Dialogue Volume 15, Issue 2 2019 - Page 51

DISCIPLINE SUMMARIES For complete details of the Order, please see the full decision at www.cpso.on.ca. Select Find a Doctor and enter the doctor’s name. At the conclusion of the hearing, Dr. Hyson waived his right to an appeal and the Committee administered the public reprimand. DR. RAVI KAKAR PRACTICE LOCATION: Markham AREA OF PRACTICE: Psychiatry HEARING INFORMATION: Admission; Agreed Statement on Facts; Contested Penalty On November 16, 2018, the Discipline Committee found that Dr. Kakar committed an act of profes- sional misconduct in that he engaged in an act or omission that would be regarded by members as disgraceful, dishonourable or unprofessional. Third Party Report Concerns Dr. Kakar first met Patient A in July, 2016. Patient A reported to Dr. Kakar a one-day hospitalization in March 2016 for depression resulting from alienation. Dr. Kakar concluded that Patient A was suffering from an adjustment disorder with depressed mood but saw no evidence that Patient A was suffering from psychosis. Dr. Kakar concluded that Patient A was not suffering from an identifiable mental disor- der, but he continued to see and monitor Patient A. Dr. Kakar next saw Patient A in August 2016, for a follow up appointment. Patient A was a student at a local community college and requested a letter from Dr. Kakar to provide an opinion about whether she was fit to attend school for the fall semester. He provided a report which concluded that she was fit to attend school. Dr. Kakar did not obtain any of Patient A’s medical records or additional information about her hospitalization prior to completing the third party report. He continued to treat Patient A with psychotherapy until December 2016. On August 17, 2016, the College received informa- tion from the local community college regarding the psychiatric report prepared by Dr. Kakar on behalf of Patient A. As a result of the concerns, the College retained a Medical Inspector to provide an opinion on the care Dr. Kakar provided to Patient A and on the third party report that had been prepared by Dr. Kakar on behalf of Patient A. In the Medical Inspector’s opinion, there were no is- sues with Dr. Kakar’s clinical care of Patient A and no concerns about harm or injury to Patient A. The medi- cal inspector identified, however, deficiencies with Dr. Kakar’s third party report and his record-keeping. Specifically, the Medical Inspector found that Dr. Kakar’s report was not comprehensive and there was inadequate substantiation of facts because: a) Dr. Kakar should have obtained the hospital records reflecting Patient A’s hospital admission prior to writ- ing the report; and b) the report should have made it clear that it was based on information obtained directly from Patient A and that Dr. Kakar had failed to independently confirm information obtained from the patient. Breach of Undertaking On February 16, 2016, Dr. Kakar entered into an undertaking with the College in lieu of an Order in respect of a prior discipline referral. The undertak- ing required that all third party reports authored by Dr. Kakar be reviewed and approved by his Clinical Supervisor before being provided to the third party. On October 13, 2016, College staff attended at Dr. Kakar’s office to monitor his compliance with the terms on his certificate of registration. They identi- fied four forms, for four different patients, from Dr. Kakar which were not approved by his Clinical Supervisor before being provided to the third party. These four forms were: • A Psychological Health Medical Update Form • An Application for Determination of Catastrophic Impairment Form • A Clinical Information Form • A Medical Follow-Up Form All of four forms constituted Third Party Reports pursuant to the College’s Third Party Reports Policy. ISSUE 2, 2019 DIALOGUE 51