As from February 16, 2019, the following is imposed as terms, conditions and
limitations on the certificate of registration held by Dr. Laurence Harold
Klotz in accordance with an undertaking and consent given by Dr. Klotz to the
College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. LAURENCE HAROLD KLOTZ
("Dr. Klotz")
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. Klotz, certificate of registration number 30375, am a member of
the College.
(3) I, Dr. Klotz, acknowledge that the College conducted investigations
bearing File Numbers 7216525 and 100516 into my urology practice (the
"Investigations").
B. UNDERTAKING
(4) I, Dr. Klotz, undertake to abide by the provisions of this Undertaking,
effective immediately ("Effective Date").
(5) Professional Education
(a) I, Dr. Klotz, undertake to participate in and successfully complete
all aspects of the detailed IEP, attached hereto as Appendix "A",
including all of the following professional education (the
"Professional Education"):
(i) programs satisfactory to the College in communications.
(b) I, Dr. Klotz, undertake to provide proof to the College of my
successful completion of the Professional Education, including
proof of registration and attendance and any participant assessment
reports, within one (1) month of completing it. I acknowledge that
the College will determine, in its sole discretion, whether I have
successfully completed the Professional Education.
(c) I, Dr. Klotz, undertake to complete this requirement by November
30, 2019 or, if a program satisfactory to the College is not
available by that time, by the first possible opportunity
thereafter.
(d) I, Dr. Klotz, acknowledge that a report or reports may be provided
to the College regarding my progress and compliance with the
Professional Education.
(6) Practice Restrictions
(a) I, Dr. Klotz, undertake to perform ureteric and renal surgery for
trauma cases requiring immediate operative intervention (within
eight [8] hours of injury) only in the presence of the general
surgeon on call for trauma surgery, who is prepared to assist if
needed.
(b) I, Dr. Klotz, undertake, subject to sections 6(c) and (d) below, to
abide in all respects by the terms set out in my agreement with
Sunnybrook Health Sciences Centre (my "Practice Agreement"), the
relevant parts of which are attached to this Undertaking at
Appendix "B," by which, among other things, I will not perform:
i. Partial nephrectomies;
ii. Nephro-ureterectomies;
iii. Cytoreductive nephrectomies;
iv. Nephrectomies except under the conditions listed in Appendix
"A;"
v. Retroperitoneal lymph node dissections for testicular cancer;
vi. Reconstructive procedures including ureterectomies for
malignancy with ureteral reconstruction;
vii. Radical cystectomies; and
viii. Open (non-robotic) prostatectomy for benign or malignant
disease.
For greater certainty, I will not perform the procedures set out in
section (6)(b)(i) through (viii) above anywhere that I practise
medicine. However, I understand that nothing in this section
prevents me from performing ureteric and renal surgery as necessary
for trauma cases in compliance with section 6(a).
(c) I, Dr. Klotz, acknowledge that if I and Sunnybrook Health Sciences
Centre propose at any time to modify any term of my Practice
Agreement, we may do so only upon notice to and with the approval
of the ICR Committee, the granting of which is within the ICR
Committee's discretion.
(7) Reports from Division Head
(a) I, Dr. Klotz, undertake to have the Head of the Urology Division at
Sunnybrook Health Sciences Centre, or another person in a similar
position who is acceptable to the College (the "Division Head"),
assist in the monitoring of my compliance with this Undertaking.
(b) I, Dr. Klotz, acknowledge that I have reviewed the undertaking of
the Division Head attached hereto as Appendix "C", and understand
what is required of the Division Head, including annual reports
regarding my compliance and provision of any supporting
information.
(c) I, Dr. Klotz, undertake to ensure that Appendix "C" to this
Undertaking, is signed and delivered to the College within seven
(7) days of the Effective Date.
(d) I, Dr. Klotz, undertake that if any person who has given an
undertaking in Appendix "C" to this Undertaking is unable or
unwilling to continue to fulfill its terms, I shall, within twenty
(20) 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.
(8) Monitoring
(a) I, Dr. Klotz, acknowledge that I currently practise medicine only
at (i) Sunnybrook Health Sciences Centre and (ii) Can-Am HIFU (my
current "Practice Location(s)"). I acknowledge that at Can-Am HIFU
my practice is limited to high-intensity focused ultrasound of the
prostate. I undertake that I shall not commence practising
medicine at any other location without notifying the College at
least fourteen (14) days in advance, and that I shall notify the
College immediately if I cease practising at any Practice
Location(s).
(b) I, Dr. Klotz, undertake and agree that I will submit to, and not
interfere with, unannounced inspections of my Practice Location(s)
and patient records by a College representative for the purposes of
monitoring my compliance with the provisions of this Undertaking.
(c) I, Dr. Klotz, 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.
(d) I, Dr. Klotz, acknowledge that I have executed the OHIP consent
form, attached hereto as Appendix "D".
C. ACKNOWLEDGEMENT
(9) I, Dr. Klotz, acknowledge that all appendices attached to or referred to
in this Undertaking form part of this Undertaking.
(10) I, Dr. Klotz, 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. Klotz, 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. Klotz, 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").
(13) I, Dr. Klotz, 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.
(14) I, Dr. Klotz, 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. Klotz, acknowledge that, during the time period that this
Undertaking remains in effect, this Undertaking shall be posted on
the Public Register.
(b) I, Dr. Klotz, 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:
College investigations were conducted into Dr. Klotz's
urology practice. As a result of the investigations:
* Dr. Klotz will perform ureteric and renal surgery
for trauma cases requiring immediate operative
intervention (within 8 hours of injury) only in
the presence of the general surgeon on call for
trauma surgery, who is prepared to assist if
needed.
* Dr. Klotz will abide in all respects with the
terms set out in an agreement with Sunnybrook
Health Sciences Centre, by which, among other
things, he will not perform:
i. Partial nephrectomies;
ii. Nephro-ureterectomies;
iii. Cytoreductive nephrectomies;
iv. Nephrectomies except under certain
conditions listed in Appendix "A" to his
undertaking;
v. Retroperitoneal lymph node dissections for
testicular cancer;
vi. Reconstructive procedures including
ureterectomies for malignancy with ureteral
reconstruction;
vii. Radical cystectomies; and
viii. Open (non-robotic) prostatectomy for benign
or malignant disease.
Dr. Klotz will not perform the above procedures anywhere that
he practises medicine. This does not prevent him from
performing ureteric and renal surgery as necessary for trauma
cases as described above.
* Dr. Klotz will not commence practising medicine at any
location other than Sunnybrook Health Sciences Centreor
Can-Am HIFU without notifying the College at least 14
days in advance, and will notify the College
immediately if he ceases to practise medicine at any of
his practice locations.
D. CONSENT
(16) I, Dr. Klotz, give my irrevocable consent to the College to provide the
following information to any person who requires this information,
including all Chief(s) of Staff and the Division Head:
(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.
(17) I, Dr. Klotz, give my irrevocable consent to all Chief(s) of Staff, the
Surgeon-in-Chief and the Division Head to disclose to the College, and to
one another, any information:
(a) relevant to this Undertaking;
(b) relevant to the terms of the agreement at Appendix "B";
(c) relevant to the provisions of the Division Head's undertaking set
out at Appendix "C";
(d) relevant for the purposes of monitoring my compliance with this
Undertaking; and/or
(e) which comes to his or her attention and which he or she reasonably
believes indicates a potential risk of harm to my patients.