Effective December 1, 2020, Dr. See has completed the education and remediation portion of his Undertaking dated August 12, 2016. The prescribing restriction remains active on the public register as noted below:
"Dr. See will not issue new prescriptions or renew existing prescriptions for the following substances: narcotic drugs, narcotic preparations, controlled drugs, benzodiazepines and other targeted substances. Dr. See shall post a sign in the waiting room of all practice locations" Clauses B(4) through (7)
As from August 12, 2016, the following are imposed as a terms, conditions and limitations on the certificate of registration held by Dr. Hilario See, in accordance with an undertaking and consent given by Dr. See to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. HILARIO SEE
("Dr. See")
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.
(2) I, Dr. See, certificate of registration number 70970, am a member of the College. The College has received information regarding my standard of practice.
(3) I, Dr. See, acknowledge that the College initiated investigations bearing File Numbers 94610 and 7214927 (the "Investigations") into whether I engaged in professional misconduct and/or am incompetent in my family practice.
B. UNDERTAKING
(4) Resignation of Prescribing Privileges
(a) I, Dr. See, acknowledge that I have executed the Prescribing Resignation Letter to Health Canada, which is attached hereto as Schedule "A" (the "Resignation Letter").
(b) I, Dr. See, consent to the College sending the Resignation Letter to Health Canada on my behalf.
(c) I, Dr. See, undertake and agree that I will not issue new prescriptions or renew existing prescriptions for any of the following substances:
(i) Narcotic Drugs (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
(ii) Narcotic Preparations (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
(iii) Controlled Drugs (from Part G of the Food and Drug Regulations under the Food and Drugs Act, S.C., 1985, c. F-27);
(iv) Benzodiazepines and Other Targeted Substances (from the Benzodiazepines and Other Targeted Substances Regulations made under the Controlled Drugs and Substances Act., S.C., 1996, c. 19);
(A summary of the above-named drugs [from Appendix I to the Compendium of Pharmaceuticals and Specialties] is attached hereto as Schedule "B"; and the current regulatory lists are attached hereto as Schedule "C")
(v) All other Monitored Drugs (as defined under the Narcotics Safety and Awareness Act, 2010, S.O. 2010, c. 22 as noted in Schedule "D");
and as amended from time to time.
(5) I, Dr. See, undertake that I will return any supplies of the substances referred to in section (4)(c) above that are presently in my possession, in any place, to a pharmacy in a safe and secure manner, as stipulated in the College's Policy Number 8-12, "Prescribing Drugs."
(6) I, Dr. See, 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.
(7) Posting a Sign
(a) I, Dr. See, undertake that I shall post a sign in the waiting room(s) of all my Practice Locations, in a clearly visible and secure location, in the form set out at Schedule "E". For further clarity, this sign shall state as follows:
IMPORTANT NOTICE
Dr. See must not prescribe any of the following:
- Narcotic Drugs
- Narcotic Preparations
- Controlled Drugs
- Benzodiazepines and Other Targeted Substances
- All other Monitored Drugs
Further information may be found on the College of Physicians and Surgeons of Ontario website at www.cpso.on.ca
(b) I, Dr. See, undertake to post a certified translation in any language in which I provide services, of the sign described in section (7)(a) above, in the waiting room(s) of all my Practice Locations, in a clearly visible and secure location, in the form set out at Schedule "E".
(c) I, Dr. See, undertake to provide the certified translation(s) described in section (7)(b), to the College within thirty (30) days of executing this Undertaking.
(d) I, Dr. See, undertake that if I elect, after the execution of this Undertaking, to provide services in any other language(s), I will notify the College prior to providing any such services.
(e) I, Dr. See, undertake to provide to the College the certified translation(s) described in section (7)(c) prior to beginning to provide services in the language(s) described in section (7)(d).
(8) Clinical Supervision
(a) I, Dr. See, 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. See, acknowledge that I have reviewed the Clinical Supervisor's undertaking, attached hereto as Schedule "F", and understand what is required of the Clinical Supervisor(s). The Clinical Supervisor(s) will, at minimum:
(i) Facilitate the education program set out in the Individualized Education Plan ("IEP") attached as Schedule "G";
(ii) Review materials and have an initial meeting to discuss practice improvement recommendations;
(iii) Meet with me at least once every other week ("Moderate Level Supervision"). If, after a minimum of three (3) months of Moderate Level Supervision, the Clinical Supervisor recommends it and the College approves, Clinical Supervision will be reduced such that the Clinical Supervisor will meet with me at least once every month ("Low Level Supervision");
(iv) Review at least twenty (20) of my patient charts at every meeting;
(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, or more frequently if the Clinical Supervisor(s) has concerns about my standard of practice.
(c) I, Dr. See, acknowledge that the charts reviewed shall be selected by the Clinical Supervisor(s), independent of my participation, based on the educational needs identified in the IEP set out at Schedule "G" to my Undertaking, as well as the areas of concern identified in the reports of the medical inspectors dated March 18, 2015, April 10, 2015, April 15, 2015, February 12, 2016 and May 16, 2016 ("the Medical Inspectors' Reports"), and concerns that may arise during the period of Clinical Supervision.
(d) I, Dr. See, undertake to cooperate fully with the Clinical Supervision of my practice, conducted under the term of this Undertaking and Schedule "F" 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. See, undertake to ensure that Schedule "F" to this Undertaking, is signed and delivered to the College within ten (10) days of the date the ICR Committee approves this Undertaking.
(f) I, Dr. See, undertake that if a person who has given an undertaking in Schedule "F" 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.
(g) I, Dr. See, agree that if I am unable to obtain a Clinical Supervisor on the provisions set out under sections (8)(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. See, agree that if I am required to cease practise as a result of section (8)(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.
(9) Professional Education
(a) I, Dr. See, undertake to participate in and successfully complete the following professional education:
(i) all aspects of the detailed IEP, attached hereto as Schedule "G"; and
(ii) any additional professional education recommended by my Clinical Supervisor(s).
(b) I, Dr. See, undertake to provide proof to the College of my successful completion of the professional education set out in section (9)(a) within one (1) month of completing it.
(c) I, Dr. See, 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 (9)(a).
(10) Reassessment of Practice
(a) I, Dr. See, undertake that, approximately six (6) months after the completion of the Clinical Supervision set out in section (8) above and Schedule "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. See, 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. See, 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. See, 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. See, undertake that, following the decision referenced in section (10)(d) above, I will abide by those recommendations of the Assessor(s) that the ICR Committee has determined are reasonable.
(f) I, Dr. See, hereby consent to any of 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:
(i) any recommendations of the Assessor(s) which are terms, conditions or limitations on my practice;
(ii) any recommendations of the Assessor(s) which the ICR Committee has identified in its decision referenced in section (10)(d) as terms, conditions or limitations on my practice.
C. ACKNOWLEDGEMENT
(11) I, Dr. See, acknowledge that all schedules attached to or referred to in this Undertaking form part of this Undertaking.
(12) I, Dr. See, acknowledge and agree that I am bound by this Undertaking from the date on which I sign it.
(13) I, Dr. See, acknowledge that a breach 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.
(14) I, Dr. See, acknowledge and agree 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. See, 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. See, 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.
(17) I, Dr. See, 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. See was the subject of a College investigation into whether he engaged in professional misconduct and/or is incompetent in his prescribing, family practice. As a result of the investigation:
Dr. See will practise under the guidance of a Clinical Supervisor acceptable to the College for 12 months.
Dr. See's practice will be reassessed by an assessor selected by the College within 6 months of the end of the period of Clinical Supervision.
Dr. See must not issue new prescriptions or renew existing prescriptions for any of the following substances:
(i) Narcotic Drugs (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
(ii) Narcotic Preparations (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
(iii) Controlled Drugs (from Part G of the Food and Drug Regulations under the Food and Drugs Act, S.C., 1985, c. F-27);
(iv) Benzodiazepines and Other Targeted Substances (from the Benzodiazepines and Other Targeted Substances Regulations made under the Controlled Drugs and Substances Act., S.C., 1996, c. 19);
(v) All other Monitored Drugs (as defined under the Narcotics Safety and Awareness Act, 2010, S.O. 2010, c. 22);
and as amended from time to time.
Dr. See must post a clearly visible sign in the waiting rooms of all his Practice Locations, which states as follows:
IMPORTANT NOTICE
Dr. See must not prescribe any of the following:
- Narcotic Drugs
- Narcotic Preparations
- Controlled Drugs
- Benzodiazepines and Other Targeted Substances
- All other Monitored Drugs
Further information may be found on the College of Physicians and Surgeons of Ontario website at www.cpso.on.ca
D. CONSENT
(18) I, Dr. See, undertake and agree that I will submit to, and not interfere with, unannounced inspections of my Practice Location(s) and 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. See, give my irrevocable consent to the College to make appropriate enquiries of OHIP, NMS, and 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.
(20) I, Dr. See, acknowledge that I have executed the OHIP and NMS consent forms, attached hereto as Schedule "H" and Schedule "I", respectively.
(21) I, Dr. See, 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 (9) 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.
(22) I, Dr. See, give my irrevocable consent to the College to provide this Undertaking to any Chief of Staff, or a colleague with similar responsibilities, 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.
(23) I, Dr. See, give my irrevocable consent to any person who facilitates my completion of the professional education set out in section (9) 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 Schedule "F";
(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 (9) above and which he or she reasonably believes indicates a potential risk of harm to my patients.