As from June 23, 2020, the following are imposed as terms, conditions and
limitations on the certificate of registration held by Dr. Paramanathan
Thamilvaanan in accordance with an undertaking and consent given by Dr.
Thamilvaanan to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. PARAMANATHAN THAMILVAANAN
("Dr. Thamilvaanan")
to
COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
(the "College")
A. PREAMBLE
(1) In this Undertaking:
"Code" means the Health Professions Procedural Code, which is Schedule 2
to the Regulated Health Professions Act, 1991, S.O. 1991, c. 18, as
amended;
"ICR Committee" means the Inquiries, Complaints and Reports Committee of
the College;
"OHIP" means the Ontario Health Insurance Plan;
"Public Register" means the College's register that is available to the
public.
(2) I, Dr. Thamilvaanan, certificate of registration number 97510, am a
member of the College.
(3) I, Dr. Thamilvaanan, acknowledge that following a public complaint that
raised concerns about my care of a patient in my emergency medicine
practice, I underwent remediation and a reassessment of my practice. The
reassessment report subsequently received by the College continued to
raise concerns about my practice.
B. UNDERTAKING
(4) I, Dr. Thamilvaanan, undertake to abide by the provisions of this
Undertaking, effective immediately.
(5) Clinical Supervision
(a) I, Dr. Thamilvaanan, undertake to practise under the guidance of a
clinical supervisor or clinical supervisors acceptable to the
College (the "Clinical Supervisor" or "Clinical Supervisors"), for
at least six (6) months ("Clinical Supervision").
(b) I, Dr. Thamilvaanan, acknowledge that I have reviewed the Clinical
Supervisor's undertaking, attached hereto as Appendix "A", and
understand what is required of the Clinical Supervisor. The
Clinical Supervisor will, at minimum:
(i) Facilitate the education program set out in the
Individualized Education Plan ("IEP"), attached hereto as
Appendix "B";
(ii) Review the materials provided by the College and have an
initial meeting to discuss the objectives for the Clinical
Supervision and practice improvement recommendations;
(iii) Meet with me at my Practice Location, or another location
approved by the College, once every month;
(iv) Review at least fifteen (15) of my patient charts at every
meeting;
(v) Discuss any concerns arising from the chart reviews;
(vi) Make recommendations to me for practice improvements and
ongoing professional development and inquire into my
compliance with the recommendations;
(vii) Perform any other duties, such as reviewing other documents
or conducting interviews with staff or colleagues, that the
Clinical Supervisor deems necessary to my Clinical
Supervision; and
(viii)Submit written reports to the College at least once every
three (3) months, or more frequently if the Clinical
Supervisor has concerns about my standard of practice.
(c) I, Dr. Thamilvaanan, acknowledge that the charts reviewed shall be
selected by the Clinical Supervisor based on the educational needs
identified in the IEP, attached hereto as Appendix "B", as well as
the areas of concern identified in the reports of the assessor
dated September 2, 2019, January 14, 2020, and February 4, 2020,
and concerns that may arise during the period of Clinical
Supervision.
(d) I, Dr. Thamilvaanan, undertake to cooperate fully with the Clinical
Supervision of my practice, conducted under the term of this
Undertaking and Appendix "A" to this Undertaking, and to abide by
the recommendations of my Clinical Supervisor, including but not
limited to, any recommended practice improvements and ongoing
professional development.
(e) I, Dr. Thamilvaanan, undertake to ensure that Appendix "A" to this
Undertaking is signed and delivered to the College within thirty
(30) days of the date I execute this Undertaking.
(f) I, Dr. Thamilvaanan, undertake that if a person who has given an
undertaking in Appendix "A" to this Undertaking is unable or
unwilling to continue to fulfill its provisions, I 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.
(g) I, Dr. Thamilvaanan, undertake that if I am unable to obtain a
Clinical Supervisor on the provisions set out under sections (5)(e)
and/or (f) above, I will cease practising medicine until such time
as I have obtained a Clinical Supervisor acceptable to the College.
(h) I, Dr. Thamilvaanan, acknowledge that if I am required to cease
practise as a result of section (5)(g) above this will constitute a
term, condition or limitation on my certificate of registration and
that term, condition or limitation will be included on the public
register.
(6) Professional Education
(a) I, Dr. Thamilvaanan, undertake to participate in and successfully
complete all aspects of the detailed IEP, attached hereto as
Appendix "B", including all of the following professional education
(the "Professional Education"):
(i) Review, reflection, a written summary, and discussion with my
Clinical Supervisor of Chapter 3: Assessment and
Hospitalization Under the Mental Health Act of A Practical
Guide to Mental Health and the Law in Ontario, Ontario
Hospital Association;
(ii) Review, reflection and a discussion with my Clinical
Supervisor of CPSO's Medical Records Documentation policy;
(iii) CMPA's Documentation: Charting Medical Records and
Documentation II: Principles of Medical Record keeping
eLearning Modules; and
(iv) any additional professional education recommended by my
Clinical Supervisor.
(b) I, Dr. Thamilvaanan, undertake to provide proof to the College of
my successful completion of the Professional Education, including
proof of registration and attendance and participant assessment
reports, within one (1) month of completing it. I acknowledge that
the College will determine, in its sole discretion, whether I have
successfully completed the Professional Education.
(c) I, Dr. Thamilvaanan, undertake to complete this requirement within
three (3) months.
(d) I, Dr. Thamilvaanan, acknowledge that a report or reports may be
provided to the College regarding my progress and compliance with
the Professional Education.
(7) Reassessment of Practice
(a) I, Dr. Thamilvaanan, undertake that, approximately six (6) months
after the completion of the Clinical Supervision set out in section
(5) above and Appendix "A" to this Undertaking, and the completion
of the Professional Education set out in section (6) above, I will
submit to a reassessment of my practice ("the Reassessment") by an
assessor or assessors selected by the College (the "Assessor" or
"Assessors"). I acknowledge that the Reassessment may include a
chart review of a minimum of fifteen (15) charts, direct
observation of my care, interviews with me, colleagues and
co-workers, feedback from patients, and any other tools deemed
necessary by the College.
(b) I, Dr. Thamilvaanan, undertake to co-operate fully with the
Reassessment, conducted under the term of this Undertaking.
(c) I, Dr. Thamilvaanan, acknowledge that my Clinical Supervisor may
receive and review the findings of the Assessor, and may discuss
with the Assessor any issues or concerns arising from the
Reassessment.
(d) I, Dr. Thamilvaanan, acknowledge that the results of the
Reassessment will be provided to me and reported to the College and
the Reassessment may form the basis of further action by the
College.
(8) Monitoring
(a) I, Dr. Thamilvaanan, undertake to inform the College of each and
every location at which I practise or have privileges, including,
but not limited to, any hospitals, clinics, offices, and any
Independent Health Facilities with which I am affiliated, in any
jurisdiction (collectively my "Practice Location" or "Practice
Locations"), within five (5) days of executing this Undertaking.
Going forward, I further undertake to inform the College of any and
all new Practice Locations within five (5) days of commencing
practice at that location.
(b) I, Dr. Thamilvaanan, undertake that I will submit to, and not
interfere with, unannounced inspections of my Practice Locations
and patient records by a College representative for the purposes of
monitoring my compliance with the provisions of this Undertaking.
(c) I, Dr. Thamilvaanan, give my irrevocable consent to the College to
make appropriate enquiries of OHIP and/or any person who or
institution that may have relevant information, in order for the
College to monitor my compliance with the provisions of this
Undertaking.
(d) I, Dr. Thamilvaanan, acknowledge that I have executed the OHIP
consent form, attached hereto as Appendix "C".
C. ACKNOWLEDGEMENT
(9) I, Dr. Thamilvaanan, acknowledge that all appendices attached to or
referred to in this Undertaking form part of this Undertaking.
(10) I, Dr. Thamilvaanan, acknowledge and undertake that I shall be solely
responsible for payment of all fees, costs, charges, expenses, etc.
arising from the implementation of any of the provisions of this
Undertaking.
(11) I, Dr. Thamilvaanan, acknowledge that I have read and understand the
provisions of this Undertaking and that I have obtained independent legal
counsel in reviewing and executing this Undertaking, or have waived my
right to do so.
(12) I, Dr. Thamilvaanan, acknowledge that the College will provide this
Undertaking to any Chief of Staff, or a colleague with similar
responsibilities, at any Practice Location ("Chief of Staff" or "Chiefs
of Staff").
(13) I, Dr. Thamilvaanan, acknowledge that a breach by me of any provision of
this Undertaking 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.
(14) I, Dr. Thamilvaanan, acknowledge that this Undertaking constitutes terms,
conditions, and limitations on my certificate of registration for the
purposes of section 23 of the Code.
(15) Public Register
(a) I, Dr. Thamilvaanan, acknowledge that, during the time period that
this Undertaking remains in effect, this Undertaking shall be
posted on the Public Register.
(b) I, Dr. Thamilvaanan, acknowledge that, in addition to this
Undertaking being posted in accordance with section (15)(a) above,
the following summary shall be posted on the Public Register during
the time period that this Undertaking remains in effect:
Dr. Thamilvaanan underwent remediation and submitted to a
reassessment of his practice following a College
investigation. The reassessment report subsequently received
by the College continued to raise concerns about his
practice. As a result:
Dr. Thamilvaanan will practise under the guidance of a
Clinical Supervisor acceptable to the College for 6 months.
Dr. Thamilvaanan will engage in professional education in
psychiatric assessment and hospitalization, and medical
record-keeping.
Dr. Thamilvaanan's practice will be reassessed by an assessor
selected by the College within 6 months of the end of the
period of Clinical Supervision.
(c) I, Dr. Thamilvaanan, acknowledge that this Undertaking remains in
effect until the College determines its terms are satisfied.
D. CONSENT
(16) I, Dr. Thamilvaanan, give my irrevocable consent to the College to
provide the following information to any person who requires this
information for the purposes of facilitating my completion of the
Professional Education and to all Clinical Supervisors, and/or Assessors:
(a) any information the College has that led to the circumstances of my
entering into this Undertaking;
(b) any information arising from any investigation into, or assessment
of, my practice; and
(c) any information arising from the monitoring of my compliance with
this Undertaking.
(17) I, Dr. Thamilvaanan, give my irrevocable consent to the College to
provide all Chiefs of Staff with any information the College has that led
to the circumstances of my entering into this Undertaking and/or any
information arising from the monitoring of my compliance with this
Undertaking.
(18) I, Dr. Thamilvaanan, give my irrevocable consent to any persons who
facilitate my completion of the Professional Education, and to all
Clinical Supervisors, Chiefs of Staff and Assessors, to disclose to the
College, and to one another, any of the following:
(a) any information relevant to this Undertaking;
(b) any information relevant to the provisions of the Clinical
Supervisor's undertaking set out at Appendix "A" to this
Undertaking;
(c) any information relevant to the Reassessment;
(d) any information relevant for the purposes of monitoring my
compliance with this Undertaking; and/or
(e) any information which comes to their attention in the course of
providing the Professional Education and which they reasonably
believe indicates a potential risk of harm to my patients.