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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: 28/03/24 18:35:25 PM

Hasnain, Haider

CPSO#: 64959

MEMBER STATUS
Revoked: Discipline Committee as of 26 Aug 2019
CURRENT OR PAST CPSO REGISTRATION CLASS
None as of 19 May 2017

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education: Schulich School of Medicine and Dentistr, 1992

Practice Information

Primary Location of Practice
Practice Address Not Available

Professional Corporation Information


Corporation Name: Hasnain Medicine Professional Corporation
Certificate of Authorization Status: Inactive: Oct 1 2019
Corporation Name: Hasnain, Sekhon and Sayed-Ali Medicine Professional Corporation
Certificate of Authorization Status: Inactive: Sep 17 2015

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.



USA - Michigan

Specialties

Specialty Issued On Type
Family Medicine Effective:05 Dec 1994 CFPC Specialist

Postgraduate Training

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



Schulich School of Medicine and Dentistr, 15 Jun 1992 to 14 Jun 1993
Other - Family Medicine

Schulich School of Medicine and Dentistr, 01 Jul 1993 to 30 Jun 1994
Resident 2 - Family Medicine

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 15 Jun 1992
Transfer of class of registration to: Independent Practice Certificate Effective: 15 Jun 1993
Transfer of class of certificate to: Restricted certificate Effective: 19 May 2017
Terms and conditions imposed on certificate Effective: 19 May 2017
Terms and conditions amended by Inquiries, Complaints and Reports Committee Effective: 14 May 2018
Terms and conditions amended by member Effective: 07 Jan 2019
Suspension of registration imposed: Discipline Committee Effective: 17 Jan 2019
Revoked: Discipline Committee. Effective: 26 Aug 2019

Previous Hearings

Committee: Discipline
Decision Date: 17 Jan 2019
Summary:

On January 17, 2019, the Discipline Committee found that Dr. Haider Hasnain committed an act of professional misconduct: in that he engaged in sexual abuse of a patient; and 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.

AGREED STATEMENT OF FACTS
Dr. Haider Hasnain is a 54-year-old family physician who received his certificate of registration authorizing independent practice in Ontario in 1992 and his specialist qualification in family medicine in 1994. His practice is located in the Windsor-Tecumseh area. Dr. Hasnain's CPSO number is 64959. During the relevant period, Dr. Hasnain practised out of the Tecumseh Community Care Centre ("the clinic"), providing service as a family physician at the clinic, including at the urgent-care clinic located in the same premises. Dr. Hasnain was the lessee for the clinic space.

The clinic operated on a shared chart system. All physicians treating a particular patient contributed to one global chart at the clinic. At the time, the charts were hand-written. In addition to Dr. Hasnain, who owned the clinic, four other physicians, Drs. B (a pediatrician), C, D and D, provided medical services to patients on a full-time basis. Two other physicians, Drs. F and G, provided medical services on a part-time basis.

Ms. Z is in her 50’s. Between June 2008 and January 2009, Ms. Z was treated at the clinic by physicians other than Dr. Hasnain on several occasions for a variety of issues, including asthma, anxiety and concerns around a mammogram. The physicians include Drs. G, D, C and F.

On February 6, 2009, Ms. Z sought medical treatment at the clinic. She was initially seen by a nurse at the clinic who noted her observations of Ms. Z on the medical chart as follows: "pulse 60, increased lethargic, weight gain, depression, bp 106/60". Dr. Hasnain was working in the urgent care area of the clinic and he provided treatment to Ms. Z. Dr. Hasnain noted in the chart that Ms. Z missed her previous menstrual cycle and that she was not sexually active at all. Dr. Hasnain requisitioned a blood sample. That same day, a laboratory technician at the clinic drew a blood sample from Ms. Z. The test results were faxed back to the clinic later that day. Dr. Hasnain submitted a claim to OHIP for an intermediate assessment. Hematology results suggested that Ms. Z's iron levels were slightly below normal. A nurse reviewed this information with Ms. Z the following day.

On February 10, 2009, Ms. Z was seen again by Dr. Hasnain. Dr. Hasnain noted in the patient chart that Ms. Z previously experienced constipation when taking iron pills. Dr. Hasnain prescribed six vials of 2 ml iron injections. Dr. Hasnain submitted a claim to OHIP for a minor assessment.

On February 19th and February 24th, 2009, a nurse at the clinic administered two iron injections to Ms. Z, as previously directed by Dr. Hasnain and as recorded in the patient chart.

Ms. Z received medical treatment from Dr. G and other clinic physicians for various issues between February 2009 and May 2009. According to her patient chart, Ms. Z saw Dr. G on three occasions between February 2009 and April 2009 for gynecological issues including a pap smear and a referral to Dr. J, a specialist gynecologist. During March and April 2009, Ms. Z was treated by four other clinic physicians on four occasions for complaints including throat infections.

Sometime in May 2009, Ms. Z and Dr. Hasnain commenced a consensual sexual relationship.

The relationship spanned from May 2009 to either December 2009 or January 2010 and included approximately 8-10 occasions of mutual oral sex and one occasion of sexual intercourse, as well as other sexual activity such as mutual sexual touching. All of the sexual interactions occurred in one room within the clinic, with the exception of one encounter that occurred elsewhere in the clinic. The final sexual encounter was the act of sexual intercourse that took place either in late December 2009 or early January 2010.

After the commencement of the sexual relationship with Dr. Hasnain, Ms. Z received treatment from G on August 23, 2009, for anxiety. Ms. Z was provided with a prescription for Celexa. Ms. Z also saw another clinic physician, Dr. E, on September 10, 2009, December 28, 2009, December 31, 2009 and January 8, 2010, regarding asthma and throat symptoms and back pain as set out in the patient chart.

Following the commencement of the sexual relationship in May 2009, Dr. Hasnain provided treatment to Ms. Z on three occasions in September 2009 and provided a prescription on one occasion in August 2009. The treatments provided in September 2009 were provided within the urgent care area of the clinic, at times when Dr. Hasnain was the only assigned physician.

On August 6, 2009, Ms. Z filled a prescription for a medication issued by Dr. Hasnain. There are no chart or OHIP entries related to this prescription. 

On September 1, 2009, Dr. Hasnain provided treatment for Ms. Z, recorded as follows in her patient chart: "Bloodwork re alopecia, assessment, alopecia and get blood work results first".

Ms. Z consented to the release of her most recent bloodwork results, which had been requisitioned by Dr. J, referred to in paragraph 13 above. On September 1, 2009, Medical Laboratories of Windsor forwarded the lab results, originally requested by Dr. J, to the clinic.

After reviewing the results some time that night or the next day Dr. Hasnain wrote on the bottom of the fax coversheet from Medical Laboratories, "See Dr. G." Dr. Hasnain submitted a claim to OHIP for a minor assessment.

On September 3, 2009, Ms. Z advised one of the nurses that she was experiencing "chest pains".

Dr. Hasnain was the only physician in the clinic at the time. Dr. Hasnain ordered an EKG. The results of the EKG revealed no abnormalities. Dr. Hasnain made the following notes on Ms. Z's medical chart: "states history of arrhythmia and occurs a bit, and abdominal pain on and off, well and dizzy +++, observed no acute distress and assess well and EKG normal" A claim was submitted to OHIP by Dr. Hasnain as a minor assessment.

On September 4, 2009, at approximately 11:39 a.m., a nurse wrote "f/u [follow up] re: bloodwork" in Ms. Z's chart. Dr. Hasnain's notes in Ms. Z's medical chart states: "well, observed not acutely distressed and assess as well and second set of labwork ordered re alopecia and anemia". A blood sample was drawn at the clinic on that day. Dr. Hasnain reviewed the results that night or the next day and wrote "let her know" on the results to advise the nurses to share the iron level results with Ms. Z. Dr. Hasnain submitted a claim to OHIP for a minor assessment.

Ms. Z commenced videotaping her encounters with Dr. Hasnain, including sexual encounters, as of June 5, 2009 without his knowledge. Ms. Z videotaped the medical encounters on September 1, 3 and 4, 2009. The Videos of the appointments demonstrate that the appointments lasted the following length of time: appointment of September 1, 2009 - 1 minute and 46 seconds; appointment of September 3, 2009 - 1 minute and 10 seconds; appointment of September 4, 2009 2 minutes and 21 seconds.

- SEXUAL ABUSE OF A PATIENT
To fall within the meaning of the sexual abuse as defined in the legislation, the Discipline Committee must find that the sexual relations occurred between a physician and a patient. As noted by the Ontario Court of Appeal in the case of Leering at para 37, “The disciplinary offence of sexual abuse is defined in the Code for the purpose of these proceedings as the concurrence of a sexual relationship and a health care professional-patient relationship. There is no further inquiry once those two factual determinations have been made.” The Committee considered whether Ms. Z was a patient of Dr. Hasnain using the analytical approach adopted in the case law prior to legislative amendments coming into effect on May 1, 2018. This included a consideration of the factors outlined in the previous discipline case of Redhead to determine whether Ms. Z was a patient of Dr. Hasnain’s in the relevant time period.

The Committee also considered whether Ms. Z was a patient of Dr. Hasnain by retrospectively applying the new definition of patient in the Health Professions Procedural Code (the Code) and the criteria in the new Patient Criteria Regulation. The Committee found that Ms. Z was a patient of Dr. Hasnain’s under both approaches.

Regarding the episodic visits with Dr. Hasnain, the Committee stated that there may be many months and, in some cases, years between office visits, even when a patient has a designated family physician. In the interim period when a patient is not attending one physician regularly, the patient may be attended to by other physicians. In the Committee’s opinion, an interval of six or seven months between office visits with a physician is not, by itself, determinative that a physician-patient relationship did not exist, or had ended.

The Committee concluded that the diagnosis and management of iron deficiency, which was diagnosed in February 2009, treated and followed up by Dr. Hasnain in September 2009, did not fall within the category of treatment of a minor condition. The College Policy, Treating Self and Family Members, published February 2007, that was in effect at the time states that, “Generally, a “minor condition” is a non-urgent, non-serious condition that requires only short-term, routine care and is not likely to be an indication of, or lead to, a more serious condition.” The Committee stated that iron deficiency is a significant, chronic medical condition that if left untreated, can lead to anemia and more serious conditions. Dr. Hasnain appears to have concluded in September that anemia was present; his note dated September 4, 2009 states that, "well, observed not acutely distressed and assess as well and second set of labwork ordered re alopecia and anemia". Alopecia (hair loss) in women, first diagnosed by Dr. Hasnain on September 1 and followed up on September 4, is not a minor condition, as it may indicate an underlying medical condition that warrants investigation, as evidenced by Dr. Hasnain ordering a second set of blood work for it and anemia on September 4, 2009.

Regarding treatment by other physicians at the clinic, the Committee found that no one physician at the clinic assumed the role of Ms. Z’s primary care physician. In Ms. Z’s case, the model of health care provided to her at the clinic was a “shared care model,” where there were a number of physicians involved in Ms. Z’s circle of care. Taking into account the model of care provided to Ms. Z at the clinic, the Committee concluded that a physician-patient relationship was established with more than one physician in Ms. Z’s circle of care. Dr. Hasnain was the only physician at the clinic who treated Ms. Z’s iron deficiency and there was no evidence before the Committee that he transferred her care or instructed her to see another physician at the clinic regarding her iron deficiency.

Regarding the brevity of the September interactions, the Committee found that there is no reference, condition or factor in Redhead, or other cases, or in the amended legislation, that requires office visits to be of certain duration in order to determine that a physician-patient relationship is established.

Also, the Committee found that the September 3, 2009 visit was not emergency in nature. The Agreed Statement of Facts stated that on September 3, 2009, Ms. Z advised a nurse that she was experiencing “chest pains.” It is unclear whether Ms. Z was experiencing chest pains sometime prior to, or at the time, she was speaking with the nurse. The nurse did not make a note in the chart. There was no mention in Dr. Hasnain’s clinical note on September 3, 2009 that Ms. Z was experiencing chest pain. Dr. Hasnain’s note states, “States history of arrhythmia and occurs a bit, and abdominal pain on and off, well and dizzy+++, observed in no acute distress and assess well and ekg normal.” The Committee noted that Dr. Hasnain billed for only a minor assessment, which suggested he did not treat it as urgent or an emergency. On reviewing the video recording of the September 3, 2009 visit, there was no appearance of a sense of urgency on Dr. Hasnain’s part and the encounter was very brief, lasting approximately two minutes and twenty-one seconds. The College Policy, Treating Self and Family Members, published February 2007, that was in effect at the time states, “An “emergency” exists where an individual is apparently experiencing severe suffering or is at risk of sustaining serious bodily harm if medical intervention is not promptly provided.” On reviewing the clinic notes and the video, the Committee determined that this visit was not in the nature of an emergency.

After careful consideration, and an analysis using the approach taken prior to the legislative amendments coming into effect on May 1, 2018, the Committee was satisfied that Ms. Z was a patient of Dr. Hasnain during all five patient visits, i.e., that a physician-patient relationship was established on February 6, 2009 and continued until at least September 4, 2009.

In applying the conditions in paragraph 1 of the new Patient Criteria Regulation to the February 6 and 10, 2009 clinic visits, the Committee found that Dr. Hasnain engaged in direct interactions with Ms. Z on those dates and that not just one but three conditions - i, ii and iv – are satisfied, in that Dr. Hasnain charged OHIP for his assessments, contributed to Ms. Z’s health record, and at the February 10th visit, prescribed to her a drug for which a prescription is needed. In the opinion of the Committee, condition iii regarding consent is also met for these visits, as Dr. Hasnain received implied consent from Ms. Z to the health care services provided by him. Regarding the three clinic visits in September, the Committee found that at least two conditions – conditions i (charged OHIP) and ii (contributed to health care record) - in paragraph 1 of the Patient Criteria Regulation are met, and in August 2009, condition iv was met, when Dr. Hasnain prescribed to Ms. Z a drug for which a prescription is needed. Condition iii regarding consent is also met for the September visits, as Dr. Hasnain received implied consent from Ms. Z to the health care services provided by him. Therefore, based on the Patient Criteria Regulation, the Committee finds that Ms. Z was a patient of Dr. Hasnain on each of her five encounters with him and that the physician-patient relationship was established on February 6, 2009.

Subparagraph 1(6)(a) of the Code states that, “an individual who was a member’s patient within one year or such longer period of time as may be prescribed from the date on which the individual ceased to be the member’s patient….” There was no evidence before the Committee of a date on which Ms. Z ceased to be Dr. Hasnain’s patient.

The three conditions in paragraph 2 of the Patient Criteria Regulation, to determine whether Ms. Z was not a patient of Dr. Hasnain, were not met. First, there was not at the time Dr. Hasnain provided health care services to Ms. Z on February 6 and 10, 2009, a sexual relationship between Dr. Hasnain and Ms. Z. Second, although there was a sexual relationship between Dr. Hasnain and Ms. Z at the time that Dr. Hasnain provided health care services to Ms. Z on September 1, 3 and 4, 2009, the Committee finds that Dr. Hasnain’s continuing follow up of Ms. Z’s iron deficiency on September 4 and his diagnosis and follow up of alopecia on September 1 and 4 respectively, are not health care services of a minor nature and Dr. Hasnain’s care of Ms. Z on September 3 is not a heath care service in emergency circumstances. Third, the Committee found that Dr. Hasnain did not take steps to transfer his care of Ms. Hasnain’s iron deficiency to another physician at any time.

The Committee found that regardless of whether the Patient Criteria Regulation is applied retrospectively or whether pre-Patient Criteria Regulation approach is taken, a physician-patient relationship existed between Ms. Z and Dr. Hasnain and that it was established on February 6, 2009 and continued until at least September 4, 2009.

The Agreed Statement of Facts confirmed that the sexual relationship between Dr. Hasnain and Ms. Z commenced in May 2009 and extended into late December 2009 or early January 2010.

Therefore, the Agreed Statement of Facts confirmed that there was an ongoing sexual relationship when Dr. Hasnain wrote a prescription for Ms. Z in August 2009 and assessed Ms. Z and provided health care services to her on the three occasions in September 2009. The Committee found that the physician-patient relationship established in February 2009 continued until at least September 4, 2009 and that the sexual relationship between Dr. Hasnain and Ms. Z, which spanned the period May 2009 until late December 2009 or January 2010, was concurrent with the physician-patient relationship.

As stated in Leering, once the Committee makes the factual determination that a sexual relationship between a patient and the physician was concurrent with the physician-patient relationship, no further inquiry is required and the allegation of sexual abuse of a patient is established. Therefore, the Committee found that the allegation of sexual abuse was proven.

DISHONOURABLE, DISGRACEFUL, OR UNPROFESSIONAL CONDUCT

The Committee found that Dr. Hasnain 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, by engaging in a sexual relationship with his patient.

IMMEDIATE INTERIM SUSPENSION
Given the Committee’s findings, the Committee made an immediate interim order suspending Dr. Hasnain’s certificate of registration, until such time as the Committee makes its decision on penalty. 

DISPOSITION
On August 26, 2019, the Committee ordered that:
 
- The Registrar revoke Dr. Hasnain’s certificate of registration effective immediately;

- Dr. Hasnain reimburse the College for funding provided to the patient 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 sixty (60) days of this order in the amount of
$16,060.00;

- Dr. Hasnain appear before the panel to be reprimanded;

- Dr. Hasnain pay the College its costs of this proceeding in the amount of $20,550.00 within sixty (60) days from the date of this Order.


Decision: Download Full Decision (PDF)
Hearing Date(s): Hearing: July 4, 2018 Penalty hearing: August 26, 2019

Concerns

Source: Inquiries, Complaints and Reports Committee
Active Date: October 3, 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.

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)

 

Source: Inquiries, Complaints and Reports Committee
Active Date: October 3, 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.
 
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)

 

Source: Inquiries, Complaints and Reports Committee
Active Date: July 13, 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)

 

Source: Compliance and Monitoring Department
Active Date: July 13, 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)

 

Source: Inquiries, Complaints and Reports Committee
Active Date: January 18, 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)