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THE FOLLOWING INFORMATION WAS OBTAINED FROM THE DOCTOR SEARCH SECTION OF THE WEBSITE OF THE COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO WWW.CPSO.ON.CA
Date: 06/12/19 12:33:51 PM

Armogan, Edward Davindra

CPSO#: 62095

MEMBER STATUS
Active Member as of 15 Oct 2019
CPSO REGISTRATION CLASS
Restricted as of 27 Apr 2015
Flag: Indicates a concern or additional information

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education:The University of Western Ontario, 1990

Practice Information

Primary Location of Practice
570 Wonderland Rd N
London ON  N6H 3E3
Phone: (519) 668-6074 Electoral District: 02

Professional Corporation Information


Corporation Name: E.D. Armogan Medicine Professional Corporation
Certificate of Authorization Status: Issued Date:  Nov 01 2012

Shareholders:
Dr. E. Armogan ( CPSO# 62095 )

Business Address:
570 Wonderland Road North
London ON  N6H 3E3
Phone Number: (519) 681-3114


Medical Licences in Other Jurisdictions

Effective September 1, 2015, the College by-laws require the College to indicate on the register if the member has a licence or is registered to practise medicine in a jurisdiction outside Ontario, if this is known to the College.



Barbados

Guyana

Specialties

Specialty Issued On Type
Family Medicine Effective: 01 Jun 1992 CFPC Specialist

Postgraduate Training

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



The University of Western Ontario, 15 Jun 1990 to 14 Jun 1991
Other - Comprehensive Internship

The University of Western Ontario, 01 Jul 1991 to 30 Jun 1992
Resident 2 - Family Medicine

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 15 Jun 1990
Transfer of class of registration to: Independent Practice Certificate Effective: 09 Jul 1991
Transfer of class of certificate to: Restricted certificate Effective: 27 Apr 2015
Terms and conditions imposed on certificate by member Effective: 27 Apr 2015
Terms and conditions amended by member Effective: 27 May 2015
Terms and conditions amended by member Effective: 10 Aug 2015
Terms and conditions amended by member Effective: 13 May 2016
Terms and conditions amended by member Effective: 20 Jun 2018
Terms and conditions amended by member Effective: 05 Jul 2018
Terms and conditions amended by member Effective: 12 Jul 2018
Terms and conditions amended by Discipline Committee Effective: 15 Aug 2019
Suspension of registration imposed: Discipline Committee Effective: 15 Aug 2019
Suspension of registration removed Effective: 15 Oct 2019

Practice Restrictions Flag: indicates a concern or additional information

Imposed By Effective Date Expiry Date Status
Discipline Committee Effective: 15 Aug 2019 Active
             (1 of 2)
            As from 12:01 a.m., August 15, 2019, by order of the Discipline Committee of
            the College of Physicians and Surgeons of Ontario, the following terms,
            conditions and limitations are imposed on the certificate of registration held
            by Dr. Edward Davindra Armogan:

            Compliance with Policy re Suspension

            (i)   Dr. Armogan shall comply with the College Policy on "Practice Management
                  Considerations for Physicians Who Cease to Practise, Take an Extended
                  Leave of Absence or Close Their Practice Due to Relocation", a copy of
                  which is attached at Schedule "A", in respect of the suspension of his
                  certificate of registration at paragraph 3 above.

            Prescribing Restriction

            (ii)  Dr. Armogan shall not prescribe stimulant medication to patients who are
                  eighteen (18) years of age or older, unless the medication has been first
                  prescribed by a psychiatrist, as documented in a consultation letter from
                  the psychiatrist to be maintained by Dr. Armogan in the patient's chart.
                  For greater certainty, and without restricting the foregoing, if a
                  patient of Dr. Armogan who is eighteen (18) years of age or older was
                  previously prescribed stimulant medication, but such prescribing has been
                  discontinued or the medication has not been taken for the past three (3)
                  or more months, Dr. Armogan shall not prescribe stimulant medication to
                  the patient unless a psychiatrist first assesses the patient and
                  initiates a new prescription, as documented in a consultation letter to
                  be maintained by Dr. Armogan in the patient's chart.

            Individualized Ethics Instruction

            (iii) Dr. Armogan shall participate in and successfully complete, within six
                  (6) months of the date of this Order, individualized instruction in
                  medical ethics satisfactory to the College, with an instructor approved
                  by the College, who shall provide a summative report to the College
                  including his or her conclusion about whether Dr. Armogan successfully
                  completed the instruction.

            (iv)  Dr. Armogan shall consent to the College providing any information the
                  College has that led to the circumstances of this Order and any
                  information arising from the monitoring of his compliance with this Order
                  to any person who requires this information to facilitate his completion
                  of the individualized instruction in medical ethics set out at paragraph
                  4(iii). 

            Maintenance of Prescribing Log

            (v)   Dr. Armogan shall keep a log of all prescriptions for Narcotic Drugs,
                  Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other
                  Targeted Substances (A summary of the above-named drugs [from Appendix I
                  to the Compendium of Pharmaceuticals and Specialties] is attached hereto
                  as Schedule "B"; and links to the current regulatory lists are attached
                  hereto as Schedule "C"), and All Other Monitored Drugs (as defined under
                  the Narcotics Safety and Awareness Act, 2010, S.O. 2010, c. 22, as
                  amended, with a link to the current regulatory list attached hereto at
                  Schedule "D"), such log to be in the form attached at Schedule "E" (the
                  "Prescribing Log"), which will include at least the following
                  information:

                  (a)   the date of the appointment; 
                  
                  (b)   the name of the patient and chart/file number; 
                  
                  (c)   the name of the medication prescribed, dose, direction, number of
                        tablets to be dispensed and frequency;
                  
                  (d)   the clinical indication;
                  
                  (e)   whether the prescription is for a new medication and/or different
                        dose or frequency than currently prescribed to the patient (Y/N); 
                  
                  (f)   Dr. Armogan's signature; 
                  
                  (g)   the date of the Clinical Supervisor's review (if applicable, as set
                        out below); and
                  
                  (h)   the Clinical Supervisor's signature (if applicable, as set out
                        below).
                  
                  (vi)  Dr. Armogan shall keep a copy of all prescriptions he writes for
                        Narcotic Drugs, Narcotic Preparations, Controlled Drugs,
                        Benzodiazepines and Other Targeted Substances and All Other
                        Monitored Drugs, in the corresponding patient chart. 
                  
            Clinical Supervision

            (vii) Upon the conclusion of the suspension of Dr. Armogan's certificate of
                  registration under paragraph 3 above, Dr. Armogan shall practise under
                  the guidance of a clinical supervisor acceptable to the College (the
                  "Clinical Supervisor") who shall sign an undertaking in the form attached
                  at Schedule "F," for three (3) months, on the terms set out below and as
                  described in Schedule "F" (the "Clinical Supervision").

            (viii)Dr. Armogan shall cooperate fully with the Clinical Supervision and abide
                  by all recommendations of his Clinical Supervisor including, but not
                  limited to, any recommended practice improvements and professional
                  development. 

            (ix)  Dr. Armogan shall review with his Clinical Supervisor every patient for
                  whom he has prescribed any Narcotic Drugs, Narcotic Preparations,
                  Controlled Drugs, Benzodiazepines and Other Targeted Substances and/or
                  All Other Monitored Drugs to ensure that assessment, clinical
                  examination, risk assessment for addiction and ongoing management and
                  follow up is appropriate. 

            (x)   Dr. Armogan shall ensure that his Clinical Supervisor confirms their
                  review of his patient care with him as described above in paragraph 4(ix)
                  by signing the Prescribing Log and the patient chart in question within
                  two (2) weeks of Dr. Armogan issuing any prescription for Narcotic Drugs,
                  Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other
                  Targeted Substances and/or All Other Monitored Drugs.

            (xi)  Dr. Armogan shall ensure that Schedule "F" to this Order is signed and
                  delivered to the College by an approved Clinical Supervisor prior to the
                  conclusion of the suspension of his certificate of registration. 

            (xii) If a person who has given an undertaking in Schedule "F" to this Order is
                  unable or unwilling to fulfill its provisions, Dr. Armogan shall, within
                  fourteen (14) days of receiving notice of the same, ensure that he has
                  delivered to the College an executed undertaking in the same form from a
                  similarly qualified person who is acceptable to the College.  

            (xiii)If Dr. Armogan is unable to obtain a Clinical Supervisor on the terms set
                  out in paragraphs 4(xi) and (xii) above, he will cease prescribing
                  Narcotic Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines
                  and Other Targeted Substances and/or All Other Monitored Drugs until he
                  has obtained a Clinical Supervisor acceptable to the College, and this
                  will constitute a term, condition, or limitation on his certificate of
                  registration.

            (xiv) Dr. Armogan shall consent to the disclosure by the Clinical Supervisor to
                  the College, and by the College to the Clinical Supervisor, of all
                  information the Clinical Supervisor or the College deems necessary or
                  desirable in order to fulfill the Clinical Supervisor's undertaking and
                  to monitor Dr. Armogan's compliance with this Order. This shall include,
                  without limitation, providing the Clinical Supervisor with any reports of
                  any assessments of or prior clinical supervision of Dr. Armogan's
                  practice in the College's possession. 

            Reassessment

            (xv)  Approximately six (6) months after the Clinical Supervision above has
                  ceased, Dr. Armogan will submit to a reassessment (the "Reassessment") of
                  his family practice, including but not limited to his prescribing of
                  Narcotic Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines
                  and Other Targeted Substances and All Other Monitored Drugs, by an
                  assessor or assessors selected by the College (the "Assessor(s)"). The
                  Reassessment may include chart reviews, direct observation of Dr.
                  Armogan's care, interviews with colleagues and co-workers, feedback from
                  patients and any other tools deemed necessary by the College. The results
                  of the Reassessment will be reported to the College and may form the
                  basis of further action by the College.

            (xvi) Dr. Armogan shall cooperate fully with the Reassessment and with the
                  Assessor(s). Dr. Armogan shall consent to the disclosure among the
                  Clinical Supervisor, the College, and the Assessor(s) of all information
                  any of them deems necessary or desirable to complete the Reassessment and
                  to monitor Dr. Armogan's compliance with this Order. This shall include,
                  without limitation, providing the Assessor(s) with any reports of any
                  assessments of or clinical supervision of Dr. Armogan's practice in the
                  College's possession

            (xvii)If it deems the Reassessment satisfactory, the Inquiries, Complaints and
                  Reports Committee of the College may direct that any or all of the terms,
                  conditions and limitations on Dr. Armogan's certificate of registration
                  set out at paragraphs 4(ii), 4(v), and/or 4(vi) above be lifted.

            Compliance and Monitoring

            (xviii)Dr. Armogan shall cooperate with unannounced inspections of his office
                  practice and patient charts for the purpose of monitoring and enforcing
                  his compliance with the terms of this Order.

            (xix) Dr. Armogan shall inform the College of each and every location where he
                  practices, including but not limited to hospitals(s), clinic(s) and
                  office(s), in any jurisdiction, within ten (10) days of this Order. Going
                  forward, he shall inform the College of any and all new Practice
                  Locations in any jurisdiction five (5) days in advance of commencing
                  practice at that location. 

            (xx)  Dr. Armogan shall give his irrevocable consent to the College to make
                  enquiries of the Ontario Health Insurance Plan ("OHIP"), the Drug Program
                  Services Branch, the Narcotics Monitoring System ("NMS") implemented
                  under the Narcotics Safety and Awareness Act, 2010 and/or any person or
                  institution who may have relevant information, in order for the College
                  to monitor his compliance with the provisions of this Order.

            (xxi) Dr. Armogan shall be responsible for any and all costs associated with
                  implementing the terms of this Order. 

            (2 of 2)
            As from April 27, 2015, the following is imposed as a term, condition and
            limitation on the certificate of registration held by Dr. Edward Davindra
            Armogan, in accordance with an undertaking and consent given by Dr. Armogan to
            the College of Physicians and Surgeons of Ontario:

                  Dr. Armogan will only prescribe psychotropic medications for patients
                  under the age of 18 after a consultation with a psychiatrist and
                  obtaining the approval of the psychiatrist for the prescription.
                  
                  
            (

Previous Hearings Flag: indicates a concern or additional information

Committee: Discipline
Decision Date: 14 Aug 2019
Summary:

On August 14, 2019, on the basis of an Agreed Statement of Facts and Admission, the Discipline 
Committee found that Dr. Armogan committed an act of professional misconduct, in that he has 
failed to maintain the standard of practice of the profession, and has engaged in an act or 
omission relevant to the practice of medicine that, having regard to all circumstances, would 
reasonably be regarded by members as disgraceful, dishonourable or unprofessional. 
Background 
 
Dr. Edward Davindra Armogan (“Dr. Armogan”) is a 53 year-old family physician who received 
his certificate of registration authorizing independent practice from the College of Physicians and 
Surgeons of Ontario (“the College”) in June 1990.   
At the relevant time, Dr. Armogan practised family medicine in London, Ontario. A significant 
portion of his practice has focused on providing general practitioner psychotherapy and treatment 
to patients with psychological disorders. The remaining portion of his practice is general family 
medicine for patients.  Dr. Armogan also maintains a cosmetic medicine practice which is not the 
subject of this matter.  
Dr. Armogan signed an undertaking on April 27, 2015 (the “2015 Undertaking”). Among other 
things, Dr. Armogan agreed to undergo clinical supervision of his prescribing of opioids and 
other controlled medications. As a result, Dr. Armogan engaged in clinical supervision with Dr. 
Rashmi Bhalla from June 8, 2015 to August 17, 2016.  
During supervision, Dr. Bhalla identified concerns about Dr. Armogan’s prescribing of 
stimulants for treatment of attention deficit hyperactivity disorder (“ADHD”) in adults.  
As a result of the concerns raised by Dr. Bhalla, Dr. Armogan entered into a supplemental 
undertaking on May 13, 2016 (the “2016 Supplemental Undertaking”). The 2016 Supplemental 
Undertaking specified that Dr. Armogan was not to prescribe stimulant medication to adults for 
augmentation in the treatment of depression or for the treatment of adult ADHD unless the 
medication was first prescribed by a psychiatrist.     
Data obtained by the College from the provincial Narcotics Monitoring System (“NMS”) showed 
that on several occasions Dr. Armogan breached the 2016 Supplemental Undertaking, by 
initiating or re-initiating prescriptions for stimulants for adult patients for the treatment of 
ADHD without ensuring the medication was first prescribed by a psychiatrist.   
In general, Dr. Armogan’s breaches of his 2016 Supplemental Undertaking comprised of the 
following circumstances: 
         a) Matters in which Dr. Armogan re-initiated prescribing of stimulants to 
            adult patients without a psychiatrist having written the first prescription 
            or having completed a consultation prior to Dr. Armogan’s prescribing; 
             
         b) Matters in which Dr. Armogan initiated prescribing of stimulants after 
            having obtained a consultation with a psychiatrist, but where the 
            psychiatrist had not written the first prescription and in some cases had 
            not endorsed a current ADHD diagnosis or initiation of stimulant 
            prescribing at this time; and 
        
          c) Matters in which Dr. Armogan initiated prescribing of stimulants based on 
             information from the patient that the patient had been prescribed 
             stimulants for ADHD in the past, but where Dr. Armogan did not ensure 
             that the information was correct and/or did not ensure the currency of any 
             first prescription written by a psychiatrist.  
        
 Standard of Practice  
        
 Dr. Armogan’s 2015 Undertaking required him to undergo a reassessment of his family practice 
after completion of a period of clinical supervision. Dr. Joy Weisbloom was retained to conduct 
the reassessment. She reviewed fifteen patient records and interviewed Dr. Armogan. 

As concluded by Dr. Weisbloom, Dr. Armogan failed to maintain the standard of practice of the 
profession in eleven of the fifteen patient charts reviewed, including with respect to appropriate 
prescribing of stimulants and narcotics, conduct of and response to urine drug screens, and 
medical record-keeping.  

Dr. Weisbloom did find that Dr. Armogan had made positive changes since she first assessed his 
practice in 2014 prior to his entering into the 2015 Undertaking, and that it was evident he cared 
about his patients and was endeavouring to improve his practice to provide better care. She noted 
that the major deficiencies had been addressed and shown improvements.  
       
Admission 
 
Dr. Armogan admits the facts specified above, and admits that, based on these facts, he engaged 
in professional misconduct, in that: 

         a) he failed to maintain the standard of practice of the profession, under paragraph 
            1(1)2 of Ontario Regulation 856/93, made under the Medicine Act, 1991; and  
             
         b) he engaged in 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, under paragraph 1(1)33 of Ontario 
            Regulation 856/93, made under the Medicine Act, 1991.  
 
AGREED STATEMENT OF FACTS RELEVANT TO PENALTY 
 
Clinical Supervision and Cooperation with the College 

Dr. Armogan cooperated with the College Compliance Case Manager’s requests for information 
regarding prescriptions for specific patients. After the Compliance Case Manager drew the 
College’s compliance concerns to Dr. Armogan’s attention, no new compliance concerns arose.  
 
Pending the discipline hearing, Dr. Armogan voluntarily agreed to abide by an interim 
undertaking to the College requiring, among other things, that his practice be under clinical 
supervision.   
   
 As a result of this interim undertaking, Dr. Armogan’s practice has been under the clinical 
 supervision of Dr. Shelendra Joshi since August 2018. Among other things, Dr. Joshi undertook 
 to review with Dr. Armogan every patient chart regarding each patient to whom Dr. Armogan 
 prescribes any narcotic drugs, narcotic preparations, controlled drugs, benzodiazepines and other 
 targeted substances, and/or all other monitored drugs to ensure that assessment, clinical 
 examination, risk assessment for addiction and ongoing management and follow-up is 
appropriate.  
 
Dr. Joshi’s report of May 26, 2019 notes among other things that:  
    -  Dr. Armogan’s prescribing of controlled substances was reasonable in dose and amounts 
       dispensed.  
    -  Dr. Armogan has become more diligent regarding updating the medication lists in his 
       cumulative patient profiles.  His documentation for prescribing opioids has been meeting 
       the standard of practice required.  
    -  Dr. Armogan has been abiding by the terms of his restrictions regarding prescribing of 
       stimulants for ADHD.  
  
 Relevant History with the College 

 In October 2010, Dr. Armogan was required by the Inquiries, Complaints and Reports 
 Committee (“ICRC”) to attend at the College to be cautioned regarding the assessment and 
 management of anxiety, depression and ADHD and, specifically, what is required to assess these 
 conditions before prescribing potentially dangerous combinations of medications.  

In 2015, the ICRC accepted Dr. Armogan’s 2015 Undertaking in resolution of a public complaint 
regarding his care of a patient and a broader investigation into his prescribing to pediatric 
patients.  

In the 2015 Undertaking, Dr. Armogan agreed to a restriction on his prescribing stimulants to 
patients under the age of 18 without prior approval of a consulting psychiatrist. This restriction 
 remains in effect and is not in issue in the present matter. No concerns have arisen to date 
 regarding Dr. Armogan’s compliance with this restriction.  

 Remediation 

 In addition to engaging in the remediation and clinical supervision required by his 2015 
 Undertaking, 2016 Supplemental Undertaking and interim undertaking pending the present 
 discipline hearing, Dr. Armogan voluntarily attended the Safe Opioid Prescribing Course at the 
 University of Toronto, which he completed on December 7, 2018.  

 ORDER 
  
 The Discipline Committee ordered that: 
    -  Dr. Armogan to attend before the panel to be reprimanded 
        
-  The Registrar suspend Dr. Armogan’s certificate of registration for a period of two (2) 
   months, commencing from August 15, 2019 at 12:01 a.m. 
    
-  The Registrar place the following terms, conditions and limitations on Dr. Armogan’s 
   certificate of registration:  
              
   Compliance with Policy re Suspension 

   (i)   Dr. Armogan shall comply with the College Policy on “Practice Management 
        Considerations for Physicians Who Cease to Practise, Take an Extended Leave of 
        Absence or Close Their Practice Due to Relocation”, a copy of which is attached 
        at Schedule “A” to the Order, in respect of the suspension of his certificate of 
        registration at paragraph 3 above. 

  Prescribing Restriction 

  (ii)  Dr. Armogan shall not prescribe stimulant medication to patients who are 
        eighteen (18) years of age or older, unless the medication has been first prescribed 
        by a psychiatrist, as documented in a consultation letter from the psychiatrist to be 
        maintained by Dr. Armogan in the patient’s chart. For greater certainty, and 
        without restricting the foregoing, if a patient of Dr. Armogan who is eighteen (18) 
        years of age or older was previously prescribed stimulant medication, but such 
        prescribing has been discontinued or the medication has not been taken for the 
        past three (3) or more months, Dr. Armogan shall not prescribe stimulant 
        medication to the patient unless a psychiatrist first assesses the patient and 
        initiates a new prescription, as documented in a consultation letter to be 
        maintained by Dr. Armogan in the patient’s chart. 

  Individualized Ethics Instruction 

  (iii) Dr. Armogan shall participate in and successfully complete, within six (6) months 
         of the date of the Order, individualized instruction in medical ethics satisfactory 
         to the College, with an instructor approved by the College, who shall provide a 
         summative report to the College including his or her conclusion about whether 
         Dr. Armogan successfully completed the instruction. 

   (iv)  Dr. Armogan shall consent to the College providing any information the College 
         has that led to the circumstances of the Order and any information arising from 
         the monitoring of his compliance with the Order to any person who requires this 
        information to facilitate his completion of the individualized instruction in 
        medical ethics. 

  Maintenance of Prescribing Log 

   (v)   Dr. Armogan shall keep a log of all prescriptions for Narcotic Drugs, Narcotic 
         Preparations, Controlled Drugs, Benzodiazepines and Other Targeted Substances 
        (A summary of the above-named drugs [from Appendix I to the Compendium of 
        Pharmaceuticals and Specialties] is attached to the Order as Schedule “B”; and 
       links to the current regulatory lists are attached hereto as Schedule “C”), and All 
       Other Monitored Drugs (as defined under the Narcotics Safety and Awareness 
       Act, 2010, S.O. 2010, c. 22, as amended, with a link to the current regulatory list 
       attached hereto at Schedule “D”), such log to be in the form attached at Schedule 
       “E” (the “Prescribing Log”) to the Order, which will include at least the 
       following information: 

           (a) the date of the appointment;  

           (b) the name of the patient and chart/file number;  

           (c) the name of the medication prescribed, dose, direction, number of tablets 
              to be dispensed and frequency; 

           (d) the clinical indication; 

           (e) whether the prescription is for a new medication and/or different dose or 
              frequency than currently prescribed to the patient (Y/N);  

           (f) Dr. Armogan’s signature;  

           (g) the date of the Clinical Supervisor’s review (if applicable, as set out 
              below); and 

           (h) the Clinical Supervisor’s signature (if applicable, as set out below). 

(vi)  Dr. Armogan shall keep a copy of all prescriptions he writes for Narcotic Drugs, 
      Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other Targeted 
      Substances and All Other Monitored Drugs, in the corresponding patient chart.  

Clinical Supervision 

(vii) Upon the conclusion of the suspension of Dr. Armogan’s certificate of registration 
      under paragraph 3 above, Dr. Armogan shall practise under the guidance of a 
      clinical supervisor acceptable to the College (the “Clinical Supervisor”) who shall 
      sign an undertaking in the form attached at Schedule “F” to the Order, for three 
      (3) months, on the terms set out below and as described in Schedule “F” (the 
      “Clinical Supervision”). 

(viii) Dr. Armogan shall cooperate fully with the Clinical Supervision and abide by all 
      recommendations of his Clinical Supervisor including, but not limited to, any 
      recommended practice improvements and professional development.  

(ix)  Dr. Armogan shall review with his Clinical Supervisor every patient for whom he 
       has prescribed any Narcotic Drugs, Narcotic Preparations, Controlled Drugs, 
       Benzodiazepines and Other Targeted Substances and/or All Other Monitored 
       Drugs to ensure that assessment, clinical examination, risk assessment for 
      addiction and ongoing management and follow up is appropriate.  
 (x)   Dr. Armogan shall ensure that his Clinical Supervisor confirms their review of his 
       patient care with him as described above in paragraph 4(ix) by signing the 
       Prescribing Log and the patient chart in question within two (2) weeks of Dr. 
      Armogan issuing any prescription for Narcotic Drugs, Narcotic Preparations, 
      Controlled Drugs, Benzodiazepines and Other Targeted Substances and/or All 
      Other Monitored Drugs. 

(xi)  Dr. Armogan shall ensure that Schedule “F” to the Order is signed and delivered 
       to the College by an approved Clinical Supervisor prior to the conclusion of the 
       suspension of his certificate of registration.  

 (xii) If a person who has given an undertaking in Schedule “F” to the Order is unable 
       or unwilling to fulfill its provisions, Dr. Armogan shall, within fourteen (14) days 
       of receiving notice of the same, ensure that he has delivered to the College an 
       executed undertaking in the same form from a similarly qualified person who is 
       acceptable to the College.   

 (xiii) If Dr. Armogan is unable to obtain a Clinical Supervisor on the terms set out in 
       paragraphs 4(xi) and (xii) above, he will cease prescribing Narcotic Drugs, 
       Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other Targeted 
       Substances and/or All Other Monitored Drugs until he has obtained a Clinical 
       Supervisor acceptable to the College, and this will constitute a term, condition, or 
       limitation on his certificate of registration. 

 (xiv) Dr. Armogan shall consent to the disclosure by the Clinical Supervisor to the 
       College, and by the College to the Clinical Supervisor, of all information the 
       Clinical Supervisor or the College deems necessary or desirable in order to fulfill 
       the Clinical Supervisor’s undertaking and to monitor Dr. Armogan’s compliance 
       with the Order. This shall include, without limitation, providing the Clinical 
       Supervisor with any reports of any assessments of or prior clinical supervision of 
       Dr. Armogan’s practice in the College’s possession.  

 Reassessment 

 (xv)  Approximately six (6) months after the Clinical Supervision above has ceased, 
       Dr. Armogan will submit to a reassessment (the “Reassessment”) of his family 
       practice, including but not limited to his prescribing of Narcotic Drugs, Narcotic 
       Preparations, Controlled Drugs, Benzodiazepines and Other Targeted Substances 
       and All Other Monitored Drugs, by an assessor or assessors selected by the 
       College (the “Assessor(s)”). The Reassessment may include chart reviews, direct 
      observation of Dr. Armogan’s care, interviews with colleagues and co-workers, 
      feedback from patients and any other tools deemed necessary by the College. The 
      results of the Reassessment will be reported to the College and may form the basis 
      of further action by the College. 

(xvi) Dr. Armogan shall cooperate fully with the Reassessment and with the 
      Assessor(s). Dr. Armogan shall consent to the disclosure among the Clinical 
            Supervisor, the College, and the Assessor(s) of all information any of them deems 
            necessary or desirable to complete the Reassessment and to monitor Dr. 
            Armogan’s compliance with the Order. This shall include, without limitation, 
            providing the Assessor(s) with any reports of any assessments of or clinical 
            supervision of Dr. Armogan’s practice in the College’s possession 

      (xvii) If it deems the Reassessment satisfactory, the Inquiries, Complaints and Reports 
            Committee of the College may direct that any or all of the terms, conditions and 
            limitations on Dr. Armogan’s certificate of registration set out at paragraphs 4(ii), 
            4(v), and/or 4(vi) above be lifted. 

      Compliance and Monitoring 

      (xviii) Dr. Armogan shall cooperate with unannounced inspections of his office practice 
            and patient charts for the purpose of monitoring and enforcing his compliance 
            with the terms of the Order. 

      (xix) Dr. Armogan shall inform the College of each and every location where he 
            practices, including but not limited to hospitals(s), clinic(s) and office(s), in any 
            jurisdiction, within ten (10) days of the Order. Going forward, he shall inform the 
            College of any and all new Practice Locations in any jurisdiction five (5) days in 
            advance of commencing practice at that location.  

      (xx)  Dr. Armogan shall give his irrevocable consent to the College to make enquiries 
            of the Ontario Health Insurance Plan (“OHIP”), the Drug Program Services 
            Branch, the Narcotics Monitoring System (“NMS”) implemented under the 
            Narcotics Safety and Awareness Act, 2010 and/or any person or institution who 
            may have relevant information, in order for the College to monitor his compliance 
            with the provisions of the Order. 

      (xxi) Dr. Armogan shall be responsible for any and all costs associated with 
            implementing the terms of the Order.  

-  Dr. Armogan pay costs to the College in the amount of $6,000 within thirty (30) days of the 
   date of the Order.


Decision: Download Full Decision (PDF)
Hearing Date(s): August 14, 2019 half-day hearing start time 1:00 p.m.

Concerns Flag: indicates a concern or additional information

Source: ICR Committee
Active Date: September 4, 2019
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.
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Source: ICR Committee
Active Date: May 17, 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.
Download Full Document (PDF)