As from December 11, 2015, the following is imposed as a term, condition and limitation on the certificate of registration held by Dr. David Hamp Martin, in accordance with an undertaking and consent given by Dr. Martin to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. DAVID HAMP MARTIN
("Dr. Martin")
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;
"ICR Committee" means the Inquiries, Complaints and Reports Committee of the College.
(2) I, Dr. Martin, certificate of registration number 51040, am a member of the College. The College has received information regarding my standard of practice.
(3) I, Dr. Martin, acknowledge that I am currently the subject of College investigations bearing File Numbers 91521 and 7214351 (the "Investigations") into allegations regarding my clinical care and conduct towards patients.
B. UNDERTAKING
(4) I, Dr. Martin, acknowledge and agree that I am bound by this Undertaking from the date on which I sign it.
(5) I, Dr. Martin, undertake that, effective immediately, I will not practise in a hospital setting.
(6) Clinical Supervision
(a) I, Dr. Martin, undertake to practise under the guidance of a clinical supervisor acceptable to the College (the "Clinical Supervisor"), for twelve (12) months ("Clinical Supervision").
(b) I, Dr. Martin, acknowledge that I have reviewed the Clinical Supervisor's undertaking, attached hereto as Appendix "A", and understand what is required of the Clinical Supervisor. The Clinical Supervisor will, at minimum:
(i) Facilitate the education program set out in the Individualized Education Plan ("IEP") attached as Appendix "B";
(ii) Review at least ten (10) of my patient charts at each supervision visit described in Appendix "B" and in paragraph (iii) below;
(iii) Weekly visits with direct observation for one-half day for a minimum period of one (1) month following which, upon receiving permission from the College, to transition to meeting with my clinical Supervisor once per month;
(iv) Discuss any concerns arising from the chart reviews;
(v) Make recommendations to me for practice improvements and ongoing professional development and inquire into my compliance with the recommendations;
(vi) Perform any other duties, such as reviewing other documents or conducting interviews with staff or colleagues, that the Clinical Supervisor deem necessary to my Clinical Supervision; and
(vii) Submit written reports to the College at the end of one month of supervision and thereafter at least once every quarter, or more frequently if the Clinical Supervisor has concerns about my standard of practice.
(c) I, Dr. Martin, acknowledge that the charts reviewed shall be selected by the Clinical Supervisor based on the educational needs identified in the IEP set out at Appendix "B" to my Undertaking, as well as the areas of concern identified in the reports of the medical inspectors dated March 25, 2014, and July 27, 2015, and concerns that may arise during the period of Clinical Supervision.
(d) I, Dr. Martin, undertake to cooperate fully with the Clinical Supervision of my practice, conducted under the term of this Undertaking and Appendix "A" attached, and to abide by the recommendations of my Clinical Supervisor(s), including but not limited to, any recommended practice improvements and ongoing professional development.
(e) I, Dr. Martin, undertake that if a person who has given an undertaking in Appendix "A" to this Undertaking is unable or unwilling to continue to fulfill its provisions, I shall, within twenty (20) 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.
(f) I, Dr. Martin, agree that if I am unable to obtain a Clinical Supervisor on the provisions set out under section (e) above, I will cease practising medicine until such time as I have obtained a Clinical Supervisor acceptable to the College.
(g) I, Dr. Martin, agree that if I am required to cease practice as a result of section (f) above this will constitute a term, condition or limitation on my certificate of registration and that term, condition or limitation will be included on the public register.
(7) Reassessment of Practice
(a) I, Dr. Martin, undertake that, approximately twelve (12) months after the completion of the Clinical Supervision set out in section (6) above and Appendix "A" attached, I will submit to a Reassessment of my practice ("the Reassessment") by an assessor or assessors selected by the College (the "Assessor(s)"). I acknowledge and agree that the Reassessment will include a chart review of a minimum of fifteen (15) patient charts, an interview, direct observation of my care, interviews with colleagues and co-workers, feedback from patients and any other tools deemed necessary by the College and as outlined in Appendix "B".
(b) I, Dr. Martin, undertake to co-operate fully with the Reassessment, conducted under the term of this Undertaking, and to abide by those recommendations of the Assessor(s) that are approved by the ICR Committee.
(c) I, Dr. Martin, acknowledge and agree that my Clinical Supervisor(s) may receive and review the findings of the Assessor(s), and may discuss with the Assessor(s) any issues or concerns arising from the Reassessment. I also acknowledge that the results of the Reassessment will be provided to me and reported to the College and the report may form the basis of further action by the College.
(d) I, Dr. Martin, understand and agree that if I am of the view that any of the Assessor(s)'s recommendations are unreasonable, I will have thirty (30) days following my receipt of the recommendations within which to provide the College with my submissions in this regard. I further understand and agree that thereafter, the ICR Committee will consider my submissions and make a determination regarding whether or not the recommendations, or any of them, are reasonable and if so, whether they, or any of them, constitute limitations or restrictions on my practice, and that decision will be provided to me.
(e) I, Dr. Martin, undertake that, following the decision referenced in section (d) above, I will abide by those recommendations of the Assessor(s) that the ICR Committee has determined are reasonable.
(f) I, Dr. Martin, hereby consent to the following being included on the public register as terms, conditions or limitations on my certificate of registration, for the purposes of section 23 of the Code: any recommendations of the Assessor(s) which are terms, conditions or limitations on my practice and/or which the ICR Committee has identified in its decision referenced in section (d) above as terms, conditions or limitations on my practice.
(8) Monitoring
(a) I, Dr. Martin, undertake to inform the College of each and every location that I practise or have privileges, including, but not limited to, clinic(s) and office(s), in any jurisdiction (collectively my "Practice Location(s)"), within fifteen (15) days of executing this Undertaking. Going forward, I further undertake to inform the College of any and all new Practice Locations within fifteen (15) days of commencing practice at that location.
(b) I, Dr. Martin, undertake and agree that I will submit to, and not interfere with, unannounced inspections of my Practice Location(s) and patient records by a College representative for the purposes of monitoring my compliance with the provisions of this Undertaking.
(c) I, Dr. Martin, give my irrevocable consent to the College to make appropriate enquiries of the Ontario Health Insurance Plan ("OHIP"), and/or any person or institution who may have relevant information, in order for the College to monitor my compliance with the provisions of this Undertaking.
(d) I, Dr. Martin, acknowledge that I have executed the OHIP consent form(s), attached hereto as Appendix "C".
(9) I, Dr. Martin, undertake to comply with this Undertaking and 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 of the College.
C. ACKNOWLEDGEMENT
(10) I, Dr. Martin, acknowledge that all appendices attached to or referred to in this Undertaking form part of this Undertaking.
(11) I, Dr. Martin, acknowledge 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. Martin, acknowledge and confirm 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. Martin, acknowledge that this entire Undertaking constitutes terms, conditions, and limitations on my certificate of registration for the purposes of section 23 of the Code. I understand that this Undertaking shall be information on the College's Register that is available to the public during the time period that the Undertaking remains in effect.
(14) I, Dr. Martin, acknowledge that the following summary will appear on the College's Register that is available to the public during the time period that this Undertaking remains in effect:
Dr. Martin was the subject of a College investigation into allegations regarding his clinical care and conduct towards patients. As a result of the investigation:
Dr. Martin will practise under the guidance of a Clinical Supervisor acceptable to the College for 12 months.
Dr. Martin's practice will be reassessed by an assessor selected by the College within 12 months of the end of the period of Clinical Supervision.
Dr. Martin will not practice in a hospital setting.
D. CONSENT
(15) I, Dr. Martin, 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 and to all Clinical Supervisors, and/or Assessors:
(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.
(16) I, Dr. Martin, give my irrevocable consent to any person who facilitates my completion of the professional education set out in section (6) above, and to all Clinical Supervisors and Assessors, to disclose to the College, and to one another, any information:
(a) relevant to this Undertaking;
(b) relevant to the provisions of the Clinical Supervisor's undertaking set out at Appendix "A";
(c) relevant to the Reassessment;
(d) relevant for the purposes of monitoring my compliance with this Undertaking; and/or
(e) which comes to his or her attention in the course of providing the professional education set out above and which he or she reasonably believes indicates a potential risk of harm to my patients.
Terms and conditions imposed on certificate by: Member
