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Schwarz, Peter Robert

CPSO#: 66826

MEMBER STATUS
Revoked: Discipline Committee as of 02 Dec 2019
EXPIRY DATE
02 Dec 2019
CURRENT OR PAST CPSO REGISTRATION CLASS
None as of 13 Apr 2017

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education: University of Ottawa, 1993

Practice Information

Primary Location of Practice
Practice Address Not Available

Professional Corporation Information


Corporation Name: Peter Schwarz Medicine Professional Corporation
Certificate of Authorization Status: Inactive: May 7 2020

Hospital Privileges

No Privileges reported.


Hospital Notices

Source:  Hospital
Active Date:  September 21, 2016
Expiry Date:  
Summary:  
On October 12, 2016, North Shore Health Network notified the College that Dr. Peter Schwarz's privileges were suspended, effective September 21, 2016.

Source:  Hospital
Active Date:  September 19, 2016
Expiry Date:  
Summary:  
On October 13, 2016, Sault Area Hospital notified the College that Dr. Peter Schwarz's privileges were suspended, effective September 19, 2016.

Source:  Hospital
Active Date:  September 19, 2008
Expiry Date:  
Summary:  
NOTICE OF SUSPENSION OF HOSPITAL PRIVILEGES:

On September 25, 2008, Sault Area Hospital notified the College that Dr. Peter Robert Schwarz's privileges were suspended effective September 19, 2008.

Specialties

Specialty Issued On Type
Family Medicine Effective:13 Jun 1995 CFPC Specialist

Postgraduate Training

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



University of Ottawa, 01 Jul 1993 to 30 Jun 1994
PostGrad Yr 1 - Family Medicine

University of Ottawa, 01 Jul 1994 to 30 Jun 1995
Resident 2 - Family Medicine

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 01 Jul 1993
Transfer of class of registration to: Independent Practice Certificate Effective: 16 Jun 1995
Transfer of class of certificate to: Restricted certificate Effective: 13 Apr 2017
Terms and conditions imposed on certificate Effective: 13 Apr 2017
Terms and conditions amended by Inquiries, Complaints and Reports Committee Effective: 29 Nov 2017
Suspension of registration imposed: Discipline Committee Effective: 08 Mar 2019
Revoked: Discipline Committee. Effective: 02 Dec 2019

Previous Hearings

Committee: Discipline
Decision Date: 19 Feb 2020
Summary:

On February 19, 2020, on the basis of agreed facts and admission, the Discipline Committee (the “Committee”) of the College of Physicians and Surgeons of Ontario found that Dr. Peter Robert Schwarz (“Dr. Schwarz”) is incompetent and committed an act of professional misconduct, , in that he failed to maintain the standard of practice of the profession in his care of patients, and set out its penalty and costs order with written reasons to follow.

FACTS

Dr. Schwarz is a 51-year-old family physician. He received his certificate authorizing independent practice from the College of Physicians and Surgeons of Ontario (the “College”) in 1995. He obtained CCFP certification on June 13, 1995.

At the relevant times, Dr. Schwarz practiced as a general/family physician in a solo practice in Sault Ste Marie, Ontario.

Background

In August 2016, in the context of another investigation, the College obtained Narcotics Monitoring System information regarding Dr. Schwarz’s prescribing to patients. The College subsequently obtained Cumulative Patient Profiles for 12 drop-in patients to whom Dr. Schwarz prescribed opioids and controlled substances.

Incompetence / Failure to Maintain the Standard of Practice

On March 28, 2017, on the basis of the information above, the Inquiries, Complaints and Reports Committee of the College (“ICRC”) approved an appointment of investigators to inquire into whether Dr. Schwarz had committed professional misconduct in his prescribing and medical record keeping.

The College selected 25 charts to review, including the 12 drop-in patients. Dr. Schwarz provided complete charts for 5 of the 25 patients. With respect to the remaining 20 patients, Dr. Schwarz was unable to confirm that he had provided complete patient records. Counsel for Dr. Schwarz advised that these patients were drop-in patients for whom Dr. Schwarz had not initially opened a patient record. Instead, he had filed notes for these patient encounters “by date”.

Counsel for Dr. Schwarz advised that Dr. Schwarz had recently taken a Medical Record Keeping Course, following which he had changed his practice and now opened a chart for all drop-in patients.

Counsel for Dr. Schwarz confirmed that Dr. Schwarz would not have seen prior records (i.e., records filed “by date” and not by patient name) at the time of any drop-in patient’s subsequent visit.

Reports of Dr. Chris Giorshev

The College retained the services of Dr. Chris Giorshev, a family physician with expertise in emergency medicine, chronic pain management and addictions medicine, to provide an independent expert opinion on the care provided by Dr. Schwarz to the 25 patients. Dr. Giorshev interviewed Dr. Schwarz and reviewed his patient charts.

In his report dated December 10, 2017, and addendum report dated January 3, 2018, Dr. Giorshev opined that Dr. Schwarz did not meet the standard of practice of the profession, demonstrated a lack of judgment, and posed a risk of harm to patients in 23/25 of the charts reviewed.

Dr. Giorshev identified significant deficiencies in Dr. Schwarz’s care of patients which he categorized into two groups – chronic pain and addiction patients.

i. Chronic Pain Patients

1. Decision to initiate opioids for pain patients:

Dr. Schwarz’s decision to initiate opioids was far below the standard of care, demonstrated a lack of judgment and posed a risk of harm to patients and/or the public (in terms of drug diversion). This included:

-Failure to perform a comprehensive documentation of the patient’s pain condition, general medical condition and psychosocial history, psychiatric status, and substance abuse history, such that it was not possible to understand what Dr. Schwarz was treating based on the documentation;

-Failure to independently confirm patients’ self-reported prescribing history before prescribing opioids. That is, patients reported to Dr. Schwarz that they were taking opioids (including at high doses) and Dr. Schwarz began prescribing opioids to these patients without confirming the pre-existing prescription. This placed patients at high risk of overdose and death if they were in fact opioid naïve, and placed the public at risk resulting from drug diversion;

-Failure to risk stratify patients;

-Failure to determine if patients had a pain condition where opioids were indicated;

-Failure to perform urine drug screens;

-Failure to document informed consent discussion.

2. Conducting an opioid trial/long-term monitoring opioid therapy:

Dr. Schwarz fell below the standard of care, demonstrated a lack of judgment and posed a risk of harm to patients and/or the public with respect to conducting an opioid trial and long-term monitoring of opioid therapy. This included through:
 
-Failure to document whether patients were advised to avoid driving until a stable dosage was achieved. A sedated driver is a risk to both the patient and the public;

-Failure to reasonably document monitoring of aberrant behaviour or use urine drug
screens;

-Failure to adequately address aberrant behaviour when it arose (Dr. Giorshev noted there were multiple instances of early release for self-escalation and lost or stolen medications documented in the individual case summaries), which posed a high risk of harm for patients and the public;

-Failure to document risk discussion pertaining to combining sedating medications with high dose opioids. This included, in one case, prescribing an elderly patient extremely high dose opioids as well as benzodiazepines, without documenting or evaluating the risks, which included a high risk of death for this patient.

ii. Addictions Patients

Dr. Schwarz’s care of addictions patients fell below the standard of care, demonstrated a lack of judgment and posed a risk of harm to patients and/or the public. This included
through:

-Failure to document an adequate evaluation of the patient’s clinical conditions prior to prescribing Suboxone;

-Failure to document a diagnosis of opioid dependence to justify prescribing Suboxone;

-Failure to document contraindications to the prescribing of Suboxone, including during pregnancy, and failure to perform pregnancy tests prior to initiating Suboxone on female patients. This put both the patient and any possible fetus at risk;

-Failure to adhere to CAMH clinical practice guidelines, in that he:
-Failed to document withdrawal prior to induction. Patients who are initiated on Suboxone without being in withdrawal can experience precipitated withdrawal, which is dangerous for the patient;
-Failed to reassess patients within one to three days of induction or otherwise follow up with patients in a timely fashion. Often, he did not see patients for a month or two following induction;
-Failed to monitor clinically unstable patients as frequently as required.
Clinically unstable patients require more frequent monitoring, but Dr. Schwarz saw patients once or twice per month regardless of the patient’s clinical stability;
-Prescribed double the recommended starting dose of Suboxone;
-Failed to supervise patients’ doses during the first two months of treatment;
-Provided inappropriate take-home doses, including to patients who had not achieved clinical stability. Dr. Giorshev found that Dr. Schwarz’s care deviated markedly from the CAMH guideline and the standard of care, as he routinely gave patients 5-6 carries from the outset, including to patients who did not display clinical stability. Inappropriately giving take-home doses to unstable addictions patients represents a significant risk for diversion and a significant harm to the patient and the public;
-Performed urine drugs screens infrequently (once every one or two months, rather than twice a week to biweekly), a routine which can easily be gamed by addictions patients;

-Inappropriately permitting a patient’s mother to supervise her son’s urine drug screen. Dr. Giorshev opined that this represented inappropriate monitoring.

iii. Individual Patient Concerns

Further concerns relating to individual patients are set out in Dr. Giorshev’s report, dated December 10, 2017, at pp. 9-49. In addition, Dr. Giorshev highlighted two particularly troubling cases at p. 5 of his report.

iv. Dr. Giorshev’s Interview of Dr. Schwarz

Dr. Giorshev interviewed Dr. Schwarz on December 8, 2017 in order to understand if his deficiencies resulted from a lack of knowledge skill or judgment. Dr. Giorshev was satisfied that there was no significant lack of knowledge; however, he opined that this interview raised additional concerns regarding Dr. Schwarz’s significant lack of judgment in his care of chronic pain and addictions patients. Dr. Giorshev outlined these additional concerns in his report dated December 10, 2017 at pp. 6-7.

v. Lack of Oversight and Reliance on Pharmacists

Dr. Giorshev opined that one of the most concerning issues in his review of Dr. Schwarz’s care related to Dr. Schwarz’s lack of oversight of addictions patients (i.e., failure to ensure withdrawal prior to induction; failure to assess patients in a timely manner after induction, and failure to assess patients frequently enough to ensure they were benefitting from the therapy and were not being harmed). When asked about this in his interview, Dr. Schwarz responded that pharmacists in his area were experienced in dispensing Suboxone, and that he expected that pharmacists would continually reassess his patients and then recommend or make dose adjustments along the way. Dr. Schwarz specifically described that the pharmacist would be the clinical assessor for his patients, and that he relied on the pharmacist to manage patients.

Dr. Giorshev noted that as the physician, Dr. Schwarz is responsible for the evaluation and reassessment of patients. He is responsible for ensuring that the patients are receiving proper care. It is outside the scope of practice of pharmacists to practice medicine and it is not legal for them to independently change an opioid prescription. Dr. Giorshev opined that Dr. Schwarz’s lack of oversight demonstrated a significant lack of care for his patients and significant lack of judgment that was a risk of harm to his patients and the public.

On February 7, 2018, two pharmacists who dispensed Suboxone to patients of Dr. Schwarz were interviewed by the College investigator. Pharmacist A advised that he had been dispensing Suboxone to Dr. Schwarz’s patients for four to five years. Pharmacist B advised that he had been doing so for three to four years.

The pharmacists advised of a number of steps they took with respect to Suboxone patients (such as taking a medical history, explaining the difference between addiction and drug dependence, monitoring the first dose for adverse reaction and requiring patients to adhere to a prescribing schedule).

With respect to ensuring withdrawal prior to induction, both pharmacists advised that they would confirm patients were in withdrawal prior to providing the first dose of Suboxone. However, it was understood and agreed that Dr. Schwarz would also verify withdrawal prior to issuing the prescription;

With respect to assessing patients:

-Both pharmacists advised that their pharmacies monitored patients for aberrant behaviour. However, neither pharmacy completed urine drug screens;

-The pharmacists advised that they monitored patients for missed or withheld doses and would communicate with Dr. Schwarz regarding missed or withheld doses;

-Pharmacist A advised that his pharmacy did complete clinical assessments to determine if dosing was appropriate. However, Pharmacist A assumed that Dr. Schwarz was also completing clinical assessments. He assumed that Dr. Schwarz was reassessing patients over the course of a prescription to ensure that the medication and dosing were appropriate for the patient;

-Pharmacist B advised that his pharmacy did not clinically assess patients. He assumed that Dr. Schwarz was completing clinical assessments, including over the duration of a prescription. He stated that it was his understanding that Dr. Schwarz was responsible for the patient;

With respect to dosing adjustments:

-Pharmacist A advised that if he had concerns regarding the patient’s dose, he may provide recommendations to Dr. Schwarz. He would not make dosing adjustments himself, as he is not allowed to do so as a pharmacist;

-Pharmacist B advised that he did not make any dosing adjustments or recommendations for dosing changes. If the patient had concerns with their doses, he would advise the patient to follow-up directly with Dr. Schwarz.

ICRC’s Interim Order and Cessation of Prescribing

On November 28, 2017, after receiving an interim report from Dr. Giorshev and a response from Dr. Schwarz, the ICRC imposed an interim order pursuant to s. 25.4 of the Health Professions Procedural Code, prohibiting Dr. Schwarz from prescribing narcotics and other controlled or monitored substances, unless under the guidance of a clinical supervisor. Dr. Schwarz did not obtain a clinical supervisor. Consequently, on January 13, 2018, he ceased prescribing narcotics and other controlled or monitored substances.

On January 30, 2018, Dr. Schwarz advised the College, through counsel, that he did not wish to maintain or seek reinstatement of his prescribing privileges.

FACTS ON PENALTY

On March 8, 2019, the Discipline Committee found that Dr. Schwarz had engaged in professional misconduct, in that he engaged in sexual abuse of a patient and engaged in conduct or an act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be considered by members as disgraceful, dishonourable or unprofessional.

On December 2, 2019, the Discipline Committee imposed a penalty including the immediate revocation of Dr. Schwarz's certificate of registration, requiring Dr. Schwarz to reimburse the College for costs related to the patient under program required by section 85.7 of the Code and to appear at the College for a reprimand, and the payment of costs to the College.

On November 14, 2013, the Inquiries, Complaints and Reports Committee of the College ("ICRC") decided to issue a written caution to Dr. Schwarz regarding his care of a patient and, in particular, regarding his follow-up when symptoms change; conducting an examination when indicated; ensuring a prompt referral; and having a process in place to track referrals. The Committee also directed Dr. Schwarz to complete a Specified Continuing Education or Remediation Program ("SCERP"), whereby it required him to complete a Record-Keeping Course and to undergo a reassessment.

In November 2009, the ICRC decided to require Dr. Schwarz to attend at the College to be cautioned regarding his care of a patient and, in particular, regarding the presentation of laryngeal cancer and the steps necessary to achieve a timely diagnosis and referral for patients presenting with this condition.

Dr. Schwarz completed a course on medical record-keeping at the University of Toronto on June 23, 2014.

DISPOSITION

On February 19, 2020, the Discipline Committee issued its Order that

-The Registrar suspend Dr. Schwarz's certificate of registration for a period of three (3) months, commencing from February 20, 2020 at 12:01 a.m.

-The Registrar place the following terms, conditions and limitations on Dr. Schwarz's certificate of registration effective immediately:

Restriction on Prescribing

(i) Dr. Schwarz shall not issue new prescriptions or renew existing prescriptions for or administer any of the following substances:
(a) Narcotic Drugs (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
(b) Narcotic Preparations (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act; S.C., 1996, c. 19);
(c) Controlled Drugs (from Part G of the Food and Drug Regulations under the Food and Drugs Act, S.C., 1985, c. F-27);
(d) Benzodiazepines and Other Targeted Substances (from the Benzodiazepines and Other Targeted Substances Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19; (A summary of the above-named drugs and links to the current regulatory lists are attached has schedules to the Order);
(e) Monitored Drugs (as defined under the Narcotics Safety and Awareness Act, 2010, S.O. 2010, c. 22, with a link to the current regulatory list in a schedule to the Order);

(ii) Dr. Schwarz shall post a sign in all waiting rooms, examination rooms and consulting rooms, in all of his practice locations, in a clearly visible and secure location, in the form set out at Schedule "D" to the Order. For further clarity, this sign shall state as follows:

IMPORTANT NOTICE

Dr. Schwarz must not prescribe or administer any of the following:
Narcotic Drugs
- Narcotic Preparations
- Controlled Drugs
- Benzodiazepines and Other Targeted Substances
- Monitored Drugs

Further information may be found on the College of Physicians and Surgeons of Ontario website at www.cpso.on.ca

(iii) Dr. Schwarz shall post a certified translation(s) in any language(s) in which he provide services, of the sign described in paragraph 4(ii) above in all waiting rooms, examination rooms and consulting rooms, in all of his Practice Locations, in a clearly visible and secure location.

(iv) Dr. Schwarz shall provide the certified translation(s) described in paragraph 4(iii) above, to the College within thirty (30) days of this Order.

(v) Should Dr. Schwarz elect to provide services in any other language(s), he must notify the College prior to providing any such services.

(vi) Dr. Schwarz shall provide to the College the certified translations) described in paragraph 4(iv) prior to beginning to provide services in the languages) described in paragraph 4(v).

Clinical Supervision

(vii) Prior to the expiry of the period of suspension and/or the reinstatement of Dr. Schwarz's certificate of registration, Dr. Schwarz shall retain a clinical supervisor acceptable to the College (the "Clinical Supervisor"), who has signed an undertaking in the form attached to the Order as Schedule "E".

(viii) For a period of four (4) months commencing on the date Dr. Schwarz resumes practice, Dr. Schwarz may practice medicine only under the supervision of the Clinical Supervisor (the "Clinical Supervision"), who shall facilitate the education program set out in the Individualized Education Plan attached to the Order .

(ix) After an initial meeting, Dr. Schwarz shall meet with the Clinical Supervisor every month for four (4) months. At each meeting the Clinical Supervisor shall:

(a) Review a minimum of fifteen (15) patient charts, to be selected at the sole discretion of the Clinical Supervisor;
(b) Discuss with Dr. Schwarz any concerns the Clinical Supervisor may have arising from the chart reviews;
(c) Make recommendations to Dr. Schwarz for practice improvements and inquire into Dr. Schwarz's compliance with the recommendations;
(d) Keep a log of all patient charts reviewed along with patient identifiers; and
(e) Perform any other duties, such as reviewing other documents or conducting interviews with staff or colleagues, that the Clinical Supervisor deems necessary to the Clinical Supervision.

(x) The Clinical Supervisor shall submit written reports to the College after two (2) and four (4) months of Clinical Supervision, or more frequently if the Clinical Supervisor has concerns about Dr. Schwarz's standard of practice.

(xi) Throughout the period of Clinical Supervision, Dr. Schwarz shall cooperate fully with the Clinical Supervision and abide by all recommendations of his Clinical Supervisor with respect to practice improvement and ongoing professional development.

(xii) If the Clinical Supervisor who has given an undertaking in Schedule "E" to the Order is unable to unwilling to continue to fulfill its terms, Dr. Schwarz 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.

(xiii) If Dr. Schwarz is unable to obtain a Clinical Supervisor as set out in the Order, he shall cease practising medicine until he has obtained a Clinical Supervisor acceptable to the College.

(xiv) If Dr. Schwarz is required to cease to practise medicine as a result of section (4)(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.

Professional Education

(xv) Dr. Schwarz shall participate in and successfully complete all aspects of the detailed IEP, attached to the Order as Schedule "F", including all of the following professional education (the "Professional Education"):

(a) Completion of two (2) CMPA e-modules on record-keeping;
(b) Review and discussion with the Clinical Supervisor of:
1) College Prescribing Drugs Policy;
2) College Medical Records Policy;
3) Canadian Guideline for Opioid Use in Non-Cancer Pain.

(xvi) Dr. Schwarz shall provide proof to the College of his successful completion of the Professional Education, including proof of registration and attendance and participant assessment reports, if applicable, within one (1) month of completing it.

Reassessment of Practice

(xvii) Approximately three (3) months after the completion of the Clinical Supervision and Professional Education, Dr. Schwarz shall undergo a reassessment of his practice by a College-appointed assessor (the "Reassessment"; the "Assessor")

(xviii) The Reassessment may include a review of Dr. Schwarz's patient charts, direct observations, and interviews with staff and/or patients and any other tools deemed necessary by the College. Dr. Schwarz 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.

(xix) Dr. Schwarz shall consent to such sharing of information among the Assessor, the Clinical Supervisor, and the College, as any of them deem necessary or desirable in order to fulfill their respective obligations.

Monitoring

(xx) Dr. Schwarz shall inform the College of each and every location where he practices or has privileges, in any jurisdiction (his "Practice Locations)") within fifteen (15) days of commencing practice at that location.

(xxi) Dr. Schwarz shall cooperate with unannounced inspections of his practice by a College representative(s) for the purpose of monitoring and enforcing his compliance with the terms of the Order.

(xxii) Dr. Schwarz shall consent to the College's making appropriate enquiries of the Ontario Health Insurance Plan, the Narcotics Monitoring System 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.

(xxiii) Dr. Schwarz shall be responsible for any and all costs associated with implementing the terms of this Order.

-Dr. Schwarz shall attend before the panel to be reprimanded.

Dr. Schwarz shall pay costs to the College in the amount of $6,000 within 30 days of the date of the Order.


Decision: Download Full Decision (PDF)
Hearing Date(s): February 19, 2020

 

Committee: Discipline
Decision Date: 08 Mar 2019
Summary:

On March 8, 2019, the Discipline Committee found that Dr. Peter Robert Schwarz committed an act of professional misconduct, in that he engaged in sexual abuse of a patient; and in that he has engaged in an act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional.

Sexual Abuse and Disgraceful, Dishonourable or Unprofessional Conduct regarding
Patient A

Patient A testified that she had seen a specialist about a problem with her cervix and had had an abnormal Pap test and had a subsequent loop electrosurgical excision procedure (LEEP) and “cone” procedure. She understood there were cancer cells present and that she had an HPV infection. She “Googled” information about HPV and realized the virus could also be in her mouth as it was sexually transmitted.

Patient A testified that subsequently, she went to see her dentist and asked him to check her mouth for HPV related lesions. She said her dentist became embarrassed because she told him that she enjoyed giving oral sex. She found his embarrassment and discomfort to be amusing. She stated she was not trying to embarrass the dentist and was trying to make light of the situation. The dentist checked her mouth and found no HPV related problems.

Patient A described a visit to Dr. Schwarz on October 2, 2015. She testified that during that visit, she told Dr. Schwarz about the dental visit and that the dentist was embarrassed. She stated that Dr. Schwarz laughed and as she was preparing to leave, he said that “it’s funny he (the dentist) was embarrassed and it’s funny that you like doing that.”

Patient A testified that Dr. Schwarz opened the door for her and she left the room first and as she entered the hallway she replied, “not any more and you are lucky I have self- control.” Patient A testified that her comment “not any more” meant “I don’t like oral sex anymore”. The second part of her comment, “you are lucky I have self control” was intended as a joke and a comeback. She did not mean it literally but the comment implied that she would give him oral sex. Patient A testified that she had never made a sexual joke to Dr. Schwarz before and neither had he made a sexual joke to her.

Following the October 2, 2015 appointment, Patient A described having her blood work done as ordered by Dr. Schwarz. She testified that she received a phone call from Dr. Schwarz’s secretary on October 15th saying that the doctor wished to see her and giving her an appointment for Tuesday the 20th of the next week (five days later). She became very worried that this meant her laboratory tests were abnormal. She decided not to wait and so attended as a walk-in patient the next day, October 16, 2015.

Patient A testified that Dr. Schwarz seemed more casual than usual when he came into the room for the appointment. He greeted her by her last name, which was unusual. He rubbed her back and said to her “don’t talk like that in the hallway, someone might hear you”. This was in reference to the remarks about oral sex she made at that previous appointment. Patient A testified that she then asked about her blood work and he said it was okay. He told her that the specialist wanted her to have the HPV vaccine and to stop smoking. She found this unusual, as she was already aware of the specialist’s opinion. She then asked about her cholesterol and he said it was okay and asked her “how much weight did you lose?” She replied “75 pounds - no 65 pounds as I have put 10 back on.” He asked “where?” She responded to say “right here”, and to show him her abdominal fat roll by grabbing it in her two hands.

Patient A testified that he responded by grabbing her roll of fat and by saying, “that’s not fat.” He then “grabbed my boob” and said, “The fat didn’t go there either.” Patient A described that she sat there “frozen” and in disbelief as to what just happened. Patient A testified that Dr. Schwarz then told her to stand up and he put both of his arms around her from the front and placed his hands on her “butt,” rubbed the area and said, “the fat didn’t go there either.” Patient A described Dr. Schwarz’s hands as making cupped, circular motions while on her buttocks and his hand to be making a soft rubbing motion while on her breast. Patient A testified that then, she stepped back away from Dr. Schwarz and he cupped her left breast again. Patient A said she stepped away again and he said “come here little one” and hugged her and said, “again, don’t talk like that in the hallway.” Patient A testified she sat down again briefly and then to end the visit, the patient opened the door to the examining room and said, “Well, this has been an interesting visit.” She then left the office.

Patient A was hospitalized on October 24th for an episode of vomiting and abdominal pain and subsequently returned to see Dr. Schwarz on December 4th, ostensibly to obtain a repeat prescription for a cream she used for eczema, and also to question him about what he had done.

Patient A testified that her real intention was to confront Dr. Schwarz with his behavior and have her questions answered. Patient A testified that Dr. Schwarz responded to all her questions. Among other things, Patient A said Dr. Schwarz told her “I turned him on…it doesn’t matter that we’re married…when two people like each other, nothing like that matters.” Patient A testified that she told Dr. Schwarz she was not interested in “sexual activities,” and then as she went to leave Dr. Schwarz “grabs my butt.” She felt he had not listened to her and she could not believe what had just happened.

Patient A subsequently reported these incidents to a doctor at the local hospital and she also reported the matter to the police.

On the basis of its assessment of the witnesses’ credibility and the consideration of the evidence as a whole, the Committee accepted Patient A’s version of the events and concluded that Dr. Schwarz engaged in sexual abuse of Patient A by touching of a sexual nature, that is, by touching of her breasts and buttocks during office visits on October 16th and December 4th, 2015 in a manner that was not clinically indicated or appropriate.

The Committee also found that comments made by Dr. Schwarz to Patient A, such as his responses to her questions on December 4, 2015 that she turned him on and that it did not matter that they were both married, were clearly inappropriate and sexualized, and that this constitutes sexual abuse of a patient by remarks of sexual nature.

Sexual abuse of a patient violates a patient’s trust, autonomy and dignity. Such conduct towards a patient constitutes disgraceful, dishonourable or unprofessional conduct.

Disgraceful, Dishonourable or Unprofessional Conduct regarding Nurse A, Nurse B and Nurse C by Behavior and Remarks of a Sexual Nature
Dr. Schwarz is a family physician practising in City 1,Ontario. Dr. Schwarz held privileges at a Hospital between 2003 and 2015.

The Committee found that Dr. Schwarz committed an act of professional misconduct, in that he has engaged in an act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional, regarding Nurse A, Nurse B and Nurse C.

Nurse A

Nurse A worked at the Hospital. During a night shift circa 2012, at approximately 11:30 p.m., Dr. Schwarz and Nurse A were standing alone near the nursing station. Dr. Schwarz hooked his finger into the rim of Nurse A’s scrub pants, and pulled them down no more than two inches to view her lower back tattoo. He said, “What’s that.” Nurse A said “Whoa” and pulled away. In an effort to diffuse the situation without making it awkward, Nurse A then lifted her shirt slightly to allow Dr. Schwarz to see the tattoo, said “It’s my tattoo,” and left the room.

The incident made Nurse A highly uncomfortable. Afterwards, she no longer wanted to work the night shift with Dr. Schwarz, and arranged her schedule accordingly. She did not want to be alone in the department with him, especially at night. She subsequently reported the incident to the department’s Chief of Staff. After the event, Dr. Schwarz had no further incidents involving Nurse A.

Nurse B

Nurse B began working at the Hospital. During one early afternoon shift in the Hospital, circa 2010, Nurse B received lab results for a patient which required a physician’s review. Nurse B went into the doctor’s lounge to provide Dr. Schwarz with the lab
 
results. Nurse B and Dr. Schwarz reviewed the results together. As they were exiting the doctor’s lounge, Dr. Schwarz slapped Nurse B on the buttocks. Nurse B turned around and said, “Don’t touch me like that.”

After this incident, Nurse B felt uncomfortable around Dr. Schwarz. She would no longer go to the doctor’s lounge in person to provide test results as she did not want to be subjected to this conduct again. She subsequently reported the incident to the department’s Chief of Staff.

Sometime after this incident, Dr. Schwarz approached Nurse B while she was seated at a computer and squeezed her shoulders in a massage-like fashion. Nurse B gave Dr. Schwarz a “dirty look,” after which he departed. After the events, Dr. Schwarz had no further incidents involving Nurse B.

Nurse C

Nurse C began working in the Hospital. During one day shift, Nurse C entered the medication room to retrieve an item. The medication room is small: approximately six feet by seven feet. Dr. Schwarz followed Nurse C into the room and stood in the doorway, approximately four feet away from Nurse C. When Nurse C reached up to take down some medication, Dr. Schwarz said, “you have a lower back tattoo, that’s so sexy, can I see it.” Nurse C said “no.” She felt very uncomfortable, because she had no way out of the room. Dr. Schwarz laughed and walked away.

During another shift, after the first incident, Nurse C and Dr. Schwarz were alone in the Department. Nurse C was seated at a computer. Dr. Schwarz approached her from behind and began to massage her neck and shoulders. Nurse C stopped what she was doing and tensed up. She felt extremely uncomfortable. Dr. Schwarz continued the massage for approximately one minute before walking away.

On another occasion around the same time period, Dr. Schwarz made an inappropriate sexual comment to Nurse C. Nurse C felt uncomfortable and shut down the conversation.

As a result of these encounters, Nurse C tried to avoid Dr. Schwarz as much as she could while continuing to do her job. After the events described above, Dr. Schwarz had no further incidents involving Nurse C.

Given the Committee’s findings of touching of a sexual nature of the patient’s breasts and buttocks, the Committee makes an immediate interim order suspending Dr. Schwarz’s certificate of registration, until such time as the Committee makes an order under subsection 5 or 5.2 of the Code.

Penalty hearing held on September 10 and 11, 2019. The Committee reserved its decision on penalty.

On December 2, 2019, the Committee released its penalty Order and reasons. The Committee ordered that:

1. The Registrar revoke Dr. Schwarz’s certificate of registration, effective immediately;

2. Dr. Schwarz is required to reimburse the College for funding provided to the patient under the program required by s. 85.7 of the Code, in the amount of $16,060, and to post an irrevocable letter of credit or other security acceptable to the College, in that amount, to guarantee payment of any amounts he may be required to reimburse;

3. Dr. Schwarz is required to appear before the Committee to be reprimanded within 60 days of the date of this Order;

4. Dr. Schwarz is required to pay costs to the College in the amount of $82,960.00, within 90 days of the date of this Order.

Appeal

On December 30, 2019, Dr. Schwartz appealed the Discipline Committee’s March 8, 2019 decision on finding and December 2, 2019 decision on penalty to the Divisional Court.

On May 5, 2021, the Divisional Court released its decision dismissing Dr. Schwarz’s appeal.


Decision: Download Full Decision (PDF)
Appeal: Appeal Dismissed
Appeal Decision Date: May 5, 2021
Hearing Date(s): motion July 26, 2018. hearing dates: November 26 to 30 and December 3, 2018 penalty hearing dates: September 10, 2019

Concerns

Source: Member
Active Date: September 29, 2016
Expiry Date:
Summary:
Criminal Charges:

Effective May 29, 2015,Where a member has been charged with an offence under the Criminal Code of Canada or the Ontario Health Insurance Act and the charge is outstanding and is known to the College, the College By-laws require certain information about the charge to be posted on the register.

The following are outstanding charges against this member, as known to the College, together with the corresponding information:

It is alleged that Peter Robert Schwarz:
(1) on or about December 4, 2015, at the City of Sault Ste Marie did commit a sexual assault on XX, contrary to Section 271 of the Criminal Code.
(2) on or about October 15, 2015, at the City of Sault Ste Marie did commit a sexual assault on XX, contrary to Section 271 of the Criminal Code.

Date of charges: September 16, 2016
Place of charges: Sault Ste Marie, Ontario
Sault Ste Marie Police Service