(1 of 2)
As from July 14, 2020, the following are imposed as terms, conditions
and limitations on the certificate of registration held by Dr. Paul Ian Pancham
in accordance with an undertaking and consent given by Dr. Pancham to the
College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. PAUL IAN PANCHAM
("Dr. Pancham")
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;
"OHIP" means the Ontario Health Insurance Plan;
"Public Register" means the College's register that is available to the
public.
(2) I, Dr. Pancham, certificate of registration number 67728, am a member of
the College.
(3) I, Dr. Pancham, acknowledge that the College conducted an investigation
bearing File Number 1106323 (the "Investigation") into whether I engaged
in professional misconduct and/or am incompetent in my
Obstetrics/Gynecology practice.
B. UNDERTAKING
(4) I, Dr. Pancham, undertake to abide by the provisions of this Undertaking,
effective immediately ("Effective Date").
(5) Practice Restrictions
(a) I, Dr. Pancham, undertake that I shall not conduct a pelvic or
internal examination on a patient of any age, in any jurisdiction,
unless the examination takes place in the continuous presence and
under the continuous observation of a monitor who is a regulated
health professional acceptable to the College (the "Practice
Monitor" or "Practice Monitors"), and unless the other requirements
provided in this Undertaking are fulfilled.
(b) I, Dr. Pancham, undertake to inform my patients of the indication
for any pelvic or internal examination and to document the
discussion in the corresponding patient chart.
(c) I, Dr. Pancham, acknowledge that I have reviewed the Practice
Monitor's undertaking in respect of my office-based practice,
attached hereto as Appendix "A" and understand what is required of
the Practice Monitor including, but not limited to:
(i) providing reports (as described in the Practice Monitor's
undertaking) to the College on at least a monthly basis;
(ii) remaining present at all times during all pelvic or internal
examinations I conduct on any patient;
(iii) carefully observing all pelvic or internal examinations I
conduct on any patient. I further acknowledge my obligation
to ensure the Practice Monitor's view of all pelvic or
internal examinations I conduct is unobstructed at all times;
(iv) refraining from performing any other functions, except those
required in the Practice Monitor's undertaking attached as
Appendix "A", while observing me conduct any pelvic or
internal examination on patients;
(v) maintaining a log of all pelvic or internal examinations I
conduct on patients in the form attached to this Undertaking
as Appendix "B" (the "Log") and in the manner described in
Appendix "A", including listing the indication I described to
my patient for any pelvic or internal examination performed
and confirming that I have documented the discussion in the
corresponding patient chart;
(vi) initialing all corresponding entries in the records of
patients noted in the Log; and
(vii) submitting the original Log to the College on a monthly
basis.
(d) I, Dr. Pancham, acknowledge that I have reviewed the Supervising
Practice Monitor's undertaking in respect of my hospital-based
practice, attached hereto as Appendix "C" and understand what is
required of the Supervising Practice Monitor including, but not
limited to:
1. providing reports (as described in the Supervising Practice
Monitor's undertaking) to the College on at least a monthly
basis;
2. remaining present, or ensuring another regulated health
professional ("RHP") remains present, at all times during all
pelvic or internal examinations I conduct on patients;
3. carefully observing, or ensuring another RHP carefully
observes, all pelvic or internal examinations I conduct on
patients. I further acknowledge my obligation to ensure that
the Supervising Practice Monitor's (or any other RHP's) view
of all pelvic or internal examinations I conduct on patients
is unobstructed at all times;
4. ensuring that any RHP who works in a hospital area where I
may conduct pelvic or internal examinations on patients has
been notified that I am not permitted to conduct any pelvic
or internal examinations on patients of any age unless the
pelvic or internal examination takes place in the continuous
presence and under the continuous observation of a monitor
who is a regulated health professional;
5. refraining from performing any other functions, and ensuring
any other RHP so refrains, except those functions required in
the Supervising Practice Monitor's undertaking attached as
Appendix "C", while observing me during all pelvic or
internal examinations conducted by me on patients, except
that the Supervising Practice Monitor or other RHP may assist
in patient care if any emergency arises during a pelvic or
internal examination;
6. maintaining a log of all pelvic or internal examinations I
conduct on patients in the form attached to this Undertaking
as Appendix "B" (the "Log") and in the manner described in
Appendix "C";
7. initialing, or ensuring any other RHP initials, all
corresponding entries in the records of patients noted in the
Log; and
8. submitting the original Log to the College on a monthly
basis.
(e) I, Dr. Pancham, undertake to maintain an up to date copy of the
Log(s) from both my office-based and hospital-based practices by
ensuring a copy is made at the end of each business day, and to
make it available to the College upon request.
(6) I, Dr. Pancham, 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.
(7) Posting a Sign
(a) I, Dr. Pancham, undertake that I shall post a sign in all waiting
rooms, examination rooms and consulting rooms, in all of my
Practice Locations, except hospital units, in a clearly visible and
secure location, in the form set out in Appendix "D" that states:
"Patients please note that Dr. Pancham will perform all
internal/pelvic examinations in the continuous presence and under
the continuous observation of a registered nurse or registered
practical nurse".
(b) I, Dr. Pancham, undertake to post a certified translation in any
language in which I provide services, of the sign described in
section (7)(a), in all waiting rooms, examination rooms and
consulting rooms, in all of my Practice Locations, except hospital
units, in a clearly visible and secure location, in the form set
out at Appendix "D."
(c) I, Dr. Pancham, undertake to provide the certified translation
described in section (7)(b), to the College within thirty (30) days
of executing this Undertaking.
(d) I, Dr. Pancham, undertake that if I elect, after the execution of
this Undertaking, to provide services in any other language, I will
notify the College prior to providing any such services.
(e) I, Dr. Pancham, undertake to provide to the College the certified
translation described in section (7)(b) prior to beginning to
provide services in any language described in section (7)(d).
(8) Clinical Supervision
(a) I, Dr. Pancham, undertake to practise under the direct observation
of a clinical supervisor or clinical supervisors acceptable to the
College (the "Clinical Supervisor" or "Clinical Supervisors"), in
my hospital practice, for a minimum of 72 clinical hours, to be
completed within a period of six (6) months ("Clinical
Supervision").
(b) I, Dr. Pancham, acknowledge that I have reviewed the Clinical
Supervisor's undertaking, attached hereto as Appendix "E", and
understand what is required of the Clinical Supervisor. The
Clinical Supervisor will, at minimum,
(i) Review the materials provided by the College;
(ii) Directly observe me in my hospital practice for a minimum of
72 clinical hours over a six (6) month period. Such
observation shall include observation of all pelvic and
internal examinations done by me during the 72 clinical
hours;
(iii) Make recommendations to me for practice improvements and
ongoing professional development;
(iv) 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; and
(v) Submit a written report to the College at the end of Clinical
Supervision, or more frequently if the Clinical Supervisor
has concerns about my standard of practice.
(c) I, Dr. Pancham, undertake to cooperate fully with the Clinical
Supervision of my practice, conducted under the term of this
Undertaking and Appendix "E" 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.
(d) I, Dr. Pancham, undertake to ensure that Appendix "E" to this
Undertaking is signed and delivered to the College within thirty
(30) days of the date I execute this Undertaking.
(e) I, Dr. Pancham, undertake that if a person who has given an
undertaking in Appendix "E" 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.
C. ACKNOWLEDGEMENT
(9) I, Dr. Pancham, acknowledge that all appendices attached to or referred
to in this Undertaking form part of this Undertaking.
(10) I, Dr. Pancham, 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. Pancham, 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. Pancham, 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. Pancham, acknowledge that a breach of any provision of this
Undertaking may constitute an act of professional misconduct and may
result in a referral of specified allegations to the Discipline
Committee.
(14) I, Dr. Pancham, 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. Pancham, acknowledge that, during the time period that this
Undertaking remains in effect, this Undertaking shall be posted on
the Public Register.
(b) I, Dr. Pancham, 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:
A College investigation was conducted into whether Dr.
Pancham engaged in professional misconduct and/or was
incompetent in his Obstetrics/Gynecology practice. As a
result of the investigation:
Dr. Pancham must not conduct pelvic or internal examinations
on patients of any age, in any jurisdiction, unless the
examination takes place in the continuous presence and under
the continuous observation of a practice monitor who is a
regulated health professional acceptable to the College.
Dr. Pancham shall post a sign in all waiting rooms,
examination rooms and consulting rooms, in all Practice
Locations, except hospital units, in a clearly visible and
secure location, that states: "Patients please note that Dr.
Pancham will perform all internal/pelvic examinations in the
continuous presence and under the continuous observation of a
registered nurse or registered practical nurse".
Dr. Pancham will practise under the guidance of a Clinical
Supervisor for a minimum of 72 clinical hours.
D. CONSENT
(16) I, Dr. Pancham, 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.
(17) I, Dr. Pancham, acknowledge that I have executed the OHIP consent form,
attached hereto as Appendix "F".
(18) I, Dr. Pancham, consent to submit and not interfere with, unannounced
inspections of my Practice Locations and to the inspection of patient
charts by the College and to any other activity the College deems
necessary in order to monitor my compliance with the provisions of this
Undertaking.
(19) I, Dr. Pancham, give my irrevocable consent to the College to provide the
following information to all Practice Monitors and to all RHPs carrying
out duties under the Supervising Practice Monitor's undertaking, and to
all Clinical Supervisors:
(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.
(20) I, Dr. Pancham, give my irrevocable consent to all Practice Monitors and
RHPs carrying out duties under the Supervising Practice Monitor's
undertaking, Clinical Supervisors and 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 to the provisions of the Practice
Monitor's undertakings set out at Appendix "A" and "C" to this
Undertaking;
(c) any information relevant to the provisions of the Clinical
Supervisor's undertaking set out at Appendix "E" to this
Undertaking;
(d) any information relevant for the purposes of monitoring my
compliance with this Undertaking.
(21) I, Dr. Pancham, 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.
(2 of 2)
As from June 7, 2017, the following is imposed as a term, condition
and limitation on the certificate of registration held by Dr. Paul Ian Pancham,
in accordance with an undertaking and consent given by Dr. Pancham to the
College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. PAUL PANCHAM
("Dr. Pancham")
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;
"Public Register" means the College's register that is available to the
public.
(2) I, Dr. Pancham, certificate of registration number 67728, am a member of
the College. The College has received information regarding my standard
of practice.
(3) I, Dr. Pancham, acknowledge that the College initiated an investigation
bearing File Number 7214769 (the "Investigation") into my conduct and
practice at Lakeridge Health Oshawa.
(4) I, Dr. Pancham, acknowledge that, after the College receives an original
copy of this Undertaking as signed by me, no further action will be taken
on the Investigation.
B. UNDERTAKING
(5) I, Dr. Pancham, undertake to abide by the provisions of this Undertaking,
effective immediately.
(6) Return to Work Agreement with Lakeridge Health
(a) I, Dr. Pancham, acknowledge that I have entered into an agreement
with Lakeridge Health setting out terms for my return to work and
dated July 13, 2016 (the "Return to Work Agreement") which is
attached to, and forms part of, this Undertaking as Appendix "A".
(b) I, Dr. Pancham, undertake to fully comply with the Return to Work
Agreement.
(c) I, Dr. Pancham, agree that in the event that I fail to fully comply
with my Return to Work Agreement, such action may constitute a
breach of this Undertaking and an act of professional misconduct.
(7) Workplace Reporting
(a) I, Dr. Pancham, acknowledge and agree that the person who is the
Chief of Obstetrics and Gynecology at Lakeridge Health will be
required to execute an undertaking in the form attached hereto as
Appendix "B". I have reviewed this undertaking and understand what
is required of the Chief of Obstetrics and Gynecology which
includes, without limiting the generality of the foregoing:
i. a report to the College regarding my completion of the Peer
Monitoring phase set out in the Return to Work Agreement;
ii. a report to the College regarding my completion to date of
the Supervised Independent Work phase set out in the Return
to Work Agreement;
iii. a report to the College regarding my completion of the
Supervised Independent Work phase set out in the Return to
Work Agreement;
iv. a report to the College one year after my completion of the
Supervised Independent Work phase set out in the Return to
Work Agreement;
v. such reports to include information regarding my clinical
skills, behaviour, conduct, communications and
professionalism, whether observed by him or her, or as
reported to him or her by nursing, midwifery, and/or medical
staff; and
vi. immediate reporting to the College if he or she has any
concerns: about my clinical skills, behaviour, conduct,
communications or professionalism; about my capacity to
practise medicine; that my patients may be at risk of harm or
injury; or that I am not in compliance with my Undertaking.
(8) PHP Contract
(a) I, Dr. Pancham, acknowledge that I have entered into a contract
with the PHP dated June 23, 2016 ("PHP Contract") which is attached
to, and forms part of, this Undertaking as Appendix "C".
(b) I, Dr. Pancham, undertake to remain a participant in the PHP, and
to fully comply with the requirements of the PHP Contract.
(c) I, Dr. Pancham, agree that in the event that I terminate my
relationship with the PHP, or if I fail to fully comply with my PHP
Contract, such action may constitute a breach of this Undertaking,
and an act of professional misconduct.
(9) Delivery of reports mandated under PHP Contract
(a) I, Dr. Pancham, undertake to obtain copies of all of the reports
set out below and, within seven (7) days of receiving the reports,
to provide copies of the reports to the College:
i. PULSE survey results and feedback reports (two per year);
ii. Reports of Dawn Martin to the PHP (quarterly reports over a
twelve-month period); and
iii. Reports of the PHP to Lakeridge Health (semi-annually over
the term of the PHP contract).
(10) Monitoring
(a) I, Dr. Pancham, 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. Pancham, undertake 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. ACKNOWLEDGEMENT
(11) I, Dr. Pancham, acknowledge that all appendices attached to or referred
to in this Undertaking form part of this Undertaking.
(12) I, Dr. Pancham, 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.
(13) I, Dr. Pancham, 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.
(14) I, Dr. Pancham, 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").
(15) I, Dr. Pancham, 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.
(16) I, Dr. Pancham, acknowledge that this Undertaking constitutes terms,
conditions, and limitations on my certificate of registration for the
purposes of section 23 of the Code.
(17) Public Register
(a) I, Dr. Pancham, acknowledge that, during the time period that this
Undertaking remains in effect, this Undertaking shall be posted on
the Public Register.
(b) I, Dr. Pancham, acknowledge that, in addition to this Undertaking
being posted in accordance with section (17)(a) above, the
following summary shall be posted on the Public Register during the
time period that this Undertaking remains in effect:
A College investigation was conducted into Dr. Pancham's
conduct and practice at Lakeridge Health Oshawa. As a result
of the investigation:
* Dr. Pancham will comply with the terms of his Return to
Work Agreement with Lakeridge Health.
* The Chief of Obstetrics and Gynecology at Lakeridge
Health will provide periodic reports to the College
about Dr. Pancham.
* Dr. Pancham will comply with the terms of his PHP
Contract.
* Dr. Pancham will provide the College with copies of
certain reports mandated under his PHP Contract.
D. CONSENT
(18) I, Dr. Pancham, 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 compliance with the Return to Work Agreement
and/or PHP Contract:
(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.
(19) I, Dr. Pancham, 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.
(20) I, Dr. Pancham, give my irrevocable consent to any persons who facilitate
my compliance with the Return to Work Agreement and/or PHP Contract, and
to all Chiefs of Staff, to disclose to the College, and to one another,
any information:
(a) relevant to this Undertaking;
(b) relevant to the provisions of the Return to Work Agreement set out
at Appendix "A" to this Undertaking;
(c) relevant to the provisions of the Chief of Obstetrics and
Gynecology's undertaking set out at Appendix "B" to this
Undertaking;
(d) relevant to the provisions of the PHP Contract set out at Appendix
"A" to this Undertaking;
(e) relevant for the purposes of monitoring my compliance with this
Undertaking; and/or
(f) which comes to their attention and which they reasonably believes
indicates a potential risk of harm to my patients.