News Release

Discipline Committee Decisions

Dr. Calvin T. Lian; Dr. Roland C.K. Wong; Dr. David Stuart Lambert; Dr. Munjal S. Parikh; Dr. Alex S.S. Rivlin; Dr. Leonard A. Makerewich; Dr. Garry Y. Shomair; Dr. John K. Pariag; Dr. Samuel J. Wassermann; Dr. Robert S. Cameron

Jan 31, 2013

The College of Physicians and Surgeons of Ontario (“the College”) released the results of its most recent disciplinary hearings. The College is the licensing and disciplinary body for physicians in Ontario. Hearings are held to review allegations of professional misconduct and incompetence, and are open to the public. The following are brief summaries of recent discipline hearing results. The Discipline Committee’s full decisions and reasons for decisions are posted on the College’s website as they become available. Full decisions are located by entering the doctor’s name at All Doctor Search.

Dr. Calvin T. Lian, Toronto. On November 26, 2012, the Discipline Committee found that Dr. Lian committed an act of professional misconduct, in that he has been found guilty of an offence that is relevant to his suitability to practise. Dr. Lian admitted to the allegation.

Dr. Lian is a family physician practising emergency medicine in Toronto, Ontario.

On December 22, 2009, Dr. Lian pleaded to and was found guilty of one count of assault under section 266 of the Criminal Code in relation to an assault on his wife. He received a conditional discharge, contingent upon 18 months' probation. Prior to the 2009 assault which is the subject of this proceeding, Dr. Lian pleaded guilty to assault in relation to an assault on his wife in 2002, for which he received an absolute discharge.

Dr. Lian entered into individual and marital counselling in October 2009.

The Committee ordered a public reprimand, and directed that the Registrar impose the following terms, conditions and limitations on Dr. Lian's certificate of registration until the term referred to in paragraph (a) below has been completed:

  1. Dr. Lian shall participate in and successfully complete an educational program in ethics facilitated by the College, relating to the ethical issues raised by his misconduct;
  2. Dr. Lian shall be responsible for any and all associated costs.

Dr. Lian was further ordered to pay to the College costs in the amount of $3,650.

Dr. Roland C.K. Wong, Toronto. On December 12, 2012, the Discipline Committee found that Dr. Wong committed an act of professional misconduct, in that he failed to maintain the standard of practice of the profession with respect to:

  • his completion of the Special Diet Allowance (SDA) forms, in that he did not take the necessary steps to satisfy himself that the 15 patients, whose records were before the Committee, had the conditions reported on the forms;
  • his record-keeping, in that his documentation in the 15 charts reviewed supporting confirmation of each condition varied from minimal to non-existent;
  • his OHIP billing, in that he did not obtain sufficient information to attest to the various medical conditions which he confirmed on the SDA forms. Consequently, he did not meet the requirement of taking a reasonable history of the reported condition prior to billing OHIP for a partial assessment in the 15 charts reviewed.

In addition, he engaged in unprofessional conduct by confirming diagnoses on SDA forms, without first satisfying himself that the patient had the specified condition.

A penalty hearing is yet to be scheduled.

Dr. David Stuart Lambert, Mississauga. On November 2, 2011, the Discipline Committee found that Dr. Lambert committed an act of professional misconduct, in that he sexually abused a patient. In the course of an investigation into Dr. Lambert's practice, the College retained the services of several private investigators, including Ms X, who contacted Dr. Lambert to inquire about cosmetic procedures he advertised on his website. Dr. Lambert consulted with her regarding the procedures and agreed to meet Ms X to administer the procedures at which time Ms X became his patient. During the course of their scheduled appointment, Dr. Lambert intentionally touched the breast of Ms X, thus committing sexual abuse of a patient.

The Committee also found that Dr. Lambert committed acts of professional misconduct, in that he:

  1. contravened a term, condition or limitation on his certificate of registration by:
    1. treating or offering to treat female patients;
    2. seeing patients outside the context of services listed on OHIP's Schedule of Benefits; and
    3. (having dealings with his patients in respect of the sale of skin care products.
  2. had a conflict of interest, in that he recommended cosmetic products in which he held a personal commercial interest to his patients.
  3. contravened a regulation made under the Medicine Act, 1991, specifically paragraph 16(d) of Ontario Regulation 114/94.
  4. engaged in disgraceful, dishonourable or unprofessional conduct.

On December 5, 2012, the Discipline Committee ordered a public reprimand, and directed the Registrar to revoke Dr. Lambert's certificate of registration, effective immediately.

Dr. Lambert was further ordered to pay to the College costs in the amount of $27,375.

Dr. Munjal S. Parikh, North York. On December 6, 2012, the Discipline Committee found that Dr. Parikh committed an act of professional misconduct, in that he has engaged in disgraceful, dishonourable or unprofessional conduct. Dr. Parikh admitted to the allegation.

Dr. Parikh is a family physician. After a counselling session with Patient A in 2006, during which the patient's difficult situation was discussed, in his examination room, without a chaperone present, Dr. Parikh initiated a hug with Patient A. Although Dr. Parikh indicates that it was a supportive hug, Patient A believed that sexual intent was present.

During 2006, Dr. Parikh gave Patient A sums of cash amounting to approximately $7,000 to assist her with her financial difficulties. He also provided Patient A with his cell phone number. In 2005 and 2006, Dr. Parikh and Patient A engaged in cell phone contact.

The Discipline Committee ordered a public reprimand, a two-month suspension of Dr. Parikh’s certificate of registration, and directed that the Registrar impose the following terms, conditions and limitations on his certificate of registration, including that he shall:

  • successfully complete, at his own expense, College-facilitated instruction in Ethics and in Understanding Boundaries.
  • ensure that he has available at all times he sees female patients, a female chaperone to be present during an appointment if a patient so requests.
  • post a sign in his waiting room and in each of his examination rooms, in clearly visible locations, that states: "A female chaperone is available to all female patients of Dr. Parikh. Please advise the receptionist or Dr. Parikh if you would like to have a chaperone present during your appointment."
  • ensure that information sheets are available in his waiting room at all times, advising patients that he will ensure that a chaperone is available to female patients to be in attendance for any visit or part of a visit, if requested.

Dr. Parikh was further ordered to pay to the College costs in the amount of $3,650.

Dr. Alex S.S. Rivlin, Thornhill. On December 11, 2012, the Discipline Committee found that Dr. Rivlin committed an act of professional misconduct, in that he has been found guilty of an offence that is relevant to his suitability to practise, and has engaged in disgraceful, dishonourable or unprofessional conduct. Dr. Rivlin admitted to the allegations.

On or about December 21, 2010, Dr. Rivlin pleaded guilty in the Ontario Court of Justice to one count of fraud over $5,000 and one count of possession of a prohibited weapon with ammunition. Convictions were entered on the basis of Dr. Rivlin's admissions to fraudulently billing OHIP in the amount of $168,794.21 between September of 2000 and February of 2008, while he was out of the country. He also admitted to illegally possessing a prohibited firearm and ammunition in a locked safe at his residence, which he had, at a patient's request, agreed to store in his safe after the patient inadvertently left it in his office, until the patient's return to Canada from the United States. It was seized by police during the execution of the search warrant in March of 2008.

In the criminal proceedings, Dr. Rivlin was given a nine-month conditional sentence with three months house arrest, followed by a two-year term of probation. He was also prohibited from billing OHIP for the duration of his conditional sentence and probation. At the time of his guilty plea and sentencing, Dr. Rivlin made restitution to OHIP.

The Discipline Committee ordered a public reprimand, a 12-month suspension of Dr. Rivlin’s certificate of registration and costs of $3,650.

Dr. Leonard A. Makerewich, Niagara Falls. On December 12, 2012, the Discipline Committee found that Dr. Makerewich committed an act of professional misconduct, in that he has been found guilty of an offence that is relevant to his suitability to practise; and in that he has engaged in disgraceful, dishonourable or unprofessional conduct. Dr. Makerewich admitted to the allegations.

Dr. Makerewich’s practice of billing for a special surgical consultation (A935A) was inappropriate as Dr. Makerewich did not himself personally spend the 50 minutes of time with the patient as required by the Schedule of Benefits but, instead, delegated part of this time to a non-physician staff member, who was a PhD and knowledgeable and experienced in sleep medicine.

On December 17, 2010, Dr. Makerewich was found guilty of knowingly receiving payment between January 16, 2006 and December 1, 2008 for insured services that he was not entitled to receive, thereby committing an offence pursuant to s. 44 of the Health Insurance Act. He admitted that he billed OHIP and was paid, in respect of seven patient visits for two different patients which did not meet the requirements in the Schedule of Benefits because in each instance he did not have a direct physical encounter with the patient or perform a physical examination. These patients were seen by the same non-physician staff member.

Dr. Makerewich advised the court that, shortly after the charges to which he plead guilty were laid [in June 2009], he substantially modified his practice and billing practices to ensure that they conformed with billing requirements and that he ceased billing service code A935A for patients jointly seen with his staff member. In fact, this was not correct, as he continued this practice until May 27, 2010.

The Discipline Committee ordered a public reprimand, a two-month suspension of Dr. Makerewich's certificate of registration, and directed the Registrar impose the following term, condition and limitation on Dr. Makerewich's certificate of registration:

  • Dr. Makerewich must successfully complete, at his own expense, College-facilitated instruction in Ethics within one year from the date of this Order.

Dr. Makerewich was further ordered to pay to the College costs in the amount of $3,650.

Dr. Garry Y. Shomair, Toronto. On December 18, 2012, the Discipline Committee found that Dr. Shomair failed to maintain the standard of practice of the profession in regard to his record-keeping in 18 of 26 charts and in regard to his psychiatric care and treatment of multiple patients, including in his diagnostic, psychopharmacological and monitoring practices. Dr. Shomair admitted to the allegation.

Dr. Shomair was under clinical supervision from November 2010, pending the outcome of the discipline hearing. Since November 2011, Dr. Shomair's clinical supervisor indicates that Dr. Shomair's care meets the standard of practice.

The Discipline Committee ordered a public reprimand, and directed that the Registrar impose specified terms, conditions and limitations on Dr. Shomair's certificate of registration for the specified periods of time set out, including that he shall:

  • practice only under the supervision of the clinical supervisor, for a period of 12 months. The clinical supervisor will meet with Dr. Shomair on a bi-weekly basis for the duration of the supervision.
  • abide by all recommendations of his clinical supervisor with respect to his standard of practice in respect of, but not limited to, the treatment of patients with bipolar disorder, medication dosages, pharmacotherapy and record-keeping and documentation;
  • undergo a re-assessment of his clinical practice by a College-appointed assessor, approximately six months after the completion of the period of supervision. This re-assessment will include determining whether Dr. Shomair meets the standard of practice of the profession and whether Dr. Shomair is in compliance with this Order. The assessor(s) shall make recommendations regarding Dr. Shomair's practice and shall report the results of the re-assessment to the College. The College shall determine, in its sole discretion, what recommendations, if any, Dr. Shomair must abide by and whether any of the recommendations will constitute terms, conditions or limitations on his certificate or registration;
  • participate in and successfully complete: an educational program in medical record-keeping approved by the College; and, at minimum, two courses in pharmacology, approved by the College, and the content of these courses shall include the topic of child and adolescent psychopharmacology;
  • be responsible for any and all costs associated with implementing the terms of this Order.

Dr. Shomair was further ordered to pay to the College costs in the amount of $3,650.

Dr. John K. Pariag, Mississauga. On March 22, 2012, the Discipline Committee found that Dr. Pariag committed an act of professional misconduct, in that he failed to maintain the standard of practice of the profession. The Committee also found that Dr. Pariag is incompetent. Dr. Pariag admitted to the allegations of professional misconduct and incompetence, as follows:

Regarding a review of 35 patient charts from his surgical practice:

  • improper placement of chest tubes in a CF patient;
  • performing cholecystectomy in the presence of evidence that the common bile duct was not clear;
  • failure to protect an anastomosis with a stoma where appropriate;
  • improperly discharging three post-surgical patients with elevated white blood cell counts and fevers;
  • unnecessary transfusion of one patient;
  • questionable decision to perform a targeted bowel resection in a patient with rectal blood loss when the point of bleeding was unknown, and failure to investigate a possible foreign body as indicated by x-rays of the patient;
  • incorrectly repairing a hernia, leading to recurrence;
  • unnecessary removal of three healthy appendices;
  • failure to obtain a right breast ultrasound despite a radiologist's suggestion in a cancer patient;
  • failed to give DVT [deep vein thrombosis] prohylaxis perioperatively to a patient with known breast cancer;
  • failure to properly control intraoperative bleeding;
  • improperly performing surgery without first addressing the patient's elevated INR;
  • perforating a patient's bowel while removing two 0.25 cm polyps;
  • improperly ordering blood transfusion of a 12-year-old with a haemoglobin count of 108, which order was subsequently cancelled by another physician, and failure to investigate percutaneous pelvic abscess drainage before proceeding to perform a laparotomy on that patient;
  • improperly performing an elective thyroidectomy without supervision when Dr. Pariag had never performed such a procedure at the hospital and had not reviewed thyroid surgery during his residency; and
  • dissecting a patient's portal triad during surgery to correct a bowel obstruction, which error resulted in the patient's death due to hemorrhagic shock.

Regarding patient A, who had surgeries for an intra-abdominal mass, later identified as a sarcoma:

  • failed to adequately document a differential diagnosis, treatment plan, or informed consent discussions with Patient A; and,
  • after the recurrence of the sarcoma, failed to solicit an opinion from the Regional Cancer Centre where the patient had been seen in the past, and improperly attempted to treat the sarcoma outside a multi-disciplinary care center.

On December 19, 2012, the Discipline Committee ordered a public reprimand, and directed that specified terms, conditions and limitations be imposed on Dr. Pariag's certificate of registration for an indefinite period of time, including that:

  1. Dr. Pariag is prohibited from engaging in any hospital-based surgical practice save and except as a surgical assistant when a College-approved certified surgeon is performing the surgery and is in attendance. At no time shall Dr. Pariag be the most responsible physician with respect to any patient in a hospital setting;
  2. Dr. Pariag is prohibited from performing surgery in an office-based setting save and except for minor surgical procedures under local anaesthetic involving the skin and subcutaneous tissues;
  3. At his own expense, Dr. Pariag shall undergo a comprehensive practice assessment (CPA) of the office-based practice described in paragraph (b) by an assessor selected by the College. Dr. Pariag shall abide by any and all recommendations made as result of the CPA; and Dr. Pariag shall promptly notify the College should he cease practising medicine before completion of the CPA.
  4. The terms, conditions and limitations on Dr. Pariag's certificate of registration under (a) and (b) are to be included on a written form and the written form is to be presented to any patient before Dr. Pariag sees the patient, and a copy signed by the patient is to be included in the patient's chart.

Dr. Pariag was further ordered to pay to the College costs in the amount of $3,650.

Dr. Samuel J. Wassermann, Toronto. On January 11, 2013, the Discipline Committee found that Dr. Wassermann committed an act of professional misconduct, in that he failed to maintain the standard of practice of the profession, and engaged disgraceful, dishonourable or unprofessional conduct. Dr. Wassermann admitted to the allegations.

Dr. Wasserman temporarily closed his practice around December 18, 2009. Between November 2008 and March 2011, 17 patients made repeated requests for their medical records. Dr. Wassermann failed to respond in a timely manner. In June 2011, Dr. Wasserman transferred his medical records to a medical records storage service. By March 21, 2012, after contact by a College investigator, Dr. Wasserman arranged for 16 of the patients to receive their records and advised one of the patients that those records were missing.

Based on an investigation, the College's independent expert's opinion was that Dr. Wassermann failed to maintain the standard of practice in his care and treatment of 23 patients and exposed these patients to risk of harm, including:

  • inadequate medical record keeping;
  • failure to document rationale for certain tests and comment on certain results;
  • various prescribing issues;
  • failure to follow up certain clinical indications and test results;
  • repeated failure to adequately monitor patients' blood pressure;
  • inappropriate management of a patient's migraine with sedatives;
  • inadequate management of anemia.

The Discipline Committee ordered a public reprimand and directed that the Registrar impose a number of specified terms, conditions and limitations on Dr. Wassermann's certificate of registration:

  1. Dr. Wassermann shall practise only in a group practise environment approved by the College.
  2. Dr. Wassermann shall ensure that the director, chief of staff, office manager or other person in a comparable role who is acceptable to the College, at each location at which he practices (the "reporting director(s)"), sign an undertaking that the reporting director(s) shall report to the College on a quarterly basis in respect of Dr. Wassermann's office and practise management, his administrative and organizational performance and his communication/interactions with patients and colleagues;
  3. If a reporting director is unwilling or unable to continue to fulfill its terms, Dr. Wassermann shall, within 30 days, obtain an undertaking in the same form from a person who is acceptable to the College;
  4. If Dr. Wassermann is unable to obtain a reporting director at a location at which he practices, he shall cease to practise at that location immediately until such time as he has obtained a Reporting Director at that location;
  5. Dr. Wassermann shall undergo a preceptorship under the supervision of a preceptor acceptable to the College, which shall include:
    • a. For the first six months, monthly chart reviews of 25 patient charts from all practice locations, selected by the preceptor in his/her sole discretion, monthly meetings for discussion of any concerns and recommendations of the preceptor, and monthly reports to the College - the first preceptorship meeting to take place within two weeks of the preceptorship commencing;
    • b. After the first six months of the preceptorship, if the preceptor believes it appropriate and reports the basis for this belief to the College, the number of charts reviewed may be decreased to 10 charts per month for a further six months, with monthly meetings for discussion of any concerns and recommendations of the preceptor, and monthly reports to the College;
  6. If Dr. Wassermann's preceptor is unwilling or unable to continue to fulfill the terms of this Order, Dr. Wassermann shall, within 20 days, obtain an undertaking in the same form from a person who is acceptable to the College, failing which Dr. Wassermann shall immediately cease practice until this requirement is satisfied;
  7. Dr. Wassermann shall continue his participation in, and full compliance with, the Physician Health Program ("PHP"), and he shall ensure that the PHP provides the College quarterly reports regarding his compliance, progress, and any recommendations regarding his practise (including any changes in recommendation as to the amount of time Dr. Wassermann should spend in practice);
  8. Following the completion of the preceptorship, Dr. Wassermann shall undergo a Comprehensive Practise Assessment by an assessor(s) appointed by the College;
  9. Dr. Wassermann shall abide by any and all recommendations of his reporting director(s), the preceptor(s), the PHP, and the assessors, including with respect to any practice improvements and/or ongoing professional development and/or education;
  10. Nothing in this Order shall alter or detract from Dr. Wassermann's obligations pursuant to the College's policy on Re-entering Practice, or such equivalent policies as may apply to Dr. Wassermann in the future; and
  11. Dr. Wassermann shall be solely responsible for all fees, costs and expenses associated with his compliance with the terms of this Order.

Dr. Wassermann was further ordered to pay to the College costs in the amount of $3,650.

Dr. Robert S. Cameron, Windsor. On January 14, 2013, the Discipline Committee found that Dr. Cameron committed an act of professional misconduct, in that he engaged in disgraceful, dishonourable or unprofessional conduct. Dr. Cameron admitted to the allegation.

Between 2008 and 2010, Dr. Cameron worked with Ms. AB, a registered practical nurse, and made unwanted and inappropriate remarks of a sexual nature, including stories of sexual interactions with his girlfriend. Around February 2010, while Ms. AB was working, Dr. Cameron put his arm around her hip and waist, with his hand resting on the upper part her left buttock. Ms. AB ultimately reported the matter to the police.

Commencing in August 2009, Ms. CD, a registered practical nurse, worked with Dr. Cameron.

Dr. Cameron made unwanted, inappropriate and unprofessional comments of a personal nature regarding his ex-wife and his girlfriend and spoke unprofessionally regarding Ms. CD to the father of a young patient. In early 2010, Dr. Cameron raised his voice at Ms. CD in an irate fashion where patients were present.

In or about January 2010, in a conversation with Ms. AB, Dr. Cameron made threatening remarks with respect to Dr. EF. Ms. AB reported to Dr. EF and the police that Dr. Cameron stated he would like to meet Dr. EF in a dark alley with a baseball bat.

On March 3, 2010, Dr. Cameron was charged with sexual assault with respect to Ms. AB and uttering threats with respect to Dr. EF. On June 18, 2010, the charges were withdrawn on the condition that Dr. Cameron enter into a peace bond for a one-year period. The conditions of the bond included not communicating with Ms. AB and Dr. EF and not to be within a 50-metre radius of the hospital.

The Discipline Committee ordered a public reprimand, a three-month suspension of Dr. Cameron’s certificate of registration and directed that the Registrar impose the following terms, conditions and limitations on Dr. Cameron's certificate of registration:

  • Dr. Cameron shall, at his own expense, participate in and successfully complete a one-to-one course in boundary issues and communications approved by the College;

Dr. Cameron was further ordered to pay to the College costs in the the amount of $3,650.