(1 of 4)
As from April 20, 2023, the following are imposed as terms, conditions and limitations on the certificate of registration held by Dr. Naseeruddin Syed in accordance with an undertaking and consent given by Dr. Syed to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. NASEERUDDIN SYED
("Dr. Syed")
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;
"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. Syed, certificate of registration number 60201, am a member of the College.
(3) I, Dr. Syed, acknowledge that following a public complaint, the College conducted an investigation bearing File Number CAS-416382-B5S6W2 (the "Investigation") into my care of and communication with a patient in my family practice.
B. UNDERTAKING
(4) I, Dr. Syed, undertake to abide by the provisions of this Undertaking, effective immediately.
(5) Professional Education
(a) I, Dr. Syed, undertake to participate in and successfully complete all aspects of the detailed IEP, attached hereto as Appendix "A", including all of the following professional education (the "Professional Education"):
(i) Review and reflection of the following policy:
1. Boundary Violations, College policy; and
(ii) individualized instruction in professionalism/ethics and communications coaching satisfactory to the College, with an instructor or instructors selected by the College.
(b) I, Dr. Syed, 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. Syed, undertake to complete this requirement within three (3) months, or, if no satisfactory program is available by that time, by the first possible opportunity thereafter.
(d) I, Dr. Syed, acknowledge that a report or reports may be provided to the College regarding my progress and compliance with the Professional Education.
(e) I, Dr. Syed, 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.
(6) Monitoring
(a) I, Dr. Syed, undertake to inform the College of each and every location at which I practise or have privileges, including, but not limited to, any hospitals, clinics, offices, and any 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.
C. ACKNOWLEDGEMENT
(7) I, Dr. Syed, acknowledge that all appendices attached to or referred to in this Undertaking form part of this Undertaking.
(8) I, Dr. Syed, 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.
(9) I, Dr. Syed, 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.
(10) I, Dr. Syed, 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").
(11) I, Dr. Syed, 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.
(12) I, Dr. Syed, acknowledge that this Undertaking constitutes terms, conditions, and limitations on my certificate of registration for the purposes of section 23 of the Code.
(13) Public Register
(a) I, Dr. Syed, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. Syed, acknowledge that, in addition to this Undertaking being posted in accordance with section (13)(a) above, the following summary shall be posted on the Public Register during the time period that this Undertaking remains in effect:
Following a public complaint, a College investigation was conducted into Dr. Syed's care of and communication with a patient in his family practice. As a result of the investigation:
Dr. Syed will engage in professional education in boundaries, professionalism, and communication.
(c) I, Dr. Syed, acknowledge that this Undertaking remains in effect until the College determines its terms are satisfied.
D. CONSENT
(14) I, Dr. Syed, 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:
(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.
(15) I, Dr. Syed, 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.
(16) I, Dr. Syed, give my irrevocable consent to any persons who facilitate my completion of the Professional Education, and to all 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 for the purposes of monitoring my compliance with this Undertaking;
(c) 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.
(2 of 4)
As from September 20, 2022, the following are imposed as terms, conditions and limitations on the certificate of registration held by Dr. Naseeruddin Syed in accordance with an undertaking and consent given by Dr. Syed to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. NASEERUDDIN SYED
("Dr. Syed")
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;
"NMS" means the Drug Program Services Branch, the Narcotics Monitoring System implemented under the Narcotics Safety and Awareness Act, 2010;
"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. Syed, certificate of registration number 60201, am a member of the College.
(3) I, Dr. Syed, acknowledge that following receipt of a reassessment report, I underwent remediation and submitted to a further reassessment of my practice. The reassessment report subsequently received by the College raised concerns about my standard of practice in general medicine. The College conducted an investigation bearing File Number CAS-130587-D7D0P8 (the "Investigation") into whether I engaged in professional misconduct and/or am incompetent in my general medicine practice.
B. UNDERTAKING
(4) I, Dr. Syed, undertake to abide by the provisions of this Undertaking, effective immediately.
(5) Clinical Supervision
(a) I, Dr. Syed, undertake to practise under the guidance of a clinical supervisor or clinical supervisors acceptable to the College (the "Clinical Supervisor" or "Clinical Supervisors"), for six (6) months ("Clinical Supervision").
(b) I, Dr. Syed, undertake to remain free of any conflict of interest with the Clinical Supervisor.
(c) I, Dr. Syed, 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 week for a minimum of one (1) month ("high-level Clinical Supervision");
(iv) After a minimum of one (1) month of high-level 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 two (2) weeks for a further two (2) months ("moderate-level Clinical Supervision");
(v) After a minimum of two (2) months of moderate-level 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 three (3) months ("low-level Clinical Supervision");
(vi) Review at least fifteen (15) of my patient charts at every meeting;
(vii) Directly observe at least fifteen (15) of my patient encounters at every meeting;
(viii) Discuss any concerns arising from the chart reviews;
(ix) Make recommendations to me for practice improvements and ongoing professional development and inquire into my compliance with the recommendations;
(x) 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;
(xi) Submit written reports to the College as follows:
1. During the period of high-level Clinical Supervision, at least once every week for one (1) month or until the College approves a reduction in the level of supervision from high-level to moderate-level, or more frequently if the Clinical Supervisor has concerns about my standard of practice;
2. During the period of moderate-level supervision, at least once every month for two (2) months or until the College approves a reduction in the level of supervision from moderate-level to low-level, or more frequently if the Clinical Supervisor has concerns about my standard of practice;
3. During the period of low-level Clinical Supervision, once at the end of the period of Clinical Supervision, or more frequently if the Clinical Supervisor has concerns about my standard of practice; and
(xii) Remain free of any conflict of interest with me.
(d) I, Dr. Syed, 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 reports of the assessor dated June 2, 2021 and November 12, 2021, and concerns that may arise during the period of Clinical Supervision.
(e) I, Dr. Syed, 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. Syed, 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.
(g) I, Dr. Syed, 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.
(h) I, Dr. Syed, undertake that if I am unable to obtain a Clinical Supervisor on the provisions set out under sections (5)(f) and/or (g) above, I will cease practising medicine until such time as I have obtained a Clinical Supervisor acceptable to the College.
(i) I, Dr. Syed, acknowledge that if I am required to cease practise as a result of section (5)(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.
(6) Professional Education
(a) I, Dr. Syed, 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) Review, reflection, and discussion with the Clinical Supervisor of the following policies and other self-study:
1. Prescribing Drugs, College Policy;
2. Medical Records Documentation, College Policy;
3. Managing Tests, College Policy;
4. Good Practices - Physician-patient: Documentation and record keeping, CMPA resource; and
(ii) any additional professional education recommended by my Clinical Supervisor.
(b) I, Dr. Syed, undertake to complete this requirement by December 31, 2022. I acknowledge that the College will determine, in its sole discretion, whether I have successfully completed the Professional Education.
(c) I, Dr. Syed, acknowledge that a report or reports may be provided to the College regarding my progress and compliance with the Professional Education.
(d) I, Dr. Syed, 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.
(7) Reassessment of Practice
(a) I, Dr. Syed, 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. Syed, undertake to co-operate fully with the Reassessment, conducted under the term of this Undertaking.
(c) I, Dr. Syed, 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. Syed, 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.
(8) Monitoring
(a) I, Dr. Syed, 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. Syed, 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. Syed, give my irrevocable consent to the College to make appropriate enquiries of OHIP, NMS 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. Syed, acknowledge that I have executed the OHIP and NMS consent forms, attached hereto as Appendix "C" and Appendix "D", respectively.
C. ACKNOWLEDGEMENT
(9) I, Dr. Syed, acknowledge that all appendices attached to or referred to in this Undertaking form part of this Undertaking.
(10) I, Dr. Syed, 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.
(11) I, Dr. Syed, 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.
(12) I, Dr. Syed, 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").
(13) I, Dr. Syed, 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.
(14) I, Dr. Syed, acknowledge that this Undertaking constitutes terms, conditions, and limitations on my certificate of registration for the purposes of section 23 of the Code.
(15) Public Register
(a) I, Dr. Syed, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. Syed, 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:
Following receipt of a reassessment report that raised concerns about my standard of practice in family medicine, a College investigation was conducted into whether Dr. Syed engaged in professional misconduct and/or is incompetent in his general medicine practice. As a result of the investigation:
Dr. Syed will practise under the guidance of a Clinical Supervisor acceptable to the College for 6 months.
Dr. Syed will engage in professional education in prescribing, medical records documentation, and managing tests.
Dr. Syed's practice will be reassessed by an assessor selected by the College within 6 months of the end of the period of Clinical Supervision.
(c) I, Dr. Syed, acknowledge that this Undertaking remains in effect until the College determines its terms are satisfied.
D. CONSENT
(16) I, Dr. Syed, 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.
(17) I, Dr. Syed, 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.
(18) I, Dr. Syed, 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.
(3 of 4)
Effective June 15, 2018, Dr. Syed has not yet obtained a clinical supervisor for his narcotics prescribing practice. Therefore, Dr. Syed must cease prescribing Narcotic Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other Targeted Substances and All other Monitored Drugs until such time as he has obtained a Clinical Supervisor acceptable to the College.
(4 of 4)
As from 11:59 p.m., June 15, 2018, by order of the Ontario Physicians & Surgeons Tribunal 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. Naseeruddin Syed:
A. Prescribing Log
(i) Dr. Syed, shall keep a Log of all prescriptions for Narcotic Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other Targeted Substances and All other Monitored Drugs (as set out in Schedule "A"), in the form attached as set out in Schedule "B", which will include at least the following information (the "Prescribing Log"):
(a) the date of the appointment;
(b) the name of the patient and chart/file number;
(c) the name of the medication prescribed, dose, direction, number of tablets to be dispensed and frequency;
(d) the clinical indication;
(e) whether the prescription is for a new medication and/or different dose or frequency than currently prescribed to the patient (Y/N);
(f) Dr. Syed's signature;
(g) the date of the Clinical Supervisor's review (if applicable, as set out below); and
(h) the Clinical Supervisor's signature (if applicable, as set out below).
(ii) Dr. Syed is to keep a copy of all prescriptions he writes for Narcotic Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other Targeted Substances and All other Monitored Drugs, in the corresponding patient chart.
B. Clinical Supervision re: Narcotic Practice
(i) Dr. Syed is to practise under the guidance of a clinical supervisor acceptable to the College (the "Clinical Supervisor"), for a minimum of nine (9) months on the terms set out below (the "Clinical Supervision").
(ii) The Clinical Supervisor shall sign an undertaking in the form attached hereto as Schedule "C".
(iii) Dr. Syed shall cooperate fully with the Clinical Supervision and abide by all recommendations of his Clinical Supervisor with respect to practice improvements and education.
(iv) Dr. Syed shall consent to the disclosure by the Clinical Supervisor to the College, and by the College to his Clinical Supervisor, of all information the Clinical Supervisor or the College deems necessary or desirable in order to fulfill the Clinical Supervisor's undertaking and to monitor Dr. Syed's compliance with this Order. This shall include, without limitation, providing the Clinical Supervisor with any reports of any assessments of Dr. Syed's practice in the College's possession.
(v) If the Clinical Supervisor who has given an undertaking in Schedule "C" to this Order is unable or unwilling to continue to fulfill its terms, Dr. Syed shall, within seven (7) 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.
(vi) Dr. Syed shall not prescribe any narcotics or controlled substances unless and until the Clinical Supervision is in place.
(vii) If Dr. Syed is unable to obtain a Clinical Supervisor on the terms set out in sections 4.B, he will cease prescribing Narcotic Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other Targeted Substances and All other Monitored Drugs until such time as he has obtained a Clinical Supervisor acceptable to the College.
(viii)If Dr. Syed is required to cease prescribing Narcotic Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other Targeted Substances and All other Monitored Drugs as a result of section 4.B(vii) above this will constitute a term, condition or limitation on his certificate of registration and that term, condition or limitation will be included on the Public Register.
Phase 1 of Clinical Supervision ("Phase 1")
(ix) Dr. Syed is to engage in Phase 1 of Clinical Supervision for a minimum of two (2) months on the terms set out below.
(x) During Phase 1, Dr. Syed is to meet with the Clinical Supervisor once a week to discuss the Clinical Supervisor's review of a minimum of twenty (20 charts for patients to whom Dr. Syed has prescribed:
(a) Narcotic Drugs, or
(b) Narcotic Preparations; or
(c) Controlled Drugs, Benzodiazepines and Other Targeted Substances and All other Monitored Drugs where the patient is also prescribed a Narcotic Drug and/or Narcotic Preparation.
(xi) If there are not twenty (20) charts for patients to whom Dr. Syed has prescribed the above substances, the Clinical Supervisor shall review the charts of all patients listed in the prescribing log since his prior review.
(xii) During Phase 1, the Clinical Supervisor must sign and date the Prescribing Log to confirm the charts that the Clinical Supervisor has reviewed and discussed with Dr. Syed.
(xiii) During Phase 1, the Clinical Supervisor will provide a report to the College at least once a week.
(xiv) After a minimum of two (2) months of Phase 1, if the Clinical Supervisor is satisfied that Dr. Syed has the necessary knowledge, skills and judgment to practice in a less highly supervised environment, the Clinical Supervisor may recommend to the College that supervision be reduced.
Phase 2 of Clinical Supervision ("Phase 2")
(xv) Upon the recommendation of the Clinical Supervisor and approval by the College, Dr. Syed shall engage in Phase 2 of Clinical Supervision for a minimum of three months on the terms set out below.
(xvi) During Phase 2, Dr. Syed is to with the Clinical Supervisor at least once every two (2) weeks the Clinical Supervisor's review of a minimum of fifteen (15) charts for patients to whom Dr. Syed has initiated a new prescription for:
(a) Narcotic Drugs, or
(b) Narcotic Preparations; or
(c) Controlled Drugs, Benzodiazepines and Other Targeted Substances and All other Monitored Drugs where the patient is also prescribed a Narcotic Drug and/or Narcotic Preparation.
(xvii) If there are not fifteen (15) charts for patients to whom Dr. Syed has initiated a new prescription for the above substances, the Clinical Supervisor shall review the charts of all patients listed in the prescribing log since his prior review.
(xviii) During Phase 2, the Clinical Supervisor must sign and date the Prescribing Log to confirm the charts that the Clinical Supervisor has reviewed and discussed with Dr. Syed.
(xix) During Phase 2, the Clinical Supervisor will provide a report to the College at least once every two (2) weeks.
(xx) After a minimum of three (3) months of Phase 2, if the Clinical Supervisor is satisfied that Dr. Syed has the necessary knowledge, skills and judgment to practice in a less highly supervised environment, the Clinical Supervisor may recommend to the College that supervision be reduced.
Phase 3 of Clinical Supervision ("Phase 3")
(xxi) Upon the recommendation of the Clinical Supervisor and approval by the College, Dr. Syed, shall engage in Phase 3 of Clinical Supervision for a minimum of four (4) months on the terms set out below.
(xxii)During Phase 3, Dr. Syed shall with the Clinical Supervisor at least once a month the Clinical Supervisor's review of a minimum of fifteen (15) charts for patients to whom Dr. Syed has initiated a new prescription for:
(a) Narcotic Drugs, or
(b) Narcotic Preparations; or
(c) Controlled Drugs, Benzodiazepines and Other Targeted Substances and All other Monitored Drugs where the patient is also prescribed a Narcotic Drug and/or Narcotic Preparation.
(xxiii) If there are not fifteen (15) charts for patients to whom Dr. Syed has initiated a new prescription for the above substances, the Clinical Supervisor shall review the charts of all patients listed in the prescribing log since his prior review.
(xxiv) During Phase 3, the Clinical Supervisor must sign and date the Prescribing Log to confirm the charts that the Clinical Supervisor has reviewed and discussed with Dr. Syed.
(xxv) During Phase 3, the Clinical Supervisor(s) will provide a report to the College at least once every month.
(xxvi)After a minimum of four (4) months of Phase 3, if the Clinical Supervisor is satisfied that Dr. Syed has the necessary knowledge, skills and judgment to practice without supervision, the Clinical Supervisor may recommend to the College that the Clinical Supervision cease.
C. Clinical Supervision re: Non-Narcotic Practice
(i) By June 15, 2018, Dr. Syed shall obtain a clinical supervisor acceptable to the College, who will supervise Dr. Syed's general practice upon completion of his suspension for a period of nine (9) months, and who will sign an undertaking in the form attached hereto as Schedule "D" (the "General Practice Clinical Supervisor").
(ii) Dr. Syed shall cooperate fully with the Clinical Supervision and abide by all recommendations of his General Practice Clinical Supervisor with respect to practice improvements and education.
(iii) Dr. Syed shall consent to the disclosure by the General Practice Clinical Supervisor to the College, and by the College to his General Practice Clinical Supervisor, of all information the General Practice Clinical Supervisor, of all information the General Practice Clinical Supervisor or the College deems necessary or desirable in order to fulfill the General Practice Clinical Supervisor's undertaking and to monitor Dr. Syed's compliance with this Order. This shall include, without limitation, providing the General Practice Clinical Supervisor with any reports of any assessments of Dr. Syed's practice in the College's possession.
(iv) If the General Practice Clinical Supervisor who has given an undertaking in Schedule "D" to this Order is unable or unwilling to continue to fulfill its terms, Dr. Syed 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.
(v) If Dr. Syed is unable to obtain a General Practice Clinical Supervisor in accordance with paragraphs 4(C)(i) or 4(C)(iv) of this Order, he shall cease practising medicine until such time as he has done so, and the fact that he has will constitute a term, condition or limitation on his certificate of registration until that time.
D. Reassessment of Practice
(i) Approximately three (3) months after each aspect of the Clinical Supervision set out above has ceased, Dr. Syed will submit to a comprehensive reassessment of his entire practice by an assessor or assessors selected by the College (the "Assessor(s)"). The Reassessment may include a chart review, direct observation of Dr. Syed's care, interviews with colleagues and co-workers, feedback from patients and any other tools deemed necessary by the College. Dr. Syed shall abide by all recommendations made by the Assessor(s), and the results of the Reassessment will be reported to the College and may form the basis of further action by the College.
E. Compliance
(i) Dr. Syed shall co-operate with unannounced inspections of his office practice and patient charts for the purpose of monitoring and enforcing his compliance with the terms of this Order.
(ii) Dr. Syed shall inform the College of any and all new practice locations including, but not limited to, hospital(s), clinic(s) and office(s), in any jurisdiction five (5) days in advance of commencing practice at that location.
(iii) Dr. Syed shall give his irrevocable consent to the College to make appropriate enquiries of the Ontario Health Insurance Plan ("OHIP"), the Drug Program Services Branch, the Narcotics Monitoring System ("NMS") implemented under the Narcotics Safety and Awareness Act, 2010 and/or any person or institution who may have relevant information, in order for the College to monitor my compliance with the provisions of this Order.
(iv) Dr. Syed shall be responsible for any and all costs associated with implementing the terms of this Order.