Buttoo, Kenneth (CPSO#: 50324)

Current Status: Active Member as of 14 Nov 1978

CPSO Registration Class: Restricted as of 01 Feb 2013

Indicates a concern or additional information

Summary

Former Name: Buttoo, Kuldip Singh (used until: 23 Mar 1983 )

Gender: Male

Languages Spoken: English

Education:University of Manchester, 1976

Practice Information

Primary Location of Practice
Unit 5D
1099 Kingston Road
Pickering ON  L1V 1B5
Phone: (905) 420-9626
Fax: (905) 420-3279
Electoral District: 05
View Professional Corporation Information

Professional Corporation Information

Corporation Name: Kenneth Buttoo Medicine Professional Corporation

Certificate of Authorization Status: Issued Date:  Jan 15 2013

Shareholders:
Dr. K. Buttoo ( CPSO# 50324 )

Business Address:
Unit 5D
1099 Kingston Road
Pickering ON  L1V 1B5
Phone Number: (905) 420-9626

Hospital Privileges

Hospital Location
Kirkland and District Hospital Kirkland Lake
Lakeridge Health,Ajax and Pickering Site Ajax

Specialties

Specialty Issued On Type
Internal Medicine Effective: 07 Jun 1982 RCPSC Specialist
Clinical Immunology Effective: 03 Dec 1984 RCPSC Specialist

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 14 Nov 1978
Transfer of class of registration to: Independent Practice Certificate Effective: 14 Oct 1983
Transfer of class of certificate to: Restricted certificate Effective: 01 Feb 2013
Terms and conditions imposed on certificate by Discipline Committee Effective: 01 Feb 2013
Terms and conditions amended by Discipline Committee Effective: 02 Mar 2013
Terms and conditions amended by Discipline Committee Effective: 12 Mar 2013
Terms and conditions amended by member Effective: 05 Jul 2018

Practice Restrictions

Imposed By Effective Date Expiry Date Status  
member Effective: 05 Jul 2018 Active View Details [+]
            As from July 5, 2018, the following terms, conditions and limitations are
            imposed on the certificate of registration held by Dr. Kenneth Buttoo, in
            accordance with an undertaking and consent Dr. Buttoo has given to the College
            of Physicians and Surgeons of Ontario:

                               UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT 
                                            ("Undertaking")

                                                  of

                                          DR. KENNETH BUTTOO
                                            ("Dr. Buttoo")

                                                  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; 
                  
                  "ICR Committee" means the Inquiries, Complaints and Reports Committee of
                  the College;
                  
                  "OHIP" means the Ontario Health Insurance Plan;

                  "Public Register" means the College's register that is available to the
                  public.
                  
            (2)   I, Dr. Buttoo, certificate of registration number 50324, am a member of
                  the College.  

            (3)   I, Dr. Buttoo, acknowledge that as a result of a Discipline Committee
                  Order of February 1, 2013 (the "Discipline Order"), I underwent
                  remediation and submitted to a reassessment of my practice, which has
                  identified concerns about my standard of practice in internal medicine.  

            B.    UNDERTAKING

            (4)   I, Dr. Buttoo, undertake to abide by the provisions of this Undertaking,
                  effective immediately.

            (5)   Reassessment of Practice

                  (a)   I, Dr. Buttoo, undertake that, within approximately three (3)
                        months of the date on which I execute this Undertaking, I will
                        submit to a further reassessment of my practice ("the
                        Reassessment") by an assessor or assessors selected by the College
                        (the "Assessor(s)").  I acknowledge that the Reassessment may
                        include a chart review, direct observation of my care, interviews
                        with colleagues and co-workers, feedback from patients and any
                        other tools deemed necessary by the College.
                  
                  (b)   I, Dr. Buttoo, undertake to co-operate fully with the Reassessment,
                        conducted under the term of this Undertaking. 
                  
                  (c)   I, Dr. Buttoo, acknowledge the results of the Reassessment will be
                        provided to me and reported to the College and the report may form
                        the basis of further action by the College. 
                  
            (6)   Monitoring 

                  (a)   I, Dr. Buttoo, undertake to inform the College of each and every
                        location that I practise or have privileges, including, but not
                        limited to, hospital(s), clinic(s) and office(s), in any
                        jurisdiction (collectively my "Practice Location(s)"), 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.
                  
                  (b)   I, Dr. Buttoo, give my irrevocable consent to the College to make
                        appropriate enquiries of OHIP and/or 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. 
                  
                  (c)   I, Dr. Buttoo, acknowledge that I have executed the OHIP consent
                        form attached hereto as Appendix "A". 
                  
            C.    ACKNOWLEDGEMENT

            (7)   I, Dr. Buttoo, acknowledge that the appendix attached to and referred to
                  in this Undertaking forms part of this Undertaking.

            (8)   I, Dr. Buttoo, 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. 

            (9)   I, Dr. Buttoo, 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.

            (10)  I, Dr. Buttoo, acknowledge that the College will provide this Undertaking
                  to any Chief of Staff, or a colleague with similar responsibilities, at
                  any Practice Location ("Chief(s) of Staff").


            (11)  I, Dr. Buttoo, 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 of the College.

            (12)  I, Dr. Buttoo, acknowledge that this Undertaking constitutes terms,
                  conditions, and limitations on my certificate of registration for the
                  purposes of section 23 of the Code. 

            (13)  Public Register

                  (a)   I, Dr. Buttoo, acknowledge that, during the time period that this
                        Undertaking remains in effect, this Undertaking shall be posted on
                        the Public Register.
                  
                  (b)   I, Dr. Buttoo, acknowledge that, in addition to this Undertaking
                        being posted in accordance with section (13)(a) above, the
                        following summary shall be posted on the Public Register during the
                        time period that this Undertaking remains in effect:
                  
                        Dr. Buttoo underwent a practice reassessment as a result of an
                        order of the Discipline Committee dated February 13, 2016. As a
                        result of the report of the practice reassessment:
                  
                        Dr. Buttoo will undergo a further reassessment of his practice by
                        an assessor selected by the College within approximately three
                        months of the date of his undertaking to the College. 
                  
                  (c)   I, Dr. Buttoo, acknowledge that this Undertaking remains in effect
                        until the College determines its terms are satisfied.
                  
            D.    CONSENT

            (14)  I, Dr. Buttoo, give my irrevocable consent to the College to provide the
                  following information to Assessors:

                  (a)   any information the College has that led to the circumstances of my
                        entering into this Undertaking;
                  
                  (b)   any information arising from any investigation into, or assessment
                        of, my practice; and 
                  
                  (c)   any information arising from the monitoring of my compliance with
                        this Undertaking or the Discipline Order.
                  
            (15)  I, Dr. Buttoo, give my irrevocable consent to the College to provide all
                  Chief(s) of Staff with any information the College has that led to the
                  circumstances of my entering into this Undertaking and/or any information
                  arising from the monitoring of my compliance with this Undertaking.

            (16)  I, Dr. Buttoo, give my irrevocable consent to any Clinical Supervisor(s)
                  under the terms of the Discipline Order, Chiefs of Staff and Assessors
                  under this Undertaking or the terms of the Discipline Order, to disclose
                  to the College, and to one another, any of the following:

                  (a)   any information relevant to this Undertaking or the terms of the
                        Discipline Order;
                  
                  (b)   any information relevant to the Reassessment;
                  
                  (c)   any information relevant for the purposes of monitoring my
                        compliance with this Undertaking; and/or  
                  
                  (d)   any information which comes to their attention which they
                        reasonably believe indicates a potential risk of harm to my
                        patients.
                  
                  
                  
            As from 11:59 p.m., February 1, 2013, 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. Kenneth Buttoo:

            (a)   For an indefinite period of time, Dr. Buttoo shall not prescribe inhaled
                  corticosteroids and/or anticholinergic medication for a patient unless he
                  or she has a diagnosis of asthma, and in any case Dr. Buttoo shall not
                  prescribe such medication in cases in which the patient has had a
                  negative methacholine challenge.  

            (b)   While Dr. Buttoo is subject to the term, condition and limitation set out
                  at paragraph 3(a), Dr. Buttoo shall maintain a log (the "Log") listing
                  all patients to whom he has prescribed inhaled corticosteroids and/or
                  anticholinergic medication, their OHIP number, the date on which he saw
                  the patient, whether the patient has a diagnosis of asthma, whether a
                  methacholine challenge has been conducted, and, if so, whether the
                  challenge was positive or negative.  Dr. Buttoo shall maintain the
                  original Log and shall send a copy of the Log to the College on a
                  quarterly basis until completion of the re-assessment referred to below
                  in paragraph 3(g), and thereafter shall produce the Log at any time upon
                  request of the College.

            (c)   Dr. Buttoo shall, within thirty (30) days from the date of this Order,
                  retain a College-approved clinical supervisor, who will sign an
                  undertaking in the form attached hereto as Schedule "A" (the "Clinical
                  Supervisor").  For a period of at least twelve (12) months commencing on
                  the day the Clinical Supervisor is retained, Dr. Buttoo may practice only
                  under the supervision of the Clinical Supervisor, who will meet with Dr.
                  Buttoo on a monthly basis for the duration of the supervision, except
                  that after three (3) months of supervision, the frequency of meetings may
                  be decreased to every two months if the Clinical Supervisor is of the
                  view that this is appropriate and it has been pre-approved by the
                  College.  

            (d)   For the duration of the clinical supervision required by paragraph 3(c),
                  Dr. Buttoo shall, within twenty (20) days of receiving notice that his
                  Clinical Supervisor is unwilling or unable to continue to fulfill the
                  terms of his or her undertaking attached hereto as Schedule "A", obtain
                  an executed undertaking from a similarly qualified person who is
                  acceptable to the College and ensure that it is delivered to the College
                  within that time.  If Dr. Buttoo is unable to obtain a Clinical
                  Supervisor on the terms set out under paragraphs 3(c) and 3(d) to this
                  Order, he shall cease to practice until such time as he has obtained a
                  Clinical Supervisor acceptable to the College, and the fact that he has
                  ceased to practice shall be a term, condition and limitation on his
                  Certificate of Registration until that time.  

            (e)   Dr. Buttoo shall abide by all recommendations of his Clinical Supervisor
                  with respect to practice improvements and education.

            (f)   Dr. Buttoo shall consent to the disclosure by his Clinical Supervisor to
                  the College, and by the College to his Clinical Supervisor, of all
                  information the Clinical Supervisor or the College deems necessary or
                  desirable in order to fulfill the Clinical Supervisor's undertaking and
                  to monitor Dr. Buttoo's compliance with the Order.  This shall include,
                  without limitation, providing the Clinical Supervisor with the reports of
                  any assessments of Dr. Buttoo's practice in the College's possession.

            (g)   Approximately twelve (12) months after the completion of the period of
                  supervision required by paragraph 3(c), Dr. Buttoo shall undergo a
                  re-assessment of his clinical practice by a College-appointed assessor
                  (the "Assessor(s)").  This re-assessment will include determining whether
                  Dr. Buttoo meets the standard of practice of the profession and whether
                  Dr. Buttoo is in compliance with this Order.  The Assessor(s) shall make
                  recommendations regarding Dr. Buttoo's practice and shall report the
                  results of the re-assessment to the College.  

            (h)   Dr. Buttoo shall consent to the disclosure to the Assessor(s) of the
                  reports of the Clinical Supervisor arising from the supervision, and
                  shall consent to the sharing of all information among the Clinical
                  Supervisor, the Assessor(s) and the College, as any of them deem
                  necessary or desirable in order to fulfill their respective obligations.

            (i)   For an indefinite period of time, Dr. Buttoo shall inform the College of
                  each and every location where he practices including, but not limited to
                  hospitals, clinics, and offices, in any jurisdiction (collectively, his
                  "Practice Location(s)"), within fifteen (15) days of this Order, and
                  shall inform the College of any and all new Practice Locations within 15
                  days of commencing practice at that location.

            (j)   For an indefinite period of time, Dr. Buttoo shall consent to the College
                  making appropriate enquiries of the Ontario Health Insurance Plan and/or
                  any person or institution who may have relevant information, in order for
                  the College to monitor his compliance with this Order.


            (k)   For an indefinite period of time, Dr. Buttoo shall submit to, and not
                  interfere with, unannounced inspections of his Practice Location(s) and
                  patient records by a College representative for the purposes of
                  monitoring his compliance with this Order.

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

Previous Hearings

Committee: Discipline
Decision Date: 01 Feb 2013
Summary:

On February 1, 2013, the Discipline Committee found that Dr. Kenneth Buttoo committed an act 
of professional misconduct, in that he failed to maintain the standard of practice of the 
profession. Dr. Buttoo admitted to the allegation.  
 
As a result of concerns regarding his practice, Dr. Buttoo executed an undertaking to the College 
on March 10, 2009, by which he agreed that he would engage in an assessment of his practice 
within one year. As a result of concerns that arose out of the subsequent practice assessment, the 
College proceeded with a section 75 investigation into Dr. Buttoo's practice and retained a 
medical inspector to review 20 patient charts, visit the site, interview Dr. Buttoo and observe five 
patient visits in February 2010. As set out in the inspector's report, Dr. Buttoo fell below the 
standard of practice of the profession in the areas of allergy management and respiratory 
management. In particular, in the care of multiple patients in 2009-2010, Dr. Buttoo:  
 
      inappropriately ordered and/or recommended testing that was unnecessary and/or not 
      indicated; 
      inappropriately failed to mention airways resistance findings in his interpretation of 
      pulmonary function test results;  
      in circumstances in which Dr. Buttoo made a provisional diagnosis of asthma and then 
      conducted testing which did not support the diagnosis, he inappropriately failed to 
      address the provisional asthma diagnosis in his follow-up consultation letters to referring 
      physicians and did not state that asthma had been ruled out;  
      inappropriately presented "hyper responsive airways" to referring physicians in terms that 
      suggested it represented a final diagnosis of a patient's condition, when in fact no 
      diagnosis had been reached on the basis of the testing conducted and the patient's 
      symptoms remained undiagnosed;  
      inappropriately prescribed medications that were unnecessary and not indicated; and  
      utilized inappropriate sterilization techniques. 
 
The Discipline Committee ordered and directed that: 
 
      the Registrar impose the following terms, conditions and limitations on Dr. Buttoo's 
      Certificate of Registration: 
 
      (a)   For an indefinite period of time, Dr. Buttoo shall not prescribe inhaled 
            corticosteroids and/or anticholinergic medication for a patient unless he or she has 
            a diagnosis of asthma, and in any case Dr. Buttoo shall not prescribe such 
            medication in cases in which the patient has had a negative methacholine 
            challenge.   
 
      (b)   While Dr. Buttoo is subject to the term, condition and limitation set out at 
            paragraph 3(a), Dr. Buttoo shall maintain a log (the "Log") listing all patients to 
            whom he has prescribed inhaled corticosteroids and/or anticholinergic medication, 
            their OHIP number, the date on which he saw the patient, whether the patient has 
            a diagnosis of asthma, whether a methacholine challenge has been conducted, and, 
            if so, whether the challenge was positive or negative.  Dr. Buttoo shall maintain 
      the original Log and shall send a copy of the Log to the College on a quarterly 
      basis until completion of the re-assessment referred to below in paragraph 3(g), 
      and thereafter shall produce the Log at any time upon request of the College. 
              
(c)   Dr. Buttoo shall, within thirty (30) days from the date of this Order, retain a 
      College-approved clinical supervisor, who will sign an undertaking in the form 
      attached hereto as Schedule "A" (the "Clinical Supervisor").  For a period of at 
      least twelve (12) months commencing on the day the Clinical Supervisor is 
      retained, Dr. Buttoo may practice only under the supervision of the Clinical 
      Supervisor, who will meet with Dr. Buttoo on a monthly basis for the duration of 
      the supervision, except that after three (3) months of supervision, the frequency of 
      meetings may be decreased to every two months if the Clinical Supervisor is of 
      the view that this is appropriate and it has been pre-approved by the College.   
              
(d)   For the duration of the clinical supervision required by paragraph 3(c), Dr. Buttoo 
      shall, within twenty (20) days of receiving notice that his Clinical Supervisor is 
      unwilling or unable to continue to fulfill the terms of his or her undertaking 
      attached hereto as Schedule "A", obtain an executed undertaking from a similarly 
      qualified person who is acceptable to the College and ensure that it is delivered to 
      the College within that time.  If Dr. Buttoo is unable to obtain a Clinical 
      Supervisor on the terms set out under paragraphs 3(c) and 3(d) to this Order, he 
      shall cease to practice until such time as he has obtained a Clinical Supervisor 
      acceptable to the College, and the fact that he has ceased to practice shall be a 
      term, condition and limitation on his Certificate of Registration until that time.   
              
(e)   Dr. Buttoo shall abide by all recommendations of his Clinical Supervisor with 
      respect to practice improvements and education. 
              
(f)   Dr. Buttoo shall consent to the disclosure by his Clinical Supervisor to the 
      College, and by the College to his Clinical Supervisor, of all information the 
      Clinical Supervisor or the College deems necessary or desirable in order to fulfill 
      the Clinical Supervisor's undertaking and to monitor Dr. Buttoo's compliance with 
      the Order.  This shall include, without limitation, providing the Clinical 
      Supervisor with the reports of any assessments of Dr. Buttoo's practice in the 
      College's possession. 
              
(g)   Approximately twelve (12) months after the completion of the period of 
      supervision required by paragraph 3(c), Dr. Buttoo shall undergo a re-assessment 
      of his clinical practice by a College-appointed assessor (the "Assessor(s)").  This 
      re-assessment will include determining whether Dr. Buttoo meets the standard of 
      practice of the profession and whether Dr. Buttoo is in compliance with this 
      Order.  The Assessor(s) shall make recommendations regarding Dr. Buttoo's 
      practice and shall report the results of the re-assessment to the College.   
              
              
(h)   Dr. Buttoo shall consent to the disclosure to the Assessor(s) of the reports of the 
      Clinical Supervisor arising from the supervision, and shall consent to the sharing 
      of all information among the Clinical Supervisor, the Assessor(s) and the College, 
      as any of them deem necessary or desirable in order to fulfill their respective 
      obligations. 
              
(i)   For an indefinite period of time, Dr. Buttoo shall inform the College of each and 
      every location where he practices including, but not limited to hospitals, clinics, 
      and offices, in any jurisdiction (collectively, his "Practice Location(s)"), within 
      fifteen (15) days of this Order, and shall inform the College of any and all new 
      Practice Locations within 15 days of commencing practice at that location. 
              
(j)   For an indefinite period of time, Dr. Buttoo shall consent to the College making 
      appropriate enquiries of the Ontario Health Insurance Plan and/or any person or 
      institution who may have relevant information, in order for the College to monitor 
      his compliance with this Order. 
              
(k)   For an indefinite period of time, Dr. Buttoo shall submit to, and not interfere with, 
      unannounced inspections of his Practice Location(s) and patient records by a 
      College representative for the purposes of monitoring his compliance with this 
      Order. 
              
(l)   Dr. Buttoo shall be responsible for any and all costs associated with implementing 
      the terms of this Order.  
              
Dr. Buttoo attend before the panel to be reprimanded. 
              
Dr. Buttoo pay to the College costs in the amount of $3,650 within thirty (30) days of the 
date of this Order. 
              
              

Decision: Download Full Decision (PDF)
Appeal: No Appeal
Hearing Date(s): February 1, 2013

Concerns

Source: Member
Active Date: July 5, 2018
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Kenneth Buttoo to the College of Physicians and Surgeons of Ontario, effective July 5, 2018:

Dr. Buttoo underwent a practice reassessment as a result of an order of the Discipline Committee dated February 13, 2016. As a result of the report of the practice reassessment:

Dr. Buttoo will undergo a further reassessment of his practice by an assessor selected by the College within approximately three months of the date of his undertaking to the College.