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Syed, Naseeruddin

CPSO#: 60201

MEMBER STATUS
Active Member as of 15 Jun 2018
CPSO REGISTRATION CLASS
Restricted as of 17 Feb 2017

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English, Urdu

Education:Osmania University, 1981

Practice Information

Primary Location of Practice
900 Albion Rd
Appletree Medical Clinic
Etobicoke ON  M9V 1A5
Phone: 647-722-2370
Fax: 647-490-6330 Electoral District: 10

Additional Practice Location(s)

Lansdowne Place Walk in Clinic
Superstore Upstairs
769 Bordon Ave
Peterborough ON  K9J 0B6
Canada
Phone: (705) 725-0444
Fax: (707) 775-0437
County: County of Peterborough
Electoral District: 06

Specialties

Specialty Issued On Type
No Speciality Reported

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 03 Aug 1988
Transfer of class of registration to: Independent Practice Certificate Effective: 30 Jul 1990
Transfer of class of certificate to: Restricted certificate Effective: 17 Feb 2017
Terms and conditions imposed on certificate by Inquiries, Complaints and Repo Effective: 17 Feb 2017
Suspension of registration imposed: Discipline Committee Effective: 15 Apr 2018
Suspension of registration removed Effective: 15 Jun 2018
Terms and conditions amended by Discipline Committee Effective: 15 Jun 2018
Terms and conditions amended by Discipline Committee Effective: 15 Jun 2018
Terms and conditions amended by Discipline Committee Effective: 15 Jun 2018
Terms and conditions amended by member Effective: 13 May 2019
Terms and conditions amended by member Effective: 09 Aug 2019
Terms and conditions amended by member Effective: 14 May 2020

Practice Restrictions

Imposed By Effective Date Expiry Date Status
member Effective: 14 May 2020 Active
             (1 of 3) As from May 14, 2020, the following are imposed as terms, conditions
            and limitations on the certificate of registration held by Dr. Naseeruddin Syed
            in accordance with an undertaking and consent given by Dr. Syed to the College
            of Physicians and Surgeons of Ontario:

                        UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT 
                                          ("Undertaking")
                  
                                                of
                  
                                    DR. NASEERUDDIN SYED
                                          ("Dr. Syed")
                  
                                                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;
                  
                  "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. Syed, certificate of registration number 60201, am a member of the
                  College.  

            (3)   I, Dr. Syed, acknowledge that pursuant to an Order of the Discipline
                  Committee of the College dated May 5, 2018, I underwent remediation and
                  submitted to a reassessment of my practice. The reassessment report
                  subsequently received by the College raised concerns about my standard of
                  practice in family medicine.

            B.    UNDERTAKING

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

            (5)   Clinical Supervision 

                  (a)   I, Dr. Syed, undertake to practise under the guidance of a clinical
                        supervisor or clinical supervisors acceptable to the College (the
                        "Clinical Supervisor" or "Clinical Supervisors"), for six (6)
                        months ("Clinical Supervision"). 
                  
                  (b)   I, Dr. Syed, acknowledge that I have reviewed the Clinical
                        Supervisor's undertaking, attached hereto as Appendix "A", and
                        understand what is required of the Clinical Supervisor. The
                        Clinical Supervisor will, at minimum: 
                  
                        (i)   Facilitate the education program set out in the
                              Individualized Education Plan ("IEP"), attached hereto as
                              Appendix "B";
                  
                        (ii)  Review the materials provided by the College and have an
                              initial meeting to discuss the objectives for the Clinical
                              Supervision and practice improvement recommendations;
                  
                        (iii) Meet with me at my Practice Location, or another location
                              approved by the College, once every month;
                  
                        (iv)  Review at least fifteen (15) of my patient charts at every
                              meeting;
                  
                        (v)   At one (1) meeting, directly observe no less than five (5) of
                              my patient encounters;
                  
                        (vi)  Discuss any concerns arising from the chart reviews and
                              observation;
                  
                        (vii) Make recommendations to me for practice improvements and
                              ongoing professional development and inquire into my
                              compliance with the recommendations; 
                  
                        (viii)Perform any other duties, such as reviewing other documents
                              or conducting interviews with staff or colleagues, that the
                              Clinical Supervisor deems necessary to my Clinical
                              Supervision; and
                  
                        (ix)  Submit written reports to the College at least once every
                              three months, or more frequently if the Clinical Supervisor
                              has concerns about my standard of practice.
                  
                  (c)   I, Dr. Syed, acknowledge that the charts reviewed shall be selected
                        by the Clinical Supervisor based on the educational needs
                        identified in the IEP, attached hereto as Appendix "B", as well as
                        the areas of concern identified in the report of the assessor
                        dated December 10, 2019, and concerns that may arise during the
                        period of Clinical Supervision.
                  
                  (d)   I, Dr. Syed, undertake to cooperate fully with the Clinical
                        Supervision of my practice, conducted under the term of this
                        Undertaking and Appendix "A" to this Undertaking, and to abide by
                        the recommendations of my Clinical Supervisor, including but not
                        limited to, any recommended practice improvements and ongoing
                        professional development.
                  
                  (e)   I, Dr. Syed, undertake to ensure that Appendix "A" to this
                        Undertaking is signed and delivered to the College within
                        forty-five (45) days of the date I execute this Undertaking.
                  
                  (f)   I, Dr. Syed, undertake that if a person who has given an
                        undertaking in Appendix "A" to this Undertaking is unable or
                        unwilling to continue to fulfill its provisions, I shall, within
                        twenty (20) days of receiving notice of same, obtain an executed
                        undertaking in the same form from a similarly qualified person who
                        is acceptable to the College and ensure that it is delivered to the
                        College within that time.
                  
                  (g)   I, Dr. Syed, undertake that if I am unable to obtain a Clinical
                        Supervisor on the provisions set out under sections (5)(e) and/or
                        (f) above, I will cease practising medicine until such time as I
                        have obtained a Clinical Supervisor acceptable to the College.  
                  
                  (h)   I, Dr. Syed, acknowledge that if I am required to cease practise as
                        a result of section (5)(g) above this will constitute a term,
                        condition or limitation on my certificate of registration and that
                        term, condition or limitation will be included on the public
                        register.
                  
            (6)   Professional Education  

                  (a)   I, Dr. Syed, undertake to participate in and successfully complete
                        all aspects of the detailed IEP, attached hereto as Appendix "B",
                        including all of the following professional education (the
                        "Professional Education"):
                  
                        (i)   review, reflection and written summary of: 
                  
                              1.    Anti-infective Guidelines for Community-acquired
                                    Infections, MUMS Health; 
                              2.    Antibiotic Stewardship, Choosing Wisely Canada; and
                              3.    College Policy "Medical Records Documentation"; 
                  
                        (ii)  The eLearning Module "Documentation: Charting Medical
                              Records" produced by the Canadian Medical Protective
                              Association; and 
                  
                        (iii) any additional professional education recommended by my
                              Clinical Supervisor.
                  
                  (b)   I, Dr. Syed, 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. Syed, undertake to complete this requirement within three
                        (3) months of the date I execute this undertaking or, if no
                        satisfactory program is available by that time, by the first
                        possible opportunity thereafter.
                  
                  (d)   I, Dr. Syed, acknowledge that a report or reports may be provided
                        to the College regarding my progress and compliance with the
                        Professional Education.
                  
            (7)   Reassessment of Practice

                  (a)   I, Dr. Syed, undertake that, approximately three (3) months after
                        the completion of the Clinical Supervision set out in section (5)
                        above and Appendix "A" to this Undertaking, and the completion of
                        the Professional Education set out in section (6) 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. Syed, undertake to co-operate fully with the Reassessment,
                        conducted under the term of this Undertaking. 
                  
                  (c)   I, Dr. Syed, acknowledge that my Clinical Supervisor may receive
                        and review the findings of the Assessor, and may discuss with the
                        Assessor any issues or concerns arising from the Reassessment. 
                  
                  (d)   I, Dr. Syed, 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. 
                  
            (8)   Monitoring 

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

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

            (10)  I, Dr. Syed, 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. 

            (11)  I, Dr. Syed, 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.

            (12)  I, Dr. Syed, 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").

            (13)  I, Dr. Syed, 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.

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

            (15)  Public Register

                  (a)   I, Dr. Syed, acknowledge that, during the time period that this
                        Undertaking remains in effect, this Undertaking shall be posted on
                        the Public Register.
                  
                  (b)   I, Dr. Syed, acknowledge that, in addition to this Undertaking
                        being posted in accordance with section (15)(a) above, the
                        following summary shall be posted on the Public Register during the
                        time period that this Undertaking remains in effect:
                  
                              Pursuant to an order of the Discipline Committee dated May 5,
                              2018, Dr. Syed underwent remediation and a reassessment of
                              his practice. The reassessment raised concerns about Dr.
                              Syed's standard of practice in family medicine. As a result
                              of the reassessment:
                  
                              Dr. Syed will practise under the guidance of a Clinical
                              Supervisor acceptable to the College for 6 months. 
                  
                              Dr. Syed will engage in professional education in medical
                              recordkeeping, community-acquired infections, and antibiotic
                              prescribing.
                  
                              Dr. Syed's practice will be reassessed by an assessor
                              selected by the College within 3 months of the end of the
                              period of Clinical Supervision.
                  
                  (c)   I, Dr. Syed, acknowledge that this Undertaking remains in effect
                        until the College determines its terms are satisfied.
                  
            D.    CONSENT

            (16)  I, Dr. Syed, give my irrevocable consent to the College to provide the
                  following information to any person who requires this information for the
                  purposes of facilitating my completion of the Professional Education and
                  to all Clinical Supervisors, and/or Assessors:

                  (a)   any information the College has that led to the circumstances of my
                        entering into this Undertaking;
                  
                  (b)   any information arising from any investigation into, or assessment
                        of, my practice; and 
                  
                  (c)   any information arising from the monitoring of my compliance with
                        this Undertaking.
                  
            (17)  I, Dr. Syed, 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.

            (18)  I, Dr. Syed, give my irrevocable consent to any persons who facilitate my
                  completion of the Professional Education, and to all Clinical
                  Supervisors, Chiefs of Staff and Assessors, to disclose to the College,
                  and to one another, any of the following:

                  (a)   any information relevant to this Undertaking;
                  
                  (b)   any information relevant to the provisions of the Clinical
                        Supervisor's undertaking set out at Appendix "A" to this
                        Undertaking;
                  
                  (c)   any information relevant to the Reassessment;
                  
                  (d)   any information relevant for the purposes of monitoring my
                        compliance with this Undertaking; and/or  
                  (e)   any information which comes to their attention in the course of
                        providing the Professional Education and which they reasonably
                        believe indicates a potential risk of harm to my patients.
                  
                  
            (2 of 3) Effective June 15, 2018, Dr. Syed has not yet obtained a clinical
            supervisor for his narcotics prescribing practice. Therefore, Dr. Syed must
            cease prescribing Narcotic Drugs, Narcotic Preparations, Controlled Drugs,
            Benzodiazepines and Other Targeted Substances and All other Monitored Drugs
            until such time as he has obtained a Clinical Supervisor acceptable to the
            College.

            (3 of 3) As from 11:59 p.m., June 15, 2018, 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. Naseeruddin Syed:

            A.    Prescribing Log 

                  (i)   Dr. Syed, shall keep a Log of all prescriptions for Narcotic Drugs,
                        Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other
                        Targeted Substances and All other Monitored Drugs (as set out in
                        Schedule "A"), in the form attached as set out in Schedule "B",
                        which will include at least the following information (the
                        "Prescribing Log"):
                  
                        (a)   the date of the appointment;
                        (b)   the name of the patient and chart/file number;
                        (c)   the name of the medication prescribed, dose, direction,
                              number of tablets to be dispensed and frequency;
                        (d)   the clinical indication;
                        (e)   whether the prescription is for a new medication and/or
                              different dose or frequency than currently prescribed to the
                              patient (Y/N);
                        (f)   Dr. Syed's signature;
                        (g)   the date of the Clinical Supervisor's review (if applicable,
                              as set out below); and
                        (h)   the Clinical Supervisor's signature (if applicable, as set
                              out below).
                  
                  (ii)  Dr. Syed is to keep a copy of all prescriptions he writes for
                        Narcotic Drugs, Narcotic Preparations, Controlled Drugs,
                        Benzodiazepines and Other Targeted Substances and All other
                        Monitored Drugs, in the corresponding patient chart.
                  
            B.    Clinical Supervision re: Narcotic Practice 
                  
                  (i)   Dr. Syed is to practise under the guidance of a clinical supervisor
                        acceptable to the College (the "Clinical Supervisor"), for a
                        minimum of nine (9) months on the terms set out below (the
                        "Clinical Supervision").
                  (ii)  The Clinical Supervisor shall sign an undertaking in the form
                        attached hereto as Schedule "C".
                  (iii) Dr. Syed shall cooperate fully with the Clinical Supervision and
                        abide by all recommendations of his Clinical Supervisor with
                        respect to practice improvements and education.
                  (iv)  Dr. Syed shall consent to the disclosure by the 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 to monitor Dr. Syed's compliance with
                        this Order. This shall include, without limitation, providing the
                        Clinical Supervisor with any reports of any assessments of Dr.
                        Syed's practice in the College's possession.
                  (v)   If the Clinical Supervisor who has given an undertaking in Schedule
                        "C" to this Order is unable or unwilling to continue to fulfill its
                        terms, Dr. Syed shall, within seven (7) days of receiving notice of
                        same, obtain an executed undertaking in the same form from a
                        similarly qualified person who is acceptable to the College and
                        ensure that it is delivered to the College within that time.
                  (vi)  Dr. Syed shall not prescribe any narcotics or controlled substances
                        unless and until the Clinical Supervision is in place.
                  (vii) If Dr. Syed is unable to obtain a Clinical Supervisor on the terms
                        set out in sections 4.B, he will cease prescribing Narcotic Drugs,
                        Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other
                        Targeted Substances and All other Monitored Drugs until such time
                        as he has obtained a Clinical Supervisor acceptable to the College.
                  (viii)If Dr. Syed is required to cease prescribing Narcotic Drugs,
                        Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other
                        Targeted Substances and All other Monitored Drugs as a result of
                        section 4.B(vii) above this will constitute a term, condition or
                        limitation on his certificate of registration and that term,
                        condition or limitation will be included on the Public Register.
                  
                  Phase 1 of Clinical Supervision ("Phase 1")
                  
                  (ix)  Dr. Syed is to engage in Phase 1 of Clinical Supervision for a
                        minimum of two (2) months on the terms set out below.
                  (x)   During Phase 1, Dr. Syed is to meet with the Clinical Supervisor
                        once a week to discuss the Clinical Supervisor's review of a
                        minimum of twenty (20 charts for patients to whom Dr. Syed has
                        prescribed:
                        (a)   Narcotic Drugs, or
                        (b)   Narcotic Preparations; or
                        (c)   Controlled Drugs, Benzodiazepines and Other Targeted
                              Substances and All other Monitored Drugs where the patient is
                              also prescribed a Narcotic Drug and/or Narcotic Preparation.
                  (xi)  If there are not twenty (20) charts for patients to whom Dr. Syed
                        has prescribed the above substances, the Clinical Supervisor shall
                        review the charts of all patients listed in the prescribing log
                        since his prior review.
                  (xii) During Phase 1, the Clinical Supervisor must sign and date the
                        Prescribing Log to confirm the charts that the Clinical Supervisor
                        has reviewed and discussed with Dr. Syed.
                  (xiii)During Phase 1, the Clinical Supervisor will provide a report to
                        the College at least once a week.
                  (xiv) After a minimum of two (2) months of Phase 1, if the Clinical
                        Supervisor is satisfied that Dr. Syed has the necessary knowledge,
                        skills and judgment to practice in a less highly supervised
                        environment, the Clinical Supervisor may recommend to the College
                        that supervision be reduced.
                  
                  Phase 2 of Clinical Supervision ("Phase 2")
                  
                  (xv)  Upon the recommendation of the Clinical Supervisor and approval by
                        the College, Dr. Syed shall engage in Phase 2 of Clinical
                        Supervision for a minimum of three months on the terms set out
                        below.
                  (xvi) During Phase 2, Dr. Syed is to with the Clinical Supervisor at
                        least once every two (2) weeks the Clinical Supervisor's review of
                        a minimum of fifteen (15) charts for patients to whom Dr. Syed has
                        initiated a new prescription for:
                        (a)   Narcotic Drugs, or
                        (b)   Narcotic Preparations; or
                        (c)   Controlled Drugs, Benzodiazepines and Other Targeted
                              Substances and All other Monitored Drugs where the patient is
                              also prescribed a Narcotic Drug and/or Narcotic Preparation.
                  (xvii)If there are not fifteen (15) charts for patients to whom Dr. Syed
                        has initiated a new prescription for the above substances, the
                        Clinical Supervisor shall review the charts of all patients listed
                        in the prescribing log since his prior review.
                  (xviii)During Phase 2, the Clinical Supervisor must sign and date the
                        Prescribing Log to confirm the charts that the Clinical Supervisor
                        has reviewed and discussed with Dr. Syed.
                  (xix) During Phase 2, the Clinical Supervisor will provide a report to
                        the College at least once every two (2) weeks.
                  (xx)  After a minimum of three (3) months of Phase 2, if the Clinical
                        Supervisor is satisfied that Dr. Syed has the necessary knowledge,
                        skills and judgment to practice in a less highly supervised
                        environment, the Clinical Supervisor may recommend to the College
                        that supervision be reduced.
                  
                  Phase 3 of Clinical Supervision ("Phase 3")
                  
                  (xxi) Upon the recommendation of the Clinical Supervisor and approval by
                        the College, Dr. Syed, shall engage in Phase 3 of Clinical
                        Supervision for a minimum of four (4) months on the terms set out
                        below.
                  (xxii)During Phase 3, Dr. Syed shall with the Clinical Supervisor at
                        least once a month the Clinical Supervisor's review of a minimum of
                        fifteen (15) charts for patients to whom Dr. Syed has initiated a
                        new prescription for:
                        (a)   Narcotic Drugs, or
                        (b)   Narcotic Preparations; or
                        (c)   Controlled Drugs, Benzodiazepines and Other Targeted
                              Substances and All other Monitored Drugs where the patient is
                              also prescribed a Narcotic Drug and/or Narcotic Preparation.
                  (xxiii)If there are not fifteen (15) charts for patients to whom Dr. Syed
                        has initiated a new prescription for the above substances, the
                        Clinical Supervisor shall review the charts of all patients listed
                        in the prescribing log since his prior review.
                  (xxiv)During Phase 3, the Clinical Supervisor must sign and date the
                        Prescribing Log to confirm the charts that the Clinical Supervisor
                        has reviewed and discussed with Dr. Syed.
                  (xxv) During Phase 3, the Clinical Supervisor(s) will provide a report to
                        the College at least once every month.
                  (xxvi)After a minimum of four (4) months of Phase 3, if the Clinical
                        Supervisor is satisfied that Dr. Syed has the necessary knowledge,
                        skills and judgment to practice without supervision, the Clinical
                        Supervisor may recommend to the College that the Clinical
                        Supervision cease.
                  
            C.    Clinical Supervision re: Non-Narcotic Practice 

                  (i)   By June 15, 2018, Dr. Syed shall obtain a clinical supervisor
                        acceptable to the College, who will supervise Dr. Syed's general
                        practice upon completion of his suspension for a period of nine (9)
                        months, and who will sign an undertaking in the form attached
                        hereto as Schedule "D" (the "General Practice Clinical
                        Supervisor").
                  (ii)  Dr. Syed shall cooperate fully with the Clinical Supervision and
                        abide by all recommendations of his General Practice Clinical
                        Supervisor with respect to practice improvements and education.
                  (iii) Dr. Syed shall consent to the disclosure by the General Practice
                        Clinical Supervisor to the College, and by the College to his
                        General Practice Clinical Supervisor, of all information the
                        General Practice Clinical Supervisor or the College deems necessary
                        or desirable in order to fulfill the General Practice Clinical
                        Supervisor's undertaking and to monitor Dr. Syed's compliance with
                        this Order. This shall include, without limitation, providing the
                        General Practice Clinical Supervisor with any reports of any
                        assessments of Dr. Syed's practice in the College's possession.
                  (iv)  If the General Practice Clinical Supervisor who has given an
                        undertaking in Schedule "D" to this Order is unable or unwilling to
                        continue to fulfill its terms, Dr. Syed shall, within twenty (20)
                        days of receiving notice of same, obtain an executed undertaking in
                        the same form from a similarly qualified person who is acceptable
                        to the College and ensure that it is delivered to the College
                        within that time.
                  (v)   If Dr. Syed is unable to obtain a General Practice Clinical
                        Supervisor in accordance with paragraphs 4(C)(i) or 4(C)(iv) of
                        this Order, he shall cease practising medicine until such time as
                        he has done so, and the fact that he has will constitute a term,
                        condition or limitation on his certificate of registration until
                        that time.
                  
            D.    Reassessment of Practice 

                  (i)   Approximately three (3) months after each aspect of the Clinical
                        Supervision set out above has ceased, Dr. Syed will submit to a
                        comprehensive reassessment of his entire practice by an assessor or
                        assessors selected by the College (the "Assessor(s)"). The
                        Reassessment may include a chart review, direct observation of Dr.
                        Syed's care, interviews with colleagues and co-workers, feedback
                        from patients and any other tools deemed necessary by the College.
                        Dr. Syed shall abide by all recommendations made by the
                        Assessor(s), and the results of the Reassessment will be reported
                        to the College and may form the basis of further action by the
                        College.
                  
            E.    Compliance 

                  (i)   Dr. Syed shall co-operate with unannounced inspections of his
                        office practice and patient charts for the purpose of monitoring
                        and enforcing his compliance with the terms of this Order.
                  (ii)  Dr. Syed shall inform the College of any and all new practice
                        locations including, but not limited to, hospital(s), clinic(s) and
                        office(s), in any jurisdiction five (5) days in advance of
                        commencing practice at that location.
                  (iii) Dr. Syed shall give his irrevocable consent to the College to make
                        appropriate enquiries of the Ontario Health Insurance Plan
                        ("OHIP"), the Drug Program Services Branch, the Narcotics
                        Monitoring System ("NMS") implemented under the Narcotics Safety
                        and Awareness Act, 2010 and/or any person or institution who may
                        have relevant information, in order for the College to monitor my
                        compliance with the provisions of this Order.
                  (iv)  Dr. Syed shall be responsible for any and all costs associated with
                        implementing the terms of this Order.

Previous Hearings

Committee: Discipline
Decision Date: 05 Mar 2018
Summary:

On March 5, 2018, the Discipline Committee found that Dr. Naseeruddin Syed committed an act of 
professional misconduct, in that he has failed to maintain the standard of practice of the profession.  
 
Dr. Syed is a general practitioner, with a practice in Peterborough. 
 
Investigation  One 
 
On August 2014, Dr. Syed’s former nurse contacted the College expressing concern regarding various 
aspects of Dr. Syed’s practice, including his prescribing practices. Based on the information requested by the 
College in April 2015 regarding claims for all monitored drugs made by Dr. Syed’s patients, the College 
commenced an investigation. 
 
The College retained an expert who reviewed 25 of Dr. Syed’s patient charts, pharmacy records, 
narcotic monitoring system data and conducted an interview with Dr. Syed. He opined that  Dr. 
Syed's dedication to the practice of medicine and his belief that he is truly acting in the best 
interests of his patients are not questioned, but he had concerns about Dr. Syed’s knowledge and 
judgment which may expose his patients to possible harm. He also was of the view that Dr. Syed’s 
skill was difficult to determine due the extremely poor and woefully sparse documentation on the 
charts reviewed. He concluded that 24 of 25 charts reviewed failed to meet standards; 6 out of 25 
patient charts displayed a lack of knowledge, the majority regarding dosing of psychoactive drugs; 
4 out of 25 patient charts displayed a lack of judgment, the majority regarding prescriptions of 
benzodiazepines, narcotics and antidepressants; and 6 of 25 patient charts reveal exposure of Dr. 
Syed's patients to harm or injury, specifically relating to his general prescribing practices. 
       
Investigation Two 
 
The College received information from two physicians who practise in a methadone maintenance practice at 
the Ontario Addiction Treatment Centres (“OATC”) in Peterborough, outlining concerns regarding Dr. 
Syed’s prescribing of high doses and large amounts of benzodiazepines to several methadone patients.  
Concerns regarding serious or fatal respiratory depression were relayed. 6 patients were identified and 
concerns were raised about an admission to the local hospital's Intensive Care Unit in the group of patients 
due to recent benzodiazepine overdose.  
       
Dr. Syed stated to the College investigator that he was not aware that the 6 patients were being prescribed 
methadone.  
 
The manager of the pharmacy located at the same address as Dr. Syed’s practice, relayed to the College 
investigator concerns regarding the early release of medications in patients claiming to have lost their 
prescriptions and regarding the maximum dosages of benzodiazepines being prescribed. By letter dated July 
5, 2015, one of the physicians who contacted the College expressing concerns regarding Dr. Syed’s 
prescribing provided a further report with respect to his concerns about specific patients. 
 
The College retained an expert who reviewed Dr. Syed’s general medicine practice, including his 
prescribing practice. After reviewing 10 patient charts, pharmacy records and interviewing Dr. Syed the 
expert concluded, among other things, that despite the guidelines for documentation afforded by the EMR, in 
not a single case during this chart review of these 6 patients was the record of treatment properly populated 
with adequate detail to meet College standards. In fact, there were glaring absences of documentation in the 
vast majority of charts reviewed, such that not one met record-keeping standards. The latter case is similar to 
that of the five previous, in that these patients were all prescribed psychoactive drugs, many in excessive 
quantities, despite all being on methadone and followed by a physician managing their addictions. While Dr. 
 
                                           

Syed maintained in his interview that he was unaware that these patients were on methadone, he 
acknowledged that many of the clientele of this walk-in clinic were drug addicts with poor social support. 
The expert noted that with this knowledge the physician managing these patients should be extremely 
diligent in assessing and treating these patients, including careful history taking and thorough physical 
examination to ensure the safety of the patient. According to the expert, in 6 patients whose charts were 
reviewed, Dr. Syed has failed to meet the standard of practice of the profession and at times may have 
exposed his patients to potential harm. 
 
Dr. Syed advised the College that he did not know the patients to whom the two physicians referred were on 
methadone. However, during the investigation, the College reviewed Dr. Syed’s charts for these patients, 
which revealed that: 
 
-  Dr. Syed had received a fax from the pharmacy indicating that Patient A, who was identified by the two 
   physicians, was on methadone in January, 2015. Despite this, he prescribed benzodiazepines to Patient 
   A in February, 2015. 
-  Dr. Syed continued to prescribe narcotics and benzodiazepines to Patient B throughout February, March 
   and April, 2015 and prescribed benzodiazepines to Patient C in March 2015 in two cases after being told 
   by both physicians that they were methadone patients. 
-  Patient D identified by both physicians was seen in the emergency department for overdose of sedatives 
   (specifically having taken many of the 2mg tablets of Clonazepam prescribed by Dr. Syed at once). The 
   patient was admitted to the ICU for overdose of sedatives. Five days later, there was no patient visit in 
   his chart, yet Dr. Syed prescribed Ativan to Patient D. About ten days later, Dr. Syed discussed the 
   recent overdose and admission to hospital with Patient D as well as the recent letter from the physician 
   and again prescribed Ativan to patient D.  
    
Complaint of Patient E  
 
In March 2015, the College received a complaint from Patient E expressing concerns that Dr. Syed failed to 
provide appropriate care when ordering medications for him during a walk-in visit. Specifically, Dr. Syed 
prescribed a medication that patient E was allergic to, prescribed high doses of benzodiazepines, knowing 
that Patient E is on methadone and has a general lack of knowledge concerning mental health patients and is 
over-prescribing to them.  
 
The College retained an expert who reviewed the standard of care provided by Dr. Syed to Patient E. The 
expert opined, in part, that not one of the patient’s eight visits in 2015 contained the required elements to 
meet the standards of record keeping of the College: the histories were incomplete, the physical exams often 
undocumented and the diagnoses usually only represented by OHIP billing codes. The plans for management 
were prescriptions only with rare advice as to how to specifically manage the patient's presenting 
complaints. Dr. Syed demonstrated lack of knowledge concerning the management of drug-seeking, 
habituated methadone patients. Dr. Syed demonstrated lack of skill in advising tapering of benzodiazepines 
without specific instructions. Dr. Syed demonstrated lack of judgment by allowing himself to be 
manipulated into repeat prescriptions of such a class of drugs and his prescriptions of narcotics, including 
Nucynta, in this patient. The pharmacist brought to light Dr. Syed's lack of knowledge of a potentially 
serious drug interaction between Nuycynta and Cymbalta. Dr. Syed demonstrated a lack of judgment by 
stopping the antidepressant instead of the narcotic in this instance. The clinical practice of Dr. Syed with 
regard to Patient E had the potential in several instances to expose his patient to harm. 
 
 
 
 
 
                                           

Complaint of Patient F  
 
In May 2016, the College received a complaint from Patient F expressing concerns that Dr. Syed failed to 
provide appropriate assessment, diagnosis and treatment when she attended the walk-in clinic with 
gynaecological concerns about a growth. Dr. Syed did not conduct a physical examination of the patient and 
proceeded to prescribe her medication without adequate explanation. The patient consulted a pharmacist, 
who expressed some disagreement with the prescription. As a result, the patient did not fill the complete 
prescription.  
 
The College retained an expert who reviewed the standard of care provided by Dr. Syed to Patient F. The 
expert concluded, in part, that the care provided by Dr. Syed did not meet the standard of the profession.  
The expert noted that the patient's concern was of the lesion on her labia, and it is standard practice to 
examine this lesion. According to the expert, sometimes a physician may defer exam, but this would be 
based on agreement with the patient, which was not the case in this instance. Regarding the concern about 
the prescription provided, the expert noted that for a typical yeast infection, a patient may potentially be 
prescribed Diflucan 150mg for one day and/or a topical treatment (such as the Terazol 7), while Dr. Syed 
prescribed Diflucan for seven days along with a repeat. According to the expert, this is a definite concern, as 
it is not the standard treatment for a common yeast infection (as Dr. Syed implied it was in his letter). The 
expert further noted that Patient F’s short visit demonstrated concerns regarding the knowledge, skill and 
judgment provided by Dr. Syed. According to the expert, there is reason to believe that Dr. Syed's clinical 
practice may expose patients to harm or injury, as examination of patients is vital to the correct diagnosis 
and that the prescription provided in the case of Patient F appears to be excessive and may cause harm to the 
patient. However, the expert noted that this is one short encounter, and may not be indicative of Dr. Syed's 
overall practice style. 
 
The Interim Order of the the Inquiries, Complaints and Reports Committee (ICRC) 
 
On February 14, 2017, the ICRC directed the Registrar to impose terms, conditions and limitations on Dr. 
Syed’s certificate of registration, which remain in effect until April 15, 2018. 
 
Disposition 
 
On March 5, 2018, the Discipline Committee ordered that: 
 
-  Dr. Syed attend before the panel to be reprimanded. 
-  the Registrar suspend Dr. Syed’s certificate of registration for two (2) months, to commence at 12:01 
   a.m.  on April 15, 2018. 
-  the Registrar impose the following terms, conditions and limitations on Dr. Syed’s certificate of 
   registration upon his return to practice at the conclusion of his suspension: 
   -  Prescribing Log  
      -  Dr. Syed, shall keep a Log of all prescriptions for Narcotic Drugs, Narcotic Preparations, 
         Controlled Drugs, Benzodiazepines and Other Targeted Substances and All other Monitored 
         Drugs (as set out in Schedule “A”), in the form attached as set out in Schedule “B”, which will 
         include at least the following information (the “Prescribing Log”): 
          -  the date of the appointment; 
          -  the name of the patient and chart/file number; 
          -  the name of the medication prescribed, dose, direction, number of tablets to be dispensed 
             and frequency; 
          -  the clinical indication; 
          
                                        

       -  whether the prescription is for a new medication and/or different dose or frequency than 
          currently prescribed to the patient (Y/N); 
       -  Dr. Syed’s signature; 
       -  the date of the Clinical Supervisor’s review (if applicable, as set out below); and 
       -  the Clinical Supervisor’s signature (if applicable, as set out below). 
   -  Dr. Syed is to keep a copy of all prescriptions he writes for Narcotic Drugs, Narcotic 
      Preparations, Controlled Drugs, Benzodiazepines and Other Targeted Substances and All other 
      Monitored Drugs, in the corresponding patient chart. 
-  Clinical Supervision re: Narcotic Practice  
   -  Dr. Syed is to practise under the guidance of a clinical supervisor acceptable to the College (the 
      “Clinical Supervisor”), for a minimum of nine (9) months on the terms set out below (the 
      “Clinical Supervision”). 
   -  The Clinical Supervisor shall sign an undertaking in the form attached hereto as Schedule “C”. 
   -  Dr. Syed shall cooperate fully with the Clinical Supervision and abide by all recommendations of 
      his Clinical Supervisor with respect to practice improvements and education. 
   -  Dr. Syed shall consent to the disclosure by the 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 to 
      monitor Dr. Syed’s compliance with this Order. This shall include, without limitation, providing 
      the Clinical Supervisor with any reports of any assessments of Dr. Syed’s practice in the 
      College’s possession. 
   -  If the Clinical Supervisor who has given an undertaking in Schedule “C” to this Order is unable 
      or unwilling to continue to fulfill its terms, Dr. Syed shall, within seven (7) days of receiving 
      notice of same, obtain an executed undertaking in the same form from a similarly qualified 
      person who is acceptable to the College and ensure that it is delivered to the College within that 
      time. 
   -  Dr. Syed shall not prescribe any narcotics or controlled substances unless and until the Clinical 
      Supervision is in place. 
   -  If Dr. Syed is unable to obtain a Clinical Supervisor on the terms set out in sections 4.B, he will 
      cease prescribing Narcotic Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines and 
      Other Targeted Substances and All other Monitored Drugs until such time as he has obtained a 
      Clinical Supervisor acceptable to the College. 
   -  If Dr. Syed is required to cease prescribing Narcotic Drugs, Narcotic Preparations, Controlled 
      Drugs, Benzodiazepines and Other Targeted Substances and All other Monitored Drugs as a 
      result of section 4.B(vii) above this will constitute a term, condition or limitation on his 
      certificate of registration and that term, condition or limitation will be included on the Public 
      Register. 
   Phase 1 of Clinical Supervision (“Phase 1”) 
   -  Dr. Syed is to engage in Phase 1 of Clinical Supervision for a minimum of two (2) months on the 
      terms set out below. 
   -  During Phase 1, Dr. Syed is to meet with the Clinical Supervisor once a week to discuss the 
      Clinical Supervisor’s review of a minimum of twenty (20 charts for patients to whom Dr. Syed 
      has prescribed: 
      -  Narcotic Drugs, or 
      -  Narcotic Preparations; or 
      -  Controlled Drugs, Benzodiazepines and Other Targeted Substances and All other Monitored 
         Drugs where the patient is also prescribed a Narcotic Drug and/or Narcotic Preparation. 
   -  If there are not twenty (20) charts for patients to whom Dr. Syed has prescribed the above 
      substances, the Clinical Supervisor shall review the charts of all patients listed in the prescribing 
      log since his prior review. 
          
                                     

-  During Phase 1, the Clinical Supervisor must sign and date the Prescribing Log to confirm the 
   charts that the Clinical Supervisor has reviewed and discussed with Dr. Syed. 
-  During Phase 1, the Clinical Supervisor will provide a report to the College at least once a week. 
-  After a minimum of two (2) months of Phase 1, if the Clinical Supervisor is satisfied that Dr. 
   Syed has the necessary knowledge, skills and judgment to practice in a less highly supervised 
   environment, the Clinical Supervisor may recommend to the College that supervision be reduced. 
Phase 2 of Clinical Supervision (“Phase 2”) 
-  Upon the recommendation of the Clinical Supervisor and approval by the College, Dr. Syed shall 
   engage in Phase 2 of Clinical Supervision for a minimum of three months on the terms set out 
   below. 
-  During Phase 2, Dr. Syed is to meet with the Clinical Supervisor at least once every two (2) 
   weeks to discuss the Clinical Supervisor’s review of a minimum of fifteen (15) charts for patients 
   to whom Dr. Syed has initiated a new prescription for: 
   -  Narcotic Drugs, or 
   -  Narcotic Preparations; or 
   -  Controlled Drugs, Benzodiazepines and Other Targeted Substances and All other Monitored 
      Drugs where the patient is also prescribed a Narcotic Drug and/or Narcotic Preparation. 
-  If there are not fifteen (15) charts for patients to whom Dr. Syed has initiated a new prescription 
   for the above substances, the Clinical Supervisor shall review the charts of all patients listed in 
   the prescribing log since his prior review. 
-  During Phase 2, the Clinical Supervisor must sign and date the Prescribing Log to confirm the 
   charts that the Clinical Supervisor has reviewed and discussed with Dr. Syed. 
-  During Phase 2, the Clinical Supervisor will provide a report to the College at least once every 
   two (2) weeks. 
-  After a minimum of three (3) months of Phase 2, if the Clinical Supervisor is satisfied that Dr. 
   Syed has the necessary knowledge, skills and judgment to practice in a less highly supervised 
   environment, the Clinical Supervisor may recommend to the College that supervision be reduced. 
Phase 3 of Clinical Supervision (“Phase 3”) 
-  Upon the recommendation of the Clinical Supervisor and approval by the College, Dr. Syed, shall 
   engage in Phase 3 of Clinical Supervision for a minimum of four (4) months on the terms set out 
   below. 
-  During Phase 3, Dr. Syed shall mee with the Clinical Supervisor at least once a month to discuss 
   the Clinical Supervisor’s review of a minimum of fifteen (15) charts for patients to whom Dr. 
   Syed has initiated a new prescription for: 
   -  Narcotic Drugs, or 
   -  Narcotic Preparations; or 
   -  Controlled Drugs, Benzodiazepines and Other Targeted Substances and All other Monitored 
      Drugs where the patient is also prescribed a Narcotic Drug and/or Narcotic Preparation. 
-  If there are not fifteen (15) charts for patients to whom Dr. Syed has initiated a new prescription 
   for the above substances, the Clinical Supervisor shall review the charts of all patients listed in 
   the prescribing log since his prior review. 
-  During Phase 3, the Clinical Supervisor must sign and date the Prescribing Log to confirm the 
   charts that the Clinical Supervisor has reviewed and discussed with Dr. Syed. 
-  During Phase 3, the Clinical Supervisor(s) will provide a report to the College at least once every 
   month. 
-  After a minimum of four (4) months of Phase 3, if the Clinical Supervisor is satisfied that Dr. 
   Syed has the necessary knowledge, skills and judgment to practice without supervision, the 
   Clinical Supervisor may recommend to the College that the Clinical Supervision cease. 
 
 
 
                                           

   -  Clinical Supervision re: Non-Narcotic Practice  
      -  By June 15, 2018, Dr. Syed shall obtain a clinical supervisor acceptable to the College, who will 
         supervise Dr. Syed’s general practice upon completion of his suspension for a period of nine (9) 
         months, and who will sign an undertaking in the form attached hereto as Schedule “D” (the 
         “General Practice Clinical Supervisor”). 
      -  Dr. Syed shall cooperate fully with the Clinical Supervision and abide by all recommendations of 
         his General Practice Clinical Supervisor with respect to practice improvements and education. 
      -  Dr. Syed shall consent to the disclosure by the General Practice Clinical Supervisor to the 
         College, and by the College to his General Practice Clinical Supervisor, of all information the 
         General Practice Clinical Supervisor or the College deems necessary or desirable in order to 
         fulfill the General Practice Clinical Supervisor’s undertaking and to monitor Dr. Syed’s 
         compliance with this Order. This shall include, without limitation, providing the General Practice 
         Clinical Supervisor with any reports of any assessments of Dr. Syed’s practice in the College’s 
         possession. 
      -  If the General Practice Clinical Supervisor who has given an undertaking in Schedule “D” to this 
         Order is unable or unwilling to continue to fulfill its terms, Dr. Syed shall, within twenty (20) 
         days of receiving notice of same, obtain an executed undertaking in the same form from a 
         similarly qualified person who is acceptable to the College and ensure that it is delivered to the 
         College within that time. 
      -  If Dr. Syed is unable to obtain a General Practice Clinical Supervisor in accordance with 
         paragraphs 4(C)(i) or 4(C)(iv) of this Order, he shall cease practising medicine until such time as 
         he has done so, and the fact that he has will constitute a term, condition or limitation on his 
         certificate of registration until that time. 
   -  Reassessment of Practice  
      -  Approximately three (3) months after each aspect of the Clinical Supervision set out above has 
         ceased, Dr. Syed will submit to a comprehensive reassessment of his entire practice by an 
         assessor or assessors selected by the College (the “Assessor(s)”). The Reassessment may include 
         a chart review, direct observation of Dr. Syed’s care, interviews with colleagues and co-workers, 
         feedback from patients and any other tools deemed necessary by the College. Dr. Syed shall 
         abide by all recommendations made by the Assessor(s), and the results of the Reassessment will 
         be reported to the College and may form the basis of further action by the College. 
   -  Compliance  
      -  Dr. Syed shall co-operate with unannounced inspections of his office practice and patient charts 
         for the purpose of monitoring and enforcing his compliance with the terms of this Order. 
      -  Dr. Syed shall inform the College of any and all new practice locations including, but not limited 
         to, hospital(s), clinic(s) and office(s), in any jurisdiction five (5) days in advance of commencing 
         practice at that location. 
      -  Dr. Syed shall give his irrevocable consent to the College to make appropriate enquiries of the 
         Ontario Health Insurance Plan (“OHIP”), the Drug Program Services Branch, the Narcotics 
         Monitoring System (“NMS”) implemented under the Narcotics Safety and Awareness Act, 2010 
         and/or any person or institution who may have relevant information, in order for the College to 
         monitor my compliance with the provisions of this Order. 
      -  Dr. Syed shall be responsible for any and all costs associated with implementing the terms of this 
         Order. 
-  Dr. Syed pay costs to the College in the amount of $10,180.00 within 30 days of the date of this Order 
   becomes final


Decision: Download Full Decision (PDF)
Hearing Date(s): March 5, 2018

Concerns

Source: Member
Active Date: May 14, 2020
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Dr. Naseeruddin Syed to the College of Physicians and Surgeons of Ontario, effective May 14, 2020:

Pursuant to an order of the Discipline Committee dated May 5, 2018, Dr. Syed underwent remediation and a reassessment of his practice. The reassessment raised concerns about Dr. Syed’s standard of practice in family medicine. As a result of the reassessment:

Dr. Syed will practise under the guidance of a Clinical Supervisor acceptable to the College for 6 months.

Dr. Syed will engage in professional education in medical recordkeeping, community-acquired infections, and antibiotic prescribing.

Dr. Syed’s practice will be reassessed by an assessor selected by the College within 3 months of the end of the period of Clinical Supervision.