skip to content

Thomas, Cholemkeril Kuncheria

CPSO#: 54092

MEMBER STATUS
Active Member as of 03 Aug 2019
CPSO REGISTRATION CLASS
Restricted as of 19 Jun 2019
Flag: Indicates a concern or additional information

Summary

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Vestibulum ac diam sit amet quam vehicula elementum sed sit amet dui. Vivamus suscipit tortor eget felis porttitor volutpat. Curabitur non nulla sit amet nisl tempus convallis quis ac lectus. Curabitur aliquet quam id dui posuere blandit. Vivamus suscipit tortor eget felis porttitor volutpat. Curabitur arcu erat, accumsan id imperdiet et, porttitor at sem. Vestibulum ac diam sit amet quam vehicula elementum sed sit amet dui. Donec sollicitudin molestie malesuada. Pellentesque in ipsum id orci porta dapibus.

Former Name: No Former Name

Gender: Male

Languages Spoken: English, Malayalam

Education:University of Kerala, 1981

Practice Information

Primary Location of Practice
Anson General Hospital
580 Anson Dr
Iroquois Falls ON  P0K 1E0
Phone: (705) 258-3911 Ext. 3321 Electoral District: 08

Professional Corporation Information


Corporation Name: C. K. Thomas Medicine Professional Corporation
Certificate of Authorization Status: Inactive: May 17 2019

Specialties

Specialty Issued On Type
Family Medicine Effective: 07 Dec 2000 CFPC Specialist
Family Medicine (Emergency Medicine) Effective: 27 Nov 2001 CFPC Specialist

Postgraduate Training

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



University of Toronto, 11 Jun 1984 to 17 Jun 1985
Other - Rotating Internship

University of Ottawa, 01 Jul 1997 to 30 Jun 1998
PostGrad Yr 2 - Emergency Medicine

University of Ottawa, 01 Jul 1998 to 21 Sep 1998
PostGrad Yr 3 - Emergency Medicine

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 11 Jun 1984
Expired: Terms and conditions of certificate of registration Expiry: 17 Jun 1985
Subsequent certificate of registration Issued: Postgraduate Education Certificate Effective: 19 Aug 1997
Expired: Terms and conditions of certificate of registration Expiry: 21 Sep 1998
Subsequent certificate of registration Issued: Independent Practice Certificate Effective: 20 Feb 2001
Transfer of class of certificate to: Restricted certificate Effective: 19 Jun 2019
Terms and conditions imposed on certificate by Discipline Committee Effective: 19 Jun 2019
Suspension of registration imposed: Discipline Committee Effective: 03 Jul 2019
Suspension of registration removed Effective: 03 Aug 2019
Terms and conditions amended by member Effective: 13 Aug 2019

Practice Restrictions Flag: indicates a concern or additional information

Imposed By Effective Date Expiry Date Status
member Effective: 13 Aug 2019 Active
 
            (1 of 2)

            As from August 13, 2019, the following terms, conditions and limitations are
            imposed on the certificate of registration held by Dr. Cholemkeril Kuncheria
            Thomas, in accordance with an undertaking and consent Dr. Thomas has given to
            the College of Physicians and Surgeons of Ontario:

                               UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT 
                                            ("Undertaking")

                                                  of

                                   DR. CHOLEMKERIL KUNCHERIA THOMAS
                                            ("Dr. Thomas")

                                                  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;
                  
                  "Narcotic Drugs" means from the Narcotic Control Regulations made under
                  the Controlled Drugs and Substances Act, S.C., 1996, c. 19, as amended;
                  
                  "Narcotic Preparations" means from the Narcotic Control Regulations made
                  under the Controlled Drugs and Substances Act, S.C., 1996, c. 19, as
                  amended;
                  
                  "Controlled Drugs" means from Part G of the Food and Drug Regulations
                  under the Food and Drugs Act, S.C., 1985, c. F-27, as amended;
                  
                  "Benzodiazepines and Other Targeted Substances" means from the
                  Benzodiazepines and Other Targeted Substances Regulations made under the
                  Controlled Drugs and Substances Act., S.C., 1996, c. 19, as amended; 
                  
                        (A summary of the above-named drugs [from Appendix I to the
                        Compendium of Pharmaceuticals and Specialties] is attached hereto
                        as Schedule "A"; and links to the current regulatory lists are
                        attached hereto as Schedule "B")
                  
                  "Monitored Drugs" means 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 "C";
                  
                  "NMS" means the Drug Program Services Branch, the Narcotics Monitoring
                  System implemented under the Narcotics Safety and Awareness Act, 2010,
                  S.O. 2010, c. 22, as amended;
                  
                  "OHIP" means the Ontario Health Insurance Plan;
                  
                  "Public Register" means the College's register that is available to the
                  public.
                  
            (2)   I, Dr. Thomas, certificate of registration number 54092, am a member of
                  the College.  

            (3)   I, Dr. Thomas, acknowledge that the College conducted an investigation
                  bearing File Number 1100121 (the "Investigation") into whether I engaged
                  in professional misconduct and/or am incompetent in my family practice.

            (4)   I, Dr. Thomas, acknowledge that I am the subject of an Order of the
                  Discipline Committee of the College dated June 19, 2019 which provides
                  for the supervision and reassessment of my practice.  I, Dr. Thomas,
                  acknowledge that the supervision and reassessment components of this
                  Undertaking operate in addition to, though run concurrently with, those
                  set out in the Order of the Discipline Committee dated June 19, 2019.

            B.    UNDERTAKING

            (5)   I, Dr. Thomas, undertake to abide by the provisions of this Undertaking,
                  effective immediately.

            (6)   Practice Restrictions

                  (a)   I, Dr. Thomas, undertake to restrict my practice to Emergency
                        Medicine only, at a hospital where I hold privileges to so
                        practice.  For greater clarity, I, Dr. Thomas, may practice in an
                        Urgent Care clinic or centre at a hospital where I hold privileges
                        to practice Emergency Medicine.  I, Dr. Thomas, shall not practice
                        Family Medicine in any capacity or at any location including a
                        Walk-In clinic.
                  
                  (b)   I, Dr. Thomas, shall not prescribe greater than a five (5) days'
                        supply, with no repeats or refills, of any Narcotic Drug, Narcotic
                        Preparation, Controlled Drug, Benzodiazepine and Other Targeted
                        Substance or Monitored Drug to any patient.
                  
                  (c)   I, Dr. Thomas, shall keep a Log of all prescriptions for Narcotic
                        Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines and
                        Other Targeted Substances and Monitored Drugs, in the form attached
                        as set out in Appendix "A", which will include at least the
                        following information (the "Prescribing Log"):  
                  
                        (i)   the date of the appointment;
                        (ii)  the name of the patient and chart/file number;
                        (iii) the name of the medication prescribed, dose, direction,
                              number of tablets to be dispensed and frequency;
                        (iv)  the clinical indication;
                        (v)   whether the prescription is for a new medication and/or
                              different dose or frequency than currently prescribed to the
                              patient (Y/N); 
                        (vi)  Dr. Thomas's signature;
                        (vii) the date of the Clinical Supervisor's review (if applicable,
                              as set out below); and
                        (viii)the Clinical Supervisor's signature (if applicable, as set
                              out below).
                  
                  (d)   I, Dr. Thomas, undertake to keep a copy of all prescriptions I
                        write for Narcotic Drugs, Narcotic Preparations, Controlled Drugs,
                        Benzodiazepines and Other Targeted Substances and Monitored Drugs,
                        in the corresponding patient chart.
                  
                  (e)   I, Dr. Thomas, acknowledge that the practice restrictions set out
                        at sections 6(b), (c) and
                  
                   (d)   above, shall remain in effect until the College determines that I
                        have successfully completed the Reassessment described at section 9
                        below.
                  
            (7)   Clinical Supervision 

                  (a)   I, Dr. Thomas, undertake to practise under the guidance of a
                        clinical supervisor or clinical supervisors acceptable to the
                        College (the "Clinical Supervisor" or "Clinical Supervisors"), for
                        seven (7) months ("Clinical Supervision"). 
                  
                  (b)   I, Dr. Thomas, acknowledge that I have reviewed the Clinical
                        Supervisor's undertaking, attached hereto as Appendix "B", 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
                        "C";
                  
                        (ii)  Review the materials provided by the College and have an
                        initial meeting in August 2019 to discuss practice improvement
                        recommendations;
                  
                        (iii) Meet with me at my Practice Location, or another location
                        approved by the College once in November 2019, and once in February
                        2020;
                  
                        (iv)  At the meetings in November 2019 and February 2020, review
                        the charts of all patients listed in the Prescribing Log, including
                        the associated prescriptions;
                        (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 after every meeting, or
                        more frequently if the Clinical Supervisor has concerns about my
                        standard of practice.
                  
                  (c)   I, Dr. Thomas, 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 "C", as well as
                        the areas of concern identified in the reports of the assessors
                        dated October 8, 2018 and March 29, 2019, and concerns that may
                        arise during the period of Clinical Supervision.
                  
                  (d)   I, Dr. Thomas, undertake to cooperate fully with the Clinical
                        Supervision of my practice, conducted under the term of this
                        Undertaking and Appendix "B" 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. Thomas, undertake to ensure that Appendix "B" to this
                        Undertaking is signed and delivered to the College within twenty
                        (20) days of the date I execute this Undertaking.
                  
                  (f)   I, Dr. Thomas, undertake that if a person who has given an
                        undertaking in Appendix "B" 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. Thomas, undertake that if I am unable to obtain a Clinical
                        Supervisor on the provisions set out under sections (7)(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. Thomas, acknowledge that if I am required to cease practise
                        as a result of section (7)(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.
                  
            (8)   Professional Education  

                  (a)   I, Dr. Thomas, undertake to participate in and successfully
                        complete all aspects of the detailed IEP, attached hereto as
                        Appendix "C", including all of the following professional education
                        (the "Professional Education"):
                  
                        (i)   University of Toronto Faculty of Medicine program in Safe
                              Opioid Prescribing (all three webinars and in-person
                              workshop): www.cepd.utoronto.ca/opioidprescribing;
                  
                        (ii)  Review and discuss with my Clinical Supervisor the following
                              resources:
                  
                              1.    2017 Canadian Guideline for Opioids for Chronic
                                    Non-Cancer Pain:
                                    http://nationalpaincentre.mcmaster.ca/opioid;
                  
                              2.    CPSO Policy "Prescribing Drugs":
                                    http://www.cpso.on.ca/Policies-Publications/Policy/Prescribing-Drugs;
                  
                  
                              3.    the Centre for Effective Practice Management of Chronic
                                    Non-Cancer Pain Tools:
                  
                                    (i)   
                                          https://thewellhealth.ca/wp-content/uploads/2017/03/CEP_CNCP_Main_V1.pdf
                  
                                    (ii)  
                                          https://www.cfpc.ca/centre-effective-practice-updates-opioid-manager-tool/;
                                          and
                  
                                    (iii) any additional professional education recommended
                                          by my Clinical Supervisor.
                  
                              (b)   I, Dr. Thomas, 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. Thomas, undertake to complete the Professional
                                    Education within three (3) months of signing this
                                    Undertaking.
                  
                              (d)   I, Dr. Thomas, acknowledge that a report or reports may
                                    be provided to the College regarding my progress and
                                    compliance with the Professional Education.
                  
            (9)   Reassessment of Practice

                  (a)   I, Dr. Thomas, undertake that, approximately six (6) months after
                        the completion of the Clinical Supervision set out in section (7)
                        above and Appendix "B" to this Undertaking, 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,
                        direct observation of my care, interviews with colleagues and
                        co-workers, feedback from patients and any other tools deemed
                        necessary by the College.
                  
                  (b)   I, Dr. Thomas, undertake to co-operate fully with the Reassessment,
                        conducted under the term of this Undertaking. 
                  
                  (c)   I, Dr. Thomas, 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. Thomas, 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. 
                  
            (10)  Monitoring 

                  (a)   I, Dr. Thomas, 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. Thomas, 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. Thomas, give my irrevocable consent to the College to make
                        appropriate enquiries of OHIP, NMS 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. Thomas, acknowledge that I have executed the OHIP and NMS
                        consent forms, attached hereto as Appendix "D" and Appendix "E",
                        respectively. 
                  
            C.    ACKNOWLEDGEMENT

            (11)  I, Dr. Thomas, acknowledge that all appendices attached to or referred to
                  in this Undertaking form part of this Undertaking.

            (12)  I, Dr. Thomas, 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. 

            (13)  I, Dr. Thomas, 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.

            (14)  I, Dr. Thomas, 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").

            (15)  I, Dr. Thomas, 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.

            (16)  I, Dr. Thomas, acknowledge that this Undertaking constitutes terms,
                  conditions, and limitations on my certificate of registration for the
                  purposes of section 23 of the Code. 

            (17)  Public Register

                  (a)   I, Dr. Thomas, acknowledge that, during the time period that this
                        Undertaking remains in effect, this Undertaking shall be posted on
                        the Public Register.
                  
                  (b)   I, Dr. Thomas, acknowledge that, in addition to this Undertaking
                        being posted in accordance with section (17)(a) above, the
                        following summary shall be posted on the Public Register during the
                        time period that this Undertaking remains in effect:
                  
                        A College investigation was conducted into whether Dr. Thomas
                        engaged in professional misconduct and/or is incompetent in his
                        family medicine practice. As a result of the investigation:
                  
                        Dr. Thomas shall practice Emergency Medicine only, at a hospital
                        where he holds privileges to so practice, and shall not practice
                        Family Medicine including at a walk-in clinic. 
                  
                        Dr. Thomas shall not prescribe greater than a five (5) days'
                        supply, with no repeats or refills, of any Narcotic Drug, Narcotic
                        Preparation, Controlled Drug, Benzodiazepine and Other Targeted
                        Substance or Monitored Drug to any patient.
                  
                        Dr. Thomas will practise under the guidance of a Clinical
                        Supervisor acceptable to the College for seven (7) months. 
                  
                        Dr. Thomas will engage in professional education in the prescribing
                        of narcotics and controlled substances.
                  
                        Dr. Thomas's practice will be reassessed by an assessor selected by
                        the College approximately six (6) months following the period of
                        Clinical Supervision.
                  
            D.    CONSENT

            (18)  I, Dr. Thomas, 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.
                  
            (19)  I, Dr. Thomas, 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.

            (20)  I, Dr. Thomas, 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 "B" 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.
                  
                  
                  
                  
                  
                  
            (2 of 2)

            As from 4:00 p.m., June 19, 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.
            Cholemkeril Kuncheria Thomas:

                  i.    Dr. Thomas shall comply with the College Policy #2-07 "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 this
                        Order;  
            Clinical Supervision

                  ii.   For a period of nine (9) months from the date of this Order, Dr.
                        Thomas shall practice medicine only under the supervision of a
                        clinical supervisor approved by the College (the "Clinical
                        Supervision").
                  
                  iii.  Within ten (10) days of this Order, Dr. Thomas shall have a
                        College-approved clinical supervisor (the "Clinical Supervisor")
                        sign an Undertaking in the form attached hereto as Schedule "B".
                  
                  iv.   Dr. Thomas shall meet with the Clinical Supervisor once in August
                        2019, once in November 2019, and once in February 2020.  At each
                        meeting, the Clinical Supervisor shall:
                  
                        i.    Review a minimum of twenty (20) patient charts, to be
                              selected by the Clinical Supervisor in accordance with the
                              educational needs identified in the Individualized Education
                              Plan attached hereto at Schedule "C" (the "IEP");
                        ii.   Discuss with Dr. Thomas any concerns the Clinical Supervisor
                              may have arising from the chart reviews;
                        iii.  Make recommendations to Dr. Thomas for practice improvements
                              and inquire into Dr. Thomas' compliance with the
                              recommendations; and
                  
                        iv.    Keep a log of all patient charts reviewed along with patient
                              identifiers.
                  
                  v.    The Clinical Supervisor shall submit written reports to the College
                        promptly after every meeting with Dr. Thomas, or immediately if the
                        Clinical Supervisor has concerns about Dr. Thomas' standard of
                        practice or that Dr. Thomas' patients may be exposed to harm or
                        injury. 
                  
                  vi.   Dr. Thomas shall fully cooperate with the Clinical Supervision and
                        shall abide by all recommendations of the Clinical Supervisor.
                  
                  vii.  If a person who has given an Undertaking in Schedule "B" to this
                        Order is unable or unwilling to continue to fulfill its provisions,
                        Dr. Thomas 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.
                  
                  viii. If Dr. Thomas is unable to obtain a Clinical Supervisor as set out
                        in this Order, he shall cease practising medicine until such time
                        as he has obtained a Clinical Supervisor acceptable to the College.
                  
                  ix.   If Dr. Thomas is required to cease practise as a result of section
                        4.(viii) above, this will constitute a term, condition or
                        limitation on his certificate of registration and that term,
                        condition or limitation will be included on the public register.
            Reassessment

                  x.    Approximately six (6) months following completion of the Clinical
                        Supervision, Dr. Thomas shall undergo a reassessment of his
                        practice by a College-appointed assessor (the "Reassessment"). 
                  
                  xi.   The Reassessment shall focus on the educational needs addressed
                        during the period of Clinical Supervision as set out in the IEP and
                        may include a review of Dr. Thomas's patient charts, direct
                        observations, and interviews with staff and/or patients and any
                        other tools deemed necessary by the College.  The Assessor shall
                        report the results of the Reassessment to the College.
            Monitoring

                  xii.  Dr. Thomas shall inform the College of each and every location
                        where he practices, in any jurisdiction (his "Practice
                        Location(s)") within fifteen (15) days of this Order and shall
                        inform the College of any and all new Practice Locations within
                        fifteen (15) days of commencing practice at that location.
                  
                  xiii. Dr. Thomas shall consent to the sharing of information between the
                        Clinical Supervisor, the Assessor and the College as any of them
                        deem necessary or desirable in order to fulfill their respective
                        obligations.
                  
                  xiv.  Dr. Thomas shall consent to the College making enquiries of the
                        Ontario Health Insurance Program, the Narcotics Monitoring System
                        and/or any person or institution that may have relevant
                        information, in order for the College to monitor his compliance
                        with this Order and shall promptly sign such consents as may be
                        necessary for the College to obtain information from these persons
                        or institutions.
                  
                  xv.   Dr. Thomas shall co-operate with unannounced inspections of his
                        office practice and patient charts by the College for the purpose
                        of monitoring and enforcing his compliance with the terms of this
                        Order. 
                  
                  xvi.  Dr. Thomas shall notify any employer, or any hospital at which he
                        may have privileges, about this Order.
                  
                  xvii. Dr. Thomas shall be responsible for any and all costs associated
                        with implementing the terms of this Order.

Previous Hearings Flag: indicates a concern or additional information

Committee: Discipline
Decision Date: 19 Jun 2019
Summary:

On June 19th, 2019, the Discipline Committee found that Dr. Thomas 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.  
 
Facts 
 
Dr. Thomas is a 64 year-old family physician who received his certificate of registration 
authorizing independent practice from the College of Physicians and Surgeons of Ontario in 
2001. 
Dr. Thomas currently practices Emergency Medicine in Iroquois Falls, Ontario and previously 
practiced Emergency Medicine and Family Medicine in Espanola, Ontario.  
 
Background  
 
On April 19, 2017, the Inquiries, Complaints and Reports Committee of the College (the 
“ICRC”) directed that Dr. Thomas attend the College to be cautioned and required that Dr. 
Thomas complete a specified continuing education and remediation program with the following 
components: 
 
(a) Courses: Attend and complete the next available session of the following courses (with 
   proof of attendance to be provided): 
      1. The Medical Record-Keeping Course, through a course provider indicated by the 
         College; 
      2. The Safe Opioid Prescribing Course, through a course provider indicated by the 
         College (three webinars and workshop); 
      3. ATLS (Advanced Trauma Life Support) (https://www.facs.org/quality-
         programs/trauma/atls/about); and 
      4. An Emergency Medicine Review Course (for example, the National Capital 
         Conference on Emergency Medicine at http://www.emottawa.ca/eng/60-nccem.html). 
 
(b) One-on-one instruction: Complete one-on-one instruction in collaboration and 
   professionalism (including respect for colleagues and co-workers, punctuality, 
   responsiveness to calls for patient care and responsiveness to requests from the College). 
    
(c) Self-directed learning with written summaries:  Review and prepare written summaries 
   of up to 2000 words (2-4 pages) of each of the following documents with reference to 
   current standards of practice (where applicable), how it is applicable to Dr. Thomas’ 
   situation, as well as how Dr. Thomas has made, or plans to make changes, to his practice.  
   The written summaries were to be submitted within 4 months of receipt of the decision.  
      1. Clinical Practice Guidelines regarding vaginal bleeding during pregnancy;  
      2. Choosing Wisely Canada Recommendations for Emergency Medicine;  
      3. The College’s policy on Medical Records; 
       4. The College’s policy on Physician Behaviour in the Professional Environment; and  
       5. The College’s Practice Guide.  
           
 (d) Clinical Supervision: Engage a Clinical Supervisor acceptable to the College to engage in 
    focused educational sessions as set out in an Individualized Education Plan. The Clinical 
    Supervisor was required to sign an undertaking with the College within 30 days’ of Dr. 
    Thomas’ receipt of the April 19, 2017 ICRC Decision. Dr. Thomas was required to meet 
    with the Clinical Supervisor for a period of 12 months, no less than monthly for six months, 
    and then quarterly for six months; and review at least 20 Emergency Department charts at 
    each meeting. 
(e) Reassessment: Approximately six months following the completion of the education and 
    remediation set out above, Dr. Thomas’ Emergency Department practice is to be reassessed. 
     
 Dr. Thomas’ Failure To Comply With The April 2017 SCERP 
     
 On May 16, 2017, the College’s Compliance Case Manager wrote to Dr. Thomas’ counsel about 
 the implementation of the April 2017 SCERP. The Compliance Case Manager asked that a 
 Clinical Supervisor be identified to him by June 1, 2017. 
  
 Dr. Thomas proposed potential Clinical Supervisors on June 12, 2017 and June 27, 2017. The 
 two Clinical Supervisors proposed by Dr. Thomas were not approved by the College. 
 On July 11, 2017, the Compliance Case Manager advised that he had located a potential Clinical 
 Supervisor for Dr. Thomas. Dr. Thomas confirmed that he would be willing to work with the 
 College’s proposed Clinical Supervisor.    
  
 On August 2, 2017, the Compliance Case Manager confirmed that the College’s proposed 
 Clinical Supervisor (“Clinical Supervisor A”) had been approved by the College.  The 
 Compliance Case Manager urged Dr. Thomas to contact Clinical Supervisor A shortly to begin 
 the supervision meetings. On August 4, 2017, Clinical Supervisor A signed a Clinical Supervisor 
 Undertaking to the College.  
  
 On September 15, 2017, Dr. Thomas, through his counsel, wrote to the Compliance Case 
 Manager requesting an extension for completing the written summaries for the self-directed 
 learning portion of the April 2017 SCERP to October 9, 2017. At the same time, he advised that 
 Dr. Thomas had registered for the Medical Record-Keeping Course, the Safe Opioid Prescribing 
 Course and an Emergency Medicine Review Course. He did not indicate whether Dr. Thomas 
 had registered for a course in ATLS (Advanced Trauma Life Support). The College granted Dr. 
 Thomas’ request for an extension for completion of his written summaries to October 9, 2017. 
  
 In October of 2017, the Compliance Case Manager contacted Clinical Supervisor A to inquire 
 about the status of her first supervision report, which had yet to be submitted to the College.  
 Between October 17, 2017 and October 27, 2017, in an email exchange and in a telephone 
 conversation, Clinical Supervisor A indicated to the Compliance Case Manager that she had had 
 difficulty connecting and scheduling a meeting with Dr. Thomas.   
  
 On November 6, 2017, the Compliance Case Manager reminded Dr. Thomas, through his 
counsel, that it was Dr. Thomas’ responsibility to ensure that he meets monthly with his Clinical 
Supervisor and that Dr. Thomas is in breach of his undertaking.   
 
On December 7, 2017, Dr. Thomas’ counsel wrote to provide an update regarding Dr. Thomas’ 
compliance with the April 2017 SCERP. Dr. Thomas’ counsel indicated that Dr. Thomas had 
attended the Medical Record-Keeping Course, the Safe Opioid Prescribing Course and an 
Emergency Medicine Review Course and that he intended to complete a course in ATLS 
(Advanced Trauma Life Support) in early 2018. He also indicated that Dr. Thomas had 
completed an initial meeting with his one-on-one instructor, and that he had not yet completed 
the self-study with written summaries of 5 policies/guidelines (for which he had previously been 
granted an extension to October 9, 2017), but that these would be completed by December 15, 
2017. As well, he indicated that Dr. Thomas had met with his Clinical Supervisor on September 
16, 2017 and October 29, 2017.   
 
On December 15, 2017, Dr. Thomas sent several emails to the Compliance Case Manager 
requesting that he be exempted from preparing written summaries for his self-directed learning 
as required by the April 2017 SCERP. In response, the Compliance Case Manager reminded Dr. 
Thomas that he had already been provided with two extensions and stated that the written 
summaries must be provided to the College by December 22, 2017.   
 
On December 19, 2017, in response to a follow-up email from the Compliance Case Manager, 
Clinical Supervisor A advised the Compliance Case Manager that the meeting she had been 
scheduled to have with Dr. Thomas on December 12, 2017 had not occurred due to bad weather.  
Clinical Supervisor A had suggested that she could spend the day with Dr. Thomas in the 
emergency room but he had not been willing to do so. Given that Clinical Supervisor A had not 
been able to meet with Dr. Thomas in accordance with the terms of the April 19, 2017 ICRC 
Decision, the Compliance Case Manager advised that Clinical Supervisor A was no longer 
approved to act as Dr. Thomas’ Clinical Supervisor.   
 
On December 21, 2017, the Compliance Case Manager wrote to Dr. Thomas’ counsel advising 
that the name of a new proposed Clinical Supervisor should be forwarded to her by January 12, 
2018.  
 
On January 3, 2018, the Compliance Case Manager wrote to Dr. Thomas’ counsel advising that 
she had received an email from Dr. Thomas requesting yet another extension of time to complete 
his self-directed learning written summaries. She advised that she would grant one final 
extension to January 12, 2018. The Compliance Case Manager also stated that Dr. Thomas was 
required to have a College-approved Clinical Supervisor by January 12, 2018. 
 
On January 15, 2018, the Compliance Case Manager wrote to Dr. Thomas’ counsel and advised 
that Dr. Thomas had not submitted his self-directed learning written summaries, nor had she 
received the name of a proposed Clinical Supervisor. In her letter, the Compliance Case Manager 
indicated that she would grant an extension to January 26, 2018, failing which the matter would 
be returned to Committee for further direction.   
 
On March 27, 2018, the Compliance Case Manager wrote to Dr. Thomas’ counsel informing him 
that Dr. Thomas’ matter would be returning to ICRC on April 3, 2018 for consideration of action 
due to his failure to complete the terms of the April 2017 SCERP.    
 
As of April 3, 2018, when this matter was referred to the Discipline Committee by the ICRC, Dr. 
Thomas had failed to complete the terms of the April 2017 SCERP. 
 
Status of Compliance at Date of Referral to the Discipline Committee 
 
In particular, as of April 3, 2018, the status of Dr. Thomas’ compliance with the terms of the 
April 2017 SCERP was as follows: 
(a) Courses: Incomplete.  Dr. Thomas had completed some, but not all, of his coursework.   
(b) One-on-one instruction: Incomplete.  Dr. Thomas had attended an initial meeting with his 
   one-on-one instructor but then failed to attend follow-up sessions. 
(c) Self-directed learning with written summaries:  Incomplete.  On multiple occasions, Dr. 
   Thomas had requested and received extensions from the College to submit his written 
   summaries. 
(d) Clinical Supervision:  Incomplete.  Clinical Supervisor A ceased being Dr. Thomas’ 
   Clinical Supervisor on December 20, 2017, as Dr. Thomas failed to meet with her in 
   accordance with the terms of the April 2017 SCERP. Dr. Thomas failed to identify a new 
   Clinical Supervisor. 
(e) Reassessment: Incomplete.   
          
Current Status of Dr. Thomas’ Compliance with the April 2017 SCERP  
 
Following the ICRC’s referral of Dr. Thomas’ matter to the Discipline Committee, Dr. Thomas 
made some further efforts to comply with the April 2017 SCERP.   
As of June 12, 2019, the status of Dr. Thomas’ compliance with the terms of the April 2017 
SCERP is as follows: 
(a) Courses: Complete.   
(b) One-on-one instruction: Complete. 
(c) Self-directed learning with written summaries: Complete. 
(d) Clinical Supervision: Incomplete. Dr. Thomas retained a new Clinical Supervisor in 
   December of 2018.   
 
   Dr. Thomas attended Clinical Supervision meetings on the following dates:  

   -  January 12, 2019 
   -  February 17, 2019 
   -  March 16, 2019 
  -  May 10, 2019 

  Dr. Thomas was scheduled to meet with his Clinical Supervisor in mid-April of 2019.  
   However, Dr. Thomas cancelled the meeting. Therefore, Dr. Thomas did not meet with his 
   Clinical Supervisor in April of 2019. 
    Dr. Thomas was also scheduled to meet with his Clinical Supervisor on May 31, 2019.  
    However, on May 31, Dr. Thomas requested that the meeting be rescheduled. Thus, the May 
   31, 2019 meeting was rescheduled to June 2, 2019. On June 2, 2019, Dr. Thomas again 
   requested that the meeting be rescheduled.  The meeting was then rescheduled to June 3, 
   2019.  On June 3, 2019, approximately one hour before the scheduled meeting time, Dr. 
    Thomas called the Clinical Supervisor and advised that he forgot the time, would be late, and 
    asked to start the meeting one hour later. Dr. Thomas’s Clinical Supervisor was not able to 
   accommodate this third rescheduling request.  Dr. Thomas’s next meeting with his Clinical 
   Supervisor is scheduled for June 14, 2019. 

   Subject to any further delays, Dr. Thomas is scheduled to complete his Clinical Supervision 
   in February of 2020. 

(e) Reassessment:  Incomplete.  Dr. Thomas’ reassessment is to be scheduled approximately 6 
    months’ following completion of Dr. Thomas’ Clinical Supervision. 
     
 Admission 
     
 Dr. Thomas admits to the facts above, and admits that, based on these facts, he engaged in 
 professional misconduct under paragraph 1(1)33 of O Reg. 856/93, in that he engaged in acts or 
 omissions relevant to the practice of medicine that would be regarded by members as disgraceful, 
 dishonourable or unprofessional by failing to comply with the April 19, 2017 decision of the 
 Inquiries, Complaints and Reports Committee requiring that he complete a specified continuing 
 education or remediation program. 
     
 Agreed Statement of Facts Relevant to Penalty 
     
 Relevant College History 

 In June 2014, the Inquiries, Complaints and Reports Committee of the College considered a 
 complaint from a prior employer of Dr. Thomas in Ottawa. That employer complained that Dr. 
 Thomas left his position without any notice or follow-up plans for his patients, did not respond to 
 efforts by clinic staff to contact him, and took some patient records with him. In addition, Dr. 
 Thomas failed to respond to a letter from the College’s investigator with questions regarding the 
 matter. The ICRC issued a written caution to Dr. Thomas regarding his lack of appropriate 
 management upon leaving a practice.  

Additional Relevant History 

In August 1996, a complaint was received by the College of Physicians and Surgeons of Nova 
Scotia from the Nova Scotia Prescription Monitoring Program that Dr. Thomas failed to respond 
to their requests for information concerning his prescribing of controlled substances to patient X.  
 After investigation of the matter, Dr. Thomas was counseled with respect to not responding 
 promptly and appropriately to the Prescription Monitoring Program. The Investigation 
 Committee also suggested that he review the organization of his office to ensure that all mail was 
 dealt with appropriately.  
    
Disposition 
    
The Discipline Committee ordered that: 
    
-     Dr. Thomas attend before the panel to be reprimanded. 
       
-     The Registrar suspend Dr. Thomas’s certificate of registration for a period of one (1) 
      month, commencing from July 3, 2019 at 12:01 a.m. 

-     The Registrar place the following terms, conditions and limitations on Dr. Thomas’s 
      certificate of registration: 

      a.    Dr. Thomas shall comply with the College Policy #2-07 “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 this Order;   

Clinical Supervision 

      b.    For a period of nine (9) months from the date of this Order, Dr. Thomas shall 
            practice medicine only under the supervision of a clinical supervisor approved by 
            the College (the “Clinical Supervision”). 

      c.    Within ten (10) days of this Order, Dr. Thomas shall have a College-approved 
            clinical supervisor (the “Clinical Supervisor”) sign an Undertaking in the form 
            attached hereto as Schedule “B”. 

      d.    Dr. Thomas shall meet with the Clinical Supervisor once in August 2019, once in 
            November 2019, and once in February 2020.  At each meeting, the Clinical 
            Supervisor shall: 

          i.   Review a minimum of twenty (20) patient charts, to be selected by the 
               Clinical Supervisor in accordance with the educational needs identified in the 
               Individualized Education Plan attached hereto at Schedule “C” (the “IEP”); 

          ii. Discuss with Dr. Thomas any concerns the Clinical Supervisor may have 
              arising from the chart reviews; 

         iii.  Make recommendations to Dr. Thomas for practice improvements and inquire 
               into Dr. Thomas’ compliance with the recommendations; and 

         iv.    Keep a log of all patient charts reviewed along with patient identifiers. 

      e.    The Clinical Supervisor shall submit written reports to the College promptly after 
            every meeting with Dr. Thomas, or immediately if the Clinical Supervisor has 
            concerns about Dr. Thomas’ standard of practice or that Dr. Thomas’ patients 
            may be exposed to harm or injury.  
 f.    Dr. Thomas shall fully cooperate with the Clinical Supervision and shall abide by 
       all recommendations of the Clinical Supervisor. 

 g.    If a person who has given an Undertaking in Schedule “B” to this Order is unable 
       or unwilling to continue to fulfill its provisions, Dr. Thomas 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. 

 h.    If Dr. Thomas is unable to obtain a Clinical Supervisor as set out in this Order, he 
       shall cease practising medicine until such time as he has obtained a Clinical 
       Supervisor acceptable to the College. 

 i.    If Dr. Thomas is required to cease practise as a result of section 4.(viii) above, this 
       will constitute a term, condition or limitation on his certificate of registration and 
       that term, condition or limitation will be included on the public register. 

Reassessment 

j.    Approximately six (6) months following completion of the Clinical Supervision, 
      Dr. Thomas shall undergo a reassessment of his practice by a College-appointed 
      assessor (the “Reassessment”).  

k.    The Reassessment shall focus on the educational needs addressed during the 
      period of Clinical Supervision as set out in the IEP and may include a review of 
      Dr. Thomas’s patient charts, direct observations, and interviews with staff and/or 
      patients and any other tools deemed necessary by the College.  The Assessor shall 
      report the results of the Reassessment to the College. 

 Monitoring 

l.     Dr. Thomas shall inform the College of each and every location where he 
       practices, in any jurisdiction (his “Practice Location(s)”) within fifteen (15) days 
       of this Order and shall inform the College of any and all new Practice Locations 
       within fifteen (15) days of commencing practice at that location. 

m.    Dr. Thomas shall consent to the sharing of information between the Clinical 
      Supervisor, the Assessor and the College as any of them deem necessary or 
      desirable in order to fulfill their respective obligations. 

n.    Dr. Thomas shall consent to the College making enquiries of the Ontario Health 
      Insurance Program, the Narcotics Monitoring System and/or any person or 
      institution that may have relevant information, in order for the College to monitor 
      his compliance with this Order and shall promptly sign such consents as may be 
      necessary for the College to obtain information from these persons or institutions. 
      o.    Dr. Thomas shall co-operate with unannounced inspections of his office practice 
            and patient charts by the College for the purpose of monitoring and enforcing his 
            compliance with the terms of this Order.  

      p.    Dr. Thomas shall notify any employer, or any hospital at which he may have 
            privileges, about this Order. 

      q.    Dr. Thomas shall be responsible for any and all costs associated with 
            implementing the terms of this Order. 

-     Dr. Thomas pay costs to the College in the amount of $6,000.00 within 30 days of the 
      date of this Order.


Decision: Download Full Decision (PDF)
Hearing Date(s): June 19, 2019 at 1:00 p.m.

Concerns Flag: indicates a concern or additional information

Source: Member
Active Date: August 13, 2019
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Cholemkeril Kuncheria Thomas to the College of Physicians and Surgeons of Ontario, effective August 13, 2019:
A College investigation was conducted into whether Dr. Thomas engaged in professional misconduct and/or is incompetent in his family medicine practice. As a result of the investigation:

Dr. Thomas shall practice Emergency Medicine only, at a hospital where he holds privileges to so practice, and shall not practice Family Medicine including at a walk-in clinic.

Dr. Thomas shall not prescribe greater than a five (5) days’ supply, with no repeats or refills, of any Narcotic Drug, Narcotic Preparation, Controlled Drug, Benzodiazepine and Other Targeted Substance or Monitored Drug to any patient.

Dr. Thomas will practise under the guidance of a Clinical Supervisor acceptable to the College for seven (7) months.

Dr. Thomas will engage in professional education in the prescribing of narcotics and controlled substances.

Dr. Thomas’s practice will be reassessed by an assessor selected by the College approximately six (6) months following the period of Clinical Supervision.

 

Source: ICR Committee
Active Date: April 19, 2017
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)