Robinson, Linda Ann (CPSO#: 33705)

Current Status: Active Member as of 18 Sep 2002

CPSO Registration Class: Restricted as of 25 Jun 2017

Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Female

Languages Spoken: English, French

Education:McGill University, 1979

Practice Information

Primary Location of Practice
Suite 205
111 Sherwood Drive
Ottawa ON  K1Y 3V1
Phone: (613) 793-4949
Fax: (613) 725-1758
Electoral District: 07

Specialties

Specialty Issued On Type
Anesthesiology Effective: 04 Jun 1986 RCPSC Specialist

Registration History

Action Issue Date
First certificate of registration issued: Independent Practice Certificate Effective: 07 Sep 1982
Suspension of registration imposed: Board of Inquiry Effective: 26 Jul 2001
Suspension of registration removed Effective: 05 Feb 2002
Suspension of registration imposed: Executive Committee Effective: 10 Jul 2002
Suspension of registration removed Effective: 18 Sep 2002
Transfer of class of certificate to: Restricted certificate Effective: 25 Jun 2017
Terms and conditions amended by member Effective: 11 Sep 2017

Practice Restrictions

Imposed By Effective Date Expiry Date Status  
member Effective: 11 Sep 2017 Active View Details [+]
            [1 of 2]

            As from September 11, 2017, the following is imposed as a term, condition and
            limitation on the certificate of registration held by Dr. Linda Ann Robinson in
            accordance with an undertaking and consent given by Dr. Robinson to the College
            of Physicians and Surgeons of Ontario:

                               UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT 
                                            ("Undertaking")
                                                  of
                                        DR. LINDA ANN ROBINSON
                                           ("Dr. Robinson")
                                                  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.
                  
                  "NMS" means the Drug Program Services Branch, the Narcotics Monitoring
                  System implemented under the Narcotics Safety and Awareness Act, 2010,
                  S.O. 2010, c. 22, 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. Robinson, certificate of registration number 33705, am a member of
                  the College.  

            (3)   I, Dr. Robinson, acknowledge that the College conducted an investigation
                  bearing File Number 7215990 (the "Investigation") into whether I failed
                  to maintain the standard of practice of the profession and/or am
                  incompetent.

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

            B.    UNDERTAKING

            (5)   I, Dr. Robinson, undertake to abide by the provisions of this
                  Undertaking, effective upon the date this Undertaking is approved by the
                  ICR Committee ("Effective Date").

            (6)   I, Dr. Robinson, shall keep a log of all prescriptions for medical
                  marijuana, which will include at least the following information (the
                  "Prescribing Log") as set out in Schedule 
                  "A" to this Undertaking:  
                  
                        (i)   the date of the appointment;
                        (ii)  the name of the patient and chart/file number;
                        (iii) the name of the medication prescribed, dose to be dispensed
                              and frequency;
                        (iv)  the clinical indication;
                        (v)   whether the prescription is for a new medication and/or
                              different dose or frequency than currently prescribed to the
                              patient (Y/N); 
                        (vi)  Dr. Robinson's signature;
                        (vii) the date of the Clinical Supervisor's review (if applicable,
                              as set out below); and
                        (viii)the Clinical Supervisor's signature (if applicable, as set
                              out below).
                  
            (7)   I, Dr. Robinson, undertake to keep a copy of all prescriptions I write
                  for medical marijuana in the corresponding patient chart.

            (8)   Clinical Supervision

                  (a)   I, Dr. Robinson, undertake to practise under the guidance of a
                        clinical supervisor(s) acceptable to the College (the "Clinical
                        Supervisor(s)"), for a minimum of four (4) months on the terms set
                        out below (the "Clinical Supervision"). 
                  
                  (b)   I, Dr. Robinson, undertake to meet with my Clinical Supervisor(s)
                        at least once every month to discuss the Clinical Supervisor(s)'s
                        review of:
                  
                              i.    15 charts for patients to whom I have prescribed
                                    medical marijuana, or if there are not 15 patients
                                    listed in the Prescribing Log since the Clinical
                                    Supervisor(s)'s prior review, then the charts of all
                                    patients listed in the Prescribing Log since the
                                    Clinical Supervisor's prior review; and
                  
                              ii.   the chart of every patient to whom I have initiated a
                                    new prescription for medical marijuana since the
                                    Clinical Supervisor(s)'s prior review. 
                  
            (c)   I, Dr. Robinson, acknowledge that the Clinical Supervisor(s) must sign
                  and date the Prescribing Log to confirm the charts that the Clinical
                  Supervisor(s) have reviewed and discussed with me.

            (d)   I, Dr. Robinson, acknowledge that  the Clinical Supervisor(s) will
                  provide a report to the College at least once every month.

            (e)   I, Dr. Robinson, acknowledge that after a minimum of four (4) months if
                  the Clinical Supervisor(s) is satisfied that I have the necessary
                  knowledge, skills and judgment to practice without supervision, the
                  Clinical Supervisor(s) may recommend to the College that the Clinical
                  Supervision cease.

            (f)   I, Dr. Robinson, acknowledge and undertake that the Clinical Supervision
                  will only cease upon recommendation of the Clinical Supervisor(s) and
                  approval by the College.

            (g)   I, Dr. Robinson, acknowledge that I have reviewed the Clinical
                  Supervisor(s)'s undertaking, attached hereto as Schedule "B", and
                  understand what is required of the Clinical Supervisor(s).  In addition
                  to what is set out above, the Clinical Supervisor(s) will, at a minimum: 

                        (i)   Facilitate the education program set out in the
                              Individualized Education Plan ("IEP") attached as Schedule
                              "C";
                  
                        (ii)  Discuss any concerns with me arising from chart reviews and
                              observations;
                  
                        (iii) Make recommendations to me for practice improvements and
                              ongoing professional development and inquire into my
                              compliance with the recommendations; and
                  
                        (iv)  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.
                  
            (h)   I, Dr. Robinson, undertake that all meetings with my Clinical
                  Supervisor(s) will take place at my Practice Location, or another
                  location approved by the College;

                        (i)   I, Dr. Robinson, acknowledge that all charts reviewed shall
                              be independently selected by the Clinical Supervisor(s) based
                              on the educational needs identified in the IEP set out at
                              Schedule "B" to my Undertaking, as well as the areas of
                              concern identified in the report of the medical inspector
                              received July 7, 2017, and concerns that may arise during the
                              period of Clinical Supervision.
                  
            (j)   I, Dr. Robinson, undertake to cooperate fully with the Clinical
                  Supervision of my practice, conducted under the terms of this Undertaking
                  and Schedule "B" 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.

            (k)   I, Dr. Robinson, undertake to ensure that Schedule "B" to this
                  Undertaking, is signed and delivered to the College within fourteen (14)
                  days of the Effective Date.

            (l)   I, Dr. Robinson, undertake that if a person who has given an undertaking
                  in Schedule "B" to this Undertaking is unable or unwilling to continue to
                  fulfill its provisions, I shall, within fourteen (14) 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.

            (m)   I, Dr. Robinson, agree that if I am unable to obtain a Clinical
                  Supervisor on the terms set out in sections (8)(k) and/or (l) above, I
                  will cease prescribing medical marijuana until such time as I have
                  obtained a Clinical Supervisor acceptable to the College.  

            (n)   I, Dr. Robinson, agree that if I am required to cease prescribing medical
                  marijuana as a result of section (8)(m) 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.

            (9)   Professional Education  

            (a)   I, Dr. Robinson, undertake to participate in and successfully complete
                  all elements of the detailed IEP, attached hereto as Schedule "C",
                  including but not limited to, the following elements of professional
                  education (the "Professional Education"):

                  (i)   Review and discuss with my Clinical Supervisor(s) the following
                        resources:
                  
                        1.    CPSO Policy "Prescribing Drugs":
                              http://www.cpso.on.ca/Policies-Publications/Policy/Prescribing-Drugs;
                  
                        2.    the CPSO Policy on Prescribing Marijuana for Medical Purposes
                              http://www.cpso.on.ca/Policies-Publications/Policy/Marijuana-for-Medical-Purposes
                              and
                  
                        3.    the CPSO Policy on Record Keeping
                              http://www.cpso.on.ca/Policies-Publications/Policy/Medical-Records
                  
                  (ii)  University of Toronto Medical Record Keeping Course
                         https://www.cpd.utoronto.ca/recordkeeping/ and
                  
                  (iii) any additional professional education recommended by my Clinical
                        Supervisor(s).
                  
            (b)   I, Dr. Robinson, undertake to provide proof to the College of my
                  successful completion of each element of the Professional Education
                  specified above, including proof of registration, attendance and
                  participant assessment reports where available, within one (1) month of
                  completion of each element. I acknowledge that the College will
                  determine, in its sole discretion, whether I have successfully completed
                  each element of the Professional Education.

            (c)   I, Dr. Robinson, acknowledge that a report or reports may be provided to
                  the College regarding my progress and compliance with the Professional
                  Education

            (10)  Reassessment of Practice

                  (a)   I, Dr. Robinson, undertake that, approximately six (6) months
                        after the Clinical Supervision set out under section 8 of the
                        Undertaking has ceased, I will submit to a reassessment of my
                        practice by an assessor or assessors selected by the College (the
                        "Reassessment").
                  
                   (b)  I, Dr. Robinson, acknowledge and agree that the Reassessment may
                        include a chart review, direct observation of my care, an interview
                        of me, interviews with colleagues and co-workers, feedback from
                        patients and any other tools deemed necessary by the College.
                  
                  (c)   I, Dr. Robinson, undertake to co-operate fully with the
                        Reassessment, conducted under the terms of this Undertaking 
                  
                  (d)   I, Dr. Robinson, 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.  
                  
                  (e)   I, Dr. Robinson, acknowledge that the results of the Reassessment
                        will be provided to me and reported to the College and that the
                        Reassessment may form the basis of further action by the College.
                  
            (11)  Practice Restrictions

                  (a)   I, Dr. Robinson, undertake that I will not engage in any of the
                        following area of practice: Epidural Steroid Injections
                  
            (12)  Monitoring 

                  (a)   I, Dr. Robinson, 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 ten
                        (10) business days of executing this Undertaking.  Going forward, I
                        further undertake to inform the College of any and all new Practice
                        Locations within ten (10) business days of commencing practice at
                        that location.
                  
                  (b)   I, Dr. Robinson, 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. Robinson, give my 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 Undertaking. 
                  
                  (d)   I, Dr. Robinson, acknowledge that I have executed the OHIP and NMS
                        consent form(s), attached hereto as Schedule "D" and Schedule "E",
                        respectively. 
                  
            C.    ACKNOWLEDGEMENT

            (13)  I, Dr. Robinson, acknowledge that all schedules attached to or referred
                  to in this Undertaking form part of this Undertaking.

            (14)  I, Dr. Robinson, 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. 

            (15)  I, Dr. Robinson, 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.

            (16)  I, Dr. Robinson, 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").

            (17)  I, Dr. Robinson, 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.

            (18)  I, Dr. Robinson, acknowledge that this entire Undertaking constitutes
                  terms, conditions, and limitations on my certificate of registration for
                  the purposes of section 23 of the Code. 

            (19)  Public Register

                  (a)   I, Dr. Robinson, acknowledge that, during the time period that this
                        Undertaking remains in effect, this Undertaking shall be posted on
                        the Public Register.
                  
                  (b)   I, Dr. Robinson, acknowledge that, in addition to this Undertaking
                        being posted in accordance with the section above, the following
                        summary shall be posted on the Public Register during the time
                        period that this Undertaking remains in effect:
                  
                              The College conducted an investigation into whether Dr.
                              Robinson failed to maintain the standard of practice of the
                              profession and/or was incompetent. As a result of the
                              investigation:
                  
                              "Dr. Robinson has agreed not to perform epidural steroid
                              injections.
                  
                              "Dr. Robinson's prescribing of medical marijuana will be
                              supervised by a Clinical Supervisor acceptable to the College
                              for a minimum of four (4) months. 
                  
                              "Dr. Robinson will engage in professional education in the
                              prescribing of medical marijuana and record keeping.
                  
                              "Following the professional education and period of
                              supervision, Dr. Robinson's prescribing of controlled
                              substances, including narcotics, will be re-assessed by an
                              assessor selected by the College.
                  
            D.    CONSENT

            (20)  I, Dr. Robinson, 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.
                  
            (21)  I, Dr. Robinson, give my irrevocable consent to the College to provide
                  all 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.

            (22)  I, Dr. Robinson, give my irrevocable consent to any person who
                  facilitates 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 information:

                  (a)   relevant to this Undertaking;
                  
                  (b)   relevant to the provisions of the Clinical Supervisor's undertaking
                        set out at Schedule "B";
                  
                  (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 and which he or she reasonably believes
                        indicates a potential risk of harm to my patients.
                  
            [2 of 2]

            As from June 25, 2017, the following is imposed as a term, condition and
            limitation on the certificate of registration held by Dr. Linda Ann Robinson in
            accordance with an undertaking and consent given by Dr. Robinson to the College
            of Physicians and Surgeons of Ontario:

                               UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT 
                                            ("Undertaking")
                                                  of
                                        DR. LINDA ANN ROBINSON
                                           ("Dr. Robinson")
                                                  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.
                  
                  "Narcotic Drugs" means from the Narcotic Control Regulations made under
                  the Controlled Drugs and Substances Act, S.C., 1996, c. 19, as amended.
                  
                  "Narcotic Preparations" means from the Narcotic Control Regulations made
                  under the Controlled Drugs and Substances Act, S.C., 1996, c. 19, as
                  amended.
                  
                  "Controlled Drugs" means from Part G of the Food and Drug Regulations
                  under the Food and Drugs Act, S.C., 1985, c. F-27, as amended.
                  
                  "Benzodiazepines and Other Targeted Substances" means from the
                  Benzodiazepines and Other Targeted Substances Regulations made under the
                  Controlled Drugs and Substances Act., S.C., 1996, c. 19, as amended 
                  
                        (A summary of the above-named drugs [from Appendix I to the
                        Compendium of Pharmaceuticals and Specialties] is attached hereto
                        as Schedule "A"; and the current regulatory lists are attached
                        hereto as Schedule "B")
                  
                  "All other Monitored Drugs" means as defined under the Narcotics Safety
                  and Awareness Act, 2010, S.O. 2010, c. 22, as amended, as noted in
                  Schedule "C".                                          
                  
                  "NMS" means the Drug Program Services Branch, the Narcotics Monitoring
                  System implemented under the Narcotics Safety and Awareness Act, 2010,
                  S.O. 2010, c. 22, 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. Robinson, certificate of registration number 33705, am a member of
                  the College.  

            (3)   I, Dr. Robinson, acknowledge that the College received information from
                  the NMS and initiated an investigation bearing File Number 7215616 (the
                  "Investigation") into whether I failed to maintain the standard of
                  practice of the profession and/or am incompetent in my prescribing of
                  controlled substances, including narcotics.

            B.    UNDERTAKING

            (4)   I, Dr. Robinson, undertake to abide by the provisions of this Undertaking
                  effective immediately upon the signing of this Undertaking. 

            (5)   I, Dr. Robinson, shall keep a log of all prescriptions for Narcotic
                  Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other
                  Targeted Substances and All other Monitored Drugs, in the form attached
                  as set out in Schedule "D", which will include at least the following
                  information (the "Prescribing Log"):  

                        (i)the date of the appointment;
                        (ii)the name of the patient and chart/file number;
                        (iii)the name of the medication prescribed, dose, direction, number
                        of tablets to be dispensed and frequency;
                        (iv)the clinical indication;
                        (v)whether the prescription is for a new medication and/or
                        different dose or frequency than currently prescribed to the
                        patient (Y/N); 
                        (vi)Dr. Robinson's signature;
                        (vii)the date of the Clinical Supervisor's review (if applicable,
                        as set out below); and
                        (viii)the Clinical Supervisor's signature (if applicable, as set
                        out below).
                  
            (6)   I, Dr. Robinson, undertake to keep a copy of all prescriptions I write
                  for Narcotic Drugs, Narcotic Preparations, Controlled Drugs,
                  Benzodiazepines and Other Targeted Substances and All other Monitored
                  Drugs, in the corresponding patient chart.

            (7)   Clinical Supervision

                  (a)   I, Dr. Robinson, undertake to practise under the guidance of a
                        clinical supervisor(s) acceptable to the College (the "Clinical
                        Supervisor(s)"), for a minimum of seven (7) months on the terms set
                        out below (the "Clinical Supervision"). 
                  
                  (b)   I, Dr. Robinson, acknowledge and undertake that each phase of
                        Clinical Supervision set out below will only be reduced upon
                        recommendation of the Clinical Supervisor(s) and approval by the
                        College.
                  
            Phase 1 of Clinical Supervision ("Phase 1")

                  (c)   I, Dr. Robinson, undertake to engage in Phase 1 of Clinical
                        Supervision for a minimum of four (4) weeks on the terms set out
                        below.
                  
                  (d)   During Phase 1, I, Dr. Robinson, undertake to meet with my Clinical
                        Supervisor(s) at least once every week to discuss the Clinical
                        Supervisor(s)'s review of:
                  
                        i.    20 charts for patients to whom I have prescribed Narcotic
                              Drugs, Narcotic Preparations, Controlled Drugs,
                              Benzodiazepines and Other Targeted Substances and All other
                              Monitored Drugs since the Clinical Supervisor(s)'s prior
                              review, or if there are not 20 patients listed in the
                              Prescribing Log since the Clinical Supervisor(s)'s prior
                              review, then the charts of all patients listed in the
                              Prescribing Log since the Clinical Supervisor's prior review;
                              and
                  
                        ii.   the chart of every patient to whom I have initiated a new
                              prescription for Narcotic Drugs, Narcotic Preparations,
                              Controlled Drugs, Benzodiazepines and Other Targeted
                              Substances and/or All other Monitored Drugs since the
                              Clinical Supervisor(s)'s prior review.
                  
                  (e)   I, Dr. Robinson, acknowledge that during Phase 1, the Clinical
                        Supervisor(s) must sign and date the Prescribing Log to confirm the
                        charts that the Clinical Supervisor(s) 
                        have reviewed and discussed with me.
                  
                  (f)   I, Dr. Robinson, acknowledge that during Phase 1, the Clinical
                        Supervisor(s) will provide a report to the College at least once
                        every two weeks.
                  
                  (g)   I, Dr. Robinson, acknowledge that after a minimum of four (4) weeks
                        of Phase 1, if the Clinical Supervisor(s) is satisfied that I have
                        the necessary knowledge, skills and judgment to practice in a less
                        highly supervised environment, the Clinical Supervisor(s) may
                        recommend to the College that supervision be reduced. 
                  
            Phase 2 of Clinical Supervision ("Phase 2")

                  h)    Upon the recommendation of the Clinical Supervisor(s) and approval
                        by the College, I, Dr. Robinson, undertake to engage in Phase 2 of
                        Clinical Supervision for a minimum of two (2) months on the terms
                        set out below.
                  
                  (i)   During Phase 2, I, Dr. Robinson, undertake to meet with my Clinical
                        Supervisor(s) at least bi-weekly to discuss the Clinical
                        Supervisor(s)'s review of:
                  
                        i.    15 charts for patients to whom I have prescribed Narcotic
                              Drugs, Narcotic Preparations, Controlled Drugs,
                              Benzodiazepines and Other Targeted Substances and All other
                              Monitored Drugs since the Clinical Supervisor(s)'s prior
                              review, or if there are not 15 patients listed in the
                              Prescribing Log since the Clinical Supervisor(s)'s prior
                              review, then the charts of all patients listed in the
                              Prescribing Log since the Clinical Supervisor's prior review;
                              and
                  
                        ii.   the chart of every patient to whom I have initiated a new
                              prescription for Narcotic Drugs, Narcotic Preparations,
                              Controlled Drugs, Benzodiazepines and Other Targeted
                              Substances and/or All other Monitored Drugs since the
                              Clinical Supervisor(s)'s prior review. 
                  
                  (j)   I, Dr. Robinson, acknowledge that during Phase 2, the Clinical
                        Supervisor(s) must sign and date the Prescribing Log to confirm the
                        charts that the Clinical Supervisor(s) have reviewed and discussed
                        with me.
                  
                  (k)   I, Dr. Robinson, acknowledge that during Phase 2, the Clinical
                        Supervisor(s) will provide a report to the College at least once
                        bi-weekly.
                  
                  (l)   I, Dr. Robinson, acknowledge that after a minimum of two (2) months
                        of Phase 2, if the Clinical Supervisor(s) is satisfied that I have
                        the necessary knowledge, skills and judgment to practice in a less
                        highly supervised environment, the Clinical Supervisor(s) may
                        recommend to the College that supervision be reduced. 
                  
            Phase 3 of Clinical Supervision ("Phase 3")

                  (m)   Upon the recommendation of the Clinical Supervisor(s) and approval
                        by the College, I, Dr. Robinson, undertake to engage in Phase 3 of
                        Clinical Supervision for a minimum of four (4) months on the terms
                        set out below.
                  
                  (n)   During Phase 3, I, Dr. Robinson, undertake to meet with my Clinical
                        Supervisor(s) at least once every month to discuss the Clinical
                        Supervisor(s)'s review of:
                  
                        i.    15 charts for patients to whom I have prescribed Narcotic
                              Drugs, Narcotic Preparations, Controlled Drugs,
                              Benzodiazepines and Other Targeted Substances and All other
                              Monitored Drugs since the Clinical Supervisor(s)'s prior
                              review, or if there are not 15 patients listed in the
                              Prescribing Log since the Clinical Supervisor(s)'s prior
                              review, then the charts of all patients listed in the
                              Prescribing Log since the Clinical Supervisor's prior review;
                              and
                  
                        ii.   the chart of every patient to whom I have initiated a new
                              prescription for Narcotic Drugs, Narcotic Preparations,
                              Controlled Drugs, Benzodiazepines and Other Targeted
                              Substances and/or All other Monitored Drugs since the
                              Clinical Supervisor(s)'s prior review. 
                  
                  (o)   I, Dr. Robinson, acknowledge that during Phase 3, the Clinical
                        Supervisor(s) must sign and date the Prescribing Log to confirm the
                        charts that the Clinical Supervisor(s) have reviewed and discussed
                        with me.
                  
                  (p)   I, Dr. Robinson, acknowledge that during Phase 3, the Clinical
                        Supervisor(s) will provide a report to the College at least once
                        every month.
                  
                  (q)   I, Dr. Robinson, acknowledge that after a minimum of four (4)
                        months of Phase 3, if the Clinical Supervisor(s) is satisfied that
                        I have the necessary knowledge, skills and judgment to practice
                        without supervision, the Clinical Supervisor(s) may recommend to
                        the College that the Clinical Supervision cease.
                  
                  (r)   I, Dr. Robinson, acknowledge and undertake that the Clinical
                        Supervision will only cease upon recommendation of the Clinical
                        Supervisor(s) and approval by the College.
                  
                  (s)   I, Dr. Robinson, acknowledge that I have reviewed the Clinical
                        Supervisor(s)'s undertaking, attached hereto as Schedule "E", and
                        understand what is required of the Clinical Supervisor(s).  In
                        addition to what is set out above, the Clinical Supervisor(s) will,
                        at a minimum: 
                  
                        (i)   Facilitate the education program set out in the
                              Individualized Education Plan ("IEP") attached as Schedule
                              "F";
                  
                        (ii)  Discuss any concerns with me arising from chart reviews and
                              observations;
                  
                        (iii) Make recommendations to me for practice improvements and
                              ongoing professional development and inquire into my
                              compliance with the recommendations; and
                  
                        (iv)  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.
                  
                  (t)   I, Dr. Robinson, undertake that all meetings with my Clinical
                        Supervisor(s) will take place at my Practice Location, or another
                        location approved by the College;
                  
                  (u)   I, Dr. Robinson, acknowledge that all charts reviewed shall be
                        independently selected by the Clinical Supervisor(s) based on the
                        educational needs identified in the IEP set out at Schedule "F" to
                        my Undertaking, as well as the areas of concern identified in the
                        report of the medical inspector dated December 15 2016, and
                        concerns that may arise during the period of Clinical Supervision.
                  
                  (v)   I, Dr. Robinson, undertake to cooperate fully with the Clinical
                        Supervision of my practice, conducted under the terms of this
                        Undertaking and Schedule "E" 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.
                  
                  (w)   I, Dr. Robinson, undertake to ensure that Schedule "E" to this
                        Undertaking, is signed and delivered to the College within fourteen
                        (14) days of the Effective Date.
                  
                  (x)   I, Dr. Robinson, undertake that if a person who has given an
                        undertaking in Schedule "E" to this Undertaking is unable or
                        unwilling to continue to fulfill its provisions, I shall, within
                        fourteen (14) 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.
                  
                  (y)   I, Dr. Robinson, agree that if I am unable to obtain a Clinical
                        Supervisor on the terms set out in sections (7)(w) and/or (x)
                        above, I will cease prescribing Narcotic Drugs, Narcotic
                        Preparations, Controlled Drugs, Benzodiazepines and Other Targeted
                        Substances and All other Monitored Drugs until such time as I have
                        obtained a Clinical Supervisor acceptable to the College.  
                  
                  (z)   I, Dr. Robinson, agree that if I am 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 (7)(y) 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.
                  
            (8)   Professional Education  

                  (a)   I, Dr. Robinson, undertake to participate in and successfully
                        complete all elements of the detailed IEP, attached hereto as
                        Schedule "F", including but not limited to, the following elements
                        of professional education (the "Professional Education"):
                  
                        (i)   University of Toronto Faculty of Medicine program in Safe
                              Opioid Prescribing (all three webinars and in-person
                              workshop): www.cepd.utoronto.ca/opioidprescribing;
                  
                        (ii)  Review and discuss with my Clinical Supervisor(s) the
                              following resources:
                  
                              1.CPSO Policy "Prescribing Drugs":
                              http://www.cpso.on.ca/Policies-Publications/Policy/Prescribing-Drugs;
                  
                              2.the Canadian Guideline for the Safe and Effective Use of
                              Opioids for Chronic Non-Cancer Pain:
                              http://nationalpaincentre.mcmaster.ca/opioid;
                  
                              3. CMPA advice regarding preventing the misuse of opioids
                              https://www.cmpa-acpm.ca/en/advice-publications/browse-articles/2015/preventing-the-misuse-of-opioids
                  
                        (iii) any additional professional education recommended by my
                              Clinical Supervisor(s).
                  
                  (b)   I, Dr. Robinson, undertake to provide proof to the College of my
                        successful completion of each element of the Professional Education
                        specified above, including proof of registration, attendance and
                        participant assessment reports where available, within one (1)
                        month of completion of each element. I acknowledge that the College
                        will determine, in its sole discretion, whether I have successfully
                        completed each element of the Professional Education.
                  
                  (c)   I, Dr. Robinson, acknowledge that a report or reports may be
                        provided to the College regarding my progress and compliance with
                        the Professional Education.
                  
            (9)   Reassessment of Practice

                  (a)   I, Dr. Robinson, undertake that, approximately six (6) months
                        after the Clinical Supervision set out under section 7 of the
                        Undertaking has ceased, I will submit to a reassessment of my
                        practice by an assessor or assessors selected by the College (the
                        "Reassessment").
                  
                   (b)  I, Dr. Robinson, acknowledge and agree that the Reassessment may
                        include a chart review, direct observation of my care, an interview
                        of me, interviews with colleagues and co-workers, feedback from
                        patients and any other tools deemed necessary by the College.
                  
                  (c)   I, Dr. Robinson, undertake to co-operate fully with the
                        Reassessment, conducted under the terms of this Undertaking 
                  
                  (d)   I, Dr. Robinson, 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.  
                  
                  (e)   I, Dr. Robinson, acknowledge that the results of the Reassessment
                        will be provided to me and reported to the College and that the
                        Reassessment may form the basis of further action by the College.
                  
            (10)  Monitoring 

                  (a)   I, Dr. Robinson, 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 ten
                        (10) business days of executing this Undertaking.  Going forward, I
                        further undertake to inform the College of any and all new Practice
                        Locations within ten (10) business days of commencing practice at
                        that location.
                  
                  (b)   I, Dr. Robinson, 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. Robinson, give my 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 Undertaking. 
                  
                  (d)   I, Dr. Robinson, acknowledge that I have executed the OHIP and NMS
                        consent form(s), attached hereto as Schedule "G" and Schedule "H",
                        respectively. 
                  
            C.    ACKNOWLEDGEMENT

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

            (12)  I, Dr. Robinson, 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. Robinson, 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. Robinson, 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. Robinson, 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. Robinson, acknowledge that this entire 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. Robinson, acknowledge that, during the time period that this
                        Undertaking remains in effect, this Undertaking shall be posted on
                        the Public Register.
                  
                  (b)   I, Dr. Robinson, acknowledge that, in addition to this Undertaking
                        being posted in accordance with the section above, the following
                        summary shall be posted on the Public Register during the time
                        period that this Undertaking remains in effect:
                  
                              The College received information from the Narcotics
                              Monitoring System about Dr. Robinson's prescribing of
                              controlled substances, including narcotics.
                  
                              Based on the information received, the College conducted an
                              investigation into whether Dr. Robinson failed to maintain
                              the standard of practice of the profession and/or was
                              incompetent in his prescribing of controlled substances,
                              including narcotics.  As a result of the investigation:
                  
                                    "Dr. Robinson's prescribing of narcotic drugs, narcotic
                                    preparations, controlled drugs, benzodiazepines and
                                    other targeted substances, and other monitored drugs
                                    will be supervised by a Clinical Supervisor acceptable
                                    to the College for a minimum of seven (7) months. 
                  
                                    "Dr. Robinson will engage in professional education in
                                    the 
                                    prescribing of controlled substances, including
                                    narcotics.
                  
                                    "Following the professional education and period of
                                    supervision, Dr. Robinson's prescribing of controlled
                                    substances, including narcotics, will be re-assessed by
                                    an assessor selected by the College.
                  
            D.    CONSENT

            (18)  I, Dr. Robinson, 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.
                  
            (19)  I, Dr. Robinson, give my irrevocable consent to the College to provide
                  all 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.

            (20)  I, Dr. Robinson, give my irrevocable consent to any person who
                  facilitates 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 information:

                  (a)   relevant to this Undertaking;
                  
                  (b)   relevant to the provisions of the Clinical Supervisor's undertaking
                        set out at Schedule "E";
                  
                  (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 and which he or she reasonably believes
                        indicates a potential risk of harm to my patients.
                  
                  

Concerns

Source: Member
Active Date: September 11, 2017
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Linda Ann Robinson to the College of Physicians and Surgeons of Ontario, effective September 11, 2017:

The College conducted an investigation into whether Dr. Robinson failed to maintain the standard of practice of the profession and/or was incompetent. As a result of the investigation:

Dr. Robinson has agreed not to perform epidural steroid injections.

Dr. Robinson’s prescribing of medical marijuana will be supervised by a Clinical Supervisor acceptable to the College for a minimum of four (4) months.

Dr. Robinson will engage in professional education in the prescribing of medical marijuana and record keeping.

Following the professional education and period of supervision, Dr. Robinson’s prescribing of controlled substances, including narcotics, will be re-assessed by an assessor selected by the College.


Source: ICR Committee
Active Date: September 11, 2017
Expiry Date:
Summary:
Caution-in-Person:

A summary of a decision of the Inquiries, Complaints and Reports Committee in which the disposition includes a "caution-in-person" is required by the College by-laws to be posted on the register, along with a note if the decision has been appealed. A “caution-in-person” disposition requires the physician to attend at the College and be verbally cautioned by a panel of the Committee. The summary will be removed from the register if the decision is overturned on appeal or review. Note that this requirement only applies to decisions arising out of a complaint dated on or after January 1, 2015 or if there was no complaint, the first appointment of investigators dated on or after January 1, 2015.

See PDF for the summary of a decision made against this member in which the disposition includes a caution-in-person.
Download Full Document (PDF)


Source: Member
Active Date: June 25, 2017
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Linda Ann Robinson to the College of Physicians and Surgeons of Ontario, effective June 25, 2017:

The College received information from the Narcotics Monitoring System about Dr. Robinson’s prescribing of controlled substances, including narcotics.

Based on the information received, the College conducted an investigation into whether Dr. Robinson failed to maintain the standard of practice of the profession and/or was incompetent in his prescribing of controlled substances, including narcotics. As a result of the investigation:

Dr. Robinson’s prescribing of narcotic drugs, narcotic preparations, controlled drugs, benzodiazepines and other targeted substances, and other monitored drugs will be supervised by a Clinical Supervisor acceptable to the College for a minimum of seven (7) months.

Dr. Robinson will engage in professional education in the prescribing of controlled substances, including narcotics.

Following the professional education and period of supervision, Dr. Robinson’s prescribing of controlled substances, including narcotics, will be re-assessed by an assessor selected by the College.