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Birnbaum, Robert Joel

CPSO#: 24561

MEMBER STATUS
Revoked: Discipline Committee as of 09 Oct 2020
EXPIRY DATE
09 Oct 2020
CURRENT OR PAST CPSO REGISTRATION CLASS
Independent Practice as of 12 Jun 1972

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English, French, German, Sesotho, Spanish

Education: Schulich School of Medicine and Dentistr, 1969

Practice Information

Primary Location of Practice
Practice Address Not Available

Specialties

Specialty Issued On Type
Family Medicine Effective:01 Jul 1975 CFPC Specialist

Registration History

Action Issue Date
First certificate of registration issued: Independent Practice Certificate Effective: 12 Jun 1972
Expired: Resigned from membership. Expiry: 10 Jun 2020
Revoked: Discipline Committee. Effective: 09 Oct 2020

Previous Hearings

Committee: Discipline
Decision Date: 09 Oct 2020
Summary:

On October 8, 2020, on the basis of a Statement of Uncontested Facts, the Discipline Committee (“the Committee”) of the College of Physicians and Surgeons of Ontario (“the College”) found that Dr. Robert Joel Birnbaum committed an act of professional misconduct in that: he engaged in sexual abuse of a patient; and 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.

FACTS

Dr. Robert Joel Birnbaum (“Dr. Birnbaum”) is a seventy-five (75) year old physician. He received his certificate of registration authorizing independent practice from the College of Physicians and Surgeons of Ontario (the “College”) on June 12, 1972.

Dr. Birnbaum resigned his membership with the College effective June 10, 2020.

At all relevant times, Dr. Birnbaum practiced family medicine and travel medicine in Ottawa, Ontario.

DR. BIRNBAUM ENGAGED IN SEXUAL ABUSE OF AND DISGRACEFUL,
DISHONOURABLE OR UNPROFESSIONAL CONDUCT IN RESPECT TO PATIENT A

In early 2000, Patient A became a patient of Dr. Birnbaum. Dr. Birnbaum was Patient A’s family physician. Patient A knew Dr. Birnbaum as he had previously been the family physician of Patient A’s family member.

Between approximately 2000 and 2009, as his family physician, Dr. Birnbaum regularly treated Patient A, for various health concerns.

In 2009, Patient A attended a medical appointment with Dr. Birnbaum. At this appointment, Dr. Birnbaum provided treatment to Patient A. Dr. Birnbaum also ordered bloodwork for Patient A.

In April 2009, Patient A contacted Dr. Birnbaum using an electronic platform called Facebook Messenger. Patient A reached out to Dr. Birnbaum for support and guidance.

Patient A told Dr. Birnbaum that he could benefit from his advice. Dr. Birnbaum immediately replied to Patient A and the two engaged in several days of communications over Facebook Messenger. Dr. Birnbaum suggested that the two of them meet at a bar. Patient A agreed.

In April 2009, Patient A met Dr. Birnbaum at a bar. Dr. Birnbaum told Patient A that the bar was noisy and suggested that they go to Dr. Birnbaum’s apartment which was around the corner.

Patient A attended at Dr. Birnbaum’s apartment where he and Dr. Birnbaum drank wine and smoked cannabis. The two of them then engaged in sexual contact including performing oral sex on one another. When Patient A awoke at 4:00 a.m., Dr. Birnbaum asked Patient A “wasn’t that fun?”.

After the sexual encounter on April 23, 2009, Dr. Birnbaum and Patient A continued an intimate relationship. They communicated and saw each other regularly. Dr. Birnbaum counselled Patient A. Dr. Birnbaum’s communications with Patient A also became more intimate including discussions about sex. Dr. Birnbaum also introduced Patient A to his friends and family.

On April 30, 2009, about a week after their first sexual encounter, Dr. Birnbaum reviewed Patient A’s bloodwork results and issued Patient A a prescription.

Around May 2009, Dr. Birnbaum underwent a triple by-pass surgery. Patient A slept at the hospital while Dr. Birnbaum underwent surgery and provided Dr. Birnbaum support.

Following the surgery, Dr. Birnbaum moved into Patient A’s home. Dr. Birnbaum and Patient A also spent time at Dr. Birnbaum’s home.

At some point following the commencement of the sexual relationship, Dr. Birnbaum asked another physician, Dr. M, who worked at the same clinic with Dr. Birnbaum, to take over as Patient A’s primary care physician. However, during the sexual relationship, Dr. Birnbaum continued to act as Patient A’s physician and continued to provide care and treatment to Patient A.

Dr. Birnbaum married Patient A in 2010. Patient A separated from Dr. Birnbaum in 2017.

Throughout their sexual relationship and marriage, Dr. Birnbaum continued to act as Patient A’s physician and continued to provide care and treatment to Patient A.

During the investigation, the College obtained a copy of Dr. Birnbaum’s patient records for Patient A. The patient records show that between February 2000 to June 2013, Dr. Birnbaum acted as Patient A’s physician by providing regular care and treatment to him.

The patient records also show that between April 2009 (when Dr. Birnbaum commenced a sexual relationship with Patient A) to June 2013, Dr. Birnbaum continued to provide care and treatment to Patient A.

During the investigation, the College obtained data from the Ontario Health Insurance Program (“OHIP”) for all claims submitted to OHIP by Dr. Birnbaum for services rendered to Patient A between the time period December 1, 1999 to December 1, 2017.

The OHIP data shows that:
- Between February 3, 2000 to June 26, 2013, Dr. Birnbaum submitted fifty-four (54) claims to OHIP for services rendered to Patient A;
- Between February 3, 2000 to March 31, 2009, among the various codes billed to OHIP, Dr. Birnbaum submitted claims under billing code… on eight (8) different dates; and
- On June 26, 2013, Dr. Birnbau submitted two (2) claims to OHIP for services rendered under billing codes…and…

During the investigation, the College obtained a copy of pharmacy records from Shoppers Drug Mart, Store #628 in Ottawa for all prescriptions issued by Dr. Birnbaum and filled by Patient. The pharmacy records show that between March 2008 and October 2017, Dr. Birnbaum prescribed Patient A numerous medications and between March 2009 and October 2017, Dr. Birnbaum issued over fifty (50) prescriptions to Patient A.

During the investigation, the College obtained data from the Narcotic and Controlled Drug Claims on the Narcotics Monitoring System (the NMS data) for the date range of April 1, 2012 to October 31, 2019 in respect to Dr. Birnbaum and Patient A.

The NMS data shows that:

- Between July 7, 2012 and October 19, 2017, Patient A filled a total of twelve (12) prescriptions on twelve (12) separate dates issued by Dr. Birnbaum.

In addition to the care and treatment outlined above, during the marriage, Dr. Birnbaum also provided other care and treatment to Patient A.

DR. BIRNBAUM ENGAGED IN DISGRACEFUL, DISHONOURABLE OR
UNPROFESSIONAL CONDUCT BY INAPPROPRIATELY COMBINING TREATING AND PERSONAL RELATIONSHIPS WITH PATIENT A AND HIS CHILDREN

Between approximately the early 2000’s and 2009, Dr. Birnbaum was the family physician for Patient A’s family member, X.

Between approximately the early 2000’s and 2008, Dr. Birnbaum was the family physician for Patient A’s family member, Y.

X was Dr. Birnbaum’s patient at the time Dr. Birnbaum commenced a personal and sexual relationship with Patient A in April 2009. During this time, X accompanied Patient A to Dr. Birnbaum’s house for a family dinner. X met Dr. Birnbaum’s daughters and granddaughters.

Sometime in 2009, X transferred his care to another physician in Dr. Birnbaum’s clinic as X was uncomfortable having Dr. Birnbaum being his physician.

During the time that Dr. Birnbaum was married to Patient A, Dr. Birnbaum provided care and treatment to X.

DR. BIRNBAUM ENGAGED IN DISGRACEFUL, DISHONOURABLE OR UNPROFESSIONAL CONDUCT BY ISSUING PRESCRIPTIONS TO PATIENT A UNDER ANOTHER PHYSICIAN’S NAME, WITHOUT THEIR KNOWLEDGE OR CONSENT

Between approximately 2013 and 2020, Dr. Birnbaum practiced at the Riverside Travel Medicine Clinic in Ottawa. Dr. Birnbaum shared office space with another physician named Dr. T.

Patient A was never a patient of Dr. T. Patient A had only met Dr. T once in a social setting.

During the investigation, the College obtained a copy of pharmacy records from Shoppers Drug Mart, Store #628 in Ottawa for all prescriptions issued by Dr. T to Patient A.

The pharmacy records show that between March 2015 and January 2017, nine (9) prescriptions were issued to Patient A under Dr. T’s name.

Dr. Birnbaum inappropriately obtained the above prescriptions under Dr. T’s name for Patient A.

DR. BIRNBAUM ENGAGED IN DISGRACEFUL, DISHONOURABLE OR UNPROFESSIONAL CONDUCT BY PROVIDING INACCURATE AND MISLEADING INFORMATION TO THE COLLEGE DURING ITS INVESTIGATION

Dr. Birnbaum repeatedly provided inaccurate and misleading information to the College during its investigation.

Dr. Birnbaum’s Response to College Investigation dated August 29, 2018

In Dr. Birnbaum’s initial response to the College investigation dated August 29, 2018, Dr. Birnbaum stated that “[a]t no point prior to our relationship did I act as [Patient A]’s family physician or as a primary care provider.” Dr. Birnbaum further stated that “there was not a physician-patient relationship between [Patient A] and myself when we began our relationship.” This was inaccurate and misleading information. In fact, Patient A’s patient records and OHIP records establish that Patient A had been Dr. Birnbaum’s patient from approximately February 3, 2000 onwards and was Dr. Birnbaum’s patient at the time he commenced a sexual relationship with Patient A.

Dr. Birnbaum’s Response to the College Investigation dated October 2, 2019

In a further response to the College investigation dated October 2, 2019, Dr. Birnbaum stated that “during his marriage to [Patient A], he did provide care to [Patient A] for minor conditions” and further stated that “on a few occasions” he renewed Patient A’s prescriptions. This was misleading and inaccurate information. In fact, the pharmacy records and NMS data show that Dr. Birnbaum issued numerous prescriptions for various medications to Patient A during their marriage.

In addition, Dr. Birnbaum stated that he occasionally asked “Dr. [T] to provide him with prescriptions for [Patient A] and himself for minor conditions, such as travel medicine or antibiotics.” This was misleading and inaccurate information. Dr. T denied providing Patient A with any prescriptions.

Dr. Birnbaum’s Response to the College Investigation dated October 18, 2019
In a further response to the College investigation dated October 18, 2019, Dr. Birnbaum stated that from April 30, 2009 onwards the medications he prescribed to Patient A were: four(4) pills on November 8, 2012, and a renewal for a medication on February 6, 2013. Dr. Birnbaum stated that he “did not routinely prescribe medications for [Patient A]” and he “does not recall providing any other prescriptions to [Patient A].” In fact, this was inaccurate information as set out above.

PLEA OF NO CONTEST
Dr. Birnbaum does not contest the facts set out above, and does not contest that, based on these facts, he engaged in professional misconduct, in that:

- he engaged in sexual abuse of a patient under clause 51(1)(b.1) of the Health Professions Procedural Code which is schedule 2 to the Regulated Health Professions Act, 1991, S.O. 1991, c.18; and

- he 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, under paragraph 1(1)33 of Ontario Regulation 856/93, made under the Medicine Act, 1991.

PENALTY
The Committee ordered that:

- Dr. Birnbaum’s Certificate of Registration be revoked effective immediately;
- Dr. Birnbaum attend before the panel to be reprimanded
- Dr. Birnbaum reimburse the College for funding provided to the patient under the program required under section 85.7 of the Code, by posting an irrevocable letter of credit or other security acceptable to the College, within thirty (30) days of this Order in the amount of $16,060.00.

- Dr. Birnbaum pay costs to the College in the amount of $6000.00 within thirty (30) days of the date of this Order.
 
 


Decision: Download Full Decision (PDF)
Hearing Date(s): October 8, 2020

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