to the problem by the College in 2011, 
Dr. Nahri took steps to document her review. 
 
Since entering into her interim undertaking with the College, Dr. Nahri has reduced the size of 
her practice and has become a sole practitioner. Dr. Nahri has never before been the subject of 
discipline proceedings. Prior to the investigations underlying this matter, Dr. Nahri had been the 
subject of one public complaint since receiving her certificate of independent practice in 1993, in 
an unrelated matter with respect to which no action was ultimately taken.        
The Committee ordered and directed that: 
-     Dr. Nahri attend before the panel to be reprimanded. 
-     the Registrar suspend Dr. Nahri's certificate of registration for a period of six (6) months, 
            commencing from January 1, 2015 at 12:01 a.m. 
-     the Registrar impose the following terms, conditions and limitations on Dr. Nahri's 
            certificate of registration: 
(a)   Dr. Nahri shall successfully complete by June 2015 a one-on-one educational program in 
      ethics acceptable to the College, in accordance with the portion of the Individualized 
      Education Program attached hereto at Schedule "B" that relates to Dr. Nahri's educational 
      needs related to her role as Professional.    
(b)   Dr. Nahri shall, before June 1, 2015, retain a College-approved clinical supervisor, who 
            will sign an undertaking in the form attached hereto as Schedule "A," and whose 
      role shall be guided by the Individualized Education Program attached hereto at Schedule 
      "B."  Commencing on the day that Dr. Nahri resumes practice following her suspension, 
      Dr. Nahri may practice only under the supervision of the Clinical Supervisor and will 
      abide by all recommendations of her Clinical Supervisor with respect to her practice, 
      including but not limited to her recordkeeping, practice improvements, practice 
      management, and continuing education.  Dr. Nahri shall no longer be subject to this 
      term, condition and limitation after a period of at least twelve (12) months, and shall be 
      released therefrom only upon receipt of satisfactory report(s) from her Clinical Supervisor 
      and approval, in its sole discretion, by the College. 
(c)   If Dr. Nahri fails to retain a Clinical Supervisor as required above or if, prior to the 
            completion of the required period of supervision above, Dr. Nahri's Clinical 
      Supervisor is unable or unwilling to continue in that role, Dr. Nahri shall retain a new 
      College-approved Clinical Supervisor who will sign an undertaking in the form attached 
      hereto as Schedule "A" within twenty (20) days, failing which she shall cease to practice 
      until such time as she has retained a College-approved Clinical Supervisor.  
(d)   Approximately twelve (12) months following the completion of the required period of 
            supervision, Dr. Nahri shall undergo a reassessment of her practice by a 
      College-appointed Assessor.  The assessment shall include a review of Dr. Nahri's 
      patient charts, direct observations, and interviews with staff and/or patients.   Dr. Nahri 
      shall abide by all recommendations made by the Assessor, and the Assessor shall report 
      the results of the assessment to the College. 
(e)   Dr. Nahri shall consent to sharing of information among the Assessor, the Clinical 
            Supervisor, the College and the provider of the educational program in ethics as 
      any of them deem necessary or desirable in order to fulfill their respective obligations. 
(f)   Dr. Nahri shall inform the College of each and every location where she practices, in any 
            jurisdiction (her "Practice Location(s)") 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, until the report of the assessment of her practice 
      have been reported to the College. 
(g)   Dr. Nahri shall cooperate with unannounced inspections of her practice and patient charts 
            by a College representative(s) for the purpose of monitoring and enforcing her 
      compliance with the terms of this Order. 
(h)   Dr. Nahri shall consent to the College making appropriate enquiries of the Ontario Health 
            Insurance Plan and/or any person who or institution that may have relevant 
      information, in order for the College to monitor her compliance with this Order. 
(i)   Dr. Nahri shall be responsible for any and all costs associated with implementing the 
            terms of this Order. 
-     Dr. Nahri pay to the College costs in the amount of $4,460.00, within thirty (30) days of 
            the date of this Order. 
 
              

Decision: Download Full Decision (PDF)
Appeal: No Appeal
Hearing Date(s): November 25, 2014