Straka, Pavel Frantisek (CPSO#: 33493)

Current Status: Active Member as of 20 Apr 1981

CPSO Registration Class: Restricted as of 12 Dec 2015

Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Male

Languages Spoken: Czech, English

Education:University of Aberdeen, 1974

Practice Information

Primary Location of Practice
Humber River Hospital
1235 Wilson Avenue
Toronto ON  M3M 0B2
Phone: (416) 242 1000
Electoral District: 10
Find more practice locations

Additional Practice Location(s)

York Diagnostic Centre
3585 Keele Street
Toronto ON  M3J 3H5
Canada
Phone: (416) 398-2288
County: City of Toronto
Electoral District: 10

Facial Cosmetic Surgery
70 Yorkville Avenue
Toronto ON  M5R 1B9
Canada
Phone: (647) 343-0207
County: City of Toronto
Electoral District: 10

Forest Hill Institute Of Aesthetic
Plastic Surgery
1188-B Eglinton Avenue West
Toronto ON  M6C 2E3
Canada
Phone: (416) 785-7864
County: City of Toronto
Electoral District: 10

La Fontaine Jeunesse
Cosmetic Clinic
890 A Younge Street
Toronto ON  M4W 3P4
Canada
Phone: (416) 962-4444
County: City of Toronto
Electoral District: 10

Promed Endoscopy
Suite 302
1315 Finch Avenue West
Toronto ON  M3J 2G6
Canada
Phone: (416) 634-0001
County: City of Toronto
Electoral District: 10

Hifu
Suite 1401
123 Edward Street
Toronto ON  M5G 1E2
Canada
Phone: 416 924 9760
County: City of Toronto
Electoral District: 10
View Professional Corporation Information

Professional Corporation Information

Corporation Name: Pavel Straka Medicine Professional Corporation

Certificate of Authorization Status: Issued Date:  Jul 29 2010

Shareholders:
Dr. P. Straka ( CPSO# 33493 )

Business Address:
Humber River Regional Hospital
1235 Wilson Drive
Toronto ON  M3M 0B2
Phone Number: (416) 243-4154

Business Address:
York Diagnostic Centre
3835 Keele Street
Toronto ON  M3J 3H5
Phone Number: (416) 398-2288

Business Address:
Suite 301
40 Holly Street
Toronto ON  M4S 3C3
Phone Number: (416) 486-8088

Business Address:
70 Yorkville Avenue
Suite 31
Toronto ON  M5R 1B9
Phone Number: (647) 343-0207

Business Address:
890 #A Yonge Street
Toronto ON  M4W 3P4
Phone Number: (416) 962-4444

Business Address:
1315 Finch Avenue West
Suite 302
North York ON  M3C 1J4

Business Address:
3585 Keele Street
North York ON  M3J 3H5

Hospital Privileges

Hospital Location
Humber River Hospital,Wilson Site Toronto

Specialties

Specialty Issued On Type
Anesthesiology Effective: 24 Nov 1983 RCPSC Specialist

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 20 Apr 1981
Expired: Terms and conditions of certificate of registration Expiry: 30 Jun 1982
Subsequent certificate of registration Issued: Independent Practice Certificate Effective: 09 Jul 1982
Transfer of class of certificate to: Restricted certificate Effective: 12 Dec 2015
Terms and conditions amended Effective: 02 Jun 2016
Terms and conditions amended by Inquiries, Complaints and Repo Effective: 27 Sep 2017

Practice Restrictions

Imposed By Effective Date Expiry Date Status  
Inquiries, Complaints and Reports Committee Effective: 27 Sep 2017 Active View Details [+]
            Effective September 27, 2017, Dr. Pavel Frantisek Straka shall not prescribe
            (and shall not authorize any refills or renewals of prescriptions for) Narcotic
            drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines or Other
            Targeted Substances and/or any other Monitored Drugs, except for procedural
            sedation, for obstetrical procedures, pre-operatively, intra-operatively, or in
            the post anesthesia care until such time as he obtains a College approved
            clinical supervisor.

            As from 12:01 a.m., September 13, 2017, by order of the Inquiries, Complaints
            and Reports Committee of the College of Physicians and Surgeons of Ontario, the
            following terms, conditions and limitations are imposed on the certificate of
            registration held by Dr. Pavel Frantisek Straka:

            i.    Dr. Straka's practice shall be restricted in accordance with the clinical
                  supervision requirements set out below at (ii) - (xiv) of the Order of
                  the Inquiries, Complaints and Reports Committee dated September 12, 2017
                  (the "Order").  For greater clarity, Dr. Straka shall not prescribe (and
                  shall not authorize any refills or renewals of prescriptions for)
                  Narcotic Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines
                  or Other Targeted Substances and/or any other Monitored Drugs, except for
                  procedural sedation, for obstetrical procedures, pre-operatively,
                  intra-operatively, or in the post-anesthesia care unit, unless the
                  requirements set out at (ii) - (xiv) of the Order are met.

            ii.   Dr. Straka shall engage a Clinical Supervisor acceptable to the College
                  at his own expense who shall:

                  a.    review every patient with Dr. Straka prior to Dr. Straka issuing
                        any continuing prescription for or authorizing any refill or
                        renewal of a prescription for any Narcotic Drug, Narcotic
                        Preparation, Controlled Drug, Benzodiazepine or Other Targeted
                        Substance and/or Any other Monitored Drug to ensure that the
                        prescription and Dr. Straka's assessment, clinical examination,
                        risk assessment for addiction and on-going management and follow-up
                        of the patient is appropriate.
                  
                  b.    directly observe at least ten (10) patient encounters per week in
                        Dr. Straka's chronic pain practice where Dr. Straka issues a
                        prescription for a Narcotic Drug, Narcotic Preparation, Controlled
                        Drug, Benzodiazepine or Other Targeted Substance and/or any other
                        Monitored Drug.
                  
            iii.  Dr. Straka shall not initiate any new prescription for any Narcotic Drug,
                  Narcotic Preparation, Controlled Drug, Benzodiazepine or Other Targeted
                  Substance and/or any other Monitored Drug to any patient who is not
                  currently prescribed the medication in question by Dr. Straka, except
                  where the patient is already prescribed a Narcotic Drug, Narcotic
                  Preparation, Controlled Drug, Benzodiazepine or Other Targeted Substance
                  and/or any other Monitored Drug by Dr. Straka and the Clinical Supervisor
                  specifically recommends that the patient be prescribed a different or
                  additional Narcotic Drug, Narcotic Preparation, Controlled Drug,
                  Benzodiazepine or Other Targeted Substance and/or any other Monitored
                  Drug by Dr. Straka.  This restriction does not apply with respect to Dr.
                  Straka's prescribing of Narcotic Drugs, Narcotic Preparations, Controlled
                  Drugs, Benzodiazepines or Other Targeted Substances and/or any other
                  Monitored Drugs for procedural sedation, for obstetrical procedures,
                  pre-operatively, intra-operatively, or in the post-anesthesia care unit

            iv.   Dr. Straka shall keep a log of all prescriptions for, and all refills or
                  renewals of prescriptions for, Narcotic Drugs, Narcotic Preparations,
                  Controlled Drugs, Benzodiazepines and Other Targeted Substances and all
                  other Monitored Drugs, except for procedural sedation, for obstetrical
                  procedures, pre-operatively, intra-operatively, or in the post-anesthesia
                  care unit, in the form attached as Schedule "D" to the Order, which will
                  include at least the following information (the "Prescribing Log"):  

                        (a)   the date of the appointment;
                        (b)   the name of the patient and chart/file number;
                        (c)   the name of the medication prescribed, dose, direction,
                              number of tablets to be dispensed and frequency;
                        (d)   the clinical indication;
                        (e)   whether the prescription is for a new medication and/or
                              different dose or frequency than currently prescribed to the
                              patient (Y/N); 
                        (f)   Dr. Straka's signature;
                        (g)   the date of the Clinical Supervisor's review; and
                        (h)   the Clinical Supervisor's signature.
                  
            v.    Dr. Straka shall keep a copy of all prescriptions he writes and a copy of
                  all refills or renewals of prescriptions he authorizes for Narcotic
                  Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other
                  Targeted Substances and all other Monitored Drugs, in the corresponding
                  patient chart.

            vi.   Dr. Straka shall ensure that the undertaking of a Clinical Supervisor
                  attached at Schedule "E" to the Order is delivered to the College within
                  fourteen (14) days of the date of the Order.  If Dr. Straka has not
                  delivered an undertaking signed by a Clinical Supervisor to the College
                  by this date, Dr. Straka shall not prescribe (and shall not authorize any
                  refills or renewals of prescriptions for) Narcotic Drugs, Narcotic
                  Preparations, Controlled Drugs, Benzodiazepines or Other Targeted
                  Substances and/or any other Monitored Drugs, except for procedural
                  sedation, for obstetrical procedures, pre-operatively, intra-operatively,
                  or in the post-anesthesia care unit and the fact of this restriction
                  shall be a term, condition or limitation on his certificate of
                  registration.

            vii.  Dr. Straka shall fully cooperate with and abide by any recommendations of
                  his Clinical Supervisor, including with respect to patient care, practice
                  improvements, and continuing education.  For greater certainty though
                  without limiting the foregoing, if during or after an observation of a
                  patient encounter or a chart review the Clinical Supervisor is of the
                  view that any conduct or care on Dr. Straka's part will put a patient or
                  patients at risk, Dr. Straka shall immediately comply with any
                  recommendations made by the Clinical Supervisor to protect the patient(s)
                  from risk.

            viii. The Clinical Supervisor shall provide reports to the College at least
                  once every two (2) weeks in reasonable detail, containing all information
                  to assist the College in evaluating Dr. Straka's standard of practice, as
                  well as his participation in and compliance with the terms of the Order.

            ix.   Dr. Straka shall consent to the disclosure by his Clinical Supervisor and
                  by staff at any location where Dr. Straka practices to the College of all
                  information necessary to fulfil the Clinical Supervisor's undertaking and
                  to monitor and facilitate Dr. Straka's compliance with the Order.

            x.    Dr. Straka shall cooperate with any inspection of his practice
                  location(s) by the College, which may be made without notice and which
                  may include but not be limited to reviews of patient charts and/or other
                  records and to interviews of hospital staff and staff at any location
                  where Dr. Straka practices, in order to monitor his compliance with the
                  Order.  Dr. Straka shall consent to the disclosure by the College to his
                  Clinical Supervisor, to the Chief of his department at any hospital and
                  to the Medical Director and/or Quality Advisor of any location where he
                  practices of all information deemed by the College to be necessary to
                  monitor or facilitate Dr. Straka's compliance with the Order.

            xi.   If a Clinical Supervisor who has given an undertaking in the form
                  attached as Schedule "E" to the Order is unable or unwilling to continue
                  to fulfill its provisions, Dr. Straka 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.

            xii.  If Dr. Straka is unable to obtain a Clinical Supervisor on the terms set
                  out in section xi. above, Dr. Straka shall not prescribe (and shall not
                  authorize any refills or renewals of prescriptions for) Narcotic Drugs,
                  Narcotic Preparations, Controlled Drugs, Benzodiazepines or Other
                  Targeted Substances and/or Any other Monitored Drugs, except for
                  procedural sedation, for obstetrical procedures, pre-operatively,
                  intra-operatively, or in the post-anesthesia care unit and the fact of
                  this restriction shall be a term, condition or limitation on his
                  certificate of registration.

            xiii. Dr. Straka shall, within fourteen (14) days of the date of the Order,
                  provide the College with the addresses of all locations where he
                  practices, and, if he commences practice at a new location subsequently,
                  shall provide the College with its address within five (5) days of
                  commencing practice at that location.

            xiv.  Dr. Straka shall, within fourteen (14) days of the date of the Order,
                  provide to the College his irrevocable consent in the form attached as
                  Schedule "F" to the Order for the College to make appropriate enquiries
                  of the Ontario Health Insurance Plan ("OHIP"), and the Drug Program
                  Services Branch - Narcotics Monitoring System ("NMS") implemented under
                  the Narcotics Safety and Awareness Act, 2010, to monitor his compliance
                  with the terms of this Order.


            As from 11:59 p.m., June 2, 2016, by order of the Discipline Committee of the
            College of Physicians and Surgeons of Ontario, the following terms, conditions
            and limitations are imposed on the certificate of registration held by Dr.
            Pavel Frantisek Straka:

            Note: Dr. Straka has completed the period of Clinical Supervision as set out in
            paragraph [ii].

            (i)   Subject to paragraphs 3(ii)(f) and 3(vi) below, Dr. Straka shall not
                  perform anesthesia in a hospital setting on an on-call basis; 

            (ii)  Dr. Straka shall retain a College-approved clinical supervisor or
                  supervisors (the "Clinical Supervisor") with respect to his
                  hospital-based anesthesia practice, who will sign an undertaking in the
                  form attached hereto as Schedule "A."  For a period of at least six (6)
                  months commencing on the date this Order is made, Dr. Straka may practise
                  hospital-based anesthesia only under the supervision of the Clinical
                  Supervisor and will abide by all recommendations of his Clinical
                  Supervisor with respect to his practice, including but not limited to
                  practice improvements, practice management, and continuing education.
                  Clinical supervision of Dr. Straka's practice may end after a minimum of
                  six (6) months, upon the recommendation of the Clinical Supervisor and,
                  in its discretion, approval by the College.  Clinical supervision of Dr.
                  Straka's hospital-based anesthesia practice shall contain the following
                  elements:

                  (a)   Dr. Straka shall facilitate review by the Clinical Supervisor of
                        twenty (20) patient charts per month or, should Dr. Straka treat
                        fewer than twenty (20) hospital patients in any month, the charts
                        of all patients treated in that month; 
                  
                  (b)   Dr. Straka shall have an initial meeting with his Clinical
                        Supervisor regarding the process for obtaining and documenting
                        patient consent, at which they will develop a plan regarding the
                        same, and thereafter the Clinical Supervisor's consideration of Dr.
                        Straka's consent process and documentation of the same shall form
                        part of the monthly chart review described at paragraph 3(ii)(a)
                        above; 
                  
                  (c)   Dr. Straka shall pre-operatively review with the Clinical
                        Supervisor his plan for management of any patient who is a Class
                        ASA 3 or higher anesthetic risk, as well as his plan for management
                        of any patient with a known history of difficult intubation or whom
                        Dr. Straka anticipates may have a difficult airway. During such
                        review, Dr. Straka shall with his Clinical Supervisor identify when
                        and how he will call for help during the procedure if required;
                  
                  (d)   The Clinical Supervisor may be present for intubation of any
                        patient, if deemed necessary or desirable by the Clinical
                        Supervisor;
                  
                  (e)   Dr. Straka shall have an initial meeting with his Clinical
                        Supervisor regarding Dr. Straka's practice with respect to nerve
                        blocks, and thereafter consideration of Dr. Straka's practice with
                        respect to nerve blocks shall form part of the monthly chart review
                        described at paragraph 3(ii)(a) above, and if deemed necessary or
                        desirable by the Clinical Supervisor Dr. Straka shall also engage
                        in pre-planning with his Clinical Supervisor regarding particular
                        cases and permit the Clinical Supervisor to directly observe his
                        practice regarding nerve blocks; 
                  
                  (f)   After four (4) months of Clinical Supervision, if agreed to by the
                        Clinical Supervisor (which agreement may be withdrawn at any time),
                        Dr. Straka may perform anesthesia on an on-call basis for the
                        remainder of the period of Clinical Supervision under Clinical
                        Supervision consisting of the following:
                  
                        a.    At least one (1) month during which the Clinical Supervisor
                              shall directly observe Dr. Straka's pre-anesthetic
                              assessment, induction and emergence, and the Clinical
                              Supervisor shall be immediately available during the
                              remainder of the procedure in order to assist or consult with
                              Dr. Straka if necessary or desirable; 
                  
                        b.    Followed by, if the Clinical Supervisor is of the view that
                              Dr. Straka is ready, at least one (1) further month during
                              which Dr. Straka shall review the case with his Clinical
                              Supervisor before its commencement and debrief the procedure
                              with his Clinical Supervisor following its completion, with
                              the Clinical Supervisor to observe the procedure if he or she
                              deems it necessary or desirable to do so and in any case to
                              be readily available to assist Dr. Straka if needed
                              throughout the procedure. 
                  
            (iii) Dr. Straka shall successfully complete and provide proof thereof to the
                  College within six (6) months of the date of the Order: 

                  (a)   Simulator-based education in anesthesia acceptable to the College;
                  
                  (b)   Education in regional anesthesia acceptable to the College;
                  
                  (c)   Education in difficult airway management acceptable to the College;
                  
                  (d)   An evaluation of his practice knowledge acceptable to the College,
                        to result in development and submission to the College of an
                        individualized education plan within ninety (90) days of the date
                        of the Order identifying any further education and remediation to
                        be completed by Dr. Straka in response to any deficiencies in his
                        knowledge identified by the evaluation, with Dr. Straka to complete
                        such education and remediation within six (6) months of the date of
                        the Order.
                  
            (iv)  During the period of Clinical Supervision, Dr. Straka shall ensure prior
                  to performing intubation that another anesthesiologist is present on the
                  premises and available to assist him if necessary.

            (v)   If Dr. Straka fails to retain a Clinical Supervisor as required above or
                  if, prior to completion of Clinical Supervision, the Clinical Supervisor
                  is unable or unwilling to continue in that role for any reason, Dr.
                  Straka shall retain a new College-approved Clinical Supervisor who will
                  sign an undertaking in the form attached hereto as Schedule "A," and
                  shall cease to practise hospital-based anesthesia until the same has been
                  delivered to the College.

            (vi)  Approximately four (4) months after the completion of Clinical
                  Supervision, Dr. Straka shall undergo a reassessment of his
                  hospital-based anesthesia practice by a College-appointed assessor (the
                  "Assessor").  The assessment may include a review of Dr. Straka's patient
                  charts, direct observations, interviews with staff and/or patients, and a
                  formalized evaluation of Dr. Straka's knowledge base.  The results of the
                  assessment shall be reported to the College after which, should it be
                  recommended by the Assessor, the College may in its discretion permit Dr.
                  Straka to practice without restriction. 

            (vii) Dr. Straka shall consent to sharing of information among the Assessor,
                  the Clinical Supervisor, the College, and any education providers under
                  paragraph 3(iii) above as any of them deem necessary or desirable in
                  order to fulfill their respective obligations.

            (viii)Dr. Straka shall consent to the College providing any Chief(s) of Staff
                  or a colleague with similar responsibilities at any hospital where he
                  practices or has privileges ("Chief(s) of Staff") with any information
                  the College has that led to this Order and/or any information arising
                  from the monitoring of his compliance with this Order. 

            (ix)  Dr. Straka shall inform the College of each and every location where he
                  practices, in any jurisdiction (his "Practice Location(s)") within
                  fifteen (15) days of this Order and shall inform the College of any and
                  all new Practice Locations within fifteen (15) days of commencing
                  practice at that location.

            (x)   Dr. Straka shall cooperate with unannounced inspections of his
                  hospital-based anesthesia practice and patient charts by a College
                  representative(s) for the purpose of monitoring and enforcing his
                  compliance with the terms of this Order.

            (xi)  Dr. Straka shall consent to the College making appropriate enquiries of
                  the Ontario Health Insurance Plan and/or any person who or institution
                  that may have relevant information, in order for the College to monitor
                  and enforce his compliance with the terms of this Order. 

            (xii) Dr. Straka shall be responsible for any and all costs associated with
                  implementing the terms of this Order.


Previous Discipline Hearings

Committee: Discipline
Decision Date: 02 Jun 2016
Summary:

On June 2, 2016, the Discipline Committee found that Dr. Pavel Frantisek Straka has committed an act of 
professional misconduct in that he has failed to maintain the standard of practice of the profession.  

Dr. Straka is an anesthesiologist who received his certificate of independent practice in 1982. In February 
2015, pursuant to an undertaking from Dr. Straka to the College, the College received an assessment 
report outlining concerns regarding deficiencies in Dr. Straka’s practice. 

Dr. Straka provided the College with a report from an anesthesiologist after allegations were referred to 
discipline.  The defence expert disagreed with the College assessor about some aspects of the care Dr. 
Straka provided but agreed there were deficiencies in Dr. Straka’s practice, including significant 
deficiencies in documentation and certain concerns regarding judgment and knowledge.  

Dr. Straka failed to maintain the standard of practice of the profession of anesthesiology in a hospital 
setting by: 

   -  failing to document an appropriate pre-anesthetic assessment or to adequately document 
      intraoperatively in his care of multiple patients; 
   -  failing to document discussion of the risks and benefits of invasive procedures with multiple 
      patients and not having any discussion with a patient regarding a transversus abdominis plane 
      (TAPP) block which he later administered; 
   -  when administering general anesthesia, inappropriately using 100 percent oxygen during the 
      maintenance phase as a matter of routine in every case; 
   -  failing to organize and prioritize medical issues in two complex patients undergoing emergency 
      surgery; administering an inappropriately small dose of analgesic to a patient undergoing 
      gynecological surgery, as indicated by the patient’s respiratory rate and end tidal carbon dioxide; 
      and although Dr. Straka ultimately successfully intubated a patient after several attempts due to 
      the patient’s difficult airway, there were concerns regarding Dr. Straka’s level of situational 
      awareness. The patient experienced a marked hypertensive response as a result of an inadequate 
      level of anesthesia for the multiple attempts at intubation, and Dr. Straka did not document the 
      difficult airway, including the number of attempts.  

Several recommendations were made in the February 2015 report, including that Dr. Straka practise under 
high level supervision with respect to critically ill patients, that the supervisor be immediately available 
when conducting airway management, that he engage a clinical preceptor for other aspects of his hospital 
practice, and that he take educational courses.  

Dr. Straka practised under supervision pending the hearing as a result of an interim order in this 
proceeding. Since January 2016, the supervisor has reviewed and approved of all pre-operative 
assessments and treatment plans in advance of Dr. Straka providing general anesthesia, and has observed 
intubation in each case. The reports by Dr. Straka’s clinical supervisor have been positive. 

In April 2016, an expert retained by Dr. Strakafound that Dr. Straka’s documentation had improved 
significantly, that his preoperative assessments were complete, and that there were no issues with Dr. 
Straka’s performing of technical tasks under observation. When observed by this expert, Dr. Straka 
discussed the risks and benefits of blocks with patients. However, the expert identified that Dr. Straka 
appeared to have some gaps in his knowledge, that his practice of doing regional anesthesia without 
monitoring was potentially unsafe, that his reaction to stress could lead to poor judgment, and that his 
management of complicated cases was an area for improvement. The expert recommended that Dr. Straka 
not do on-call coverage in anesthesia until completion of education and a reassessment, and that he 
continue to be subject to clinical supervision with pre-operative review of his plans for higher risk 
patients and the supervisor’s presence at intubation if necessary. The expert stated that the “gaps in [Dr. 
Straka’s] practice are remedial.”  

 

PENALTY AND COSTS 

The Discipline Committee ordered and directed: 

   2. Dr. Straka to attend before the panel to be reprimanded; 
       
   3. the Registrar to impose the following terms, conditions and limitations on Dr. Straka’s certificate 
      of registration: 
   (i)   Subject to paragraphs 3(ii)(f) and 3(vi) below, Dr. Straka shall not perform anesthesia in a 
         hospital setting on an on-call basis;  
   (ii)  Dr. Straka shall retain a College-approved clinical supervisor or supervisors (the “Clinical 
         Supervisor”) with respect to his hospital-based anesthesia practice, who will sign an 
         undertaking in the form attached hereto as Schedule “A.” For a period of at least six (6) 
         months commencing on the date this Order is made, Dr. Straka may practise hospital-based 
         anesthesia only under the supervision of the Clinical Supervisor and will abide by all 
         recommendations of his Clinical Supervisor with respect to his practice, including but not 
         limited to practice improvements, practice management, and continuing education. Clinical 
         supervision of Dr. Straka’s practice may end after a minimum of six (6) months, upon the 
         recommendation of the Clinical Supervisor and, in its discretion, approval by the College. 
         Clinical supervision of Dr. Straka’s hospital-based anesthesia practice shall contain the 
         following elements: 
         a. Dr. Straka shall facilitate review by the Clinical Supervisor of twenty (20) patient charts 
            per month or, should Dr. Straka treat fewer than twenty (20) hospital patients in any 
            month, the charts of all patients treated in that month;  
         b. Dr. Straka shall have an initial meeting with his Clinical Supervisor regarding the process 
            for obtaining and documenting patient consent, at which they will develop a plan 
            regarding the same, and thereafter the Clinical Supervisor’s consideration of Dr. Straka’s 
            consent process and documentation of the same shall form part of the monthly chart 
            review described at paragraph 3(ii)(a) above;  
         c. Dr. Straka shall pre-operatively review with the Clinical Supervisor his plan for 
            management of any patient who is a Class ASA 3 or higher anesthetic risk, as well as his 
            plan for management of any patient with a known history of difficult intubation or whom 
            Dr. Straka anticipates may have a difficult airway. During such review, Dr. Straka shall 
            with his Clinical Supervisor identify when and how he will call for help during the 
            procedure if required; 
      d. The Clinical Supervisor may be present for intubation of any patient, if deemed necessary 
         or desirable by the Clinical Supervisor; 
      e. Dr. Straka shall have an initial meeting with his Clinical Supervisor regarding Dr. 
         Straka’s practice with respect to nerve blocks, and thereafter consideration of Dr. Straka’s 
         practice with respect to nerve blocks shall form part of the monthly chart review 
         described at paragraph 3(ii)(a) above, and if deemed necessary or desirable by the 
         Clinical Supervisor Dr. Straka shall also engage in pre-planning with his Clinical 
         Supervisor regarding particular cases and permit the Clinical Supervisor to directly 
         observe his practice regarding nerve blocks;  
      f. After four (4) months of Clinical Supervision, if agreed to by the Clinical Supervisor 
         (which agreement may be withdrawn at any time), Dr. Straka may perform anesthesia on 
         an on-call basis for the remainder of the period of Clinical Supervision under Clinical 
         Supervision consisting of the following: 
             a) At least one (1) month during which the Clinical Supervisor shall directly 
               observe Dr. Straka’s pre-anesthetic assessment, induction and emergence, and the 
               Clinical Supervisor shall be immediately available during the remainder of the 
               procedure in order to assist or consult with Dr. Straka if necessary or desirable;  
             b)      Followed by, if the Clinical Supervisor is of the view that Dr. Straka is 
               ready, at least one (1) further month during which Dr. Straka shall review the 
               case with his Clinical Supervisor before its commencement and debrief the 
               procedure with his Clinical Supervisor following its completion, with the Clinical 
               Supervisor to observe the procedure if he or she deems it necessary or desirable 
               to do so and in any case to be readily available to assist Dr. Straka if needed 
               throughout the procedure.  
(iii) Dr. Straka shall successfully complete and provide proof thereof to the College within six (6) 
      months of the date of the Order:  
      a. Simulator-based education in anesthesia acceptable to the College; 
      b. Education in regional anesthesia acceptable to the College; 
      c. Education in difficult airway management acceptable to the College; 
      d. An evaluation of his practice knowledge acceptable to the College, to result in 
         development and submission to the College of an individualized education plan within 
         ninety (90) days of the date of the Order identifying any further education and 
         remediation to be completed by Dr. Straka in response to any deficiencies in his 
         knowledge identified by the evaluation, with Dr. Straka to complete such education and 
         remediation within six (6) months of the date of the Order. 
(iv)  During the period of Clinical Supervision, Dr. Straka shall ensure prior to performing 
      intubation that another anesthesiologist is present on the premises and available to assist him 
      if necessary. 
(v)   If Dr. Straka fails to retain a Clinical Supervisor as required above or if, prior to completion 
      of Clinical Supervision, the Clinical Supervisor is unable or unwilling to continue in that role 
      for any reason, Dr. Straka shall retain a new College-approved Clinical Supervisor who will 
      sign an undertaking in the form attached hereto as Schedule “A,” and shall cease to practise 
      hospital-based anesthesia until the same has been delivered to the College. 
(vi)  Approximately four (4) months after the completion of Clinical Supervision, Dr. Straka shall 
      undergo a reassessment of his hospital-based anesthesia practice by a College-appointed 
      assessor (the “Assessor”). The assessment may include a review of Dr. Straka’s patient 
      charts, direct observations, interviews with staff and/or patients, and a formalized evaluation 
      of Dr. Straka’s knowledge base. The results of the assessment shall be reported to the College 
      after which, should it be recommended by the Assessor, the College may in its discretion 
      permit Dr. Straka to practice without restriction.  
(vii) Dr. Straka shall consent to sharing of information among the Assessor, the Clinical 
      Supervisor, the College, and any education providers under paragraph 3(iii) above as any of 
      them deem necessary or desirable in order to fulfill their respective obligations. 
(viii) Dr. Straka shall consent to the College providing any Chief(s) of Staff or a colleague with 
      similar responsibilities at any hospital where he practices or has privileges (“Chief(s) of 
      Staff”) with any information the College has that led to this Order and/or any information 
      arising from the monitoring of his compliance with this Order.  
(ix)  Dr. Straka shall inform the College of each and every location where he practices, in any 
      jurisdiction (his “Practice Location(s)”) within fifteen (15) days of this Order and shall 
      inform the College of any and all new Practice Locations within fifteen (15) days of 
      commencing practice at that location. 
(x)   Dr. Straka shall cooperate with unannounced inspections of his hospital-based anesthesia 
      practice and patient charts by a College representative(s) for the purpose of monitoring and 
      enforcing his compliance with the terms of this Order. 
(xi)  Dr. Straka shall consent to the College making appropriate enquiries of the Ontario Health 
      Insurance Plan and/or any person who or institution that may have relevant information, in 
      order for the College to monitor and enforce his compliance with the terms of this Order.  
(xii) Dr. Straka shall be responsible for any and all costs associated with implementing the terms 
      of this Order; and 
       
4. Dr. Straka to pay to the College costs in the amount of $10,000.00, within thirty (30) days of the 
   date of this Order.

Decision: Download Full Decision (PDF)
Hearing Date(s): June 2 2016