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 rea. 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 andhad 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.