On November 24, 2017, the Discipline Committee found that Dr. Tsai Hsing Yu committed an act of professional misconduct, in that he has engaged in an act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable, or unprofessional.
Dr. Yu is a family physician who graduated from medical school at Utkal University in India in 1976. He obtained a certificate of registration authorizing independent practice from the College of Physicians and Surgeons of Ontario (the “College”) on April 4, 1984. Dr. Yu carries on a family and walk-in practice in St. Catharines, Ontario.
2016 Undertaking
On July 27, 2016, as a result of a College investigation, Dr. Yu entered into an Undertaking with the College. Pursuant to the 2016 Undertaking, Dr. Yu agreed not to issue new prescriptions or renew existing prescriptions for any narcotics, controlled or monitored drugs, or benzodiazepines or other targeted substances, with the exception of certain specified drugs which he is permitted to prescribe where clinically indicated.
Breach of the 2016 Undertaking
Between September and November 2016, inclusive, Dr. Yu renewed prescriptions for controlled substances for three patients on three occasions:
?In October 2016, Dr. Yu renewed a prescription for Sublinox for Patient A;
?In September 2016, Dr. Yu renewed a prescription for Lorazepam for Patient B; and
?In November 2016, Dr. Yu renewed a prescription for Lorazepam for Patient C.
Lorazepam and Sublinox (also known as zolpidem tartrate) are Class 1 Targeted Substances listed in the Benzodiazepines and Other Targeted Substances Regulations made under the Controlled Drugs and Substances Act. These substances are not among the specified drugs Dr.Yu is permitted to prescribe pursuant to his 2016 Undertaking. By authorizing these prescription renewals, Dr. Yu breached his 2016 Undertaking with the College.
Penalty
The following facts about Dr. Yu’s history with the College were presented during the penalty portion of the hearing:
In 1994, as a result of a College investigation, Dr. Yu agreed to relinquish his prescribing privileges with respect to narcotics and controlled drugs pursuant to the provisions of the legislation in place at that time. A letter requesting voluntary termination of these privileges was sent to Health Canada early in 1995.
In 2009, Dr. Yu requested an amendment to his prescribing restriction. On February 11, 2011, Dr. Yu signed an undertaking with the College which modified his prescribing restriction (“2011 Undertaking”). Pursuant to the 2011 Undertaking, Dr. Yu continued to be prohibited
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from prescribing narcotics and other targeted substances, but he was permitted to prescribe stimulants for the treatment of ADHD, long-acting narcotics for terminal patients, and Androgenic Steroid Replacement.
In December 2015, after receiving information regarding Dr. Yu’s prescribing, the College commenced an investigation. In April 2016, a College investigator requested that Dr. Yu respond to the concern that he appeared to have breached his 2011 Undertaking by prescribing short-acting narcotics for patients who did not have a terminal diagnosis. In May 2016, Dr. Yu confirmed that he had prescribed short-acting narcotics to four patients who did not have a terminal diagnosis, contrary to the terms of his 2011 undertaking. Dr. Yu indicated that he would consider entering into a new undertaking whereby he would not prescribe any narcotics or controlled drugs.
In July 2016, the Inquiries, Complaints and Reports Committee of the College (“ICRC”) deferred the matter to permit negotiation of an undertaking with Dr. Yu, which he signed on July 27, 2016. On November 18, 2016, upon considering the results of the investigation, the ICRC decided to accept Dr. Yu’s 2016 Undertaking. The ICRC also required Dr. Yu to attend the College to be cautioned in person regarding his failure to comply with his practice restrictions by breaching the 2011 Undertaking.
Disposition
On November 24, 2017, the Discipline Committee ordered and directed on the matter of penalty and costs that:
- The Registrar suspend Dr. Yu’s certificate of registration for a three month period, to - commence at 12:01 a.m. on December 1, 2017.
- Dr. Yu appear before the panel to be reprimanded.
- Dr. Yu pay costs to the College in the amount of $5,500.00 within thirty (30) days of the date this Order.