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Ghumman, Ejaz Ahmed

CPSO#: 86121

MEMBER STATUS
Active Member as of 07 May 2007
CPSO REGISTRATION CLASS
Restricted as of 21 Jul 2017

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English, Panjabi/Punjabi, Persian, Urdu

Education:University of the Punjab, 1982

Practice Information

Primary Location of Practice
Leamington District Memorial
Hospital
1st Floor
194 Talbot Street West
Leamington ON  N8H 1N9
Phone: (519) 326-2830
Fax: (519) 326-4461 Electoral District: 01

Professional Corporation Information


Corporation Name: Dr. Ejaz Ghumman Medicine Professional Corporation
Certificate of Authorization Status: Issued Date:  Mar 17 2008

Shareholders:
Dr. E. Ghumman ( CPSO# 86121 )

Business Address:
Leamington District Memorial Hospital
Room 114
194 Talbot Street West
Leamington ON  N8H 1N9
Phone Number: (519) 326-2830

Specialties

Specialty Issued On Type
General Surgery Effective:23 Jun 2004 RCPSC Specialist

Registration History

Action Issue Date
First certificate of registration issued: Independent Practice Certificate Effective: 07 May 2007
Transfer of class of certificate to: Restricted certificate Effective: 21 Jul 2017
Terms and conditions imposed on certificate by Discipline Committee Effective: 21 Jul 2017
Terms and conditions amended by member Effective: 03 Jun 2020

Practice Restrictions

Imposed By Effective Date Expiry Date Status
member Effective: 03 Jun 2020 Active
             (1 of 2)
            As from June 3, 2020, the following are imposed as terms, conditions and
            limitations on the certificate of registration held by Dr. Ejaz Ahmed Ghumman
            in accordance with an undertaking and consent given by Dr. Ghumman to the
            College of Physicians and Surgeons of Ontario:


                        UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT 
                                          ("Undertaking")
                  
                                                of
                  
                                    DR. EJAZ AHMED GHUMMAN
                                          ("Dr. GHUMMAN")
                  
                                                to 
                  
                        COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
                                          (the "College")
                  
                  
                  
            A.    PREAMBLE

            (1)   In this Undertaking:

                  "Code" means the Health Professions Procedural Code, which is Schedule 2
                  to the Regulated Health Professions Act, 1991, S.O. 1991, c. 18, as
                  amended; 
                  
                  "ICR Committee" means the Inquiries, Complaints and Reports Committee of
                  the College;
                  
                  "OHIP" means the Ontario Health Insurance Plan;

                  "Public Register" means the College's register that is available to the
                  public.
                  
            (2)   I, Dr. Ghumman, certificate of registration number 86121, am a member of
                  the College.  

            (3)   I, Dr. Ghumman, acknowledge that following a patient complaint, I was
                  directed by the ICR Committee to undergo remediation and a reassessment
                  of my general surgery practice. I further acknowledge that following a
                  separate patient complaint, I was found by the Discipline Committee of
                  the College to have failed to maintain the standard of practice of the
                  profession, and was ordered to undergo additional remediation and a
                  reassessment of my general surgery practice. The reassessment report
                  subsequently received by the College in respect of both matters raised
                  concerns about my standard of practice in general surgery.

            B.    UNDERTAKING

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

            (5)   Professional Education  

                  (a)   I, Dr. Ghumman, 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)   The Canadian Association of Gastroenterology's Skills
                              Enhancement for Endoscopy (SEE) program; 
                  
                        (ii)  The University of Toronto's Medical Record Keeping course;
                  
                        (iii) CMPA e-Learning Modules:
                  
                              1.    Documentation:  Charting Medical Records; and
                              2.    Documentation II:  Principles of Medical Record
                                    Keeping.
                  
                        (iv)  Review, reflection and a written summary of the following
                              policies, clinical practice guideline and other self-study: 
                  
                              1.    CCO's Guideline on Screening Surveillance and follow up
                                    Colonoscopy; 
                              2.    Evaluation of patients with rectal bleeding and
                                    indications for biopsy for patients with Barrett's
                                    esophagus; 
                              3.    CPSO policies: Medical Records Documentation and
                                    Medical Records Management.  
                  
                  (b)   I, Dr. Ghumman, 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. Ghumman, 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. Ghumman, 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. Ghumman, undertake that, approximately six (6) 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. Ghumman, undertake to co-operate fully with the
                        Reassessment, conducted under the term of this Undertaking. 
                  
                  (c)   I, Dr. Ghumman, 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. Ghumman, 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. Ghumman, 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. Ghumman, give my irrevocable consent to the College to make
                        appropriate enquiries of OHIP and/or any person who or institution
                        that may have relevant information, in order for the College to
                        monitor my compliance with the provisions of this Undertaking. 
                  
                  (d)   I, Dr. Ghumman, acknowledge that I have executed the OHIP consent
                        form, attached hereto as Appendix "B". 
                  
            C.    ACKNOWLEDGEMENT

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

            (9)   I, Dr. Ghumman, 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. Ghumman, 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. Ghumman, 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. Ghumman, 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. Ghumman, 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. Ghumman, acknowledge that, during the time period that this
                        Undertaking remains in effect, this Undertaking shall be posted on
                        the Public Register.
                  
                  (b)   I, Dr. Ghumman, 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:
                  
                              Following two patient complaints, one of which resulted in a
                              finding that Dr. Ghumman had failed to meet the standard of
                              practice of the profession, Dr. Ghumman was ordered to
                              undergo remediation and a reassessment of his general surgery
                              practice. The reassessment report subsequently received by
                              the College in respect of both matters raised concerns about
                              his standard of practice in general surgery. As a result:
                  
                                    Dr. Ghumman will engage in professional education,
                                    including in endoscopy and medical record-keeping.
                  
                                    Dr. Ghumman's practice will be reassessed by an
                                    assessor selected by the College within 6 months of the
                                    completion of the professional education.
                  
                  (c)   I, Dr. Ghumman, acknowledge that this Undertaking remains in effect
                        until the College determines its terms are satisfied.
                  
            D.    CONSENT

            (15)  I, Dr. Ghumman, 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/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.
                  
            (16)  I, Dr. Ghumman, 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. Ghumman, give my irrevocable consent to any persons who facilitate
                  my completion of the Professional Education, and to all 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.
                  
            (2 of 2)

            As from July 21, 2017, 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. Ejaz
            Ahmed Ghumman:

            Chief of Staff Role

            a)    Dr. Ghumman shall not re-apply for the Chief of Staff position at any
                  hospital until successful completion of the re-assessment described in
                  paragraph 11 below.

            Clinical Supervision

            a)    Dr. Ghumman shall retain a College-approved Clinical Supervisor who will
                  sign an undertaking in the form attached hereto as Schedule "A";

            b)    For a period of twelve (12) months commencing on the date that the
                  Clinical Supervisor is approved by the College, Dr. Ghumman may practise
                  only under the supervision of the Clinical Supervisor;

            c)    Clinical Supervision of Dr. Ghumman's practice shall contain the
                  following elements:

            Moderate-Level Supervision

            a)    For an initial period of approximately four (4) weeks, the Clinical
                  Supervisor will engage in a period of moderate-level supervision, during
                  which time the Clinical Supervisor will at minimum:

                  (i)   Review materials provided by the College and have an initial
                        in-person meeting with Dr. Ghumman to discuss practice improvement
                        recommendations;
                  (ii)  Thereafter, discuss with Dr.  Ghumman once a week by telephone or
                        secure electronic video conference to pre-clear all general surgery
                        cases done in the operating room under a general anaesthetic;
                  (iii) For on-call cases where Dr. Ghumman is not able to speak to his
                        Clinical Supervisor prior to surgery, the Clinical Supervisor will
                        review such cases as soon as possible after the surgery and in any
                        event within approximately 24 hours post-surgery by telephone or
                        secure electronic video conference;
                  (iv)  Provide reports to the College once every two (2) weeks, or more
                        frequently if the Clinical supervisor has concerns about Dr.
                        Ghumman's standard of practice or conduct;
                  (v)   Discuss with Dr. Ghumman any concerns the Clinical Supervisor may
                        have arising from his meetings with Dr. Ghumman and case reviews;
                  (vi)  Make recommendations for practice improvements and ongoing
                        professional development, and inquire into Dr. Ghumman's compliance
                        with any recommendations;
                  (vii) Keep a log of all patient charts reviewed along with patient
                        identifiers.
                  
            Low-Level Supervision Phase 1

            a)    After the first four (4) weeks of Dr. Ghumman's Moderate-Level Clinical
                  Supervision, upon receipt of a written recommendation from the Clinical
                  Supervisor that Dr. Ghumman is ready to practise under Low-Level Clinical
                  Supervision, and subject to approval by the College, Clinical Supervision
                  shall continue for a further period of eight (8) weeks during which time
                  the Clinical Supervisor will at minimum:

                  (i)   Meet with Dr. Ghumman once every two (2) weeks in person to discuss
                        surgical cases and review a minimum of fifteen (15) patient charts,
                        to be selected in the sole discretion of the Clinical Supervisor,
                        and discuss any issues or concerns arising therefrom with Dr.
                        Ghumman. If the Clinical Supervisor is of the view that fewer than
                        fifteen (15) charts may be reviewed in this period, the Clinical
                        Supervisor shall provide a written recommendation to the College
                        and, subject to approval by the College, may review no fewer than
                        ten (10) patient charts per visit for the remaining portion of this
                        period of clinical supervision;
                  (ii)  Provide reports to the College once per month, or more frequently
                        if the Clinical supervisor has concerns about Dr. Ghumman's
                        standard of practice or conduct;
                  (iii) Discuss with Dr. Ghumman any concerns the Clinical Supervisor may
                        have arising from his meetings with Dr. Ghumman and chart reviews;
                  (iv)  Make recommendations for practice improvements and ongoing
                        professional development, and inquire into Dr. Ghumman's compliance
                        with any recommendations;
                  (v)   Keep a log of all patient charts reviewed along with patient
                        identifiers.
                  
            Low-Level Supervision Phase 2

            a)    After the first eight (8) weeks of  Low-Level Clinical Supervision, upon
                  receipt of a written recommendation from the Clinical Supervisor and
                  subject to approval by the College, Clinical Supervision shall continue
                  at Low-Level for the balance of the twelve (12) months of Clinical
                  Supervision, during which time the Clinical Supervisor will at minimum:

                  (i)   Meet with Dr. Ghumman once a month in person to discuss surgical
                        cases and review a minimum of ten (10) patient charts, to be
                        selected in the sole discretion of the Clinical Supervisor, and
                        discuss any issues or concerns arising therefrom with Dr. Ghumman;
                  (ii)  Provide reports to the College once every two months or more
                        frequently if the Clinical supervisor has concerns about Dr.
                        Ghumman's standard of practice or conduct;
                  (iii) Discuss with Dr. Ghumman any concerns the Clinical Supervisor may
                        have arising from his meetings with Dr. Ghumman and chart reviews;
                  (iv)  Make recommendations for practice improvements and ongoing
                        professional development, and inquire into Dr. Ghumman's compliance
                        with any recommendations;
                  (v)   Keep a log of all patient charts reviewed along with patient
                        identifiers.
                  
            Individualized Education Plan ("IEP") 

            a)    The Clinical Supervisor shall facilitate completion of the education
                  program, set out in an IEP to be provided to the Clinical Supervisor by
                  the College, and shall report to the College in his/her reports as to Dr.
                  Ghumman's progress in completing the IEP.

            Other Elements of Clinical Supervision

            a)    Throughout the period of Clinical Supervision, Dr. Ghumman shall abide by
                  the recommendations of the Clinical Supervisor and shall complete the IEP
                  in co-operation with the Clinical Supervisor;

            b)    If a clinical supervisor who has given an undertaking as set out in
                  Schedule "A" to this Order is unable or unwilling to continue to fulfill
                  its terms, Dr. Ghumman shall, within twenty (20) days of receiving notice
                  of same, obtain an executed undertaking in the same form from a person
                  who is acceptable to the College and ensure that it is delivered to the
                  College within that time;

            c)    If Dr. Ghumman is unable to obtain a clinical supervisor in accordance
                  with this Order, he shall cease to practice until such time as he has
                  done so;

            d)    Dr. Ghumman shall consent to the disclosure by his Clinical Supervisor to
                  the College, and by the College to his Clinical Supervisor, of all
                  information the Clinical Supervisor or the College deems necessary or
                  desirable in order to fulfill the Clinical Supervisor's undertaking and
                  Dr. Ghumman's compliance with this Order.

            Re-Assessment

            a)    Approximately six (6) months after the completion of the period of
                  supervision set out above Dr. Ghumman shall undergo a re-assessment of
                  his practice, at his own expense, by a College-appointed assessor (the
                  "Assessor(s)").  The re-assessment shall include the elements outlined in
                  the IEP, to be provided by the College. The Assessor(s) shall report the
                  results of the re-assessment to the College;

            b)    Dr. Ghumman shall consent to the disclosure to the Assessor(s) of the
                  reports of the Clinical Supervisor arising from the supervision, and
                  shall consent to the sharing of all information between the Clinical
                  Supervisor, the Assessor(s) and the College, as the College deems
                  necessary or desirable in order to fulfill their respective obligations. 

            Monitoring 

            a)    Dr. Ghumman 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.

            b)    Dr. Ghumman shall cooperate with unannounced inspections of his practice
                  and patient charts by one or more College representative(s) for the
                  purpose of monitoring and enforcing his compliance with the terms of this
                  Order.

            c)    Dr.  Ghuman  shall  consent  to  the  College's  making  appropriate
                  enquiries of  the Ontario Health Insurance Plan and/or any person or
                  institution that may have relevant  information,   in  order  for  the
                  College  to  monitor   and   enforce his compliance with the terms of
                  this Order.

            d)    Dr. Ghumman shall be responsible for any and all costs associated with
                  implementing the terms of this Order.

Previous Hearings

Committee: Discipline
Decision Date: 21 Jul 2017
Summary:

On July 21, 2017, the Discipline Committee found that Dr. Ejaz Ahmed Ghumman committed an 
act of professional misconduct in that he has failed to maintain the standard of practice of the 
profession. 
  
Dr. Ghumman is a general surgeon practising at the hospital in a city in Ontario. From 2007, Dr. 
Ghumman was a Chief of Staff at the hospital, but resigned his position in April 2017, following 
a referral of this matter to the Discipline Committee of the College.  
 
Dr. Ghumman received his medical degree in Pakistan in 1982 and a specialist qualification in 
general surgery in Ireland in 1991. In 1999, Dr. Ghumman obtained a certificate of independent 
practice in Newfoundland and received his specialist qualification in general surgery in Canada 
in 2004. In 2007, Dr. Ghumman received his certificate of independent practice in Ontario. 
 
Failure to Maintain Standard of Practice of the Profession: Patient X 
 
In June, 2015, Patient X complained to the College regarding Dr. Ghumman’s care in conducting 
her laparoscopic gallbladder removal surgery and his post-operative care. 
 
Several months prior to the complaint, Dr. Ghumman assessed Patient X for symptomatic gall 
stones. He explained to Patient X her treatment options, discussed the potential risks and benefits 
of surgery, and obtained Patient X’s informed consent for a laparoscopic gallbladder removal 
surgery, which was scheduled for the following month. On the day of the surgery, Dr. Ghumman 
discussed the surgical plan with Patient X in the day surgery area at the hospital.  
 
During the surgery, the clip applier that Dr. Ghumman applied on Patient X’s cystic artery 
unexpectedly jammed and could not be pulled off as it could damage an artery. Dr. Ghumman 
considered converting to an open procedure, but decided to continue laparoscopically and to take 
steps to divide the cystic artery in order to remove the jammed clip applier. 
 
Following the anesthetist’s suggestion to use Filshie clips, which are applied with a narrower 
clipper than other clips, Dr. Ghumman proceeded to place a Filshie clip, but was concerned that 
he might have mistakenly placed it on the common bile duct or the right hepatic artery.  Dr. 
Ghumman directed nurses to make several telephone calls, but could not find a way to remove the 
Filshie clip without risking torn vessels or tearing the bile duct.  
 
He continued with the procedure and applied another Filshie clip on the cystic artery, which 
allowed him to divide the cystic artery and remove the jammed clipper.  
 
Dr. Ghumman removed the gallbladder, which tore during removal, placed a drain and completed 
the surgery. He noted in his Operative Report that if a clip is on a common bile duct, he may have 
to refer Patient X to a Hepatobiliary Surgeon.   
 
Following the surgery, Dr. Ghumman told Patient X that the surgery went well. He indicated that 
he encountered a complication when the clipper jammed, which he was then able to remove, but 
was concerned that he might have placed a clip on her right hepatic artery or common bile duct.  
 
Patient X was discharged home the same day with instructions for monitoring and to return two 
days later for a CT scan and to remove the drain placed during surgery.  
 
When Patient X returned two days later, she reported feeling unwell, was in pain, and was having 
trouble eating. Dr. Ghumman discussed the results of Patient X’s CT scan with a radiologist at the 
hospital, who opined that Patient X’s common bile duct looked normal and indicated that no clip 
was visualized on the common bile duct. Dr. Ghumman reported to Patient X’s family doctor that 
he had a small incident during surgery but that he was satisfied, after the CT scan, that the clip 
was not on the common bile duct. He indicated that he was concerned because he had applied the 
clip “a little bit blind”, but now felt the clip was on tissues along the gallbladder, which was not a 
problem. Dr. Ghumman decided not to remove the drain that day and instructed Patient X to 
return three days later for removal of the drain and follow up tests.  
 
When Patient X returned to Dr. Ghumman for drain removal three days later, she reported feeling 
itchy, was unable to eat, and her complexion was jaundiced. 
       
The next day, Dr. Ghumman telephoned Patient X and informed her that according to her blood 
work results her bilirubin was high. Elevated bilirubin levels may cause jaundice and may indicate 
problems with the liver or bile duct, and may also account for the type of itching experienced by 
Patient X. Dr. Ghumman advised Patient X to drink plenty of fluids to stay well hydrated and call 
his office if her condition worsened.   
 
In two days, Patient X contacted Dr. Ghumman and complained of increased itching. He booked 
an ultrasound appointment and blood work for the next morning. The ultrasound results suggested 
that the common bile duct was obstructed and blood work indicated that Patient X’s bilirubin had 
increased over the previous three days. Dr. Ghumman advised Patient X that the clip he was 
concerned about had actually been placed incorrectly and had likely caused obstruction of the 
patient’s common bile duct. He organized Patient X’s immediate transportation to London Health 
Sciences Centre (“London”) for emergency admission and surgery. 
       
Following the surgery, the Hepatobiliary Surgeon noted that there was a clip going across Patient 
X’s entire bile duct. The surgery was complicated by intra-operative and post-operative bleeding, 
which required transfusion of eight units of blood. Patient X remained hospitalized in London for 
approximately one week after the surgery. 
 
In October, 2015, the College retained an expert, a general surgeon, to provide opinion regarding 
Dr. Gumman’s care of Patient X. The expert opined that although the technical complication 
involving the clip applier during surgery was beyond Dr. Ghumman’s control, his actions in 
response to the problem were below the standard of practice of the profession. He noted the 
following concerns: 
 
 - Dr. Ghumman failed to convert to an open procedure in order to first define the anatomy with 
   careful dissection around the jammed clipper; 
 - Despite his concern of having injured an important structure, Dr. Ghumman failed to obtain 
   the advice of a hepatobiliary surgeon or another general surgeon, either during or 
   immediately following the surgery. Although there was only one other surgeon in a hospital 
   in a small community where he works, he could have sought assistance through a service that 
   provides urgent and emergent support for hospital-based physicians; 
 - Dr. Ghumman’s operative note shows that he was aware of the need to obtain the critical 
   view, but he placed the Filshie clip applier in the area of undissected tissue;  
 - The fact that there was a retained portion of a surgical bag after the surgical procedure 
   demonstrates a lack of care and poor technique. 
 
 
Failure to Maintain the Standard of Practice of the Profession – Other Patients 
 
Subsequently, the College commenced an investigation under s.75 (1)(a) of the Health 
Professions Procedural Code into Dr. Ghumman’s surgical practice. The College-retained expert 
and the expert retained by Dr. Ghumman reviewed Dr. Ghumman’s twenty-five patient charts. 
Both experts opined that Dr. Ghumman failed to maintain the standard of practice of the 
profession in the following areas: 
       
 - Prolonged and unnecessary use of prophylactic antibiotics post-operatively with respect to 
   some patients. While there was no evidence of actual harm, overuse of antibiotics presents a 
   risk of potential harm to patients, particularly in the hospital setting where there is a risk that 
   antibiotic resistance will make treatment of infections more difficult. This issue was described 
   as minor by both experts; 
 - Overuse of surgical drains in some patients, in the absence of evidence of an abscess 
   requiring drainage or the development of post-operative collection of clear fluid. There was 
   no evidence of actual harm or potential risk of harm to patients. This issue was described as 
   minor by both experts; 
 - Deficient record-keeping pertaining to incomplete documentation of the patients’ consent to a 
   colonoscopy. There was no evidence of actual harm to any patient. 
 
On July 21, 2017, the Committee ordered and directed on the matter of penalty and costs that: 
 
 - The Registrar impose the following terms, conditions and limitations on Dr. Ghumman’s 
   Certificate of Registration: 
  
     Chief of Staff Role 
     a)  Dr. Ghumman shall not re-apply for the Chief of Staff position at any hospital until 
         successful completion of the re-assessment described below. 
     
     Clinical Supervision 
     (a) Dr. Ghumman shall retain a College-approved Clinical Supervisor who will sign an 
         undertaking in the form attached as Schedule “A” to the Order; 
     (b) For a period of twelve (12) months commencing on the date that the Clinical 
         Supervisor is approved by the College, Dr. Ghumman may practise only under the 
         supervision of the Clinical Supervisor; 
     (c) Clinical Supervision of Dr. Ghumman’s practice shall contain the following 
         elements: 
     
     Moderate-Level Supervision 
     a)  For an initial period of approximately four (4) weeks, the Clinical Supervisor will 
         engage in a period of moderate-level supervision, during which time the Clinical 
         Supervisor will at minimum: 
         (i)  Review materials provided by the College and have an initial in-person 
              meeting with Dr. Ghumman to discuss practice improvement 
              recommendations; 
         (ii) Thereafter, discuss with Dr.  Ghumman once a week by telephone or secure 
              electronic video conference to pre-clear all general surgery cases done in the 
              operating room under a general anaesthetic; 
    (iii) For on-call cases where Dr. Ghumman is not able to speak to his Clinical 
         Supervisor prior to surgery, the Clinical Supervisor will review such cases as 
         soon as possible after the surgery and in any event within approximately 24 
         hours post-surgery by telephone or secure electronic video conference; 
    (iv) Provide reports to the College once every two (2) weeks, or more frequently if 
         the Clinical supervisor has concerns about Dr. Ghumman’s standard of practice 
         or conduct; 
    (v)  Discuss with Dr. Ghumman any concerns the Clinical Supervisor may have 
         arising from his meetings with Dr. Ghumman and case reviews; 
    (vi) Make recommendations for practice improvements and ongoing professional 
         development, and inquire into Dr. Ghumman’s compliance with any 
         recommendations; 
    (vii) Keep a log of all patient charts reviewed along with patient identifiers. 
 
Low-Level Supervision Phase 1 
a)  After the first four (4) weeks of Dr. Ghumman’s Moderate-Level Clinical 
    Supervision, upon receipt of a written recommendation from the Clinical Supervisor 
    that Dr. Ghumman is ready to practise under Low-Level Clinical Supervision, and 
    subject to approval by the College, Clinical Supervision shall continue for a further 
    period of eight (8) weeks during which time the Clinical Supervisor will at 
    minimum: 
    (A)  Meet with Dr. Ghumman once every two (2) weeks in person to discuss 
         surgical cases and review a minimum of fifteen (15) patient charts, to be 
         selected in the sole discretion of the Clinical Supervisor, and discuss any issues 
         or concerns arising therefrom with Dr. Ghumman. If the Clinical Supervisor is 
         of the view that fewer than fifteen (15) charts may be reviewed in this period, 
         the Clinical Supervisor shall provide a written recommendation to the College 
         and, subject to approval by the College, may review no fewer than ten (10) 
         patient charts per visit for the remaining portion of this period of clinical 
         supervision; 
    (B)  Provide reports to the College once per month, or more frequently if the 
         Clinical supervisor has concerns about Dr. Ghumman’s standard of practice or 
         conduct; 
    (C)  Discuss with Dr. Ghumman any concerns the Clinical Supervisor may have 
         arising from his meetings with Dr. Ghumman and chart reviews; 
    (D)  Make recommendations for practice improvements and ongoing professional 
         development, and inquire into Dr. Ghumman’s compliance with any 
         recommendations; 
    (E)  Keep a log of all patient charts reviewed along with patient identifiers. 
    
Low-Level Supervision Phase 2 
a)  After the first eight (8) weeks of  Low-Level Clinical Supervision, upon receipt of a 
    written recommendation from the Clinical Supervisor and subject to approval by the 
    College, Clinical Supervision shall continue at Low-Level for the balance of the 
    twelve (12) months of Clinical Supervision, during which time the Clinical 
    Supervisor will at minimum: 
    (i)  Meet with Dr. Ghumman once a month in person to discuss surgical cases and 
         review a minimum of ten (10) patient charts, to be selected in the sole 
         discretion of the Clinical Supervisor, and discuss any issues or concerns arising 
         therefrom with Dr. Ghumman; 
    (ii) Provide reports to the College once every two months or more frequently if the 
         Clinical supervisor has concerns about Dr. Ghumman’s standard of practice or 
         conduct; 
    (iii) Discuss with Dr. Ghumman any concerns the Clinical Supervisor may have 
         arising from his meetings with Dr. Ghumman and chart reviews; 
    (iv) Make recommendations for practice improvements and ongoing professional 
         development, and inquire into Dr. Ghumman’s compliance with any 
         recommendations; 
    (v) Keep a log of all patient charts reviewed along with patient identifiers. 
              
Individualized Education Plan (“IEP”)  
 a) The Clinical Supervisor shall facilitate completion of the education program, set out 
    in an IEP to be provided to the Clinical Supervisor by the College, and shall report to 
    the College in his/her reports as to Dr. Ghumman’s progress in completing the IEP.  
                  
Other Elements of Clinical Supervision 
a)  Throughout the period of Clinical Supervision, Dr. Ghumman shall abide by the 
    recommendations of the Clinical Supervisor and shall complete the IEP in co-
    operation with the Clinical Supervisor; 
b)  If a clinical supervisor who has given an undertaking as set out in Schedule “A” to 
    this Order is unable or unwilling to continue to fulfill its terms, Dr. Ghumman shall, 
    within twenty (20) days of receiving notice of same, obtain an executed undertaking 
    in the same form from a person who is acceptable to the College and ensure that it is 
    delivered to the College within that time; 
c)  If Dr. Ghumman is unable to obtain a clinical supervisor in accordance with this 
    Order, he shall cease to practice until such time as he has done so; 
d)  Dr. Ghumman shall consent to the disclosure by his Clinical Supervisor to the 
    College, and by the College to his Clinical Supervisor, of all information the Clinical 
    Supervisor or the College deems necessary or desirable in order to fulfill the Clinical 
    Supervisor’s undertaking and Dr. Ghumman’s compliance with this Order. 
              
Re-Assessment 
a)  Approximately six (6) months after the completion of the period of supervision set 
    out above Dr. Ghumman shall undergo a re-assessment of his practice, at his own 
    expense, by a College-appointed assessor (the “Assessor(s)”).  The re-assessment 
    shall include the elements outlined in the IEP, to be provided by the College. The 
    Assessor(s) shall report the results of the re-assessment to the College; 
b)  Dr. Ghumman shall consent to the disclosure to the Assessor(s) of the reports of the 
    Clinical Supervisor arising from the supervision, and shall consent to the sharing of 
    all information between the Clinical Supervisor, the Assessor(s) and the College, as 
    the College deems necessary or desirable in order to fulfill their respective 
    obligations.  
                  
Monitoring  
a)  Dr. Ghumman 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. 
    b)  Dr. Ghumman shall cooperate with unannounced inspections of his practice and 
        patient charts by one or more College representative(s) for the purpose of monitoring 
        and enforcing his compliance with the terms of this Order. 
    c)  Dr.  Ghuman  shall  consent  to  the  College’s  making  appropriate  enquiries of  the 
        Ontario Health Insurance Plan and/or any person or institution that may have relevant  
        information,   in  order  for  the  College  to  monitor   and   enforce his compliance 
        with the terms of this Order. 
    d)  Dr. Ghumman shall be responsible for any and all costs associated with 
        implementing the terms of this Order. 
              
- Dr. Ghumman appear before the panel to be reprimanded. 
- Dr. Ghumman to pay costs to the College for a one day hearing in the amount of $5,500.00 
  within 30 days of the date of this Order.


Decision: Download Full Decision (PDF)
Hearing Date(s): July 21, 2017

Concerns

Source: Member
Active Date: June 3, 2020
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Ejaz Ahmed Ghumman to the College of Physicians and Surgeons of Ontario, effective June 3, 2020:

Following two patient complaints, one of which resulted in a finding that Dr. Ghumman had failed to meet the standard of practice of the profession, Dr. Ghumman was ordered to undergo remediation and a reassessment of his general surgery practice. The reassessment report subsequently received by the College in respect of both matters raised concerns about his standard of practice in general surgery. As a result:

Dr. Ghumman will engage in professional education, including in endoscopy and medical record-keeping.

Dr. Ghumman’s practice will be reassessed by an assessor selected by the College within 6 months of the completion of the professional education.

 

Source: Compliance and Monitoring Department
Active Date: April 13, 2018
Expiry Date:
Summary:
Caution-in-Person:

A summary of a decision of the Inquiries, Complaints and Reports Committee in which the disposition includes a "caution-in-person" 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 the Committee. The summary will be removed from the register if the decision is overturned on appeal or review. Note that this 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.
Download Full Document (PDF)