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Kumra, Rajiv

CPSO#: 59902

MEMBER STATUS
Expired: Resigned from membership as of 26 Apr 2019
CPSO REGISTRATION CLASS
None as of 26 Apr 2019
Flag: Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education:University of Toronto, 1988

Practice Information

Primary Location of Practice
Practice Address Not Available

Professional Corporation Information


Corporation Name: Rajiv Kumra Medicine Professional Corporation
Certificate of Authorization Status: Inactive: Jan 10 2008
Corporation Name: R. Kumra Medicine Professional Corporation
Certificate of Authorization Status: Inactive: Jun 4 2009
Corporation Name: R. Kumra Medicine Professional Corporation
Certificate of Authorization Status: Inactive: May 7 2018

Medical Records Location

Instructions: Medical records requests should be faxed to 416-981-7991
Date Received: 05 Oct 2018


Address: 110 - 1885 Glenanna Rd Pickering, ON L1V 6R6
Instructions: Patients may submit a written request for a copy of their medical record to the above address.
Date Received: 14 Feb 2018


Medical Licences in Other Jurisdictions

Effective September 1, 2015, the College by-laws require the College to indicate on the register if the member has a licence or is registered to practise medicine in a jurisdiction outside Ontario, if this is known to the College.



USA - California

Postgraduate Training

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



University of Toronto, 28 May 2001 to 30 Jun 2001
PostGrad Yr 1 - Diagnostic Radiology

University of Toronto, 01 Jul 2001 to 30 Jun 2002
PostGrad Yr 2 - Diagnostic Radiology

University of Toronto, 01 Jul 2002 to 31 Dec 2002
PostGrad Yr 2 - Diagnostic Radiology

University of Toronto, 01 Jan 2003 to 30 Jun 2003
PostGrad Yr 3 - Diagnostic Radiology

University of Toronto, 01 Jul 2003 to 30 Jun 2004
PostGrad Yr 2 - Diagnostic Radiology

University of Toronto, 16 Aug 2004 to 30 Jun 2005
PostGrad Yr 2 - Diagnostic Radiology

University of Toronto, 01 Jul 2005 to 30 Jun 2006
PostGrad Yr 2 - Diagnostic Radiology

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 13 Jun 1988
Transfer of class of registration to: Independent Practice Certificate Effective: 27 Jun 1989
Suspension of registration imposed: Board of Inquiry Effective: 21 Jun 2007
Suspension of registration removed Effective: 19 Feb 2008
Transfer of class of certificate to: Restricted certificate Effective: 27 Oct 2009
Terms and conditions imposed on certificate Effective: 27 Oct 2009
Transfer of class of certificate to: Restricted certificate Effective: 27 Oct 2009
Terms and conditions imposed on certificate Effective: 27 Oct 2009
Suspension of registration removed Effective: 27 Oct 2009
Transfer of class of registration to: Independent Practice Certificate Effective: 27 Oct 2009
Transfer of class of certificate to: Restricted certificate Effective: 10 May 2011
Terms and conditions imposed on certificate Effective: 10 May 2011
Suspension of registration imposed: Discipline Committee Effective: 10 May 2011
Transfer of class of registration to: Independent Practice Certificate Effective: 07 Oct 2011
Suspension of registration removed Effective: 11 Nov 2011
Expired: Resigned from membership. Expiry: 26 Apr 2019

Previous Hearings Flag: indicates a concern or additional information

Committee: Discipline
Decision Date: 17 Jun 2019
Summary:

On June 17, 2019, the Discipline Committee found that Dr. Kumra committed an act of 
 professional misconduct in that he has engaged in an act or omission relevant to the practice of 
medicine that, having regard to all the circumstances, would reasonably be regarded by members 
as disgraceful, dishonourable or unprofessional, and that he failed to maintain the standard of 
practice of the profession. 
 
 A.    Background 
  
 Dr. Rajiv Kumra (“Dr. Kumra”) is a 55 year-old family physician who received his certificate 
 of registration authorizing independent practice from the College of Physicians and Surgeons of 
 Ontario (“the College”) on June 27, 1989. 
  
 At the relevant time, Dr. Kumra practiced in the greater Toronto area at the following Clinic 
 locations: a) Six Points Clinic; b) Tretheway Clinic; c) Lawrence Avenue Clinic; and d) 
 Pickering Clinic. 
  
 B.    Disgraceful, Dishonourable or Unprofessional Conduct - OHIP Billing 
 
Between 2012 and 2017, Dr. Kumra engaged in disgraceful, dishonourable or unprofessional 
conduct by billing the Ontario Health Insurance Plan (“OHIP”) and receiving remuneration for 
services he did not provide. When a single patient attended Dr. Kumra’s office he directed his 
staff to register as patients, and bill OHIP, for all the members of the individual’s family or 
household (i.e. residing at the same address), notwithstanding that Dr. Kumra did not provide 
treatment to the family and/or household members at that attendance. 
 
The College’s investigation revealed facts including the following: 
 
-  On  January 14, 2017, Patient A attended Six Points Clinic alone. Her children were not 
   seen by Dr. Kumra on that date. On that date, Dr. Kumra billed OHIP and was paid for 
   services in respect of Patient A and her three children. 
-  On  August 20, 2016, Patient B attended Six Points Clinic alone. Her children were not 
    seen by Dr. Kumra on that date. On that date, Dr. Kumra billed OHIP and was paid for 
    services in respect of Patient B and her five children. Patients B’s eldest child attended Dr. 
    Kumra’s office on two occasions in August 2016. However, Dr. Kumra billed OHIP and 
    was paid for services in respect of this child on August 14, 20 and 22, 2016. 
 -  On August 27, 2016, Patient C attended Six Points Clinic alone. His children were not 
    seen by Dr. Kumra on that date. On that date, Dr. Kumra billed OHIP and was paid for 
    services in respect of Patient C and his six children. 
 -  On January 14, 2017, Patient D attended Six Points Clinic alone. Her five children were not 
    seen by Dr. Kumra on that date. On that date, Dr. Kumra billed OHIP and was paid for 
    services in respect of Patient D and her five children. 
 -  Patient E attended Six Points Clinic on one or two occasions. Dr. Kumra billed OHIP 
    and was paid for services in respect of Patient E on fifteen occasions between February 
    28, 2014 and November 1, 2016. On August 20, 2016, Patient E was not seen by Dr. Kumra 
    nor were her six siblings. On that date, Dr. Kumra billed OHIP and was paid for services in 
    respect of Patient E and her six siblings. 
-  Patient F attended Dr. Kumra’s clinic typically one time per year. None of Patient F’s ten 
   children attended Dr. Kumra’s clinic more than once per year. Dr. Kumra billed OHIP and 
   was paid for services in respect Patient F on 12 occasions between November 24, 2012 and 
   November 14, 2014. On 11 of those 12 occasions, Dr. Kumra billed OHIP and was paid for 
   services in respect of at least ten other members of his household. Patient F’s daughter 
   accompanied her father on one occasion when he visited Dr. Kumra’s office. She was not 
   seen or assessed by Dr. Kumra at any time. Dr. Kumra billed OHIP and was paid for 
   services in respect of Ms. F on fourteen occasions between February 1, 2012 and August 28, 
   2015. 
-  Patient G has not had more than three patient encounters with Dr. Kumra. None of her six 
   children who reside at the same household had more than a single patient encounter with 
   Dr. Kumra. Dr. Kumra billed OHIP and was paid for services in respect of Patient G on 
   nine occasions between June 10, 2012 and April 2, 2014. Dr. Kumra billed OHIP and was 
   paid for services in respect of five of her children on six dates between June 10, 2012 and 
   April 2, 2014. 
 
The College retained Investigative Research Group (“IRG”) to conduct surveillance on Dr. 
Kumra’s medical practices at the Six Points Clinic and the Tretheway Clinic. The information 
gathered by IRG was reconciled against Dr. Kumra’s OHIP billing data for the service dates on 
which surveillance was carried out. The reconciled data shows that Dr. Kumra billed OHIP and 
was paid for assessment-based services for individuals who did not attend either clinic and who 
did not receive assessment-based services from Dr. Kumra. 
 
Surveillance conducted on August 20, 2016 at Six Points Clinic and Tretheway Clinic 
established: 
 
-  A total of 84 individuals were observed entering the two practice locations. Only 67 
   individuals remained in a practice location for more than three minutes. However, on the 
   same date, Dr. Kumra billed OHIP and was paid for assessment-based services in respect 
   of 97 individuals. 
-  A total of 19 individuals under the age of 19 were observed entering the two practice 
   locations. However, on the same date, Dr. Kumra billed OHIP and was paid for 
   assessment-based services in respect of 53 individuals 19 years of age or younger. 
-  A total of 33 males were observed entering the two practice locations. Only 22 remained in 
   a practice location for more than three minutes. However, on the same date, Dr. Kumra 
   billed OHIP and was paid for assessment-based services in respect of 46 males. 
 
Surveillance conducted on September 3, 2016 at Six Points Clinic and Tretheway Clinic 
established: 
 
- A total of 70 individuals were observed entering the two practice locations. Only 62 
  remained in a practice location for more than three minutes. However, on the same date, Dr. 
  Kumra billed OHIP and was paid for assessment-based services in respect of 93 individuals. 
- A total of 10 individuals under the age of 19 were observed entering the two practice 
  locations. However, on the same date, Dr. Kumra billed OHIP and was paid for assessment-
  based services in respect of 46 individuals 19 years of age or younger. 
- A total of 30 males were observed entering the two practice locations. Only 27 remained in 
  a practice location for more than three minutes. However, on the same date, Dr. Kumra 
  billed OHIP and was paid for assessment-based services in respect of 47 males. 
   
C. Disgraceful, Dishonourable or Unprofessional Conduct - Special Diet Allowance Forms 
 
 The Special Diet Allowance (“SDA”) program, administered through Ontario Works, provides 
 additional financial assistance to assist individuals with the costs of a special diet that is 
 required due to an approved medical condition, as confirmed by a healthcare professional, 
 including physicians. Physicians completing SDA forms must satisfy themselves that the 
 patient has the specified condition upon which the special diet allowance is based. 
  
 Dr. Kumra engaged in disgraceful, dishonourable or unprofessional conduct by improperly 
 accepting cash from patients in exchange for executing SDA forms and by executing SDA 
 forms without sufficiently assessing the patient, and satisfying himself that the patient has the 
 specified condition upon which the special diet allowance is based. 
  
 Between 2010 and 2016, Dr. Kumra improperly charged patients $50 to complete each 
 SDA form in addition to billing OHIP for the same service. In 2016, Dr. Kumra charged 
 patients $100 to complete each SDA form in addition to billing OHIP for the same service. 
  
 On two separate occasions between 2013 and 2016, Patient A paid $350 cash for herself and 
 her three children to obtain the completed SDA forms from Dr. Kumra. 
  
 In or around September of 2014, because Ontario Works began rejecting SDA forms signed 
 by Dr. Kumra, Dr. Kumra arranged for a physician friend to attend at his clinic once a week to 
 sign SDA forms. Dr. Kumra and his physician friend shared the cash paid by the patients to 
 obtain the SDA forms. This continued for approximately nine months until May of 2015. 
 Around that time, social services resumed accepting SDA forms signed by Dr. Kumra. 
 
 D. Disgraceful, Dishonourable or Unprofessional Conduct - Medical Records 
 
 Despite multiple attempts by the College between 2013 and 2017 to obtain Dr. Kumra’s 
 patient records, Dr. Kumra failed to produce and maintain complete patient medical records 
 as required under Part V of Ontario Regulation 114/94, made under the Medicine Act, 
 1991. According to Dr. Kumra: 
  
- separate servers have been stolen on at least two occasions, including on one occasion by 
  another physician with whom he shared office space; 
- his computer has been hacked at least three times; and, 
- separate servers/computers have gone missing on at least three occasions without any 
  explanation (other than one occasion in which Dr. Kumra falsely suggested that the 
  College took it). 
 
Dr. Kumra’s claims were not consistent with evidence obtained by the College. 
        
  (i) April 24, 2013 Records Request 
  
 On April 24, 2013, College investigators attended at Dr. Kumra’s Six Points Clinic to obtain 26 
 patient charts. Dr. Kumra produced only 18 of the requested charts. 
  
Dr. Kumra maintained that the 18 charts obtained by the College were incomplete. He claimed 
that his EMR server was stolen on May 27, 2012 and his replacement computer had been 
“hacked” on three occasions. He asserted that he was no longer able to access patient records 
pre-dating May 28, 2012. 
 
Dr. Kumra’s claims were not consistent with evidence obtained by the College. A staff 
member working for Dr. Kumra in May 2012 specifically recalled that after the purported 
theft of the EMR server, patient records reappeared on the computer system. In addition, 
subsequent forensic analysis of Dr. Kumra’s server systems retrieved multiple records predating 
May 28, 2012. 
 
(ii) February 17, 2015 Records Request 
 
On February 17, 2015, College investigators attended at Dr. Kumra’s Six Points Clinic to 
obtain a variety of  information, including electronic medical records. A server was retrieved 
by the College from the Six Points Clinic at this visit. Dr. Kumra advised College investigators 
 that the complete medical records could be obtained from the Lawrence Avenue Clinic server. 
  
 The College investigators attended at the Lawrence Avenue Clinic later on February 17, 2015, 
 and removed two pieces of computer hardware. However, neither was found to contain an 
 active EMR database or patient records, contrary to the information Dr. Kumra had provided 
 to College investigators. 
  
 Prior to College investigators arriving at Lawrence Avenue Clinic, Dr. Kumra took steps to 
 have the EMR server removed from the Lawrence Avenue Clinic. 
  
 In an interview with the College on June 22, 2017, Dr. Kumra falsely suggested that 
 during the February 17, 2015 attendance, College investigators removed the “missing” 
 EMR server that purportedly contained the records. 
  
 (iii) October 6, 2016 Records Request 
  
 On October 6, 2016, College investigators attended at the Six Points Clinic to obtain patient 
 records. Dr. Kumra had prior knowledge that the College would be attending the clinic on this 
 date. 
  
 At the site visit, the College investigator provided Dr. Kumra with a letter requesting thirty 
 specific patient records. Dr. Kumra advised the College that the EMR server had been 
 stolen and that he does not have a back-up system for his electronic medical records, 
 despite having been previously advised by his EMR provider to implement a backup 
 solution. The College was unable to obtain any patient records. 
  
  (iv) July 7, 2017 Records Request 
  
 On July 7, 2017, College investigators and the College’s independent forensic expert attended 
 at Dr. Kumra’s Pickering Clinic to obtain thirty specific patient records. Dr. Kumra was not 
 present but College investigators communicated with Dr. Kumra’s counsel who was apprised of 
 the College’s attendance and activities. 
  
 While present at the Pickering Clinic, the College investigators and the independent forensic 
 expert observed from a computer terminal in the Clinic that Dr. Kumra’s EMR application was 
 actively connected to an EMR server. College investigators and the independent forensic expert 
 began to search for the EMR server. While present in the Pickering Clinic, the College 
investigators and the independent forensic expert then observed from a computer terminal, in 
real time, that the EMR server had been remotely disconnected and taken offline. 
 
The Pickering Clinic is housed in the same building as Pickering Medical Imaging, a facility 
owned by Dr. Kumra’s wife. After the server connection was lost, in an attempt to physically 
locate the server which had suddenly been disconnected, College investigators went outside the 
building to a utility closet within Pickering Imaging. The College investigators observed the 
receptionist from Pickering Medical Imaging standing at the utility closet with a cellphone to 
her ear, carrying a large bag. The College investigators were not given access to observe the 
contents of the large bag. The receptionist initially denied, but later admitted, that she was 
speaking with Dr. Kumra on her cellphone. The College investigators were not able to locate 
the EMR server. 
 
Dr. Kumra directed the receptionist to disconnect the EMR server while the College was in 
attendance and to remove it from the premises. 
 
Dr. Kumra claimed he was ill and therefore unable to attend at the office on July 7, 2017 when 
College investigators (and patients) were waiting. He also claimed that he was too ill to return 
telephone calls. However, a subsequent review of cellphone and internet records indicates that 
Dr. Kumra was actively using his phone and was mobile during this time period. 
 
  (iv) July 8, 2017 Records Request 
 
On July 8, 2017, College investigators attended at the Six Points Clinic and Tretheway Clinic to 
collect 167 patient records. Dr. Kumra had purportedly treated 26 patients that morning. Dr. 
Kumra advised College investigators that he created rough notes for these patient encounters 
but was unable to produce a single note for these 26 patient encounters. 
  
 E. Failure to Maintain the Standard of Practice of the Profession 
 
On July 19, 2016, the College retained Dr. Jeff Bloom, Family Physician-in-Chief, University 
Health Network, to provide an opinion as to whether Dr. Kumra maintained the standard of 
practice of the profession. 
  
 Dr. Bloom was provided with records the College was able to obtain from Dr. Kumra’s practice 
 and related to Dr. Kumra’s patients. These included: 
 
 - Patient records obtained in April 2013 from Six Points Clinic; 
 - EMR records forensically retrieved from Dr. Kumra’s server at Six Points Clinic 
   obtained on February 17, 2015;  
 - Patient records obtained from other health care providers; 
 - OHIP billing records; and 
 - SDA forms obtained from Ontario Works. 
 
Dr. Bloom delivered his report dated February 16, 2018. Dr. Bloom reviewed the care and 
treatment provided in 27 cases and opined that Dr. Kumra failed to maintain the standard of 
practice of the profession and displayed a lack of judgment including with respect to the 
completion of SDA forms, his billing practices and his administrative/managerial oversight of 
his EMR and office practices. 
  
 -  In many cases, there was no documentation to support the conditions identified on 
    patients’ SDA forms; 
 -  Dr. Kumra completed SDA forms for food allergies and intolerances where contradictory 
    medical records existed; 
 -  In many cases, there was no documented history or physical exam to support the 
    significant number of medical imaging studies ordered by Dr. Kumra; 
 -  In some instances, there were multiple versions of documentation for the same visit 
    and/or templated documentation identical to the documentation in other charts; 
 -  There were submissions for OHIP for which there were no patient records; and/or 
    insufficient documentation to support intermediary assessments billed to OHIP; and, 
 -  Dr. Kumra’s completion of Mandatory Special Necessities Benefit forms were not 
    substantiated by the pattern of care he provided prior and subsequent to completing the 
    form. 
 
Undertaking with the College 
 
On April 26th, 2019, Dr. Kumra signed an undertaking to resign from the College effective 
immediately and agreed not to apply or re-apply for registration as a physician to practise 
medicine in Ontario or any other jurisdiction in Canada. 

Disposition 
  
On June 17, 2019, the Discipline Committee ordered and directed that: 

 -  Dr. Kumra attend before the panel to be reprimanded. 
 -  Dr. Kumra pay costs to the College in the amount of $6,000.00 within thirty (30) days.


Decision: Download Full Decision (PDF)
Hearing Date(s): June 17, 2019 half day commence at 1:00 p.m.


Committee: Discipline
Decision Date: 15 Jul 2009
Summary:

On July 15, 2009, the Discipline Committee found that Dr. Kumra committed an act of 
professional misconduct, in that he engaged in conduct or an act or acts relevant to the practice of 
medicine that, having regard to all the circumstances, would reasonably be regarded by members 
as disgraceful, dishonourable or unprofessional. 
 
Dr. Kumra, with the support of his physician, applied for disability benefits under several 
insurance policies from 2001 through 2005. As a result, he did receive some benefits. In fact, 
during various periods of time in which he represented that he was incapacitated, Dr. Kumra had 
worked as a locum for his physician, had been engaged in a residency program, and had worked 
as a family physician in California. Dr. Kumra made false representations regarding his capacity 
to function as a physician and also authorized his physician to do so on his behalf. 
 
On October 27, 2009, the Discipline Committee ordered and directed that: 
 
1.    The Registrar suspend Dr. Kumra's certificate of registration for a period of six months, 
      effective immediately. 
 
2.    The Registrar impose the following term, condition and limitation on Dr. Kumra's 
      certificate of registration: 
 
      (i)   Dr. Kumra shall enroll in and complete the College's Medical Ethics and Informed 
            Consent course, at his own expense, at the earliest available date, and in any 
            event, within six months of the date of this Order. This condition is to be removed 
            upon Dr. Kumra providing the College with satisfactory proof of his completion 
            of the course. 
 
3.    Dr. Kumra shall appear before the panel to be reprimanded. 
 
4.    Dr. Kumra shall pay costs to the College in the amount of $25,550, within 12 months of 
      the date of this Order. 
 
On October 27, 2009, Dr. Kumra appealed the decision of the Discipline Committee to the 
Superior Court of Justice (Divisional Court). Pursuant to s. 25(1) of the Statutory Powers 
Procedure Act, the decision of the Discipline Committee was stayed pending the outcome of the 
appeal. 
 
On May 10, 2011, the Superior Court of Justice (Divisional Court) dismissed the appeal.   
Therefore, the decision of the Discipline Committee is in effect. 
 
 
 


Decision: Download Full Decision (PDF)
Appeal: Appeal Dismissed
Appeal Decision Date: 10 May 2011
Hearing Date(s): Jul 15, 2009

Concerns Flag: indicates a concern or additional information

Source: Member
Active Date: April 26, 2019
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Rajiv Kumra to the College of Physicians and Surgeons of Ontario, effective April 26, 2019:

On June 20, 2018, Dr. Kumra was referred to the Discipline Committee on allegations of professional misconduct and incompetence.

In the face of these allegations, Dr. Kumra resigned from the College and has agreed never to apply or reapply for registration as a physician in Ontario or any other jurisdiction in Canada. Once these allegations have been determined by the Discipline Committee, the decision will be available to the public on the Public Register.

Dr. Kumra was also the subject of open investigations regarding his standard of practice and conduct. In exchange for this undertaking, the College is taking no further action on these investigations.
Download Full Document (PDF)