As from July 7, 2022, the following are imposed as terms, conditions and limitations on the certificate of registration held by Dr. Koma Diryawish Israel in accordance with an undertaking and consent given by Dr. Israel to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. KOMA DIRYAWISH ISRAEL
("Dr. Israel")
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;
"Discipline Tribunal" means the Ontario Physicians and Surgeons Discipline Tribunal of the College;
"ICR Committee" means Inquiries, Complaints and Reports Committee of the College;
"OHIP" means the Ontario Health Insurance Plan;
"Ontario Physicians and Surgeons Discipline Tribunal" means the Discipline Committee established under the Code;
"Public Register" means the College's register that is available to the public.
(2) I, Dr. Israel, certificate of registration number 74647, am a member of the College.
(3) I, Dr. Israel, acknowledge that the College has received two public complaints bearing File CAS-131799-W1K6B8 and File CAS-361561-T8G3S0 (the "Investigations") regarding my conduct. I am aware of the College's concern about protecting the public.
(4) I, Dr. Israel, acknowledge that the College has accepted this Undertaking in lieu of making an Order under section 25.4 of the Code at this time.
(5) I, Dr. Israel, 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. Israel, acknowledge that this Undertaking continues in force until the matters currently being investigated are disposed of by a panel of the ICR Committee or a panel of the Discipline Tribunal.
B. UNDERTAKING AND ACKNOWLEDGEMENT
(7) I, Dr. Israel, undertake to abide by the provisions of this Undertaking, effective immediately ("Effective Date").
(8) Practice Restrictions
(a) I, Dr. Israel, undertake that I shall not engage in any professional encounters, in person or otherwise ("Professional Encounter" or "Professional Encounters"), with patients of any age, in any jurisdiction, unless the Professional Encounter takes place in the continuous presence and under the continuous observation of a monitor who is a regulated health professional acceptable to the College (the "Practice Monitor"), and unless the other requirements provided in this Undertaking are fulfilled. For further clarity, I understand that I must not be alone with any patient, for any length of time, during any Professional Encounter, whether or not the parent or guardian of the patient is also present.
(b) I, Dr. Israel, undertake to inform my patients of the indication for any breast, pelvic, genital and/or rectal examination that I may perform and to document the discussion in the corresponding patient chart.
(c) I, Dr. Israel, undertake to remain free of any conflict of interest with the Practice Monitor.
(d) I, Dr. Israel, acknowledge that I have reviewed the Practice Monitor's undertaking, attached hereto as Appendix "A" and understand what is required of the Practice Monitor including, but not limited to:
1. providing reports (as described in the Practice Monitor's undertaking) to the College on at least a monthly basis;
2. remaining present at all times during all Professional Encounters with all patients;
3. carefully observing all of my Professional Encounters with patients, including but not limited to physical and internal examinations. I further acknowledge my obligation to ensure the Practice Monitor's view of all of my Professional Encounters with patients, including physical and internal examinations, is unobstructed at all times;
4. refraining from performing any other functions, except those required in the Practice Monitor's undertaking attached as Appendix "A", while observing me in all my Professional Encounters with patients;
5. maintaining a log of all Professional Encounters with patients in the form attached to this Undertaking as Appendix "B" (the "Log");
6. initialling all corresponding entries in the records of patients noted in the Log;
7. submitting the original Log to the College on a monthly basis; and
8. remaining free of any conflict of interest with me.
(e) I, Dr. Israel, undertake to maintain an up to date copy of the Log by ensuring a copy is made at the end of each business day, and to make it available to the College upon request.
(9) I, Dr. Israel, undertake to inform the College of each and every location at which I practise, delegate or have privileges including, but not limited to any hospitals, clinics, offices, and any Out-of-Hospital Premises and 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.
(10) Posting a Sign
(a) I, Dr. Israel, undertake that, effective immediately, I shall post a sign in all waiting rooms, examination rooms and consulting rooms, in all of my Practice Locations, in a clearly visible and secure location, at all times whether or not I am physically present at the Practice Location, in the form set out in Appendix "C" that states:
"Dr. Israel must not have professional encounters, in person or otherwise, with patients, of any age, unless in the continuous presence and under the continuous observation of a practice monitor acceptable to the College of Physicians and Surgeons of Ontario. Dr. Israel must not be alone during any professional encounter with any patient. Further information may be found on the College website at www.cpso.on.ca".
(b) I, Dr. Israel, undertake to post a certified translation in any language in which I provide services, of the sign described in section (10)(a), in all waiting rooms, examination rooms and consulting rooms, in all of my Practice Locations, in a clearly visible and secure location, in the form set out at Appendix "C."
(c) I, Dr. Israel, undertake to provide the certified translation described in section (10)(b), to the College within thirty (30) days of executing this Undertaking.
(d) I, Dr. Israel, undertake that if I elect, after the execution of this Undertaking, to provide services in any other language, I will notify the College prior to providing any such services.
(e) I, Dr. Israel, undertake to provide to the College the certified translation described in section (10)(b) prior to providing services in any language described in section (10)(d).
(11) Notifying Patients
(a) I, Dr. Israel, undertake to ensure that each patient with whom I have a Professional Encounter is directly notified, prior to the Professional Encounter, of the details of the restriction described in section (8)(a), above.
(b) With respect to patients with whom I have appointments that are scheduled at least seven (7) days in advance, I, Dr. Israel, undertake to ensure that each patient is directly notified, within seven (7) days after the appointment is scheduled, of the details of the restriction described in section (8)(a), above.
(12) I, Dr. Israel, 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. Israel, 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").
(14) I, Dr. Israel, acknowledge that a breach of any provision of this Undertaking may constitute an act of professional misconduct and may result in a referral of specified allegations to the Discipline Tribunal.
(15) I, Dr. Israel, 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.
(16) I, Dr. Israel, acknowledge that, in the event of a referral to the Discipline Tribunal and in the event of an appeal of any Order of the Discipline Tribunal, if the Discipline Tribunal 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. Israel, acknowledge that all appendices attached to or referred to in this Undertaking form part of this Undertaking.
(18) I, Dr. Israel, 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. Israel, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. Israel, acknowledge that, in addition to this Undertaking being posted in accordance with section (19)(a) above, the following summary shall be posted on the Public Register during the time period that this Undertaking remains in effect:
The College has received public complaints regarding Dr. Israel's conduct and is conducting investigations into the information. During the investigation and in the event of a referral to the Discipline Tribunal:
Dr. Israel must not engage in any professional encounters, in person or otherwise, with patients of any age, in any jurisdiction, unless the patient encounter takes place in the continuous presence of a monitor who is a regulated health professional acceptable to the College, and unless the other requirements provided in Dr. Israel's Undertaking with the College are fulfilled. For further clarity, Dr. Israel must not be alone with any patient during any professional encounter.
Dr. Israel shall post a sign in all waiting rooms, examination rooms and consulting rooms, in all Practice Locations, in a clearly visible and secure location, that states: "Dr. Israel must not have professional encounters, in person or otherwise, with patients of any age, unless in the continuous presence of a practice monitor acceptable to the College of Physicians and Surgeons of Ontario. Dr. Israel must not be alone with any patient during any professional encounter. Further information may be found on the College website at www.cpso.on.ca".
C. CONSENT
(20) I, Dr. Israel, 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.
(21) I, Dr. Israel, acknowledge that I have executed the OHIP consent form, attached hereto as Appendix "D".
(22) I, Dr. Israel, consent to submit and not interfere with, unannounced inspections of my Practice Locations and patient records by the College and to any other activity the College deems necessary in order to monitor my compliance with the provisions of this Undertaking.
(23) I, Dr. Israel, give my irrevocable consent to the College to provide the following information to all Practice Monitors:
(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.
(24) I, Dr. Israel, give my irrevocable consent to all Practice Monitors 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 Practice Monitor's undertaking set out at Appendix "A";
(c) any information relevant for the purposes of monitoring my compliance with this Undertaking.
(25) I, Dr. Israel, 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.
(26) I, Dr. Israel, 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.