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Roy, William Andrew

CPSO#: 23704

MEMBER STATUS
Active Member as of 15 Jan 2019
CPSO REGISTRATION CLASS
Restricted as of 08 Jun 2017
Flag: Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education:University of Toronto, 1970

Practice Information

Primary Location of Practice
The Brooklin Medical Centre
Suite 1A
5959 Anderson Street
Brooklin ON  L1M 2E9
Phone: (905) 655-3321
Fax: (905) 655-4848 Electoral District: 05

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 01 Jul 1970
Transfer of class of registration to: Independent Practice Certificate Effective: 30 Jun 1971
Transfer of class of certificate to: Restricted certificate Effective: 08 Jun 2017
Terms and conditions imposed on certificate by member Effective: 08 Jun 2017
Terms and conditions amended by member Effective: 19 Sep 2017
Terms and conditions amended by member Effective: 27 Oct 2017
Terms and conditions amended by member Effective: 03 Mar 2018
Terms and conditions amended by member Effective: 09 Mar 2018
Terms and conditions amended by member Effective: 17 Sep 2018
Terms and conditions amended by Discipline Committee Effective: 27 Sep 2018
Suspension of registration imposed: Discipline Committee Effective: 15 Oct 2018
Suspension of registration removed Effective: 15 Jan 2019

Practice Restrictions Flag: indicates a concern or additional information

Imposed By Effective Date Expiry Date Status
Discipline Committee Effective: 27 Sep 2018 Active
 
            As from September 17, 2018, the following is imposed as a term, condition and
            limitation on the certificate of registration held by Dr. William Andrew Roy in
            accordance with an undertaking and consent given by Dr. Roy to the College of
            Physicians and Surgeons of Ontario:

                        UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
                                    ("Undertaking")
                  
                                          of
                  
                              DR.  WILLIAM ANDREW ROY
                                    ("Dr. Roy")
                  
                                          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; 
                  
                  "NMS" means the Drug Program Services Branch, the Narcotics Monitoring
                  System implemented under the Narcotics Safety and Awareness Act, 2010,
                  S.O. 2010, c. 22, as amended;
                  
                  "OHIP" means the Ontario Health Insurance Plan;
                  
                  "Public Register" means the College's register that is available to the
                  public.
                  
            (2)   I, Dr. Roy, certificate of registration number 23704, am a member of the
                  College.

            (3)   I, Dr. Roy, acknowledge that the College received information from the
                  NMS and initiated an investigation bearing File Number 7215621 (the
                  "Investigation") into whether I failed to maintain the standard of
                  practice of the profession and/or am incompetent in my prescribing of
                  controlled substances, including narcotics.

            (4)   I, Dr. Roy, acknowledge that on June 8, 2017, I entered into an
                  Undertaking as a resolution to the Investigation.

            (5)   I, Dr. Roy, acknowledge that this Undertaking replaces my June 8, 2017
                  Undertaking.

            B.    UNDERTAKING

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

            (7)   Resignation of Prescribing Privileges

                  (a)   I, Dr. Roy, acknowledge that I have executed the Prescribing
                        Resignation Letter to Health Canada, which is attached hereto as
                        Schedule "A" (the "Resignation Letter").
                  
                  (b)   I, Dr. Roy, consent to the College sending the Resignation Letter
                        to Health Canada on my behalf.
                  
                  (c)   I, Dr. Roy, undertake that I will not issue new prescriptions or
                        renew existing prescriptions for or administer any of the following
                        substances:
                  
                        (i)   Narcotic Drugs (from the Narcotic Control Regulations made
                              under the Controlled Drugs and Substances Act, S.C., 1996, c.
                              19);
                  
                        (ii)  Narcotic Preparations (from the Narcotic Control Regulations
                              made under the Controlled Drugs and Substances Act, S.C.,
                              1996, c. 19);
                  
                        (iii) Controlled Drugs (from Part G of the Food and Drug
                              Regulations under the Food and Drugs Act, S.C., 1985, c.
                              F-27); 
                  
                        (iv)  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 [from Appendix I to the
                              Compendium of Pharmaceuticals and Specialties] is attached
                              hereto as Schedule "B"; and the current regulatory lists are
                              attached hereto as Schedule "C")
                  
                        (v)   All other Monitored Drugs (as defined under the Narcotics
                              Safety and Awareness Act, 2010, S.O. 2010, c. 22 as noted in
                              Schedule "D");                       
                  
                              and as amended from time to time.
                  
                  (d)   I, Dr. Roy, undertake to immediately refer all patients to whom I
                        am prescribing any of the substances described in section (c),
                        above, to other physicians for assessment and care.
                  
                  (e)   I, Dr. Roy, undertake to keep a log of all patients referred to
                        other physicians pursuant to section (7)(d), above (the "Log"). I,
                        Dr. Roy, undertake to include in the Log the name of each patient
                        referred, the name of the physician referred to, and the date of
                        referral. 
                  
            (8)   I, Dr. Roy, undertake that I will return any supplies of the substances
                  referred to in section (7)(c) above that are presently in my possession,
                  in any place, to a pharmacy in a safe and secure manner, as stipulated in
                  the College's Policy Number 8-12, "Prescribing Drugs."

            (9)   I, Dr. Roy, undertake to inform the College of each and every location
                  that I practise or have privileges, including, but not limited to, any
                  hospitals, clinics and offices, in any jurisdiction (collectively my
                  "Practice Location" or "Practice Locations"), within five (5) days of
                  executing this Undertaking.  Going forward, I further undertake to inform
                  the College of any and all new Practice Locations within five (5) days of
                  commencing practice at that location.

            (10)  Posting a Sign 

                  (a)   I, Dr. Roy, undertake that I shall post a sign in all waiting rooms
                        and in each examination and consulting room, in all my Practice
                        Locations, in a clearly visible and secure location, in the form
                        set out at Schedule "E."  For further clarity, this sign shall
                        state as follows: 
                  
                              IMPORTANT NOTICE
                  
                        Dr. Roy has agreed not to prescribe or administer any of the
                        following: 
                  
                        *     Narcotic Drugs
                        *     Narcotic Preparations
                        *     Controlled Drugs
                        *     Benzodiazepines and Other Targeted Substances
                        *     All other Monitored Drugs
                  
                        Further information may be found on the College of Physicians and
                        Surgeons of Ontario website at www.cpso.on.ca
                  
                  (b)   I, Dr. Roy, undertake to post a certified translation in any
                        language in which I provide services, of the sign described in
                        section (7)(a) above, in all waiting rooms and in each examination
                        and consulting room, in all my Practice Locations, in a clearly
                        visible and secure location, in the form set out at Schedule "E." 
                  
                  (c)   I, Dr. Roy, undertake to provide the certified translation
                        described in section (7)(b), to the College within thirty (30) days
                        of executing this Undertaking.
                  
                  (d)   I, Dr. Roy, undertake that if I elect, after the execution of this
                        Undertaking, to provide services in any other language, I will
                        notify the College prior to providing any such services. 
                  
                  (e)   I, Dr. Roy, undertake to provide to the College the certified
                        translation described in section (10)(c) prior to beginning to
                        provide services in any language described in section (10)(d).
                  
            C.    ACKNOWLEDGEMENT

            (11)  I, Dr. Roy, acknowledge that all schedules attached to or referred to in
                  this Undertaking form part of this Undertaking.

            (12)  I, Dr. Roy, acknowledge and undertake that I shall be solely responsible
                  for payment of all fees, costs, charges, expenses, etc. arising from the
                  implementation of any of the provisions of this Undertaking.
            (13)  I, Dr. Roy, 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.

            (14)  I, Dr. Roy, 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").

            (15)  I, Dr. Roy, 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.

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

            (17)  Public Register

                  (a)   I, Dr. Roy, acknowledge that, during the time period that this
                        Undertaking remains in effect, this Undertaking shall be posted on
                        the Public Register.
                  
                  (b)   I, Dr. Roy, acknowledge that, in addition to this Undertaking being
                        posted in accordance with section (17)(a) above, the following
                        summary shall be posted on the Public Register during the time
                        period that this Undertaking remains in effect:
                  
                        Dr. Roy has agreed not to issue new prescriptions or renew existing
                        prescriptions for or administer any of the following substances:
                  
                        (i)   Narcotic Drugs (from the Narcotic Control Regulations made
                              under the Controlled Drugs and Substances Act, S.C., 1996, c.
                              19);
                  
                        (ii)  Narcotic Preparations (from the Narcotic Control Regulations
                              made under the Controlled Drugs and Substances Act, S.C.,
                              1996, c. 19);
                  
                        (iii) Controlled Drugs (from Part G of the Food and Drug
                              Regulations under the Food and Drugs Act, S.C., 1985, c.
                              F-27);
                  
                        (iv)  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); 
                  
                        (v)   All other Monitored Drugs (as defined under the Narcotics
                              Safety and Awareness Act, 2010, S.O. 2010, c. 22);

                              and as amended from time to time.
                  
                        Dr. Roy must post a clearly visible sign in the waiting rooms and
                        each examination and consulting room, in all Practice Locations,
                        which states as follows: 
                  
                              IMPORTANT NOTICE
                  
                  Dr. Roy has agreed not to prescribe or administer any of the following: 
                  
                  *     Narcotic Drugs
                  *     Narcotic Preparations
                  *     Controlled Drugs
                  *     Benzodiazepines and Other Targeted Substances
                  *     All other Monitored Drugs
                  
                  Further information may be found on the College of Physicians and
                  Surgeons of Ontario website at www.cpso.on.ca
                  
            D.    CONSENT

            (18)  I, Dr. Roy, undertake that I will submit to, and not interfere with,
                  unannounced inspections of my Practice Locations and patient charts by
                  the College and to any other activity the College deems necessary in
                  order to monitor my compliance with the provisions of this Undertaking.

            (19)  I, Dr. Roy, give my irrevocable consent to the College to make
                  appropriate enquiries of OHIP, NMS, and 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.

            (20)  I, Dr. Roy, acknowledge that I have executed the OHIP and NMS consent
                  forms, attached hereto as Schedule "F" and Schedule "G", respectively.

            (21)  I, Dr. Roy, 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 any information
                  arising from the monitoring of my compliance with this Undertaking.

Previous Hearings Flag: indicates a concern or additional information

Committee: Discipline
Decision Date: 27 Sep 2018
Summary:

On September 27, 2018, the Discipline Committee found that Dr. William Andrew Roy 
committed an act of professional misconduct, in that he has engaged in conduct or 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. 
 
Dr. Roy is a General Practitioner, practising in Toronto. He obtained his Independent Practice 
Certificate in 1971. 
 
The College received information from the Narcotics Monitoring System (NMS) identifying Dr. 
Roy as having prescribed, in 2015, eight or more patients at least 650 oral morphine equivalents 
(OMEs) per day and issued at least one prescription exceeding 20,000 OMEs. This prescribing 
exceeds the recommended watchful dose of 200 OMEs per day as set out in The Canadian 
Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain (v 5.6, April 30, 
2010). In total, 19 patients were flagged by the NMS. 
     
The College retained an expert, a family physician certified by the College of Family Physicians 
of Canada, to review this matter. The expert concluded that Dr. Roy failed to meet the standard of 
practice of the profession in 13 of the 20 charts reviewed and noted that: 
 
- the main areas of concern are his prescriptions for very high doses of opioids, often in 
  combination with high doses of benzodiazepines, poor record keeping with respect to opioid 
  prescribing, and lack of monitoring of patients with prescriptions for high doses of opioids. 
- Dr. Roy displayed a lack of knowledge in 2 charts as evident in situations where he indicated 
  that he prescribed two different long-acting opioids as one did not appear to be effective, and 
  where a patient was currently using intravenous street drugs, but he felt that the patient would 
  still require prescription opioids for his pain. 
- Dr. Roy displayed a lack of skill in 5 charts as evident by his management of patients who 
  demonstrated inappropriate behaviour or features of misuse. 
- Dr. Roy displayed a lack of judgment in 10 of the charts reviewed, which was evident in the 
  management of patients who were prescribed high doses of opioids and benzodiazepines 
  without adequate monitoring for safety and effectiveness. 
          
The expert concluded that in 7 of the 20 charts reviewed, Dr. Roy exposed patients to a potential 
risk of harm due to the extremely high doses of opioids that were prescribed in combination with 
high doses of benzodiazepines and by not monitoring the patients closely enough to ensure that 
they were taking the medications safely. 
 
Disgraceful Dishonourable or Unprofessional Conduct 
 
As a resolution, Dr. Roy entered into an undertaking with the College in June of 2017, requiring, 
among other things, that Dr. Roy practise under the guidance of a clinical supervisor acceptable to 
the College. If unable to obtain a clinical supervisor, Dr. Roy is required to cease to prescribe 
narcotic drugs, narcotic preparations, controlled drugs, benzodiazepines and other targeted 
substances, and all other monitored drugs. 
     
Dr. Roy obtained a clinical supervisor on July 19, 2017. However, on August 29, 2017, due to a 
potential conflict of interest, Dr. Roy was notified that this clinical supervisor was no longer 
suitable. Dr. Roy was provided with fourteen days to obtain a new clinical supervisor. 
     
Dr. Roy did not propose a suitable supervisor within the time limit set out in the undertaking. He 
was reminded on September 12, 2017, that, in accordance with the terms of the undertaking, he 
would have to cease prescribing by the end of the day, unless a supervisor was proposed and 
approved. Following a request by Dr. Roy’s counsel, an extension was provided until September 
15, 2017. 
     
Dr. Roy was unable to find a suitable clinical supervisor by the extended deadline. In accordance 
with the terms of the undertaking, and the terms, conditions and limitations on his certificate of 
registration effective September 19, 2017, Dr. Roy was required to 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. This restriction appeared on the public register. 
     
On October 13, 2017, another clinical supervisor was approved. On October 18, 2017, the clinical 
supervisor wrote to the College, noting that Dr. Roy had stated in their initial meeting earlier that 
day that he had continued to prescribe controlled substances during the period of time when he did 
not have a supervisor. 
 
College Compliance Case Managers selected 13 patient names from Dr. Roy's prescribing log and 
obtained copies of the prescriptions and physician's notes from the corresponding charts. NMS 
data was obtained with respect to the 13 patients, which demonstrates that Dr. Roy continued to 
prescribe monitored drugs between the period of September 19, 2017 and October 18, 2017. 
 
Disposition 
 
On September 27, 2018, the Discipline Committee ordered and directed that: 
 
-  the Registrar suspend Dr. Roy’s certificate of registration for a period of three (3) months, 
   commencing October 15, 2018.  
-  Dr. Roy participate in and successfully complete one-on-one individualized educational 
   instruction in ethics with an instructor approved by the College, and provide proof thereof to 
   the College within six (6) months of the date of this Order. 
-  Dr. Roy appear before the panel to be reprimanded.  
-  Dr. Roy pay to the College its costs of this proceeding in the amount of $10,180 within thirty 
   (30) days from the date of this Order.


Decision: Download Full Decision (PDF)
Hearing Date(s): September 27, 2018

Concerns Flag: indicates a concern or additional information

Source: Member
Active Date: September 17, 2018
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. William Andrew Roy to the College of Physicians and Surgeons of Ontario, effective September 17, 2018:

Dr. Roy has agreed not to issue new prescriptions or renew existing prescriptions for or administer any of the following substances:

(i) Narcotic Drugs (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
(ii) Narcotic Preparations (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
(iii) Controlled Drugs (from Part G of the Food and Drug Regulations under the Food and Drugs Act, S.C., 1985, c. F-27);
(iv) 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);
(v) All other Monitored Drugs (as defined under the Narcotics Safety and Awareness Act, 2010, S.O. 2010, c. 22);
and as amended from time to time.

Dr. Roy must post a clearly visible sign in the waiting rooms and each examination and consulting room, in all Practice Locations, which states as follows:

IMPORTANT NOTICE
Dr. Roy has agreed not to prescribe or administer any of the following:

Narcotic Drugs
Narcotic Preparations
Controlled Drugs
Benzodiazepines and Other Targeted Substances
All other Monitored Drugs

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


Source: ICR Committee
Active Date: July 5, 2017
Expiry Date:
Summary:
Caution-in-Person:

A summary of a decision of the Inquiries, Complaints and Reports Committee in which the disposition includes a "caution-in-person" is required by the College by-laws to be posted on the register, along with a note if the decision has been appealed. A “caution-in-person” disposition requires the physician to attend at the College and be verbally cautioned by a panel of the Committee. The summary will be removed from the register if the decision is overturned on appeal or review. Note that this requirement only applies to decisions arising out of a complaint dated on or after January 1, 2015 or if there was no complaint, the first appointment of investigators dated on or after January 1, 2015.

See PDF for the summary of a decision made against this member in which the disposition includes a caution-in-person.
Download Full Document (PDF)