As from April 8th 2023, the following are imposed as terms, conditions and limitations on the certificate of registration held by Dr. Vinod Kunhiraman Nair in accordance with an undertaking and consent given by Dr. Nair to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. VINOD KUNHIRAMAN NAIR
("Dr. Nair")
to
COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
(the "College")
________________________________________
A. PREAMBLE
(1) In this Undertaking:
"Code" means the Health Professions Procedural Code, which is Schedule 2 to the Regulated Health Professions Act, 1991, S.O. 1991, c. 18, as amended;
"Discipline Tribunal" means the Ontario Physicians and Surgeons Discipline Tribunal of the College;
"OHIP" means the Ontario Health Insurance Plan;
"Ontario Physicians and Surgeons Discipline Tribunal" means the Discipline Committee established under the Code;
"Public Register" means the College's register that is available to the public.
(2) I, Dr. Nair, certificate of registration number 70381, am a member of the College.
(3) I, Dr. Nair, acknowledge that the College conducted an investigation bearing File Number CAS-385574-S6J5S4 (the "Investigation") into whether I engaged in professional misconduct and/or am incompetent in my anaesthesiology practice and conduct, including my care and conduct in relation to the COVID-19 pandemic and my prescribing of Ivermectin for COVID-19.
(4) I, Dr. Nair, acknowledge that, in addition to accepting this Undertaking, the College will also deliver a caution in person.
B. UNDERTAKING
(5) I, Dr. Nair, undertake to abide by the provisions of this Undertaking, effective immediately.
(6) Practice Restrictions
(a) I, Dr. Nair, undertake to restrict my practice to anaesthesiology.
(b) I, Dr. Nair, undertake not to prescribe ivermectin.
(7) Posting a Sign
(a) I, Dr. Nair, undertake that I shall post a sign in all waiting rooms, examination rooms and consulting rooms, in all my Practice Locations, in a clearly visible and secure location, at all times whether or not I am physically present at the Practice Location, in the form set out at Appendix "A." If providing care in a virtual setting, I shall display the sign to the patient at the outset of the patient encounter. If the patient encounter is by telephone, I shall read the sign to the patient at the outset of the patient encounter. For further clarity, this sign shall state as follows: "Dr. Nair's practice is restricted to anaesthesiology. Dr. Nair must not prescribe ivermectin. Further information may be found on the College of Physicians and Surgeons of Ontario website at www.cpso.on.ca
(b) I, Dr. Nair, undertake to post a certified translation in any language in which I provide services, of the sign described in section (7)(a) in all waiting rooms of all my Practice Locations, in a clearly visible and secure location, in the form set out at Appendix "A."
(c) I, Dr. Nair, 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. Nair, 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. Nair, undertake to provide to the College the certified translation described in section (7)(b) prior to beginning to provide services in any language described in section (7)(d).
(f) I, Dr. Nair, acknowledge that the College may accept an alternative arrangement with respect to signage in a hospital setting, in its sole discretion.
(8) Professional Education
(a) I, Dr. Nair, 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) Medical Record-Keeping Program, University of Toronto;
(ii) Review, reflection, and a written summary of the following policies and other self-study:
1. Virtual Care, College policy;
2. Medical Records Management, College policy;
(iii) PROBE: Ethics & Boundaries Program, by receiving a passing evaluation or grade, without any condition or qualification. I, Dr. Nair, will agree to abide by any recommendations of the PROBE program;
(b) I, Dr. Nair, 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. Nair, undertake to complete this requirement within three (3) months, or, if no satisfactory program is available by that time, by the first possible opportunity thereafter.
(d) I, Dr. Nair, acknowledge that a report or reports may be provided to the College regarding my progress and compliance with the Professional Education.
(e) I, Dr. Nair, acknowledge that if any of the programs or policies listed above become unavailable, substitution requests will be reviewed by the College and the College will determine in its sole discretion whether substitution is appropriate.
(9) Monitoring
(a) I, Dr. Nair, 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. Nair, 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. Nair, give my irrevocable consent to the College to make appropriate enquiries of OHIP, and/or any person who or institution that may have relevant information, in order for the College to monitor my compliance with the provisions of this Undertaking.
(d) I, Dr. Nair, acknowledge that I have executed the OHIP consent form, attached hereto as Appendix "C".
C. ACKNOWLEDGEMENT
(10) I, Dr. Nair, acknowledge that all appendices attached to or referred to in this Undertaking form part of this Undertaking.
(11) I, Dr. Nair, 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.
(12) I, Dr. Nair, 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.
(13) I, Dr. Nair, acknowledge that the College will provide this Undertaking to any Chief of Staff, or a colleague with similar responsibilities, at any Practice Location ("Chief of Staff" or "Chiefs of Staff").
(14) I, Dr. Nair, 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 Tribunal of the College.
(15) I, Dr. Nair, acknowledge that this Undertaking constitutes terms, conditions, and limitations on my certificate of registration for the purposes of section 23 of the Code.
(16) Public Register
(a) I, Dr. Nair, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. Nair, acknowledge that, in addition to this Undertaking being posted in accordance with section (16)(a) above, the following summary shall be posted on the Public Register during the time period that this Undertaking remains in effect:
A College investigation was conducted into whether Dr. Nair in his anaesthesiology practice and conduct, including in relation to the COVID-19 pandemic and his prescribing of Ivermectin for COVID-19, engaged in professional misconduct and/or was incompetent. As a result of the investigation:
Dr. Nair's practice is restricted to anaesthesiology.
Dr. Nair must not prescribe ivermectin.
Dr. Nair shall post a clearly visible sign in the waiting rooms, examination rooms and consulting rooms of all Practice Locations, which states as follows:
IMPORTANT NOTICE
Dr. Nair's practice is restricted to anaesthesiology. Dr. Nair must not prescribe ivermectin. Further information may be found on the College of Physicians and Surgeons of Ontario website at www.cpso.on.ca
Dr. Nair will engage in professional education, including in medical record keeping and professionalism.
D. CONSENT
(17) I, Dr. Nair, 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:
(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.
(18) I, Dr. Nair, 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.
(19) I, Dr. Nair, give my irrevocable consent to any persons who facilitate my completion of the Professional Education, and to all Chiefs of Staff, to disclose to the College, and to one another, any of the following:
(a) any information relevant to this Undertaking;
(b) any information relevant for the purposes of monitoring my compliance with this Undertaking;
(c) 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.