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Ciurria, Nicholas Samuel

CPSO#: 29153

MEMBER STATUS
Active Member as of 16 Jun 1977
CPSO REGISTRATION CLASS
Restricted as of 06 Sep 2017

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English, Italian

Education:University of Toronto, 1976

Practice Information

Primary Location of Practice
Danforth Medical Centre
1473 Danforth Avenue
Toronto ON  M4J 1N5
Phone: (416) 461-0785
Fax: (416) 461-0787 Electoral District: 10

Additional Practice Location(s)

2754 Victoria Park Avenue
North York ON  M2J 4A8
Canada
Phone: (416) 491-3910
Fax: (416) 491-3919
County: City of Toronto
Electoral District: 10

Professional Corporation Information


Corporation Name: N. Ciurria Medicine Professional Corporation
Certificate of Authorization Status: Issued Date:  Aug 09 2010

Shareholders:
Dr. N. Ciurria ( CPSO# 29153 )

Business Address:
2754 Victoria Park Avenue
Toronto ON  M2J 4A8
Phone Number: (416) 491-3910

Business Address:
Danforth Medical Centre
1473 Danforth Avenue
Toronto ON  M4J 1N5
Phone Number: (416) 461-0785

Specialties

Specialty Issued On Type
No Speciality Reported

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 15 Jun 1976
Transfer of class of registration to: Independent Practice Certificate Effective: 16 Jun 1977
Transfer of class of certificate to: Restricted certificate Effective: 06 Sep 2017
Terms and conditions imposed on certificate by member Effective: 06 Sep 2017
Terms and conditions amended by member Effective: 06 Apr 2020

Practice Restrictions

Imposed By Effective Date Expiry Date Status
member Effective: 06 Apr 2020 Active
             As  from  April  6,  2020,  the  following are imposed as terms, conditions and
            limitations on the certificate of  registration  held  by  Dr.  Nicholas Samuel
            Ciurria in accordance with an undertaking and consent given by Dr.  Ciurria  to
            the College of Physicians and Surgeons of Ontario:

                        UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT 
                                          ("Undertaking")
                  
                                                of
                  
                              DR. NICHOLAS SAMUEL CIURRIA
                                          ("Dr. Ciurria")
                  
                                                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; 
                  
                  "NMS"  means  the Drug Program Services Branch, the Narcotics  Monitoring
                  System implemented under the Narcotics Safety and Awareness Act, 2010;

                  "OHIP" means the Ontario Health Insurance Plan;
                  
                  "Public Register"  means  the College's register that is available to the
                  public.
                  
            (2)   I, Dr. Ciurria, certificate  of registration number 29153, am a member of
                  the College.  

            (3)   I, Dr. Ciurria, acknowledge that  the  College  received information from
                  the NMS and conducted an investigation into whether  I failed to maintain
                  the standard of practice of the profession and/or was  incompetent  in my
                  prescribing   of   controlled   substances,   including   narcotics  (the
                  "Investigation").   As   a  result  of  the  Investigation,  I  underwent
                  remediation  and  submitted   to  a  reassessment  of  my  practice.  The
                  reassessment report subsequently  received  by  the  College continued to
                  raise concerns about my practice, including my prescribing  of controlled
                  substances.   

            B.    UNDERTAKING

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

            (5)   Professional Education  
                  (a)   I,  Dr.  Ciurria,  undertake  to  participate  in  and successfully
                        complete  all  aspects  of  the  detailed  IEP, attached hereto  as
                        Appendix "A", including all of the following professional education
                        (the "Professional Education"):
                  
                        (i)   review and reflection on: 
                  
                              1.    Benzodiazepine         Deprescribing         Algorithm,
                                    deprescribing.org
                                    www.cfp.ca/content/cfp/suppl/2018/05/14/64.5.339.DC1/Algorithm_eng.pdf;
                  
                              2.    Clinical  Toolkit -  Benzodiazepines:  Use  and  Taper,
                                    College  of   Physicians   and   Surgeons   of  Alberta
                                    www.cpsa.ca/wp-content/uploads/2017/06/Benzodiazepine-Clinical-Toolkit-Use-and-Taper.pdf;
                  
                              3.    Managing Benzodiazepine Use in Older Adults, Centre for
                                    Effective                                      Practice
                                    https://cep.health/clinical-products/benzodiazepine-use-in-older-adults/;
                  
                              4.    Opioid Tapering Template, Centre for Effective Practice
                                    https://cep.health/clinical-products/opioid-tapering-template/.
                  
                        (ii)  completion  of CMPA's Documentation: Charting Medical Records
                              and Documentation  II:  Principles  of Medical Record Keeping
                              eLearning modules; and 
                  
                        (iii) enrolment and engagement in Project ECHO's Addiction Medicine
                              and Psychosocial Interventions program.
                  
                  (b)   I, Dr. Ciurria, 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. Ciurria, undertake to complete this requirement within three
                        (3)  months or, if no satisfactory program  is  available  by  that
                        time, at the first possible opportunity thereafter.
                  
                  (d)   I, Dr.  Ciurria,  acknowledge  that  a  report  or  reports  may be
                        provided  to  the College regarding my progress and compliance with
                        the Professional Education.
                  
                  
                  
            (6)   Reassessment of Practice

                  (a)   I, Dr. Ciurria,  undertake  that,  approximately twelve (12) months
                        after  the  completion of the Professional  Education  set  out  in
                        section (5) 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.   Ciurria,   undertake   to   co-operate  fully  with  the
                        Reassessment, conducted under the term of this Undertaking. 
                  
                  (c)   I, Dr. Ciurria, 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. 
                  
            (7)   Monitoring 

                  (a)   I, Dr. Ciurria, 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. Ciurria,  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. Ciurria, 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. Ciurria, acknowledge that I have  executed  the OHIP and NMS
                        consent  forms,  attached hereto as Appendix "B" and Appendix  "C",
                        respectively. 
                  
            C.    ACKNOWLEDGEMENT

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

            (9)   I,  Dr.  Ciurria,  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. 
            (10)  I,  Dr.  Ciurria,  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.

            (11)  I,  Dr.  Ciurria,  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").

            (12)  I, Dr. Ciurria, 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.

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

            (14)  Public Register

                  (a)   I,  Dr. Ciurria, acknowledge that, during the time period that this
                        Undertaking  remains in effect, this Undertaking shall be posted on
                        the Public Register.
                  
                  (b)   I, Dr. Ciurria,  acknowledge  that, in addition to this Undertaking
                        being  posted  in  accordance  with   section  (14)(a)  above,  the
                        following summary shall be posted on the Public Register during the
                        time period that this Undertaking remains in effect:
                  
                              Dr.  Ciurria  underwent  remediation   and   submitted  to  a
                              reassessment of his practice following an investigation  into
                              his   prescribing   of   controlled   substances,   including
                              narcotics.  The reassessment report subsequently received  by
                              the College continued  to  raise concerns about his practice,
                              including his prescribing of  controlled  substances.   As  a
                              result:
                  
                                    Dr.  Ciurria  will  engage in professional education in
                                    opioid  and  benzodiazepine  prescribing,  and  medical
                                    record-keeping.
                  
                                    Dr.  Ciurria's   practice  will  be  reassessed  by  an
                                    assessor  selected  by  the  College  12  months  after
                                    completion of the professional education.
                  
                  (c)   I, Dr. Ciurria, acknowledge that this Undertaking remains in effect
                        until the College determines its terms are satisfied.
                  
            D.    CONSENT

            (15)  I, Dr. Ciurria, 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
                  all 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.
                  
            (16)  I, Dr. Ciurria, 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.

            (17)  I, Dr. Ciurria, give my irrevocable consent to any persons who facilitate
                  my  completion of the Professional Education, and to 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 Reassessment;
                  
                  (c)   any  information  relevant   for  the  purposes  of  monitoring  my
                        compliance with this Undertaking; and/or  
                  
                  (d)   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.

Concerns

Source: Member
Active Date: April 6, 2020
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Nicholas Samuel Ciurria to the College of Physicians and Surgeons of Ontario, effective April 6, 2020:

Dr. Ciurria underwent remediation and submitted to a reassessment of his practice following an investigation into his prescribing of controlled substances, including narcotics. The reassessment report subsequently received by the College continued to raise concerns about his practice, including his prescribing of controlled substances. As a result:

- Dr. Ciurria will engage in professional education in opioid and benzodiazepine prescribing, and medical record-keeping.

- Dr. Ciurria’s practice will be reassessed by an assessor selected by the College 12 months after completion of the professional education.