Olupona, Samuel Modupe (CPSO#: 68574)

Current Status: Active Member as of 30 Sep 1994

CPSO Registration Class: Restricted as of 10 Jun 2016

Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Male

Languages Spoken: English, Yoruba

Education:University of Ibadan, 1976

Practice Information

Primary Location of Practice
P O Box 4000
200 Fletcher Crescent
Alliston ON  L9R 1W7
Phone: (705) 434-5144
Fax: (705) 434-5131
Electoral District: 05
View more practice locations

Additional Practice Location(s)

Stevenson Memorial Hospital
200 Fletcher Crescent ,
Alliston
Alliston ON  L9R 1W7
Canada
Phone: (705) 434-5144
Fax: (705) 434-5131
County: County of Simcoe
Electoral District: 05
View Professional Corporation Information

Professional Corporation Information

Corporation Name: Dr. Samuel Olupona Medicine Professional Corporation

Certificate of Authorization Status: Issued Date:  Mar 17 2006

Shareholders:
Dr. S. Olupona ( CPSO# 68574 )

Business Address:
PO Box 4000
200 Fletcher Crescent
Alliston ON  L9R 1W7
Phone Number: (705) 435-6281

Hospital Privileges

Hospital Location
Stevenson Memorial Hospital Alliston

Hospital Notices

Source:  Hospital
Active Date:  July 14, 2014
Expiry Date:  
Summary:  
On July 15, 2014, Orillia Soldiers' Memorial Hospital (OSMH) notified the College of Physicians and Surgeons of Ontario that Dr. Samuel Modupe Olupona's privileges at OSMH were suspended effective July 14, 2014.

Specialties

Specialty Issued On Type
Obstetrics and Gynecology Effective: 29 May 1994 RCPSC Specialist

Registration History

Action Issue Date
First certificate of registration issued: Independent Practice Certificate Effective: 30 Sep 1994
Transfer of class of certificate to: Restricted certificate Effective: 10 Jun 2016
Terms and conditions imposed on certificate by Inquiries, Complaints and Repo Effective: 10 Jun 2016

Practice Restrictions

Imposed By Effective Date Expiry Date Status  
Inquiries, Complaints and Reports Committee Effective: 10 Jun 2016 Active View Details [+]
            As from June 10, 2016, the following is imposed as a term, condition and
            limitation on the certificate of registration held by Dr. Samuel Modupe
            Olupona, in accordance with an undertaking and consent given by Dr. Olupona to
            the College of Physicians and Surgeons of Ontario:


                        UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT 
                                          ("Undertaking")
                  
                                                of
                  
                                    DR. SAMUEL MODUPE OLUPONA
                                          ("Dr. Olupona")
                  
                                                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.
                  
            (2)   I, Dr. Olupona, certificate of registration number 68574, am a member of
                  the College.  The College has received information regarding my standard
                  of practice.

            (3)   I, Dr. Olupona, acknowledge that I was the subject of College
                  investigations bearing File Numbers 92367 and 7214355 (the
                  "Investigations") into my practice of obstetrics and gynaecology.

            (4)   I, Dr. Olupona, acknowledge that, if an original copy of this Undertaking
                  as signed by me is accepted by the ICR Committee, the College will also
                  deliver a caution in person.

            B.    UNDERTAKING

            (5)   I, Dr. Olupona, acknowledge and agree that I am bound by this Undertaking
                  from the date on which I sign it. 
            (6)   Clinical Supervision 

                  (a)   I, Dr. Olupona, 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. Olupona, 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),
                        including that 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)  Meet with me once every month to review at least twenty (20)
                              of my patient charts for a minimum of three (3) months
                              ("Moderate Supervision");
                  
                        (iii) Subject to satisfactory reports of the Clinical Supervisor,
                              and only with the approval of the College, after three (3)
                              months of Moderate Supervision, Clinical Supervision will be
                              gradually reduced such that the Clinical Supervisor(s) will
                              meet with me once every two (2) months to review at least
                              twenty (20) of my patient charts;
                  
                        (iv)  Observe me in practice for a minimum of two (2) half days
                              within the first two (2) weeks of Clinical Supervision and
                              thereafter at a frequency to be determined by the Clinical
                              Supervisor;
                  
                        (v)   Discuss any concerns arising from the chart reviews;
                  
                        (vi)  Make recommendations to me for practice improvements and
                              ongoing professional development and inquire into my
                              compliance with the recommendations; 
                  
                        (vii) Perform any other duties, such as reviewing other documents
                              or conducting interviews with staff or colleagues, that the
                              Clinical Supervisor(s) deem necessary to my Clinical
                              Supervision; and
                  
                        (viii)Submit written reports to the College at least once every
                              month for the first three (3) months of Clinical Supervision,
                              or more frequently if the Clinical Supervisor(s) has concerns
                              about my standard of practice. Subject to satisfactory
                              reports of the Clinical Supervisor, and only with the
                              approval of the College, after three (3) months of monthly
                              reporting, the frequency of reports will be reduced such that
                              the Clinical Supervisor(s) will submit written reports to the
                              College at least once every three (3) months, or more
                              frequently if the Clinical Supervisor(s) has concerns about
                              my standard of practice.
                  
                  (c)   I, Dr. Olupona, 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 dated March 17, 2014, the decision
                        of the Medical Advisory Committee dated October 3, 2014, the
                        mandatory report dated July 15, 2014, and the hospital meeting
                        minutes dated April 27, 2015, and concerns that may arise during
                        the period of Clinical Supervision.
                  
                  (d)   I, Dr. Olupona, 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. Olupona, 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. Olupona, 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-five (25) 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. Olupona, 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. Olupona, 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. Olupona, undertake to participate in and successfully
                        complete the following professional education:
                  
                        (i)   a program(s) satisfactory to the College in professionalism
                              and communications; 
                        (ii)  all aspects of the detailed IEP, attached hereto as Appendix
                              "B"; and
                  
                        (iii) any additional professional education recommended by my
                              Clinical Supervisor(s).
                  
                  (b)   I, Dr. Olupona, undertake to provide proof to the College of my
                        successful completion of the professional education set out in
                        section (7)(a) within one (1) month of completing it.
                  
                  (c)   I, Dr. Olupona, acknowledge that a report or reports may be
                        provided to the College regarding my progress and compliance with
                        the professional education set out in section (7)(a).
                  
            (8)   Reassessment of Practice

                  (a)   I, Dr. Olupona, undertake that, approximately three to six (3 to 6)
                        months after the completion of the Clinical Supervision set out in
                        section (6) 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. Olupona, 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. Olupona, 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. Olupona, 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. Olupona, 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. Olupona, hereby consent to 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: any recommendations of the Assessor(s) which are terms,
                        conditions or limitations on my practice and/or 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. Olupona, 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
                        fifteen (15) days of executing this Undertaking.  Going forward, I
                        further undertake to inform the College of any and all new Practice
                        Locations within fifteen (15) days of commencing practice at that
                        location.
                  
                  (b)   I, Dr. Olupona, 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. Olupona, give my irrevocable consent to the College to make
                        appropriate enquiries of OHIP 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 Undertaking. 
                  
                  (d)   I, Dr. Olupona, acknowledge that I have executed the OHIP consent
                        form, attached hereto as Appendix "C". 
                  
            (10)  I, Dr. Olupona, undertake to comply with this Undertaking and 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.

            C.    ACKNOWLEDGEMENT

            (11)  I, Dr. Olupona, acknowledge that all appendices attached to or referred
                  to in this Undertaking form part of this Undertaking.

            (12)  I, Dr. Olupona, acknowledge 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. 

            (13)  I, Dr. Olupona, acknowledge and confirm 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.

            (14)  I, Dr. Olupona, acknowledge that this entire Undertaking constitutes
                  terms, conditions, and limitations on my certificate of registration for
                  the purposes of section 23 of the Code. I understand that this
                  Undertaking shall be information on the College's Register that is
                  available to the public during the time period that the Undertaking
                  remains in effect.

            (15)  I, Dr. Olupona, acknowledge that the following summary will appear on the
                  College's Register that is available to the public during the time period
                  that this Undertaking remains in effect:

                        Dr. Olupona was the subject of College investigations into whether
                        he engaged in professional misconduct and/or is incompetent in his
                        practice of obstetrics and gynaecology. As a result of the
                        investigation:
                  
                        *     Dr. Olupona will practise under the guidance of a Clinical
                              Supervisor acceptable to the College for 12 months. 
                        *     Dr. Olupona will complete a program satisfactory to the
                              College in professionalism and communications.
                        *     Dr. Olupona's practice will be reassessed by an assessor
                              selected by the College within 3-6 months of the end of the
                              period of Clinical Supervision.
                  
            D.    CONSENT

            (16)  I, Dr. Olupona, 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.
                  
            (17)  I, Dr. Olupona, give my irrevocable consent to the College to provide
                  this Undertaking to any Chief(s) of Staff, or a colleague with similar
                  responsibilities approved by the College, at any Practice Location
                  ("Chief(s) of Staff"), and to provide said 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.

            (18)  I, Dr. Olupona, give my irrevocable consent to any person who facilitates
                  my completion of the professional education set out in section (7) 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 (7) above and which he or
                        she reasonably believes indicates a potential risk of harm to my
                        patients.

Concerns

Source: Member
Active Date: June 10, 2016
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Samuel Modupe Olupona to the College of Physicians and Surgeons of Ontario effective June 10, 2016:

Dr. Olupona was the subject of College investigations into whether he engaged in professional misconduct and/or is incompetent in his practice of obstetrics and gynaecology. As a result of the investigation:

- Dr. Olupona will practise under the guidance of a Clinical Supervisor acceptable to the College for 12 months.
- Dr. Olupona will complete a program satisfactory to the College in professionalism and communications.
- Dr. Olupona's practice will be reassessed by an assessor selected by the College within 3-6 months of the end of the period of Clinical Supervision.