Roy, William Andrew (CPSO#: 23704)

Current Status: Suspended as of 15 Oct 2018

CPSO Registration Class: Restricted as of 08 Jun 2017

Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education:University of Toronto, 1970

Practice Information

Primary Location of Practice
Practice Address Not Available

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 01 Jul 1970
Transfer of class of registration to: Independent Practice Certificate Effective: 30 Jun 1971
Transfer of class of certificate to: Restricted certificate Effective: 08 Jun 2017
Terms and conditions imposed on certificate by member Effective: 08 Jun 2017
Terms and conditions amended by member Effective: 19 Sep 2017
Terms and conditions amended by member Effective: 27 Oct 2017
Terms and conditions amended by member Effective: 03 Mar 2018
Terms and conditions amended by member Effective: 09 Mar 2018
Terms and conditions amended by member Effective: 17 Sep 2018
Terms and conditions amended by Discipline Committee Effective: 27 Sep 2018
Suspension of registration imposed: Discipline Committee Effective: 15 Oct 2018

Practice Restrictions

Registration Status: Suspended     Effective From: 15 Oct 2018


Imposed By Effective Date Expiry Date Status
Discipline Committee Effective: 15 Oct 2018 Active

Previous Hearings

Committee: Discipline
Decision Date: 27 Sep 2018
Summary:

On September 27, 2018, the Discipline Committee found that Dr. William Andrew Roy 
committed an act of professional misconduct, 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. 
 
Dr. Roy is a General Practitioner, practising in Toronto. He obtained his Independent Practice 
Certificate in 1971. 
 
The College received information from the Narcotics Monitoring System (NMS) identifying Dr. 
Roy as having prescribed, in 2015, eight or more patients at least 650 oral morphine equivalents 
(OMEs) per day and issued at least one prescription exceeding 20,000 OMEs. This prescribing 
exceeds the recommended watchful dose of 200 OMEs per day as set out in The Canadian 
Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain (v 5.6, April 30, 
2010). In total, 19 patients were flagged by the NMS. 
     
The College retained an expert, a family physician certified by the College of Family Physicians 
of Canada, to review this matter. The expert concluded that Dr. Roy failed to meet the standard of 
practice of the profession in 13 of the 20 charts reviewed and noted that: 
 
- the main areas of concern are his prescriptions for very high doses of opioids, often in 
  combination with high doses of benzodiazepines, poor record keeping with respect to opioid 
  prescribing, and lack of monitoring of patients with prescriptions for high doses of opioids. 
- Dr. Roy displayed a lack of knowledge in 2 charts as evident in situations where he indicated 
  that he prescribed two different long-acting opioids as one did not appear to be effective, and 
  where a patient was currently using intravenous street drugs, but he felt that the patient would 
  still require prescription opioids for his pain. 
- Dr. Roy displayed a lack of skill in 5 charts as evident by his management of patients who 
  demonstrated inappropriate behaviour or features of misuse. 
- Dr. Roy displayed a lack of judgment in 10 of the charts reviewed, which was evident in the 
  management of patients who were prescribed high doses of opioids and benzodiazepines 
  without adequate monitoring for safety and effectiveness. 
          
The expert concluded that in 7 of the 20 charts reviewed, Dr. Roy exposed patients to a potential 
risk of harm due to the extremely high doses of opioids that were prescribed in combination with 
high doses of benzodiazepines and by not monitoring the patients closely enough to ensure that 
they were taking the medications safely. 
 
Disgraceful Dishonourable or Unprofessional Conduct 
 
As a resolution, Dr. Roy entered into an undertaking with the College in June of 2017, requiring, 
among other things, that Dr. Roy practise under the guidance of a clinical supervisor acceptable to 
the College. If unable to obtain a clinical supervisor, Dr. Roy is required to cease to prescribe 
narcotic drugs, narcotic preparations, controlled drugs, benzodiazepines and other targeted 
substances, and all other monitored drugs. 
     
Dr. Roy obtained a clinical supervisor on July 19, 2017. However, on August 29, 2017, due to a 
potential conflict of interest, Dr. Roy was notified that this clinical supervisor was no longer 
suitable. Dr. Roy was provided with fourteen days to obtain a new clinical supervisor. 
     
Dr. Roy did not propose a suitable supervisor within the time limit set out in the undertaking. He 
was reminded on September 12, 2017, that, in accordance with the terms of the undertaking, he 
would have to cease prescribing by the end of the day, unless a supervisor was proposed and 
approved. Following a request by Dr. Roy’s counsel, an extension was provided until September 
15, 2017. 
     
Dr. Roy was unable to find a suitable clinical supervisor by the extended deadline. In accordance 
with the terms of the undertaking, and the terms, conditions and limitations on his certificate of 
registration effective September 19, 2017, Dr. Roy was required to cease prescribing narcotic 
drugs, narcotic preparations, controlled drugs, benzodiazepines and other targeted substances, and 
all other monitored drugs until such time as he has obtained a clinical supervisor acceptable to the 
College. This restriction appeared on the public register. 
     
On October 13, 2017, another clinical supervisor was approved. On October 18, 2017, the clinical 
supervisor wrote to the College, noting that Dr. Roy had stated in their initial meeting earlier that 
day that he had continued to prescribe controlled substances during the period of time when he did 
not have a supervisor. 
 
College Compliance Case Managers selected 13 patient names from Dr. Roy's prescribing log and 
obtained copies of the prescriptions and physician's notes from the corresponding charts. NMS 
data was obtained with respect to the 13 patients, which demonstrates that Dr. Roy continued to 
prescribe monitored drugs between the period of September 19, 2017 and October 18, 2017. 
 
Disposition 
 
On September 27, 2018, the Discipline Committee ordered and directed that: 
 
-  the Registrar suspend Dr. Roy’s certificate of registration for a period of three (3) months, 
   commencing October 15, 2018.  
-  Dr. Roy participate in and successfully complete one-on-one individualized educational 
   instruction in ethics with an instructor approved by the College, and provide proof thereof to 
   the College within six (6) months of the date of this Order. 
-  Dr. Roy appear before the panel to be reprimanded.  
-  Dr. Roy pay to the College its costs of this proceeding in the amount of $10,180 within thirty 
   (30) days from the date of this Order.

Hearing Date(s): September 27, 2018

Concerns

Source: Member
Active Date: September 17, 2018
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. William Andrew Roy to the College of Physicians and Surgeons of Ontario, effective September 17, 2018:

Dr. Roy has agreed not to issue new prescriptions or renew existing prescriptions for or administer any of the following substances:

(i) Narcotic Drugs (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
(ii) Narcotic Preparations (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
(iii) Controlled Drugs (from Part G of the Food and Drug Regulations under the Food and Drugs Act, S.C., 1985, c. F-27);
(iv) Benzodiazepines and Other Targeted Substances (from the Benzodiazepines and Other Targeted Substances Regulations made under the Controlled Drugs and Substances Act., S.C., 1996, c. 19);
(v) All other Monitored Drugs (as defined under the Narcotics Safety and Awareness Act, 2010, S.O. 2010, c. 22);
and as amended from time to time.

Dr. Roy must post a clearly visible sign in the waiting rooms and each examination and consulting room, in all Practice Locations, which states as follows:

IMPORTANT NOTICE
Dr. Roy has agreed not to prescribe or administer any of the following:

Narcotic Drugs
Narcotic Preparations
Controlled Drugs
Benzodiazepines and Other Targeted Substances
All other Monitored Drugs

Further information may be found on the College of Physicians and Surgeons of Ontario website at www.cpso.on.ca


Source: ICR Committee
Active Date: July 5, 2017
Expiry Date:
Summary:
Caution-in-Person:

A summary of a decision of the Inquiries, Complaints and Reports Committee in which the disposition includes a "caution-in-person" is required by the College by-laws to be posted on the register, along with a note if the decision has been appealed. A “caution-in-person” disposition requires the physician to attend at the College and be verbally cautioned by a panel of the Committee. 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 caution-in-person.
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