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Bray, Frederick Thomas

CPSO#: 65372

MEMBER STATUS
Active Member as of 01 Jul 1992
CPSO REGISTRATION CLASS
Restricted as of 21 Nov 2017
Flag: Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education:McGill University, 1989

Practice Information

Primary Location of Practice
1637 Woodroffe Avenue
Suite 102
Ottawa ON  K2G 1W2
Phone: (613) 739-7753
Fax: 613-739-7808 Electoral District: 07

Professional Corporation Information


Corporation Name: Dr. Frederick T. Bray Medicine Professional Corporation
Certificate of Authorization Status: Issued Date:  Jan 28 2004

Shareholders:
Dr. F. Bray ( CPSO# 65372 )

Business Address:
Suite 207
267 O'Connor Street
Ottawa ON  K2P 1V3
Phone Number: (613) 567-8000

Business Address:
102 - 1637 Woodroffe Avenue
Ottawa ON  K2G 1W2
Phone Number: (613) 739-7753

Specialties

Specialty Issued On Type
Internal Medicine Effective: 30 Jun 1993 RCPSC Specialist
Gastroenterology Effective: 26 Sep 2000 RCPSC Specialist

Postgraduate Training

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



University of Ottawa, 01 Jul 1993 to 30 Jun 1994
Resident 5 - Gastroenterology

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 01 Jul 1992
Transfer of class of registration to: Independent Practice Certificate Effective: 22 Feb 1994
Transfer of class of certificate to: Restricted certificate Effective: 21 Nov 2017
Terms and conditions imposed on certificate by member Effective: 21 Nov 2017

Practice Restrictions Flag: indicates a concern or additional information

Imposed By Effective Date Expiry Date Status
member Effective: 21 Nov 2017 Active
             As from November 21, 2017, the following terms, conditions and limitations are
            imposed on the certificate of registration held by Dr. Frederick Thomas Bray,
            in accordance with an undertaking and consent Dr. Bray has given to the College
            of Physicians and Surgeons of Ontario:

                               UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
                                            ("Undertaking")

                                                  of

                                       DR. FREDERICK THOMAS BRAY
                                             ("Dr. Bray")

                                                  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 Resolution 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. Bray, certificate of registration number 65372, am a member of the
                  College.

            (3)   I, Dr. Bray, acknowledge that the College has received information
                  regarding my practice of gastroenterology and internal medicine,
                  including my use of Propofol, and that the College is conducting an
                  investigation into the information.

            (4)   I, Dr. Bray, acknowledge that the ICR Committee has accepted this
                  Undertaking in lieu of making an Order under section 25.4 of the Code at
                  this time.

            (5)   I, Dr. Bray, acknowledge that this Undertaking does not preclude the ICR
                  Committee from making an order at a later date in accordance with the
                  Code.


            (6)   I, Dr. Bray, acknowledge that this Undertaking continues in force until
                  the matters currently being investigated are disposed of by a panel of
                  the ICR Committee or the Discipline Committee.

            B.    UNDERTAKING

            (7)   I, Dr. Bray, undertake to abide by the provisions of this Undertaking,
                  effective immediately ("Effective Date").

            (8)   Practice Restrictions

                  (a)   I, Dr. Bray, undertake to restrict my practice as follows:
                  
                        (i)   I, Dr. Bray, shall not prescribe or administer Propofol to
                              any patient; and
                  
                        (ii)  For any patient  treated by me at any Out-of-Hospital
                              Premises ("OHP") with which  I, Dr. Bray, am affiliated,
                              Propofol shall only be prescribed and shall only be
                              administered by an anaesthesiologist who meets the required
                              qualifications of the Out-of-Hospital Premises Program
                              Standards, and who first obtains written permission from the
                              College after submitting a staff affiliation notification
                              form.
                  
            (9)   Propofol Log

                  (a)   I, Dr. Bray, shall keep a log of all occasions on which Propofol is
                        administered to any patient treated by me  at any OHP with which I,
                        Dr. Bray, am affiliated in the form set out at Appendix "A", which
                        will include at least the following information:
                  
                        (i)   the date of the patient encounter;
                        (ii)  the name of the patient with chart / file number;
                        (iii) the name of the anaesthesiologist who prescribed Propofol to
                              the patient;
                        (iv)  the dose of Propofol prescribed;
                        (v)   the pharmacy that dispensed the Propofol;
                        (vi)  the name of the anaesthesiologist who administered the
                              Propofol to the patient.
                  
                  (b)   I, Dr. Bray, undertake and agree to submit the original Propofol
                        log to the College on a monthly basis.
                  
                  (c)   I, Dr. Bray, undertake and agree to maintain my own copy of the log
                        of patient encounters at all times, and to make it available to the
                        College upon request.
                  
            (10)  Posting a Sign

                  (a)   I, Dr. Bray, undertake that I shall post a sign in the waiting
                        room(s) of any Out-of-Hospital Premises ("OHP") with which I am
                        affiliated, in a clearly visible and secure location, in the form
                        set out at Appendix "B."  For further clarity, this sign shall
                        state as follows: "Dr. Bray must not prescribe or administer
                        Propofol to any patient.  In this clinic, Propofol must only be
                        prescribed and administered by an approved anesthesiologist.
                        Further information may be found on the College of Physicians and
                        Surgeons of Ontario website at www.cpso.on.ca".
                  
                  (b)   I, Dr. Bray, undertake to post a certified translation(s) in any
                        language(s) in which I provide services, of the sign described in
                        section (10)(a) in the waiting room(s) of any Out-of-Hospital
                        Premises ("OHP") with which I am affiliated, in a clearly visible
                        and secure location, in the form set out at Appendix "C." 
                  
                  (c)   I, Dr. Bray, undertake to provide the certified translation(s)
                        described in section (7)(b), to the College within thirty (30) days
                        of executing this Undertaking.
                  
                  (d)   I, Dr. Bray, undertake that if I elect, after the execution of this
                        Undertaking, to provide services in any other language(s), I will
                        notify the College prior to providing any such services. 
                  
                  (e)   I, Dr. Bray, undertake to provide to the College the certified
                        translation(s) described in section (10)(b) prior to beginning to
                        provide services in the language(s) described in section (10)(d).
                  
            (11)  Monitoring 

                  (a)   I, Dr. Bray, undertake to inform the College of each and every
                        location where I practise or have privileges, including, but not
                        limited to, hospital(s), clinic(s) and office(s), in any
                        jurisdiction (collectively my "Practice Location(s)"), 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. Bray, undertake that I will submit to, and not interfere
                        with, unannounced inspections of my Practice Locations and patient
                        charts by a College representative for the purposes of monitoring
                        my compliance with the provisions of this Undertaking.
                  
                  (c)   I, Dr. Bray, give my irrevocable consent to the College to make
                        appropriate enquiries of OHIP, and/or any person 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. Bray, acknowledge that I have executed the OHIP consent
                        form, attached hereto as Appendix "B".
                  
                  
                  
                  
            C.    ACKNOWLEDGEMENT

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

            (13)  I, Dr. Bray, 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. 

            (14)  I, Dr. Bray, 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.

            (15)  I, Dr. Bray, acknowledge that the College will provide this Undertaking
                  to any Chief of Staff, or a colleague with similar responsibilities, at
                  any Practice Location ("Chief(s) of Staff").

            (16)  I, Dr. Bray, acknowledge that, in the event of a referral to the
                  Discipline Committee and in the event of an appeal of any order of the
                  Discipline Committee, if the Discipline Committee has directed the
                  Registrar to revoke, suspend, or impose terms and conditions on my
                  certificate of registration, that order will take effect immediately
                  despite any appeal.

            (17)  I, Dr. Bray, 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.

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

            (19)  Public Register

                  (a)   I, Dr. Bray, acknowledge that, during the time period that this
                        Undertaking remains in effect, this Undertaking shall be posted on
                        the Public Register.
                  
                  (b)   I, Dr. Bray, acknowledge that, in addition to this Undertaking
                        being posted in accordance with section (10) (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 is being conducted into Dr. Bray'
                              practice.  As a result of the investigation, Dr. Bray has
                              restricted his practise as follows:
                  
                              i.    he will not prescribe or administer Propofol to any
                                    patient; and
                  
                              ii.   only an approved anaesthesiologist can prescribe or
                                    administer Propofol to Dr. Bray's patients.
                  
            D.    CONSENT

            (20)  I, Dr. Bray, give my irrevocable consent to the College to provide all
                  Chief(s) 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.

            (21)  I, Dr. Bray, give my irrevocable consent to all Chiefs of Staff to
                  disclose to the College, and to one another, any information relevant to
                  this Undertaking and/or relevant for the purposes of monitoring my
                  compliance with this undertaking.

Previous Hearings Flag: indicates a concern or additional information

Committee: Discipline
Decision Date: 18 Jun 2019
Summary:

On June 18, 2019, the Discipline Committee found that Dr. Frederick Thomas Bray 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, and has failed to maintain the 
 standard of practice of the profession. 

 Dr. Bray received his medical degree at the McGill University in 1989. He received his 
 certificate of registration authorizing independent practice in Ontario in 1992. Dr. Bray received 
 his specialist qualification in internal medicine in 1993 and in gastroenterology in 2000. 

 At the relevant times, Dr. Bray was the sole physician and the Medical Director of an Out-of-
 Hospital Premises (“OHP”), operating as “Frederick T. Bray Professional Medicine Corporation” 
 in Ottawa, Ontario, providing gastroenterology services.   

Overview of the Case  

The Out-of-Hospital Premises Inspection Program, “OHPIP”, is administered by the College and 
applies to all premises outside a hospital (“OHP premises”) that perform procedures involving 
the use of anesthesia or sedation as defined in O.Reg. 114/94, made under the Medicine Act, 
 1991, (“the Regulation”). Part XI of the Regulation sets out the definition of “procedure” for the 
 purposes of the OHPIP. The OHP program is based on trust and relies on self-reporting from 
 Medical Directors and physicians. 

 Mandatory standards for OHP premises are set out in Program Standards (“the Standards”), 
 authorized under the Regulation. Pursuant to Standard 2.2, the Medical Director of an OHP is 
 responsible for the duties outlined in the Standards. In order to ensure patient safety and quality 
 of care, strict adherence is required to the detailed requirements set out in the Standards. 

 As set out Standard 3.2, “Anesthesia”, medications producing “deep sedation”, including 
 propofol, “must be administered by a physician qualified to provide deep sedation”. This point is 
 further clarified in Standard 5.3 that states that general anesthesia can only be administered by an 
 anesthesiologist. 

 By letter dated May 17, 2016, sent to all Medical Directors of OHPs, including Dr. Bray, Dr. 
 Steven Bodley, then-chair of the Premises Inspection Committee (“PIC”), reminded Medical 
 Directors that OHP Standard 3.2 required that only a qualified anesthesiologist is permitted to 
administer propofol.  

Disgraceful, Dishonourable or Unprofessional Conduct 

 In contravention of Program Standards and his duties as Medical Director, Dr. Bray administered 
 propofol to patients, in the absence of an anesthesiologist or any other physician qualified to 
 administer propofol in accordance with the Standards.     

On July 19, 2017, the OHPIP conducted an inspection-assessment of Dr. Bray’s OHP. The 
 inspection–assessment included a review of the premises’ controlled substances storage and 
 included review of the care provided by the premises to sedated patients. Dr. Bray did not advise 
                                                                                                                                    Disposition 

                                                                                                                                    On June 1


the assessors that he was using propofol despite the fact that the assessors reviewed his practices 
and procedures around sedation and controlled substances. 

The College became aware of Dr. Bray’s use of propofol through an anonymous report made to 
the College on August 3, 2017. As a result of the report, the College conducted an unannounced 
visit on August 24, 2017, and verified that Dr. Bray was administering propofol to patients 
without an anesthesiologist. 

Twenty-five (25) patient charts were obtained in the College investigation. The charts were 
reviewed by an expert retained by the College, Dr. Ted Xenodemetropoulos, a gastroenterologist. 
As set out in Dr. Xenodemetropoulos’ report, Dr. Bray administered propofol to eleven (11) 
patients in contravention of Program Standards, in the absence of an anesthesiologist. 

Failure to Maintain Standard of Practice 

In respect of the eleven (11) patients to whom propofol was administered by Dr. Bray in the 
absence of an anesthesiologist, Dr. Xenodemetropoulos opined that Dr. Bray failed to maintain 
the standard of practice in his administration of intravenous propofol as additional sedation 
during procedures and displayed a moderate lack of judgment both in his role as Medical 
Director of the OHP and as most responsible physician to the patients in question.   

Dr. Xenodemetropoulos concluded that Dr. Bray’s use of propofol did not result in an increased 
risk of harm or injury in a sedation-related adverse event to the patients. 

Admission 

Dr. Bray admits the facts specified above, and admits that, based on these facts, he engaged in 
professional misconduct:  

(a)   engaged in conduct or an act or omission relevant to the practice of medicine that, having
      regard to all the circumstances, would reasonably be regarded by members as disgraceful,
      dishonourable or unprofessional; and

(b)   he has failed to maintain the standard of practice of the profession.


        8, 2019, the Committee ordered that: 

   - The Registrar suspend Dr. Bray’s certificate of registration for a period of 4 months.
   - Dr. Bray attend before the panel to be reprimanded.
   - Dr. Bray pay costs to the College in the amount of $6000.00

Hearing Date(s): June 18, 2019 half day start time 1:00 p.m.

Concerns Flag: indicates a concern or additional information

Source: Member
Active Date: November 21, 2017
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Frederick Thomas Bray to the College of Physicians and Surgeons of Ontario, effective November 21, 2017:

A College investigation is being conducted into Dr. Bray’ practice. As a result of the investigation, Dr. Bray has restricted his practise as follows:

he will not prescribe or administer Propofol to any patient; and

only an approved anaesthesiologist can prescribe or administer Propofol to Dr. Bray’s patients.