As from September 17, 2020, the following are imposed as terms, conditions and limitations on the certificate of registration held by Dr. Christine Marie Bertothy in accordance with an undertaking and consent given by Dr. Bertothy to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. CHRISTINE MARIE BERTOTHY
("Dr. Bertothy")
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;
"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. Bertothy, certificate of registration number 60174, am a member of the College.
(3) I, Dr. Bertothy, acknowledge that I entered into an undertaking with the College dated October 25, 2017, in which I agreed to undergo remediation and supervision in record keeping and safe opioid prescribing, as well as to submit to a reassessment of my practice. In lieu of completing the terms of the October 25, 2017 undertaking, I am entering into this Undertaking.
B. UNDERTAKING
(4) I, Dr. Bertothy, undertake to abide by the provisions of this Undertaking, effective immediately.
(5) Resignation of Prescribing Privileges
(a) I, Dr. Bertothy, 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. Bertothy, consent to the College sending the Resignation Letter to Health Canada on my behalf.
(c) I, Dr. Bertothy, undertake that I will not issue new prescriptions or renew existing prescriptions for or administer 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 links to the current regulatory lists are attached hereto as Schedule "C")
(v) Monitored Drugs (as defined under the Narcotics Safety and Awareness Act, 2010, S.O. 2010, c. 22, with a link to the current regulatory list attached hereto as Schedule "D");
and as amended from time to time.
(d) I, Dr. Bertothy, undertake to immediately refer all patients to whom I am prescribing any of the substances described in section (5)(c), above, to other physicians for assessment and care.
(e) I, Dr. Bertothy, undertake to keep a log of all patients referred to other physicians pursuant to section (5)(d), above (the "Log"). I, Dr. Bertothy, undertake to include in the Log the name of each patient referred, the name of the physician referred to, and the date of referral.
(6) I, Dr. Bertothy, undertake that I will return any supplies of the substances referred to in section (5)(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 "Prescribing Drugs."
(7) I, Dr. Bertothy, undertake to inform the College of each and every location at which I practise or have privileges, including, but not limited to, any hospitals, clinics, offices, and any Independent Health Facilities with which I am affiliated, in any jurisdiction (collectively my "Practice Location" or "Practice Locations"), within five (5) days of executing this Undertaking. Going forward, I further undertake to inform the College of any and all new Practice Locations within five (5) days of commencing practice at that location.
(8) Posting a Sign
(a) I, Dr. Bertothy, undertake that I shall post a sign in all waiting rooms and in each examination and consulting room, in 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. Bertothy must not prescribe or administer any of the following:
- Narcotic Drugs
- Narcotic Preparations
- Controlled Drugs
- Benzodiazepines and Other Targeted Substances
- 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. Bertothy, undertake to post a certified translation in any language in which I provide services, of the sign described in section (8)(a) above, in all waiting rooms and in each examination and consulting room, in all my Practice Locations, in a clearly visible and secure location, in the form set out at Schedule "E."
(c) I, Dr. Bertothy, undertake to provide the certified translation described in section (8)(b), to the College within thirty (30) days of executing this Undertaking.
(d) I, Dr. Bertothy, undertake that if I elect, after the execution of this Undertaking, to provide services in any other language, I will notify the College prior to providing any such services.
(e) I, Dr. Bertothy, undertake to provide to the College the certified translation described in section (8)(c) prior to beginning to provide services in any language described in section (8)(d).
C. ACKNOWLEDGEMENT
(9) I, Dr. Bertothy, acknowledge that all schedules attached to or referred to in this Undertaking form part of this Undertaking.
(10) I, Dr. Bertothy, acknowledge and undertake 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.
(11) I, Dr. Bertothy, acknowledge 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.
(12) I, Dr. Bertothy, acknowledge that the College will provide this Undertaking to any Chief of Staff, or a colleague with similar responsibilities, at any Practice Location ("Chief of Staff" or "Chiefs of Staff").
(13) I, Dr. Bertothy, 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.
(14) I, Dr. Bertothy, acknowledge that this Undertaking constitutes terms, conditions, and limitations on my certificate of registration for the purposes of section 23 of the Code.
(15) Public Register
(a) I, Dr. Bertothy, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. Bertothy, acknowledge that, in addition to this Undertaking being posted in accordance with section (15)(a) above, the following summary shall be posted on the Public Register during the time period that this Undertaking remains in effect:
Dr. Bertothy entered into an undertaking with the College dated October 25, 2017, in which she agreed to undergo remediation and supervision in record keeping and safe opioid prescribing, as well as submit to a reassessment of her practice. In lieu of completing the terms of the October 25, 2017 undertaking:
Dr. Bertothy must not issue new prescriptions or renew existing prescriptions for or administer 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) 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. Bertothy must post a clearly visible sign in the waiting rooms and each examination and consulting room, in all Practice Locations, which states as follows:
IMPORTANT NOTICE
Dr. Bertothy must not prescribe or administer any of the following:
- Narcotic Drugs
- Narcotic Preparations
- Controlled Drugs
- Benzodiazepines and Other Targeted Substances
- Monitored Drugs
Further information may be found on the College of Physicians and Surgeons of Ontario website at www.cpso.on.ca
D. CONSENT
(16) I, Dr. Bertothy, undertake that I will submit to, and not interfere with, unannounced inspections of my Practice Locations 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.
(17) I, Dr. Bertothy, 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.
(18) I, Dr. Bertothy, acknowledge that I have executed the OHIP and NMS consent forms, attached hereto as Schedule "F" and Schedule "G", respectively.
(19) I, Dr. Bertothy, give my irrevocable consent to the College to provide all Chiefs of Staff with any information the College has that led to the circumstances of my entering into this Undertaking and any information arising from the monitoring of my compliance with this Undertaking.