As from July 23, 2003, Dr. Jason K. Dorfman undertakes not to engage in any
incisional ophthalmological surgery in any jurisdiction, but he may perform:
(a) Pterygium surgery; and
(b) Non-incisional laser surgery
As from March 26, 2016, the following is imposed as a term, condition and
limitation on the certificate of registration held by Dr. Jason Kevin Dorfman,
in accordance with an undertaking and consent given by Dr. Dorfman to the
College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. JASON KEVIN DORFMAN
("Dr. Dorfman")
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;
"OHIP" means the Ontario Health Insurance Plan;
"public register" means the College's register that is available to the
public.
(2) I, Dr. Dorfman, certificate of registration number 52310, am a member of
the College. The College has received information regarding my standard
of practice with respect to ophthalmological surgery.
B. UNDERTAKING
(3) I, Dr. Dorfman, acknowledge and agree that I am bound by this Undertaking
from the date on which I sign it.
(4) Reassessment of Practice
(a) I, Dr. Dorfman, undertake that 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 direct observation of my
care, a review of my records from cases observed, and a chart
review, and that the Reassessment may also include, interviews with
colleagues and co-workers, feedback from patients and any other
tools deemed necessary by the College.
(b) I, Dr. Dorfman, 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. Dorfman, 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. Dorfman, 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. Dorfman, undertake that, following the decision referenced
in section (4)(d) above, I will abide by those recommendations of
the Assessor(s) that the ICR Committee has determined are
reasonable.
(f) I, Dr. Dorfman, hereby consent to any of 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:
(i) any recommendations of the Assessor(s) which are terms,
conditions or limitations on my practice;
(ii) any recommendations of the Assessor(s) which the ICR
Committee has identified in its decision referenced in
section (4)(d) as terms, conditions or limitations on my
practice.
(5) Monitoring
(a) I, Dr. Dorfman, undertake to inform the College of each and every
location that I practise or have privileges, including, but not
limited to, hospital(s), 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. Dorfman, 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. Dorfman, give my irrevocable consent to the College to make
appropriate enquiries of 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. Dorfman, acknowledge that I have executed the OHIP consent
form, attached hereto as Appendix "A".
(6) I, Dr. Dorfman, 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
(7) I, Dr. Dorfman, acknowledge that all appendices attached to or referred
to in this Undertaking form part of this Undertaking.
(8) I, Dr. Dorfman, 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.
(9) I, Dr. Dorfman, 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.
(10) I, Dr. Dorfman, 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 public register during the time
period that the Undertaking remains in effect.
(11) I, Dr. Dorfman, acknowledge that the following summary will appear on the
public register during the time period that this Undertaking remains in
effect:
The College received information about Dr. Dorfman's surgical
standard of practice. As a result, Dr. Dorfman's practice will be
reassessed by an assessor selected by the College.
D. CONSENT
(12) I, Dr. Dorfman, give my irrevocable consent to the College to provide the
following information to all 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.
(13) I, Dr. Dorfman, give my irrevocable consent to the College to provide
this Undertaking to any Chief(s) of Staff, or a colleague with similar
responsibilities approved by the College, at any Practice Location
("Chief(s) of Staff"), and to provide said Chief(s) 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.
(14) I, Dr. Dorfman, give my irrevocable consent to all Chiefs of Staff and
Assessors, to disclose to the College, and to one another, any
information:
(a) relevant to this Undertaking;
(b) relevant to the Reassessment;
(c) relevant for the purposes of monitoring my compliance with this
Undertaking; and/or
(d) which he or she reasonably believes indicates a potential risk of
harm to my patients.
Terms and conditions imposed on certificate by: Member
