Fletcher, Kenneth James (CPSO#: 55605)

Current Status: Active Member as of 26 Sep 1986

CPSO Registration Class: Restricted as of 28 Mar 2018

Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education:Dalhousie University, 1985

Practice Information

Primary Location of Practice
1237 Donald Street
Ottawa ON  K1J 8W3
Phone: (613) 695-9001
Fax: 6136958002
Electoral District: 07
View Professional Corporation Information

Professional Corporation Information

Corporation Name: K. Fletcher Medicine Professional Corporation

Certificate of Authorization Status: Issued Date:  Oct 26 2010

Shareholders:
Dr. K. Fletcher ( CPSO# 55605 )

Business Address:
1237 Donald Street
Ottawa ON  K1J 8W3
Phone Number: (613) 695-9001

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 15 Jun 1985
Expired: Terms and conditions of certificate of registration Expiry: 15 Jun 1986
Subsequent certificate of registration Issued: Independent Practice Certificate Effective: 26 Sep 1986
Transfer of class of certificate to: Restricted certificate Effective: 28 Mar 2018
Terms and conditions imposed on certificate by member Effective: 28 Mar 2018
Terms and conditions amended by member Effective: 03 Aug 2018

Practice Restrictions

Imposed By Effective Date Expiry Date Status  
member Effective: 03 Aug 2018 Active View Details [+]
            As from August 3, 2018, the following is imposed as a term, condition and
            limitation on the certificate of registration held by Dr. Kenneth James
            Fletcher, in accordance with an undertaking and consent given by Dr. Fletcher
            to the College of Physicians and Surgeons of Ontario:

                        UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT 
                                          ("Undertaking")
                  
                                                of
                  
                              DR. KENNETH JAMES FLETCHER
                                          ("Dr. Fletcher")
                  
                                                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; 
                  
                  "Discipline Committee" means the Discipline Committee of the College;
                  
                  "ICR Committee" means the Inquiries, Complaints and Reports Committee of
                  the College.
                  
                  "Narcotic Drugs" means from the Narcotic Control Regulations made under
                  the Controlled Drugs and Substances Act, S.C., 1996, c. 19, as amended.
                  "Narcotic Preparations" means from the Narcotic Control Regulations made
                  under the Controlled Drugs and Substances Act, S.C., 1996, c. 19, as
                  amended.
                  "Benzodiazepines and Other Targeted Substances" means from the
                  Benzodiazepines and Other Targeted Substances Regulations made under the
                  Controlled Drugs and Substances Act., S.C., 1996, c. 19, as amended 
                  
                        (A summary of the above-named drugs [from Appendix I to the
                        Compendium of Pharmaceuticals and Specialties] is attached hereto
                        as Schedule "A"; and the current regulatory lists are attached
                        hereto as Schedule "B")
                  
                  "All other Monitored Drugs" means as defined under the Narcotics Safety
                  and Awareness Act, 2010, S.O. 2010, c. 22, as amended, as noted in
                  Schedule "C".                                                
                  
                  "NMS" means 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. Fletcher, certificate of registration number 55605, am a member of
                  the College.  

            (3)   I, Dr. Fletcher, acknowledge that the College received information
                  regarding my standard of practice and conducted an investigation into the
                  information.

            (4)   I, Dr. Fletcher, acknowledge this Undertaking replaces my March 28, 2018
                  Undertaking with the College.

            B.    UNDERTAKING

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

            (6)   Prescribing Log

                  (a)   I, Dr. Fletcher, shall keep a log of all prescriptions for Narcotic
                        Drugs, Narcotic Preparations, Benzodiazepines and Other Targeted
                        Substances and All other Monitored Drugs, in the form attached as
                        set out in Schedule "D", which will include at least the following
                        information (the "Prescribing Log"):  
                  
                        (i)   the date of the appointment;
                        (ii)  the name of the patient and chart/file number;
                        (iii) the name of the medication prescribed, dose, direction,
                              number of tablets to be dispensed and frequency;
                        (iv)  the clinical indication;
                        (v)   whether the prescription is for a new medication and/or
                              different dose or frequency than currently prescribed to the
                              patient (Y/N); 
                        (vi)  Dr. Fletcher's signature;
                        (vii) the date of the Clinical Supervisor's review (if applicable,
                              as set out below); and
                        (viii)the Clinical Supervisor's signature (if applicable, as set
                              out below).
                  
            (7)   I, Dr. Fletcher, undertake to keep a copy of all prescriptions I write
                  for Narcotic Drugs, Narcotic Preparations, Benzodiazepines and Other
                  Targeted Substances and All other Monitored Drugs, in the corresponding
                  patient chart.

            (8)   Clinical Supervision 

                  (a)   I, Dr. Fletcher, undertake to practise under the guidance of a
                        clinical supervisor(s) acceptable to the College (the "Clinical
                        Supervisor(s)") for six months, on the terms set out below (the
                        "Clinical Supervision"). 
                  
                  (b)   I, Dr. Fletcher, undertake to identify all patients to whom I
                        currently prescribe Narcotic Drugs, Narcotic Preparations,
                        Benzodiazepines and Other Targeted Substances and All other
                        Monitored Drugs.
                  
                  (c)   I, Dr. Fletcher, undertake to compile a list of all patients
                        described in 8(b) above, and to provide this list to my Clinical
                        Supervisor(s).
                  
                  (d)   I, Dr. Fletcher, undertake to meet with my Clinical Supervisor(s)
                        at least once every two weeks for two months and monthly for four
                        months to discuss the Clinical Supervisor's review of charts for at
                        least fifteen(15) patients to be selected by the Clinical
                        Supervisor(s) independent of my participation, on the basis of the
                        areas of concern identified in the independent opinion report(s),
                        dated January 26, 2018, March 30, 2018 and June 1, 2018, including
                        opioid prescribing and pain management, and any concerns that arise
                        during the period of Clinical Supervision. 
                  
                        Such charts shall include all patients listed in the Prescribing
                        Log since the Clinical Supervisor's prior review and patients
                        included on the list described at 8(b) and (c) above.
                  
                  (e)   I, Dr. Fletcher, acknowledge that my Clinical Supervisor Clinical
                        Supervisor(s) will provide a report to the College at least once
                        every two months.
                  
                  (f)   I, Dr. Fletcher, acknowledge that the Clinical Supervisor(s) must
                        sign and date the Prescribing Log and patient chart in question to
                        confirm the charts that the Clinical Supervisor(s) has reviewed and
                        discussed with me.
                  
                  (g)   I, Dr. Fletcher, acknowledge that I have reviewed the Clinical
                        Supervisor(s)'s undertaking, attached hereto as Schedule "E", and
                        understand what is required of the Clinical Supervisor(s).  In
                        addition to what is set out above, the Clinical Supervisor(s) will,
                        at a minimum:
                  
                        i.    Facilitate the education program set out in the
                              Individualized Education Plan ("IEP") attached as Schedule
                              "F";
                        ii.   Discuss with me any concerns arising from the chart reviews;
                        iii.  Maintain a log of all patient charts reviewed and
                        iv.   Perform any other duties, such as reviewing other documents
                              or conducting interviews with staff or colleagues, that the
                              Clinical Supervisor(s) deem necessary to my Clinical
                              Supervision.
                  
                  (h)   I, Dr. Fletcher, undertake that all meetings with my Clinical
                        Supervisor(s) will take place at my Practice Location, or another
                        location approved by the College;
                  
                  (i)   I, Dr. Fletcher, acknowledge that all charts reviewed shall be
                        independently selected by the Clinical Supervisor(s) based on the
                        areas of concern identified in the independent opinion report(s)
                        dated January 26, 2018, March 30, 2018 and June 1, 2018, and
                        concerns that may arise during the period of Clinical Supervision.
                  
                  (j)   I, Dr. Fletcher, undertake to cooperate fully with the Clinical
                        Supervision of my practice, conducted under the term of this
                        Undertaking and Schedule "E" attached, and to abide by the
                        recommendations of my Clinical Supervisor(s), including but not
                        limited to, any recommended practice improvements and ongoing
                        professional development.
                  
                  (k)   I, Dr. Fletcher, undertake to ensure that Schedule "E" to this
                        Undertaking, is signed and delivered to the College within fourteen
                        (14) days of the date I execute this Undertaking.
                  
                  (l)   I, Dr. Fletcher, undertake that if a person who has given an
                        undertaking in Schedule "E" to this Undertaking is unable or
                        unwilling to continue to fulfill its provisions, I shall, within
                        fourteen (14) days of receiving notice of same, obtain an executed
                        undertaking in the same form from a similarly qualified person who
                        is acceptable to the College and ensure that it is delivered to the
                        College within that time.
                  
                  (m)   I, Dr. Fletcher, acknowledge that if I am unable to obtain a
                        Clinical Supervisor on the provisions set out under sections (8)(k)
                        and/or (l) above, I shall cease prescribing Narcotic Drugs,
                        Narcotic Preparations, Benzodiazepines and Other Targeted
                        Substances and All other Monitored Drugs until such time as I have
                        obtained a Clinical Supervisor acceptable to the College.
                  
                  (n)   I, Dr. Fletcher, acknowledge that if I am required to cease
                        prescribing Narcotic Drugs, Narcotic Preparations, Benzodiazepines
                        and Other Targeted Substances and All other Monitored Drugs as a
                        result of section (8)(m) above this will constitute a term,
                        condition or limitation on my certificate of registration and that
                        term, condition or limitation will be included on the Public
                        Register.
                  
            (9)   Professional Education  

                  (a)   I, Dr. Fletcher, undertake to participate in and successfully
                        complete all elements of the detailed IEP, attached hereto as
                        Schedule "F", including but not limited to, the following elements
                        of professional education (the "Professional Education"):
                  
                        (i)   University of Toronto Faculty of Medicine program in Safe
                              Opioid Prescribing (all three webinars and in-person
                              workshop): www.cepd.utoronto.ca/opioidprescribing;
                        (ii)  University of Toronto Faculty of Medicine program in Medical
                              Record-Keeping:  http://www.cpd.utoronto.ca/recordkeeping/;
                        (iii) Review and discuss with my Clinical Supervisor(s) the
                              following resources:
                              1.    CPSO Policy "Prescribing Drugs":
                                    http://www.cpso.on.ca/Policies-Publications/Policy/Prescribing-Drugs;
                              2.    2017 Canadian Guideline for Opioids for Chronic
                                    Non-Cancer Pain:
                                    http://nationalpaincentre.mcmaster.ca/guidelines.html;
                              3.    the Centre for Effective Practice Management of Chronic
                                    Non-Cancer Pain Tool https://thewellhealth.ca/cncp
                  
                        (iv)  Review and discuss with my Clinical Supervisor(s) the CPSO
                              Policy "Medical Records":
                              http://www.cpso.on.ca/Policies-Publications/Policy/Medical-Records;
                              and 
                        (v)   any additional professional education recommended by my
                              Clinical Supervisor(s).
                  
                  (b)   I, Dr. Fletcher, undertake to provide proof to the College of my
                        successful completion of each element of the Professional Education
                        specified above, including proof of registration, attendance and
                        participant assessment reports where available, within one (1)
                        month of completion of each element. I acknowledge that the College
                        will determine, in its sole discretion, whether I have successfully
                        completed each element of the Professional Education.
                  
                  (c)   I, Dr. Fletcher, acknowledge that a report or reports may be
                        provided to the College regarding my progress and compliance with
                        the Professional Education.
                  
            (10)  Reassessment of Practice

                  (a)   I, Dr. Fletcher, undertake that, approximately six (6) months after
                        the Clinical Supervision set out under section 8 of the Undertaking
                        has ceased, I will submit to a reassessment of my practice by an
                        assessor or assessors selected by the College (the "Reassessment").

                  (b)   I, Dr. Fletcher, acknowledge and agree that the Reassessment may
                        include a chart review, direct observation of my care, an interview
                        of me, interviews with colleagues and co-workers, feedback from
                        patients and any other tools deemed necessary by the College.
                  
                  (c)   I, Dr. Fletcher, undertake to co-operate fully with the
                        Reassessment conducted under the terms of this Undertaking 
                  
                  (d)   I, Dr. Fletcher, acknowledge and agree that my Clinical
                        Supervisor(s) may receive and review the findings of the
                        Assessor(s), and may discuss with the Assessor(s) any issues or
                        concerns arising from the Reassessment.  
                  
                  (e)   I, Dr. Fletcher, acknowledge that the results of the Reassessment
                        will be provided to me and reported to the College and that the
                        Reassessment may form the basis of further action by the College.
                  
            (11)  Monitoring

                  (a)   I, Dr. Fletcher, undertake to inform the College of each and every
                        location at which 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. Fletcher, undertake that I will submit to, and not interfere
                        with, unannounced inspections of my Practice Location(s) and to any
                        other activity the College deems necessary in order to monitor my
                        compliance with the provisions of this Undertaking.
                  
                  (c)   I, Dr. Fletcher, 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.
                  
                  (d)   I, Dr. Fletcher, acknowledge that I have executed the OHIP and NMS
                        consent form(s), attached hereto as Schedule "G" and Schedule "H",
                        respectively. 
                  
            C.    ACKNOWLEDGEMENT

            (12)  I, Dr. Fletcher, acknowledge that all schedules and appendices attached
                  to or referred to in this Undertaking form part of this Undertaking.

            (13)  I, Dr. Fletcher, 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. 

            (14)  I, Dr. Fletcher, acknowledge that I have read and understand the
                  provisions of Undertaking and that I have obtained independent legal
                  counsel in reviewing and executing this Undertaking, or have waived my
                  right to do so.

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

            (16)  I, Dr. Fletcher, acknowledge that, in the event of a referral to the
                  Discipline Committee and in the event of an appeal of any Order of the
                  Discipline Committee, if the Discipline Committee has directed the
                  Registrar to revoke, suspend, or impose terms and conditions on my
                  certificate of registration, that Order will take effect immediately
                  despite any appeal.

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

            (18)  Public Register

                  (a)   I, Dr. Fletcher, acknowledge that, during the time period that this
                        Undertaking remains in effect, this Undertaking shall be posted on
                        the Public Register.
                  
                  (b)   I, Dr. Fletcher, acknowledge that, in addition to this Undertaking
                        being posted in accordance with section (18)(a) above, the
                        following summary shall be posted on the Public Register during the
                        time period that this Undertaking remains in effect:
                  
                              Dr. Fletcher was the subject of a College investigation into
                              his prescribing. As a result of the investigation:
                  
                              Dr. Fletcher's prescribing of narcotic drugs, narcotic
                              preparations, benzodiazepines and other targeted substances,
                              and other monitored drugs will be supervised by a Clinical
                              Supervisor acceptable to the College for six months.
                  
                              Dr. Fletcher will engage in professional education in the
                              prescribing of controlled substances, including narcotics.
                  
                              Following the professional education and period of
                              supervision, Dr. Fletcher's prescribing of controlled
                              substances, including narcotics, will be re-assessed by an
                              assessor selected by the College.
                  
            D.    CONSENT

            (19)  I, Dr. Fletcher, give my irrevocable consent to the College to provide
                  the following information to any person who requires this information for
                  the purposes of facilitating my completion of the Professional Education
                  and to all Clinical Supervisors, and/or 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.
                  
            (20)  I, Dr. Fletcher, 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.

            (21)  I, Dr. Fletcher, give my irrevocable consent to any person who
                  facilitates my completion of the Professional Education, and to all
                  Clinical Supervisors, Chiefs of Staff and Assessors, to disclose to the
                  College, and to one another, any information:

                  (a)   relevant to this Undertaking;
                  
                  (b)   relevant to the provisions of the Clinical Supervisor's undertaking
                        set out at Schedule "E";
                  
                  (c)   relevant to the IEP set out at Schedule "F"
                  
                  (d)   relevant to the Reassessment;
                  
                  (e)   relevant for the purposes of monitoring my compliance with this
                        Undertaking; and/or 
                  
                  (f)   which comes to his or her attention in the course of providing the
                        Professional Education and which he or she reasonably believes
                        indicates a potential risk of harm to my patients.

Concerns

Source: Member
Active Date: August 3, 2018
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Kenneth James Fletcher to the College of Physicians and Surgeons of Ontario, effective August 3, 2018:

Dr. Fletcher was the subject of a College investigation into his prescribing. As a result of the investigation:

Dr. Fletcher's prescribing of narcotic drugs, narcotic preparations, benzodiazepines and other targeted substances, and other monitored drugs will be supervised by a Clinical Supervisor acceptable to the College for six months.

Dr. Fletcher will engage in professional education in the prescribing of controlled substances, including narcotics.

Following the professional education and period of supervision, Dr. Fletcher's prescribing of controlled substances, including narcotics, will be re-assessed by an assessor selected by the College.


Source: ICR Committee
Active Date: November 23, 2016
Expiry Date:
Summary:
Specified Continuing Education and Remediation Program:

A summary of a decision of the Inquiries, Complaints and Reports Committee in which the disposition includes a Specified Continuing Education and Remediation Program (“SCERP”) is required by the College By-laws to be posted on the register, along with a note if the decision has been appealed. A SCERP is one of the dispositions that the College’s Inquiries, Complaints and Reports Committee may make in connection with a matter before it, and this disposition requires the member to complete an education and remediation program specified for the member. A note will also be posted when all the elements of the SCERP have been completed. The summary will be removed from the register if the decision is overturned on appeal or review. Note that this requirement only applies to decisions arising out of a complaint dated on or after January 1, 2015 or if there was no complaint, the first appointment of investigators dated on or after January 1, 2015.
See PDF for the summary of a decision made against this member in which the
disposition includes a SCERP:
Download Full Document (PDF)