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Nahri, Dolly Teresa

CPSO#: 65603

MEMBER STATUS
Active Member as of 01 Jul 2015
CURRENT OR PAST CPSO REGISTRATION CLASS
Independent Practice as of 01 Feb 2023

Summary

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Former Name: No Former Name

Gender: Female

Languages Spoken: Arabic, Creole, English

Education: Dalhousie University Faculty of Medicine, 1992

Practice Information

Primary Location of Practice
1898 Barnhart Pl
Ottawa ON  K1H 5B6
Phone: 6137963131
Fax: 6132602536 Electoral District: 07

Additional Practice Location(s)

103-2706 Alta Vista Dr
Ottawa ON  K1V 7T4
Canada
Phone: (613) 366-8787
County: Regional Municipality of Ottawa-Carleton
Electoral District: 07

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: Inactive: Jan 29 2022
Corporation Name: Dolly Nahri Medicine Professional Corporation
Certificate of Authorization Status: Issued Date:  Mar 07 2022

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

Business Address:
1898 Barnhart Pl
Ottawa ON  K1H 5B6
Phone Number: 6137963131

Specialties

Specialty Issued On Type
No Speciality Reported

Terms and Conditions

(1) Dr. DOLLY TERESA NAHRI may practise only in the areas of medicine in which Dr. NAHRI is educated and experienced.

Postgraduate Training

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



Schulich School of Medicine and Dentistr, 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 Effective: 25 Nov 2014
Suspension of registration imposed: Executive Committee Effective: 01 Jan 2015
Suspension of registration removed Effective: 01 Jul 2015
Terms and conditions amended by member Effective: 10 Jun 2020
Transfer of class of registration to: Independent Practice Certificate Effective: 01 Feb 2023

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