Picard, Pierre (CPSO#: 81153)

Current Status: Revoked: Discipline Committee as of 09 Oct 2018

CPSO Registration Class: None as of 09 Oct 2018

Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Male

Languages Spoken: English, French

Education:University of Ottawa, 2004

Practice Information

Primary Location of Practice
Practice Address Not Available
View Professional Corporation Information

Professional Corporation Information

Corporation Name: Dr. Picard Medicine Professional Corporation

Certificate of Authorization Status: Inactive: Nov 29 2017

Medical Records Location

Instructions: Patients seeking a copy of their medical records may send their request to ppicard.neurology@gmail.com
Date Received: 02 Oct 2017

Specialties

Specialty Issued On Type
Neurology Effective: 30 Jun 2009 RCPSC Specialist

Postgraduate Training

Please note: This information may not be a complete record of postgraduate training.

McMaster University, 01 Jul 2004 to 30 Jun 2005
PostGrad Yr 1 - Neurology

McMaster University, 01 Jul 2005 to 30 Jun 2006
PostGrad Yr 2 - Neurology

McMaster University, 01 Jul 2006 to 30 Jun 2007
PostGrad Yr 3 - Neurology

McMaster University, 01 Jul 2007 to 30 Jun 2008
PostGrad Yr 4 - Neurology

McMaster University, 01 Jul 2008 to 30 Jun 2009
PostGrad Yr 5 - Neurology

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 01 Jul 2004
Transfer of class of registration to: Independent Practice Certificate Effective: 30 Jun 2009
Transfer of class of certificate to: Restricted certificate Effective: 21 Sep 2016
Terms and conditions imposed on certificate Effective: 21 Sep 2016
Terms and conditions amended by member Effective: 27 Mar 2017
Expired: Failure to Renew Membership Expiry: 10 Aug 2017
Revoked: Discipline Committee. Effective: 09 Oct 2018

Previous Hearings

Committee: Discipline
Decision Date: 09 Oct 2018
Summary:

On October 9, 2018, the Discipline Committee found that Dr. Pierre Picard committed an act of 
professional misconduct, in that he has engaged in sexual abuse of  ten patients; in that he has engaged in 
conduct or 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; 
in that he has failed to maintain the standard of practice of the profession; and in that he has been found 
guilty of an offence relevant to his suitability to pratise medicine.  
 
Sexual Abuse, Disgraceful Dishonourable and Unprofessional Conduct, Failure to Maintain the 
Standard of Practice 
 
Patient A   
 
Patient A was referred to Dr. Picard in around 2012 for treatment related to neck injury. She was referred 
for pain management and concussion. At the outset, she indicated that she was suffering from post-
traumatic stress disorder following a sexual assault. She saw Dr. Picard at his office in a hospital. In 2015, 
Dr. Picard started to provide lidocaine injections, initially to her neck and shoulder area, and later to her 
back and buttocks. 
 
At an appointment in 2015, after Patient A received her injections while lying on her stomach. Dr. Picard 
told Patient A that he would also provide injections in her chest area, in the pectoralis muscle, for which 
Patient A flipped over to lay on her back. She was gowned and her bra was removed. Her breasts were 
exposed. The process involved Dr. Picard touching the area of her right breast locating an injection site in 
the pectoralis and then rubbing around the cleavage area. Patient A told Dr. Picard that she had breast 
implants. He asked whether the surgery had affected the sensation in her nipples. She thought this was 
unusual. While lying on her back face-up, Dr. Picard used his elbow to push Patient A’s leg to the side and 
reached his hand between her legs, pushing her legs apart. He massaged her buttocks in the injection area 
for 15-20 seconds in a different manner and longer than at previous appointments. He told her that this 
makes the medication work faster. She was shocked. The massage was of a sexual, not clinical nature. At 
the end of the visit, Dr. Picard told Patient A that in the future she could see him in his private office as he 
would have more time to massage her. Patient A said she would call his secretary. She felt uncomfortable, 
violated and confused. Dr. Picard texted her the next day that he had an opening and she could come back 
if she felt any pain. She said she was okay, but he continued to send her text messages offering to see him 
in the clinic that week. Patient A was concerned and did not return to see Dr. Picard again. 
 
An expert retained by the College, a certified anesthetist practising in chronic pain, opined that Dr. Picard 
failed to maintain the standard of practice of the profession, noting that widespread injections were not 
clinically indicated, there was no reason to extensively massage the buttocks, and there was no supporting 
documentation of the injections that were billed to OHIP. With respect to the manner in which Dr. Picard 
massaged the patient, the expert indicated that the technique of leaning his elbow upon her leg and reaching 
beneath the buttocks from the anterior is unnecessary and inappropriate.  
 
Patient B 
 
Patient B was referred to Dr. Picard in 2014 for multiple sclerosis (MS). In 2016, at a scheduled 
appointment, she was seen by the nurse, who did a physical assessment, and then saw Dr. Picard. She 
complained of extreme sweating. Dr. Picard indicated that the overheating was due to her MS. They 
discussed her fatigue and drug coverage plan. As Patient B got up to leave, Dr. Picard got up, came around 
his desk, put his hand down the top of her dress and felt both of her breasts, telling her that he was 
checking for chafing regarding  her complaint of extreme sweating. Patient B was shocked; she did not say 
anything and left immediately. He did not inform her that he planned to check her breasts. There was no 
need to do so.  
 
Patient B terminated her doctor-patient relationship with Dr. Picard after this appointment. She later 
telephoned Dr. Picard’s nurse indicating that Dr. Picard touched her inappropriately and that he told her 
there was chafing under her breasts. Dr. Picard told the nurse not to make an entry into Patient B’s 
electronic record regarding this, which was inappropriate and unprofessional. As a result, the nurse decided 
to document this on a separate piece of paper. 
 
Patient C 
 
Patient C was referred to Dr. Picard in 2014 as a result of work-related injuries. At her initial appointments 
with Dr. Picard, Patient C remained clothed. Dr. Picard administered lidocaine injections around her head, 
neck and upper back. In subsequent appointments, the injections extended to the pectoralis, down the back 
to the lower back, and the periformis. She remained standing throughout the injections. After injecting the 
pectoralis, Dr. Picard touched both sides of each breast with an open palm. On occasions, he complimented 
her, stroked her necklace telling her it was beautiful, and touched her tattoo on her shoulder commenting 
that it was lovely. 
 
In the summer 2016, Patient C’s appointment proceeded differently. While she usually received injections 
in his office, standing up, Dr. Picard took her into the treatment room with an examination table. Patient C 
told him that she was an in-patient in a post-traumatic stress treatment program and had been released to 
attend this appointment. After administering injections to her neck area in a usual manner, Dr. Picard told 
Patient C that her pelvic floor was tight and asker to lie face down on the examination table, which she 
found stressful based on her past experiences. When lying down, Patient C felt Dr. Picard’s hand slide 
down inside her shorts into her underwear, massaging in circular motions between her buttocks and the 
labia, and approaching closer to her vaginal opening. He asked her if she was okay and she replied “yes”. 
He told her she was very tight. Patient C was immobilized with fear and confused as Dr. Picard was 
providing reports for her claims against WSIB, her employer and disability benefits. When Patient C turned 
over to her back, Dr. Picard lowered her shorts and underwear, exposing her pubic hair, and administered 
injections in her pelvic area and in her legs near the groin, which he had not injected before. He placed his 
hands over her clitoris and pubic area and said, “That should get things flowing”. He massaged her pelvic 
area. She was very shocked and confused.  
 
On another occasion, Dr. Picard placed Patient C against the wall, pulled up her shorts, and while facing 
her, administered an injection in her femoral area. Although Patient C was concerned, she attended the next 
appointment, because she was desperate for injections and trusted Dr. Picard. In addition to injecting her 
head neck and upper back, he injected her pectoralis muscle on both sides and felt each side of both breasts 
as he had been doing for months when administering injections. 
 
Patient D 
 
Patient D was referred to Dr. Picard in 2015 for Cyclic Vomiting Syndrome and migraine headaches. Due 
to her work schedule, she attended appointments at the end of the day after staff had left. At her 
appointments, Dr. Picard requested that she undress completely, except of her underpants. Initially, she 
received injections in her head, neck and shoulders, and then progressed down her back, including her 
buttocks and hips. Following each injection, Dr. Picard massaged the area, including her back, shoulders, 
buttocks and hips for about an hour, stating that this was necessary to make the medication more effective. 
College expert opined that that there was no clinical indication for this type of extensive touching and 
massaging. When, at times, Patient D cried, Dr Picard hugged her and told her she was very sensitive. 
Once, he complimented her and told her she was pretty.  
 
Initially, Patient D saw Dr. Picard once every two months, but later, upon his request, the appointments 
increased to every three weeks or so. At an appointment in summer 2016, when patient D complained of 
abdominal pain and cramps, Dr. Picard offered to inject her in the pubic and groin areas explaining that he 
does that for many patients. She agreed as she trusted him. As Dr. Picard administered injections, he laid 
his hand on her groin area, while she was standing, dressed only in her bra.  
 
At a subsequent appointment, after giving her numerous injections and massaging her head, neck back and 
buttocks, Dr. Picard advised that she needed more massages. As patient D stood dressed only in her bra, 
Dr. Picard stood behind her, placed his hands on her back and began to identify and name various muscle 
groups. He reached his arm around her and grabbed her breast, stating it was pectoralis muscle. She quickly 
collected her belongings and left.  
 
Patient E 
 
Patient E was referred to Dr. Picard following an accident to address complaints of back pain. At initial 
appointment, Dr. Picard ordered tests, prescribed lidocaine cream and other medications, and gave her 
lidocaine injections, mostly in the neck, to relieve pain. Initially, she was not required to disrobe, the 
appointments seemed comfortable. In the summer 2014, Dr. Picard recommended a massage treatment. 
Patient E arrived for her massage appointment at the end of the day when the nurse was leaving for the day. 
She removed her top, but there was no gown or blanket. When Dr. Picard asked if she wants lights “on” or 
“off”, she replied “off”. Dr. Picard started touching her back. It seemed to her that he was excited sexually. 
He asked her to roll over, touched her brachial plex and her affected arm, and grazed her breast. He asked 
if it was okay and she replied it was. He touched her breasts sexually, put his lips close to hers telling her to 
pretend they were kissing and moved his hand to her groin area. He went to put his hands down her pants. 
She stopped him telling him “I think that is enough” and that she did not want things “to get messy”.  She 
got dressed, they chatted briefly and she left. Shortly thereafter, Dr. Picard called her from a private 
number telling her he enjoyed the appointment and that he wanted to see her again. Patient E told her 
relative and considered reporting him, but thought the sexual aspect of their relationship maybe beneficial 
for her treatment, although she understood it was perverse.  
 
At their next appointment, Dr. Picard brought her beer and became sexual right away: kissing touching, 
oral sex and then intercourse. In August 2014, Dr. Picard picked up Patient E from home, took her to a 
hotel where he booked a room, and they had sexual intercourse. Thereafter, Dr. Picard went to Patient E’s 
house almost daily, they had sexual intercourse; he sometimes provided her with lidocaine injections in her 
home and she attended his office to receive treatment and have sexual intercourse. He also gave her 
cosmetic Botox injection, once at his office and once in her home.  
 
Although Dr. Picard had a girlfriend, he and Patient E continued to become very involved. He told her that 
their relationship had to be secret as it was prohibited by the College. When he was investigated by police 
because of a patient complaint, he told Patient E that he was going to discharge her from his care to protect 
their relationship and would see her only in her house. She was concerned that she would lose him as a 
doctor, but he told her he would continue to treat her and thereafter administered injections to her on a 
regular basis at her home, brought her medications, and provided her with prescriptions. He would also 
bring alcohol to Patient E, offered her money, and a job at his office. When she could not attend the office 
daily due to her pain, he brought a computer to her house so she could work for him from home. He visited 
frequently and they would have sexual intercourse. She also worked for him a couple hours a week at his 
clinic at a hospital.  
 
In early 2016, Dr. Picard went on vacation with his girlfriend whom he eventually married. Patient E’s 
relationship with Dr. Picard became strained and their sexual relationship ended.  
 
Patient F 
 
Patient F was referred to Dr. Picard in 2012 for symptoms suggestive of multiple sclerosis. Dr. Picard later 
confirmed the diagnosis and started Patient F on treatment. She complained of visual disturbances, 
headaches, neck and back pain. Dr. Picard offered lidociane injections and discussed steroids for the pain. 
Patient F was not interested in steroids treatment. Her visits with Dr. Picard included injections in her head, 
neck and back. She believed this helped to control pain and became very trusting of Dr. Picard as he 
supported her pursuit of alternative treatment and did not pressure her into steroid treatments.  
 
In 2015, while under stress from separating from her spouse, Patient F experienced difficulty with balance 
and “foot drop”. Dr. Picard was aware of the circumstances and their relationship began to change. He 
complimented her, told her she was a pretty woman and that he liked her tattoos. Dr. Picard recommended 
injections in her lower back and legs, and later to her buttocks. Dr. Picard followed all injections with a 
lengthy massage, telling Patient F that it was to allow medication reach the nerve and work the lidocaine 
through. He asked her to come more frequently and she obliged as she trusted him and felt comfortable 
with him.  
 
On one occasion, Dr. Picard told her that her pelvic area was too tight and this was causing spasms in her 
legs and the “foot drop” to increase. He told her that she would benefit from injections in her groin area. 
Patient F agreed. Dr. Picard began massaging her vulvar area, sliding her underwear over to the side, fully 
exposing her vagina, and placing his fingers at the opening of her vagina, bumping his fingers up against 
her clitoris. He requested that she attend every two weeks. On multiple appointments, he massaged Patient 
F’s vulva in a sexual manner. She would close her eyes and wait for it to be over.  
 
Patient F told her friend about her treatment as she thought it was weird. The friend was shocked, but 
Patient F assured her that it was part of the treatment as she trusted Dr. Picard. She was uncomfortable with 
what was occurring and decided to stop attending.  
 
Patient G 
 
Patient G was referred to Dr. Picard in 2013 for seizure disorder. She was a victim of domestic assault and 
had sustained multiple injuries. Dr. Picard prescribed medication for seizures, administered Botox, and 
administered lidocaine injections for headaches. He often complimented her, her outfit and hair.   
 
At an appointment in the summer 2016, Patient G wore shorts. Dr. Picard was injecting in her lower back 
and hip. Patient G was lying on the examination table. He pulled her shorts on one side along with her 
underwear, exposing her vagina, administered the injections and then placed his hand directly on top of her 
vagina over her shorts asking her if she was “okay here”. She pushed his hand away.  
 
Patient G returned to Dr. Picard as she trusted him and need the injections. At the next appointment, she 
wore a bathing suit as it was tighter; she hoped to avoid exposure. While lying on her stomach, Dr. Picard 
moved his fingers along her groin toward her vaginal are, massaging and pushing. He touched on the 
outside of her labia. He placed his entire hand from patient G’s buttocks to her vaginal area and cupped it. 
There was no clinical basis for this.  
 
Patient H 
 
Patient H was referred to Dr. Picard in 2013 due to headaches, light sensitivity, aggravation of pre-existing 
cervical and lumbar spine problems, bilateral trapezi, bilateral shoulder strains, and driving anxiety.   
 
On one occasion Dr. Picard offered Patient H free cosmetic Botox injections, stating that somebody had 
cancelled and he had an open vial. Dr. Picard administered lidocaine injection in perineal and groin area 
while she lay on her stomach with her knees turned outwards. He would then rub her inner thigh and the 
groin area under her buttocks.  
 
At one appointment which was scheduled in the late afternoon, Patient H brought her family member with 
her as she felt uncomfortable. At onother visit, Dr. Picard offered Patient H his private cell phone and told 
her that he could provide injections in her home if she was in a lot of pain.  
 
In early 2015, patient H attended Dr. Picard’s office for injections in the morning and they discussed 
having a second set of injections in the afternoon as the next day the office would be closed for the 
weekend. Later that day, Dr. Picard telephoned Patient H from his personal cell phone and asked her to 
return for injections at the end of the day. When she attended his office, no staff was present. She took off 
her sweater and pants and Dr. Picard asked her to remove her top, which she always had on in her earlier 
appointments. While lying on her stomach, Dr. Picard injected her in buttocks and began tapping her 
vagina through her underwear. He told her she had perfect skin and anatomy and that she must be tired of 
hearing how beautiful she is. He then asked her to roll over and injected her groin area. While lying on her 
back, Dr. Picard then began massaging her vulva area, telling her that he had to massage the medication 
deep into the nerve. He moved her panties over and massaged her vaginal area including her genitalia in a 
sexual manner. He removed her underwear. He told her “you’re supple now”. He told her that her pelvic 
floor was tight and offered injections or massage. He inserted his fingers into her vagina and stimulated her 
sexually. She was shocked and stated “if you keep this up, I will have an orgasm”. Dr. Picard replied 
“would you like one?” She said “we are done here.” Patient H told Dr. Picard that she had to process what 
was happening and whether he would be writing this in his report to her family physician. He replied he 
could get into a lot of trouble and asked that she keep it a secret. He asked her to return for the following 
appointment. Patient H was in shock. She did not attend the following appointments and immediately 
reported what occurred to her lawyer, her family doctor, her chiropractor, and the police.  
 
When interviewed by the police, Dr. Picard denied the allegations and asserted that double injections were 
clinically indicated. College expert opined that Dr. Picard failed to maintain the standard of practice in his 
treatment of Patient H, noting that there was no clinical indication for a second set of injections in the same 
day, that this is highly unusual, and the manner in which the femoral and sciatic nerve blocks were 
performed is not the standard of practice.  
 
Patient I  
 
Patient I was referred to Dr. Picard in 2014 for pain and intermittent numbness in her arms/hands. She had 
no complaints at any time about pain in her lower back, her buttocks or her pelvis. At the outset, Patient I 
disclosed to Dr. Picard that her family member had a neurological disorder. Dr. Picard disclosed personal 
information to Patient I about his family’s medical history. At a subsequent appointment, after Patient I 
advised the nurse of her marriage separation and the nurse recorded it in her record, Dr. Picard commented 
on her marriage breakdown at the beginning of the appointment.  
 
At another appointment in 2015, Dr. Picard started touching Patient I’s back, commented that she was very 
tight and urged her to let him administer injections along her back. She was resistant, but trusted him. Dr. 
Picard injected her back, and then asked her to pull up her dress. He told her that she was very muscular, 
that she has great muscle tone, good skin and is very hydrated. He asked her to touch her stomach, and told 
her she had a gorgeous body. He asked if she had breast augmentation and if he could touch her breasts, 
explaining that some women with implants lose sensation and that he needed to check for sensitivity in her 
nipples. He massaged her nipples, remarked that they were very sensitive and that he had never seen 
anything so beautiful. He then injected Patient I in her legs, asked her to turn over and started to feel the 
front part of her legs, moved to her pelvic area and proceeded to inject her in the pelvic area telling her that 
she was very tight. Following the injections, Dr. Picard massaged her legs and pelvic regions, while there 
was no clinical indication for this touching. He moved to massage her inner thighs, moved his hands to the 
vulva area, digitally penetrated her vagina, stimulated her clitoris and brought her to orgasm. Although she 
was confused, she believed this was part of the treatment. She noticed that he was sweating profusely.   
 
After Patient I’s initial appointment with Dr. Picard, he sent her text messages frequently, asking how she 
was feeling and if she needed an appointment. In the latter part of 2015, Dr. Picard told Patient I that he 
was having trouble in his relationship with his girlfriend, with whom he just moved in, and that they were 
on the verge of breaking up. Dr. Picard told her he wanted to remove her as his patient because he was 
interested in her. She replied that she needed him as his doctor and he assured her that he would continue to 
take care of everything she needed and agreed to continue to treat her. In October 2015, Dr. Picard 
recorded in Patient I’s medical record that she remained symptom free and did not feel the need for more 
injections. Around that time, Patient I agreed to meet Dr. Picard at a hotel and he performed oral sex on 
her. They subsequently had intercourse at her home and in his car in a school parking lot.  
 
After October 2015, Dr. Picard treated Patient I in her home on at least two occasions. After their dating 
relationship ended, he administered lidocaine injections to her at her house on two occasions and told her 
that she was beautiful and that he missed her skin and breasts. He also left several pre-filled syringes 
containing lidocaine in her home. On one occasion, Patient I attended his office for injections and they had 
sexual intercourse, while no one was present in the office. In June 2016, he ordered EMG for Patient I.  
 
Throughout their relationship Dr. Picard engaged in numerous boundary violations with Patient I, 
including: giving her gifts; loaning her money; engaging her in a business arrangement throwing Botox 
parties at her house, when he would administer Botox  to her clients and share his profit with her; and 
offering Patient I a job at his office.  
 
Patient J  
 
Patient J was referred to Dr. Picard in 2014 for acute headache and treatment of trigeminal neuralgia. Dr. 
Picard provided Botox treatment and resumed treating her in 2016.  
 
At her last appointment, Patient J complained of pain in the nerve underneath her legs to her vagina, and 
painful intercourse. Dr. Picard administered an injection and began touching her vaginal area near her 
buttocks. He put his hands on her vagina an applied pressure when he injected her. He asked her if she was 
feeling better. She replied she would know if the treatment worked when she had a relationship with 
someone and had sexual intercourse. Dr. Picard touched her vagina again and asked her if she was ok. She 
replied she was uncomfortable. When he asked if she wanted him to stop, she advised him to do what he 
had to do. She felt he was teasing her, that touching was no longer medical and that he was seeking to 
arouse her. Dr. Picard asked her to sit up and massaged her shoulders for about 10 minutes. He told her that 
he liked her, that he should not have done what he had done, and that it was her fault because she was sexy, 
and gave her numerous compliments. He positioned his face close to hers and she kissed him. He returned 
the kiss. After this visit, Dr. Picard and Patient J engaged in sexual intercourse in his office.  
 
Shortly thereafter, Dr. Picard told Patient J that they could not have a relationship as she was his patient, 
and asked her to delete her phone messages. He then provided injections in her house. After some time, 
Patient J came to his office as she required an MRI and a referral. Dr. Picard continued to treat Patient J in 
her home. He also employed her in his home to clean and paint. He left syringes containing lidocaine at her 
home so she could self-inject, gave her original instructions, and told her to not use more than.5cc at each 
injection.  
 
Criminal Conviction: Sexual Assault of Two Patients  
 
Between November 30, 2016 and February 27, 2017, Dr. Picard was criminally charged with 12 counts of 
sexual assault in respect of Patients A, B, C, D, F, G, H and I. On August 23, 2018, he pleaded guilty and 
was convicted of two counts of sexual assault in respect of Patients H and I. The remaining charges were 
withdrawn. On September 14, 2018, Dr. Picard was sentenced to 18-month imprisonment, followed by 
three-year probation. He was also ordered to comply with the Sex Offender Information Registration Act, 
provide a sample of his DNA, and have no contact with any of the victims named in the proceeding.  
 
Undertakings with the College  
 
In September 2016, during investigation, Dr. Picard entered into a voluntary undertaking with the College 
not to engage in professional encounters with female patients of any age, unless the patient encounter takes 
place in the presence of a female monitor who is a regulated health professional acceptable to the College. 
In March 2017, Dr. Picard entered into a voluntary undertaking with the College not to engage in any 
professional encounter with any female patients of any age, in any jurisdiction.  
 
 
Failure to Maintain the Standard, Incompetence, Failure to Cooperate and Failure to Comply with 
OHP Regulations 
 
Out of Hospital Premises Inspection Program (OHP program) is a College program that applies to all 
settings or premises outside a hospital that perform procedures involving the use of anesthesia or sedation. 
According to the program’s mandatory standards, all Level 2 nerve blocks used in interventional pain 
management can only be performed in out-of-hospital premises (OHP) or a hospital. The OHP program is 
based on trust and relies on self-reporting from Medical Directors, who are required to notify the program 
before opening an OHP so that the premises can be inspected to ensure safety and quality of care. Any 
member planning to operate a premise as an OHP must notify the College and the premises must be 
inspected and receive “pass” or “pass with conditions” from the Premises Inspection Committee (PIC) 
prior to providing OHP services to patients.  
 
On the basis of information obtained in the investigation of the sex abuse allegations detailed above, the 
College learned that Dr. Picard was providing interventional pain treatments to patients, including Level 2 
nerve blocks, while working in a premise that was not an approved OHP. On October 26, 2016, PIC 
directed an unannounced visit of Dr. Picard’s facility, which took place on October 27, 2016, and a report 
was prepared. The Report was considered by PIC on October 31, 2016. The premises received a “Fail”.  
Dr. Picard was not permitted to provide OHP procedures, including nerve blocks.  PIC stated that it was 
concerned that there was a risk to patient health and safety as Dr. Picard had been performing OHP 
procedures without following the proper notification process and adherence to requirements outlined in the 
OHP Program Standards. The Committee was of the opinion that Dr. Picard failed to comply with the 
requirements under Part XI of the Regulation. 
 
College Investigation re Standard of Practice and Incompetence  
  
In the course of College investigation, the College expert, an anesthesiologist, reviewed 25 charts from Dr. 
Picard’s practice in which he billed for performing Level 2 nerve blocks between June 2010 and November 
2016. The expert opined that: 
 
-  Dr. Picard failed to meet the standard of practice in 23 out of 25 charts reviewed, lacked knowledge, 
   skill and judgment and exposed patients to risk of harm or injury; 
-  Dr. Picard failed to explain changes in management over time, including performance of additional 
   nerve blocks or the adjustment of pharmacotherapy, including narcotics; 
-  He performed major nerve blocks such as femoral, sciatic pudendal, transverse scapular and 
   trigeminal, in an office setting without monitoring or assistance of emergency preparedness. Notably, 
   there was no explanation or rationale for initiating treatments in the chart. For example, there were 
   many patients that were seen for headaches for whom he performed femoral or sciatic injections 
   without any justification.   
 
The expert also opined that Dr. Picard displayed a significant lack of knowledge and judgment in his 
interventional pain and pharmacotherapeutic practice, including: 
 
-  Dr.  Picard did not thoroughly document patient assessments using the subjective, objective, 
   assessment, plan format in the majority of patient appointments reviewed. 
-  Dr. Picard did not respond appropriately and specifically to consultation questions. 
-  Dr. Picard did not implement recommendations from the Canadian Guideline for Safe and Effective 
   use of Opioids in Chronic Noncancer Pain when prescribing opioids to patients (no opioid contract, 
   no urine drug screens, no counselling re: driving, no risk assessment, no assessment of trial of 
   therapy, no low dose trial with concomitant benzodiazepines, no consideration in special populations 
   (e.g. opioid use disorder, peri-partum).  
-  Dr. Picard greatly increased opioids, benzodiazepines and anti-convulsants simultaneously in a 
   patient referred with a gait disorder and history of syncope, falls and substance dependence.  
-  Dr. Picard inappropriately prescribed fentanyl patch 75 mcg on a daily basis to a patient that had at 
   least two (2) presentations to the emergency department/hospital for respiratory depression, 
   decreased/altered level of consciousness. 
-  Dr. Picard prescribed opioids without appropriate assessment or structured opioid therapy in a new 
   mother at high risk for opioid use disorder.  
-  Dr. Picard did not thoroughly document the procedures being performed; including: consent, 
   technique/approach, needle, type and volume of local anesthetic, aseptic technique, complications, 
   recovery and monitoring.  
-  Dr. Picard performed major nerve blocks in an office setting (non-OHP approved facility) without 
   evidence of appropriate monitoring, assistance or emergency preparedness.  
-  Dr. Picard performed nerve block injections without performing an assessment (history, physical 
   exam, investigations, differential diagnosis).  
-  Dr. Picard did not perform interventional nerve blocks using standard procedures described in regional 
   anesthesia or chronic pain textbooks. 
-  There is no supporting documentation that Dr. Picard performed interventional blocks using sterile 
   techniques.  
 
The expert concluded that: 
 
-  Dr. Picard's clinical practice exposed his patients and society to a potential risk of serious harm; 
-  Dr. Picard’s injection practice was unsafe and was likely to expose his patient's to harm or injury as 
   major nerve blocks have significant complications including: nerve injury, weakness/falls, local 
   anesthetic toxicity (cardiac and respiratory arrest), and infection; and 
-  Dr. Picard's opioid prescribing was likely to expose his patients’ and society to harm by not mitigating 
   the risks associated with opioid medications (substance dependence, drug diversion, respiratory arrest, 
   altered level of consciousness). 
 
Disposition 
 
On October 9, 2018, the Discipline Committee ordered that:  
 
 - the Registrar revoke Dr. Picard’s certificate of registration effective immediately 
 - Dr. Picard appear before the panel to be reprimanded 
 - Dr. Picard reimburse the College for funding provided to patients 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 $160,600.00 
 - Dr. Picard pay to the College its costs of this proceeding in the amount of $10,180.00 within thirty (30) 
  days from the date of this Order.

Hearing Date(s): October 9, 2018

Concerns

Source: Other
Active Date: September 28, 2018
Expiry Date:
Summary:
Criminal Finding(s)

If, on or after June 1, 2015, a member is found guilty under the Criminal Code of Canada or the Ontario Health Insurance Act, the College By-laws require certain information about the finding of guilt to be posted on the register if the information is known to the College.

The following are findings of guilt made against this member on or after June 1, 2015, as known to the College, together with the corresponding information:

On August 23, 2018, Pierre Picard was found guilty of two counts of sexual assault contrary to section 271 of the Criminal Code of Canada.

On September 14, 2018, Pierre Picard was sentenced to 18 months in prison, followed by 3 years’ probation, a victim surcharge of $400, a lifetime order under the Sex Offender Information Registration Act and is prohibited from owning or possessing a weapon for 10 years and life (depending on the category). The probation order includes a condition that Pierre Picard not provide any health care services to any female under any circumstances.


Source: Member
Active Date: March 27, 2017
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Pierre Picard to the College of Physicians and Surgeons of Ontario, effective March 27, 2017:

Dr. Picard is the subject of College investigations regarding his conduct. Dr. Picard has voluntarily undertaken:

Dr. Picard has agreed not to engage in any professional encounter with any female patients of any age, in any jurisdiction.

Dr. Picard shall post a sign in the waiting room(s) and in each examination room and consulting room, in all Practice Locations, in a clearly visible and secure location, that states: “Dr. Picard has agreed not to see female patients or have any professional encounter with any female patient. Further information may be found on the College website at www.cpso.on.ca”.