Ursell, Melanie Rose Marie (CPSO#: 71356)

Current Status: Active Member as of 01 Jul 1997

CPSO Registration Class: Restricted as of 18 Dec 2017

Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Female

Languages Spoken: English

Education:University of Toronto, 1997

Practice Information

Primary Location of Practice
unit 10
345 Ecclestone Drive
Bracebridge ON  P1L 1R1
Phone: 705-640-0050
Fax: 750-640-0050
Electoral District: 05

Specialties

Specialty Issued On Type
Neurology Effective: 13 May 2003 RCPSC Specialist

Postgraduate Training

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

University of Toronto, 01 Jul 1997 to 30 Jun 1998
PostGrad Yr 1 - Neurology

University of Toronto, 01 Jul 1998 to 30 Jun 1999
PostGrad Yr 2 - Neurology

University of Toronto, 01 Jul 1999 to 30 Jun 2000
PostGrad Yr 3 - Neurology

University of Toronto, 01 Jul 2000 to 30 Jun 2001
PostGrad Yr 4 - Neurology

University of Toronto, 01 Jul 2001 to 30 Jun 2002
PostGrad Yr 5 - Neurology

University of Toronto, 01 Jul 2002 to 30 Sep 2002
PostGrad Yr 5 - Neurology

University of Toronto, 01 Oct 2002 to 30 Jun 2003
Clinical Fellow - Neurology

University of Toronto, 01 Jul 2003 to 30 Jun 2004
Clinical Fellow - Neurology

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 01 Jul 1997
Transfer of class of registration to: Independent Practice Certificate Effective: 24 Jun 2004
Transfer of class of certificate to: Restricted certificate Effective: 18 Dec 2017
Terms and conditions amended by Fitness to Practise Committee Effective: 05 Feb 2018

Practice Restrictions

Imposed By Effective Date Expiry Date Status  
Fitness to Practise Committee Effective: 05 Feb 2018 Active View Details [+]
            As from 11:59 p.m., December 18, 2017 by order of the Fitness to Practice
            Committee, the following terms, conditions and limitations are imposed on the
            certificate of registration held by Dr. Melanie Rose Marie Ursell:

            (1)   Addictions Medicine Physician

                  (a)   Dr. Ursell shall engage in a treating and monitoring relationship
                        with a physician with expertise in addiction medicine approved by
                        the College  who will sign an undertaking in the form attached
                        hereto as Schedule "A" (the "Addictions Medicine Physician").
                  
                  (b)   Dr. Ursell shall have an initial appointment with her Addictions
                        Medicine Physician at the outset of the treating and monitoring
                        relationship at which Dr. Ursell will undergo an evaluation and
                        assessment concerning her sedative, hypnotic, and anxiolytic
                        dependence disorder by her Addictions Medicine Physician.
                  
                  (c)   Dr. Ursell's Addictions Medicine Physician will have available to
                        him or her all relevant information in the College's possession,
                        including reports prepared during the course of the Fitness to
                        Practice matter.
                  
                  (d)   After her initial appointment with her Addictions Medicine
                        Physician, Dr. Ursell  shall maintain face to face contact with her
                        Addictions Medicine Physician at least once every two (2) weeks for
                        a minimum of two (2) months, or such additional period of time as
                        her Addictions Medicine Physician determines is necessary.  She
                        will agree to increase the frequency of contact if requested by her
                        Addictions Medicine Physician.
                  
                  (e)   After the first two (2) months of this Order, the frequency of Dr.
                        Ursell's appointments with her Addictions Medicine Physician will
                        be reviewed by her Addictions Medicine Physician, and may be
                        decreased with the approval of her Addictions Medicine Physician
                        and the College.
                  
                  (f)   The frequency of Dr. Ursell's appointments with her Addictions
                        Medicine Physician will never be less than once per month.
                  
                  (g)   The Addictions Medicine Physician will submit a written report to
                        the College after the initial appointment with Dr. Ursell, and will
                        submit written reports to the College on a quarterly basis
                        thereafter, or immediately if the Addictions Medicine Physician
                        believes that the symptoms of Dr. Ursell's illness have become
                        disabling, that Dr. Ursell may be at risk of harm or injury, that
                        Dr .Ursell is exposing or is likely to expose her patients to harm
                        or injury, or that Dr. Ursell is not in compliance with this Order.
                  
                  (h)   Dr. Ursell will comply with all treatment recommendations of her
                        Addictions Medicine Physician.
                  
                  (i)   Dr. Ursell's Addictions Medicine Physician may terminate his or her
                        undertaking on the basis of Dr. Ursell's chronic or repeated
                        noncompliance.
                  
                  (j)   In instances where a report is made to the College related to Dr.
                        Ursell's non-compliance with this Order, all documentation
                        contained in her Addictions Medicine Physician's file relating to
                        the compliance issue may be made available to the College upon
                        request.
                  
            (2)   Primary Care Physician

                  (a)   Dr. Ursell will attend regular appointments with a family physician
                        approved by the College, who will sign an undertaking in the form
                        attached hereto as Schedule "B" ("Primary Care Physician").
                  
                  (b)   After an initial appointment with her Primary Care Physician, the
                        frequency of Dr. Ursell's appointments with her Primary Care
                        Physician will be reviewed and determined by her Primary Care
                        Physician, with the approval of the College.  Dr. Ursell will
                        increase the frequency of contact if requested by her Primary Care
                        Physician.
                  
                  (c)   The frequency of Dr. Ursell's appointments with her Primary Care
                        Physician will never be less than twice per year.
                  
                  (d)   The Primary Care Physician will submit a written report to the
                        College after the initial appointment with Dr. Ursell, and will
                        submit written reports to the College on a twice per year
                        thereafter, or immediately if the Primary Care Physician believes
                        that the symptoms of Dr. Ursell's illness have become disabling,
                        that Dr. Ursell may be at risk of harm or injury, that Dr. Ursell
                        is exposing or is likely to expose her patients to harm or injury,
                        or that Dr. Ursell is not in compliance with this Order.
                  
                  (e)   Dr. Ursell will comply with all treatment recommendations of her
                        Primary Care Physician.
                  
                  (f)   Dr. Ursell's Primary Care Physician may terminate his or her
                        undertaking on the basis of Dr. Ursell's chronic or repeated
                        noncompliance
                  
            (3)   Workplace Monitor

                  (a)   Dr. Ursell will engage Workplace Monitor(s) approved by the College
                        who will each sign an undertaking to the College in the form
                        attached hereto as Schedule "C" ("Workplace Monitor(s)").
                  (b)   The Workplace Monitors will assist in monitoring Dr. Ursell's
                        behaviour in the workplace, at each of her office locations.
                  
                  (c)   All Workplace Monitors will have knowledge that Dr. Ursell suffers
                        from a sedative, hypnotic, and anxiolytic dependence disorder and
                        will have regular contact with her in her work environment.
                  
                  (d)   The Workplace Monitor(s) will submit written reports to the College
                        once every three months as of the date they sign the undertaking to
                        the College in the form attached hereto as Schedule "C", or
                        immediately if the Primary Care Physician believes that the
                        symptoms of Dr. Ursell's illness have become disabling, that Dr.
                        Ursell may be at risk of harm or injury, that Dr. Ursell is
                        exposing or is likely to expose her patients to harm or injury, or
                        that Dr. Ursell is not in compliance with this Order.
                  
                  (e)   In addition to submitting written reports, all Workplace Monitors
                        will respond to oral and/or written inquiries from the College.
                  
            (4)   Therapist

                  (a)   Dr. Ursell will see any therapist suggested by her Addictions
                        Medicine Physician, her Primary Care Physician, or any other
                        treating clinician, on a frequency to be determined by that
                        therapist.
                  
                  (b)   Dr. Ursell's therapist will provide reports to her Addictions
                        Medicine Physician on a regular basis as stipulated by her
                        Addictions Medicine Physician, documenting Dr. Ursell's attendance
                        in therapy and commenting on her progress, or providing other
                        information the Therapist or Addictions Medicine Physician deems
                        relevant.
                  
            (5)   Independent Clinical Assessment

                  (a)   There may be circumstances or situations that arise wherein Dr.
                        Ursell's Addictions Medicine Physician determines that Dr. Ursell
                        would benefit from an independent clinical assessment.  Dr. Ursell
                        will undergo one or more independent clinical assessments if
                        requested to do so by her Addictions Medicine Physician.
                  
                  (b)   After Dr. Ursell undergoes any independent clinical assessment, an
                        independent clinical assessment report will be provided to Dr.
                        Ursell's Addictions Medicine Physician.  Such assessments may
                        necessitate revisions or amendments to this Order.
                  
            (6)   Mutual Help Groups

                  (a)   Dr. Ursell will attend a mutual help group such as an appropriate
                        12-step program, Rational Recovery, Women for Sobriety, Caduceus
                        Group, or any other program acceptable to her Addictions Medicine
                        Physician, on a regular basis throughout the term of this Order
                        ("Mutual Help Group").
                  
                  (b)   Dr. Ursell will attend a Mutual Help Group at least once per week
                        for at least the first three (3) months of this Order. 
                  
                  (c)   After the first three (3) months of this Order, the frequency of
                        Dr. Ursell's attendance will be reviewed by her Addictions Medicine
                        Physician, and may be decreased with the approval of her Addictions
                        Medicine Physician and the College.
                  
                  (d)   The frequency of Dr. Ursell's attendance at a Mutual Help Group
                        will never be less than once per month.
                  
            (7)   Alcohol and Other Substances of Abuse

                  (a)   Dr. Ursell will abstain completely from the consumption of alcohol
                        for the duration of this Order.  This includes, but is not limited
                        to, fermented fruit juices, non-alcoholic beer or wine and
                        medicinal or hygiene products that contain alcohol.
                  
                  (b)   Dr. Ursell will abstain completely from the use of any other
                        unauthorized substance of abuse on any occasion and in any form.
                        She will not consume any controlled drugs unless they are:
                  
                        (i)   legitimately prescribed for her by a practitioner who has
                              knowledge that she suffers from a sedative, hypnotic, and
                              anxiolytic dependence disorder; and
                        (ii)  specifically approved by her Addictions Medicine Physician.
                  
                  (c)   Dr. Ursell will not use over-the-counter ("OTC") preparations that
                        are mood altering, such as sedating antihistamines and
                        decongestants, without specific authorization from her Addictions
                        Medicine Physician.
                  
                  (d)   Dr. Ursell will not self-medicate with any preparation without
                        first consulting with, and obtaining the written approval of, her
                        Addictions Medicine Physician.
                  
                  (e)   If Dr. Ursell drinks alcohol or ingests any unauthorized controlled
                        drugs or substances of abuse whatsoever, she will immediately
                        notify her Addictions Medicine Physician and her Primary Care
                        Physician.  A relapse may be considered to be a breach of this
                        Order, and may result in an extension of the term of the Order.
                  
            (8)   Random Drug and Alcohol Screening

                  (f)   Dr. Ursell will participate in a random drug and alcohol screening
                        process as described in this Order.
                  
                  (g)   During the first year of this Order, random urinalyses will be
                        performed for a variety of drugs and alcohol at a rate of at least
                        thirty-six (36) tests per year.  Notification will take place
                        according to the discretion of Dr. Ursell's Addictions Medicine
                        Physician.
                  
                  (h)   After the first year of this Order, the frequency of random testing
                        may change during the course of this Order, depending on Dr.
                        Ursell's progress in recovery and as determined by her Addictions
                        Medicine Physician.
                  
                  (i)   Dr. Ursell will submit to blood or urine screening, or hair
                        analysis or breathalyzer at any time upon the request of her
                        Addictions Medicine Physician.
                  
                  (j)   Dr. Ursell will proceed to a collection site approved by her
                        Addictions Medicine Physician before closing time on the same day
                        of notification to provide a specimen.  Dr. Ursell will provide the
                        specimens utilizing a forensic protocol.  
                  
                  (k)   Failure to adhere to this alcohol and drug screening procedure will
                        be considered a missed test.  Missed test(s) that have not been
                        excused by Dr. Ursell's Addictions Medicine Physician will be
                        considered a breach of this Order.
                  
            (9)   Vacations

                  (a)   For the first three (3) months of this Order, Dr. Ursell will
                        submit to urine drug screening as requested by her Addictions
                        Medicine Physician without exception.
                  
                  (b)   After the first three (3) months of this Order, Dr. Ursell must
                        inform her Addictions Medicine Physician in writing in advance of
                        any circumstances that might cause her to miss a test.  If she is
                        planning a vacation or knows that she will otherwise not be
                        available for testing in the usual way, she will provide two (2)
                        weeks' prior notification to her Addictions Medicine Physician.
                        Dr. Ursell may be expected to make special arrangements to be
                        available for testing using alternative procedures during that time
                        and/or submit to a urine test according to the procedures normally
                        used in the implementation of this Order on the day she becomes
                        available once again.
                  
                  (c)   Frequent vacations, or vacations of greater than two (2) weeks, may
                        require extraordinary procedures in order to maintain the integrity
                        of this Order.  Any intent to be unavailable in such a manner must
                        be reviewed by Dr. Ursell's Addictions Medicine Physician in
                        advance for approval and for alternative monitoring planning, if
                        appropriate.
                  
            (10)  Positive Test Screens

                  (a)   Any positive urine, blood, hair, or breath screen shall be reported
                        to the College.
                  
                  (b)   A urine test is considered positive if an unauthorized
                        mood-altering substance is present in the specimen, or if the
                        sample is found to be adulterated, substituted or diluted.  
                  
                  (c)   It is Dr. Ursell's responsibility not to ingest any products that
                        may induce positive test results, including, but not limited to,
                        foods or hygienic products containing alcohol, "non-alcoholic" beer
                        or wine and products containing poppy seed (e.g. a bagel, muffins
                        or cakes).  Dr. Ursell will inform her Addictions Medicine
                        Physician immediately of prescriptions or over-the-counter
                        medications being consumed for legitimate medical purposes that may
                        result in a positive test prior to providing the sample(s)
                        described above.  Failure to do so may result in a positive test.
                  
                  (d)   Dr. Ursell will provide her Addictions Medicine Physician with
                        verification of all prescriptions that she receives.
                  
            (11)  Payment for Fees, Costs, Charges, Expenses

                  (a)   Dr. Ursell shall be solely responsible for payment of all fees,
                        costs, charges, expenses, etc. arising from the implementation of
                        any of the provisions of this Order, including but not limited to
                        the cost of any and all laboratory services required for the
                        implementation of this Order.
                  
            (12)  Breach of this Order

                  (a)   Any failure to abide by the terms and conditions of this Order
                        shall constitute a breach of the Order, and may lead to an inquiry
                        regarding her capacity to practise medicine, 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 and/or the Fitness to Practise Committee of the
                        College.
                  
            (13)  Consent

                  (b)   Dr. Ursell shall submit to and not interfere with unannounced
                        inspections by the College of her Practice Location(s) and to the
                        inspection of patient charts, her personnel file, or any other
                        records relevant to her practice of medicine and to the collection
                        of information (in person, orally and/or in writing) from staff
                        that the College deems necessary in order to monitor her compliance
                        with the terms of this Order.
                  
                  (c)   Dr. Ursell shall give her irrevocable consent to the College to
                        provide any information it deems necessary to any person,
                        organization or institution who requests or requires this
                        information for the purposes of facilitating or verifying her
                        compliance with this Order, the Addictions Medicine Physician's
                        compliance with the Addictions Medicine Physician's undertaking at
                        Schedule "A", the Primary Care Physician's compliance with the
                        Primary Care Physician's undertaking at Schedule "B", the Workplace
                        Monitor's compliance with the Workplace Monitor's undertaking at
                        Schedule "C", including but not limited to any information:
                  
                        
                  
                        (i)   relevant to this Order.
                  
                        (ii)  relevant to the Addictions Medicine Physician's undertaking
                              at Schedule "A";
                  
                        (iii) relevant to the Primary Care Physician's compliance with the
                              Primary Care Physician's undertaking at Schedule "B";
                  
                        (iv)  relevant to the Workplace Monitor's compliance with the
                              Workplace Monitor's undertaking at Schedule "C";
                  
                        (v)   relevant for the purposes of monitoring her compliance with
                              this Order; and/or  
                  
                        (vi)  which comes to his or her attention and which he or she
                              reasonably believes indicates a potential risk of harm to Dr.
                              Ursell's patients.
                  
                  (d)   This Order will be considered to have been breached if Dr. Ursell
                        revokes her consent to the release of any information or
                        communication between persons described herein.
                  
            (14)  Miscellaneous

                  (a)   Dr. Ursell shall ensure that Schedules "A", "B" and "C" to this
                        Order are signed and delivered to the College within thirty (30)
                        days of the date of this Order.
                  
                  (b)   If a person who has given an undertaking in Schedules "A"  "B" or
                        "C" to this Order is unable or unwilling to continue to fulfill its
                        provisions, Dr. Ursell 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.
                  
                  (c)   If Dr Ursell is unable to obtain any one or more of an Addictions
                        Medicine Physician, Primary Care Physician, or Workplace Monitor on
                        the terms set out above, she will cease practicing medicine until
                        such a time as she has obtained each of an Addictions Medicine
                        Physician, Primary Care Physician, and Workplace Monitor acceptable
                        to the College.
                  
                  (d)   If Dr. Ursell is required to cease practice in accordance with the
                        terms of this Order, this will constitute a term, condition or
                        limitation on her certificate of registration and said term,
                        condition or limitation will be included on the public register.
                  
                  (e)   The following summary shall be posted on the Public Register during
                        the time period that this Order remains in effect:
                  
            The Fitness to Practice Committee has found that Dr. Ursell is incapacitated,
            as defined in subsection 1(1) of the Health Professions Procedural Code, being
            Schedule 2 to the Regulated Health Professions Act, 1991, S.O. 1991, c. 18.

            As a result of that finding, the Committee has ordered that detailed terms,
            conditions and limitations be imposed on Dr. Ursell's certificate of
            registration for a minimum of five (5) years ("the Order"), which can be
            summarized as follows:

                  Dr. Ursell will engage in a treating and monitoring relationship with a
                  Specialist, and a Primary Care Physician.  She will comply with all of
                  their treatment recommendations;
                  
                  Dr. Ursell shall engage Workplace Monitors to assist in monitoring her
                  behaviour in the workplace;
                  
                  Dr. Ursell will abstain completely from the consumption of alcohol,
                  controlled drugs, or over-the-counter preparations that are
                  mood-altering, with certain specified and limited exceptions;
                  
                  Dr. Ursell will be subject to health monitoring by the College;
                  
                  Dr. Ursell shall be solely responsible for payment of all fees, costs,
                  charges, expenses, etc. arising from the implementation of any of the
                  provisions of the Order;
                  
                  Any failure to abide by the terms and conditions of the Order shall
                  constitute a breach of the Order, and may lead to an inquiry regarding
                  Dr. Ursell's capacity to practise medicine, 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
                  and/or the Fitness to Practise Committee of the College.
                  
                  Dr. Ursell shall submit to and not interfere with unannounced inspections
                  by the College of her Practice Location(s) and to the inspection of
                  patient charts, her personnel file, or any other records relevant to her
                  practice of medicine and to the collection of information (in person,
                  orally and/or in writing) from staff that the College deems necessary in
                  order to monitor her compliance with the terms of the Order.
                  
                  Dr. Ursell shall give her irrevocable consent to the College to provide
                  any information it deems necessary to any person, organization or
                  institution who requests or requires this information for the purposes of
                  facilitating or verifying her compliance with the Order, the Specialist's
                  compliance with the Specialist's undertaking, the Primary Care
                  Physician's compliance with the Primary Care Physician's undertaking, the
                  Workplace Monitor's compliance with the Workplace Monitor's undertaking,
                  including but not limited to any information:
                  
                        relevant to the Order;
                  
                        relevant to the Specialist's undertaking;
                  
                        relevant to the Primary Care Physician's compliance with the
                        Primary Care Physician's undertaking;
                  
                        relevant to the Workplace Monitor's compliance with the Workplace
                        Monitor's undertaking;
                  
                        relevant for the purposes of monitoring her compliance with the
                        Order; and/or
                  
                        which comes to his or her attention and which he or she reasonably
                        believes indicates a potential risk of harm to Dr. Ursell's
                        patients.
                  
                  The Order will be considered to have been breached if Dr. Ursell revokes
                  her consent to the release of any information or communication between
                  persons described in the Order.
                  
            (f)   Dr. Ursell may bring a motion before a panel of the Fitness to Practice
                  Committee to remove or modify any of the terms, conditions and
                  limitations imposed on her certificate of registration under this Order,
                  but not earlier than five (5) years after the date of this Order.

Previous Hearings

Committee: Fitness To Practise
Decision Date: 18 Dec 2017
Summary:

The Fitness to Practice Committee has found that Dr. Ursell is incapacitated, as defined in 
subsection 1(1) of the Health Professions Procedural Code, being Schedule 2 to the Regulated 
Health Professions Act, 1991, S.O. 1991, c. 18. 
 
As a result of that finding, the Committee has ordered that detailed terms, conditions and 
limitations be imposed on Dr. Ursell’s certificate of registration for a minimum of five (5) years 
(“the Order”), which can be summarized as follows: 
 
-  Dr. Ursell will engage in a treating and monitoring relationship with a Specialist, and a 
   Primary Care Physician. She will comply with all of their treatment recommendations; 
-  Dr. Ursell shall engage Workplace Monitors to assist in monitoring her behaviour in the 
   workplace; 
-  Dr. Ursell will abstain completely from the consumption of alcohol, controlled drugs, or 
   over-the-counter preparations that are mood-altering, with certain specified and limited 
   exceptions; 
-  Dr. Ursell will be subject to health monitoring by the College; 
-  Dr. Ursell shall be solely responsible for payment of all fees, costs, charges, expenses, etc. 
   arising from the implementation of any of the provisions of the Order; 
-  Any failure to abide by the terms and conditions of the Order shall constitute a breach of the 
   Order, and may lead to an inquiry regarding Dr. Ursell’s capacity to practise medicine, 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 and/or the Fitness to 
   Practise Committee of the College. 
-  Dr. Ursell shall submit to and not interfere with unannounced inspections by the College of 
   her Practice Location(s) and to the inspection of patient charts, her personnel file, or any 
   other records relevant to her practice of medicine and to the collection of information (in 
   person, orally and/or in writing) from staff that the College deems necessary in order to 
   monitor her compliance with the terms of the Order. 
-  Dr. Ursell shall give her irrevocable consent to the College to provide any information it 
   deems necessary to any person, organization or institution who requests or requires this 
   information for the purposes of facilitating or verifying her compliance with the Order, the 
   Specialist’s compliance with the Specialist’s undertaking, the Primary Care Physician’s 
   compliance with the Primary Care Physician’s undertaking, the Workplace Monitor’s 
   compliance with the Workplace Monitor’s undertaking, including but not limited to any 
   information: 
     
     o   relevant to the Order; 
     o   relevant to the Specialist’s undertaking; 
     o   relevant to the Primary Care Physician’s compliance with the Primary Care 
         Physician’s undertaking; 
     o   relevant to the Workplace Monitor’s compliance with the Workplace Monitor’s 
         undertaking; 
     o   relevant for the purposes of monitoring her compliance with the Order; and/or 
     o   which comes to his or her attention and which he or she reasonably believes indicates 
         a potential risk of harm to Dr. Ursell’s patients. 
          
-  The Order will be considered to have been breached if Dr. Ursell revokes her consent to the 
   release of any information or communication between persons described in the Order.

Hearing Date(s): December 18, 2017

Concerns

Source: ICR Committee
Active Date: December 7, 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.
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