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Taylor, Andrew Winston

CPSO#: 64009

MEMBER STATUS
Revoked: Discipline Committee as of 04 Sep 2018
CPSO REGISTRATION CLASS
None as of 04 Sep 2018
Flag: Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education:University of Toronto, 1991

Practice Information

Primary Location of Practice
Practice Address Not Available

Professional Corporation Information


Corporation Name: Andrew W. Taylor Medicine Professional Corporation
Certificate of Authorization Status: Inactive: Dec 10 2018

Specialties

Specialty Issued On Type
Ophthalmology Effective: 30 Jun 1995 RCPSC Specialist

Postgraduate Training

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



University of Toronto, 17 Jun 1991 to 15 Jun 1992
Other - Comprehensive Internship

University of Toronto, 01 Jul 1992 to 30 Jun 1993
Resident 2 - Ophthalmology

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 17 Jun 1991
Transfer of class of registration to: Independent Practice Certificate Effective: 23 Jul 1992
Revoked: Discipline Committee. Effective: 04 Sep 2018

Previous Hearings Flag: indicates a concern or additional information

Committee: Discipline
Decision Date: 29 Jul 2016
Summary:

On July 29, 2016, the Discipline Committee found that Dr. Andrew Winston Taylor committed 
an act of professional misconduct in that he has 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. 
 
Dr. Taylor, an ophthalmologist, operated a laser eye surgery clinic in Niagara Falls which 
offered at least two types of laser eye surgery – Planoscan and Zyoptix. The Zyoptix procedure 
was the newer, more intricate procedure and required more resources. The Zyoptix procedure 
was more expensive than the Planoscan procedure. 
 
Dr. Taylor first performed the Zyoptix procedure at the clinic in the summer of 2002. From the 
summer of 2002 until May 2003 (the “material time”), over 120 patients were billed for the 
Zyoptix procedure when in fact they had received the less expensive Planoscan procedure. The 
clinic issued refund cheques to 133 patients in 2003. 
 
The Committee found that Dr. Taylor billed for medical procedures that were not performed and 
instructed members of his staff to create, alter, or otherwise manipulate medical records related 
to such procedures. The Committee found that the overbilling was deliberate and intentional and 
that Dr. Taylor altered or directed the altering of records to make it look as if patients had 
received the Zyoptix, rather than the Planoscan, procedure. The Committee found that Dr. Taylor 
directed others to carry out blank firings of the laser (meaning no patient was present but the 
laser was operated), on numerous occasions in April and May 2003 to support inappropriate 
billing. 

DR. TAYLOR BILLED FOR MEDICAL PROCEDURES NOT PERFORMED 

The Committee found that Dr. Taylor billed for the more expensive Zyoptix procedure when he 
had actually performed the less expensive Planoscan procedure.  

The Committee did not believe Dr. Taylor’s testimony that he told every patient, including the 
more than 120 patients who were charged for the wrong procedure, that they received a different 
and cheaper procedure than that initially recommended by the optometrist and paid for. The 
Committee found it utterly inconceivable that this number of patients would have left the laser 
clinic without asking for their refund, or follow up sometime afterwards, if Dr. Taylor, or any 
other member of the clinical team, had so informed them; or, if the optometrist had discussed 
with them the price difference between the Zyoptix and Planoscan procedures.  

In the Committee’s view, an informed patient would have inquired prior to leaving the clinic, or 
sometime afterwards, about the anticipated refund. The Committee found that these more than 
120 patients were not informed about the cost differential between the Zyoptix and Planoscan 
procedures and the possibility of a refund.  

Dr. Taylor’s assertion that the failure to refund was due to a communications gap between clinic 
staff was not plausible. If the failure to refund was the result of a communications gap between 
the operating room and the administrative office, there would have been no reason for the patient 
charts to be contemporaneously altered by cutting and pasting and blank firings.  
In April 2003, an office manager learned about rumours of a police investigation into 
overcharging patients at the clinic. The Committee found Dr. Taylor’s reaction to the rumoured 
police investigation striking because he did not seek any information from the police about the 
investigation. He did not attempt to confirm whether there was an investigation. Instead, Dr. 
Taylor sought the advice of a trusted friend with communications expertise while instructing his 
staff to conduct a chart and financial review.  

The Committee found that the assistance of Dr. Taylor’s trusted friend would not have been 
needed if Dr. Taylor genuinely believed that the overbilling was a mere administrative error. Dr. 
Taylor’s friend’s expert advice yielded a letter to patients accompanying the refund that was 
misleading. The letter stated, “A routine fiscal audit of all our patient records has indicated that, 
notwithstanding preoperative tests, when the final examination in the operating room occurred, 
one of the planned processes was deemed to be unessential. Regrettably this change was not 
reflected in our charge to you.” The Committee found that the refund letter accompanying 
refunds was a deliberate attempt by Dr. Taylor to deceive patients about the reason for the 
refund. The Committee was troubled by the evasive and untruthful content of the letter. In no 
way could the reason for these refunds be described as “a routine fiscal audit of all of our patient 
records.” Nothing in Dr. Taylor’s testimony indicated anything “routine” about the rumoured 
police investigation that allegedly brought the matter to Dr. Taylor’s attention. Furthermore, not 
all of the patient records were audited.  

The Committee believed the office manager’s testimony that she had tried unsuccessfully in the 
past to have Dr. Taylor cease the overbilling despite the fact she was unable to recall details of 
her attempts. The Committee found that the rumoured police investigation was the reason Dr. 
Taylor finally heeded the office manager’s advice and stopped overbilling his patients. 

Two staff members testified that Dr. Taylor had specifically told them not to refund any 2003 
patients during the first round of refunds that were dated April 30, 2003. The Committee found 
that Dr. Taylor deliberately ordered his employees in April 2003 not to refund patients who had 
been converted from Zyoptix to Planoscan between January and April 2003. Furthermore, the 
Committee found that Dr. Taylor directed his two employees to not tell the truth to his corporate 
partners in 2005 about the lack of refunds for converted patients between January and April 
2003.  

DR. TAYLOR DIRECTED THE ALTERATION OF RECORDS  

The charts of patients, who had agreed to the Zyoptix procedure but were subsequently 
converted to the Planoscan procedure, were improperly altered to make it appear as if the 
patients had received the Zyoptix procedure when in fact they had received the less-expensive 
Planoscan procedure. The Committee found that Dr. Taylor directed his staff to alter patient 
charts using a cut-and-paste method to make it appear as if the more expensive procedure had 
been performed. 

Dr. Taylor was the only party to derive financial gain from withholding the patient refunds for 
the difference in cost between the procedures. Conversely, had the chart alterations been 
instigated by the laser technicians who worked for Dr. Taylor, those technicians would have 
risked severe repercussions had the deceit been discovered by Dr. Taylor. In addition, the 
Committee noted that the laser technicians who altered the charts did not derive any personal 
financial benefit from the overbilling. Indeed, the cutting and pasting only added extra time to 
their already long surgical day. 

Cutting and pasting took place after each busy surgical day whenever Zyoptix-to-Planoscan 
conversions occurred. The altered medical records were vital to covering up the deliberate 
overbilling. The vast majority of patients during the material time were from the United States. 
These altered records would have been especially necessary for patients whose follow-up was to 
be co-managed by a different physician who was closer to where the patient lived.  

After rumours of a police investigation into overbilling began to circulate at the laser clinic in 
April 2003, it is not contested that some charts were altered using a second method. The laser 
was “blank fired” (meaning no patient was present and the laser was operated) on numerous 
occasions in April and May 2003. The “blank fired” false records included patient information 
and the original date of surgery. These records conveyed the false impression that the more 
expensive surgery had been performed instead of the less expensive procedure.  

Dr. Taylor did not contest that blank firings occurred. However, Dr. Taylor denied that he 
participated in the blank firings and/or that he instructed the staff to carry them out. The matters 
of who gave the instructions to conduct blank firings and who was involved in carrying them out 
were in dispute. The Committee found that Dr. Taylor directed the blank firings of the laser in 
April and May 2003 and thus contributed to the alteration of patient charts for the purpose of 
covering up the over-billing. The Committee found that Dr. Taylor ordered and was aware of the 
blank firings at the material time. 

The Committee found that: 

   ?  Patients were over-billed for procedures that were not performed.  
   ?  Over 120 of these patients left the laser clinic after their procedure completely unaware 
      that they were entitled to a refund.  
   ?  The charts of these patients were altered at the time of the procedure.  
   ?  These two activities – chart alteration and over-billing – were integrally linked.  

The Committee concluded that both the over-billing and the chart alteration were deliberate, and, 
when considered together, could not have been the result of a communications gap or an 
administrative error.  

The Committee found that Dr. Taylor’s role was critical. Evidence points to his role in 
instructing a small number of staff to cut and paste the charts. Dr. Taylor’s testimony that every 
patient was aware of the difference in costs between the promised Zyoptix and the delivered 
Planoscan was simply not credible since each of those patients left the clinic without asking for 
their substantial refund. The Committee also found that the letter accompanying the eventual 
refunds was not truthful. There was no evidence of any motive for the laser technicians and the 
clinic manager to allegedly create a scheme of chart alteration and over-billing, when the people 
involved would have had to risk their employment and potential criminal charges without any 
tangible financial benefit to themselves. 
 
PENALTY 
 
On January 5, 2017, the Discipline Committee reserved its decision on penalty. On April 24, 
2017, the Discipline Committee released its decision on penalty and ordered that: 
 
1. The Registrar revoke Dr. Taylor’s certificate of registration effective immediately;  
2. Dr. Taylor appear before the panel to be reprimanded within three months of this Order 
   becoming final; and 
3. Dr. Taylor pay costs to the College in the amount of $54,560 within six months of this Order 
   becoming final. 
 
APPEAL 

On August 26, 2016, Dr. Taylor appealed the July 29, 2016 decision on finding of the Discipline 
Committee and on May 26, 2017, Dr. Taylor appealed the April 24, 2017 decision on penalty 
and costs of the Discipline Committee to the Divisional Court of the Superior Court of Justice. 
Pursuant to s. 25(1) of the Statutory Powers Procedure Act, the appeal operated as a stay of the 
Committee’s decisions in the matter. Therefore, Dr. Taylor’s certificate of registration remained 
in effect pending the disposition of the appeal. 

On September 4, 2018, the Divisional Court dismissed Dr. Taylor’s appeal in all respects. 
Therefore, as of September 4, 2018, the decision of the Discipline Committee is in effect. 

On October 1, 2018, Dr. Taylor filed a motion for leave to appeal the decision of the Divisional 
Court to the Court of Appeal. On January 7, 2019, the Court of Appeal dismissed Dr. Taylor’s 
motion for leave to appeal with costs fixed at $2,500.00.


Decision: Download Full Decision (PDF)
Appeal: Notice of Appeal
Hearing Date(s): September 15-18, December 16-17, 2014; November 4 and 5, 2015, November 16 and 17, 2015, December 2 and 8, 2015. Penalty Hearing: January 5, 2017

Concerns Flag: indicates a concern or additional information

Source: ICR Committee
Active Date: July 20, 2018
Expiry Date:
Summary:
Caution-in-Person and Specified Continuing Education and Remediation Program

A summary of a decision of the Inquiries, Complaints and Reports Committee (“ICRC”) in which the disposition includes a "caution-in-person" or 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 “caution-in-person” disposition requires the physician to attend at the College and be verbally cautioned by a panel of ICRC. A SCERP is one of the dispositions that the College’s ICRC 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.

Summaries will be removed from the register if the decision is overturned on appeal or review. This posting 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 and a SCERP:
Download Full Document (PDF)


Source: ICR Committee
Active Date: December 16, 2016
Expiry Date:
Summary:
Caution-in-Person and Specified Continuing Education and Remediation Program

A summary of a decision of the Inquiries, Complaints and Reports Committee (“ICRC”) in which the disposition includes a "caution-in-person" or 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 “caution-in-person” disposition requires the physician to attend at the College and be verbally cautioned by a panel of ICRC. A SCERP is one of the dispositions that the College’s ICRC 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.

Summaries will be removed from the register if the decision is overturned on appeal or review. This posting 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.


NOTE: This decision has been appealed to the Health Professions Appeal and Review Board.
Download Full Document (PDF)