THE FOLLOWING INFORMATION WAS OBTAINED FROM THE PHYSICIAN REGISTER SECTION OF THE WEBSITE OF THE COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO (WWW.CPSO.ON.CA) AS OF THE DATE AND TIME NOTED BELOW
09/12/24 07:57:26 AM

General Information

Former Name: No Former Name
Medical School: University of Kerala, 1981
Gender: Man
Languages Spoken: ENGLISH, MALAYALAM

Practice Information

Primary Business Location: Address not Available
Business Email: No Information Available
Phone: No Information Available
Fax: No Information Available

Specialties

SPECIALTY ISSUED ON CERTIFYING BODY
Family Medicine (Emergency Medicine)
Effective: 27 Nov 2001
College of Family Physicians of Canada
Family Medicine
Effective: 07 Dec 2000
College of Family Physicians of Canada
SPECIALTY: Family Medicine (Emergency Medicine)
ISSUED ON: Effective: Nov 27 2001
CERTIFYING BODY: College of Family Physicians of Canada

SPECIALTY: Family Medicine
ISSUED ON: Effective: Dec 07 2000
CERTIFYING BODY: College of Family Physicians of Canada

Hospital Privileges

No information available

Professional Corporation Information

Corporation Name: C. K. Thomas Medicine Professional Corporation
Certificate of Authorization Status: Inactive End Date: 17 May 2019

General Information

Former Name: No Former Name
Gender: Man
Languages Spoken: ENGLISH, MALAYALAM
Medical School: University of Kerala, 1981

Practice Information

Primary Business Location: Address not Available
Business Email: No Information Available
Phone: No Information Available
Fax: No Information Available

Specialties

SPECIALTY ISSUED ON CERTIFYING BODY
Family Medicine (Emergency Medicine)
Effective: 27 Nov 2001
College of Family Physicians of Canada
Family Medicine
Effective: 07 Dec 2000
College of Family Physicians of Canada
SPECIALTY: Family Medicine (Emergency Medicine)
ISSUED ON: Effective: Nov 27 2001
CERTIFYING BODY: College of Family Physicians of Canada

SPECIALTY: Family Medicine
ISSUED ON: Effective: Dec 07 2000
CERTIFYING BODY: College of Family Physicians of Canada

Hospital Privileges

No information available

Professional Corporation Information

Corporation Name: C. K. Thomas Medicine Professional Corporation
Certificate of Authorization Status: Inactive End Date: 17 May 2019

Practice Conditions

IMPOSED BY EFFECTIVE DATE EXPIRY DATE STATUS
Ontario Physicians and Surgeons Discipline Tribunal
28 Jul 2024
Restricted
IMPOSED BY: Ontario Physicians and Surgeons Discipline Tribunal
EFFECTIVE DATE: Jul 28 2024
EXPIRY DATE:
STATUS: Restricted
A physician who has a restricted licence must follow specific terms and conditions in their practice.
A physician who has a restricted licence must follow specific terms and conditions in their practice.
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(1 of 3)

As from February 28, 2024 by order of the Ontario Physicians and Surgeons Discipline Tribunal, the following terms, conditions and limitations are imposed on the certificate of registration held by Dr. Cholemkeril Kuncheria Thomas:

i. Dr. Thomas will, at his own expense, successfully complete the PROBE Ethics & Boundaries Program offered by the Centre for Personalized Education for Professionals or one-to-one instruction in professionalism with an instructor approved by the College.

(a) If Dr. Thomas proceeds with the PROBE course, he must receive a passing evaluation or grade, without condition or qualification. Dr. Thomas will complete the PROBE program within six (6) months of the date of this Order or, if it is not available within that timeframe, will complete it at the earliest availableopportunity. Dr. Thomas will provide proof to the College of his completion, including proof of registration and attendance and participant assessment reports, within one (1) month of completing it.

(b) If Dr. Thomas proceeds with one-on-one instruction, the instructor will submit a report to the College and the College will determine in its sole discretion if the instruction has been completed satisfactorily. The one-on-one instruction will be completed within six (6) months of the date of this Order.

(2 of 3)

As from August 13, 2019, the following terms, conditions and limitations are imposed on the certificate of registration held by Dr. Cholemkeril Kuncheria Thomas, in accordance with an undertaking and consent Dr. Thomas has given to the College of Physicians and Surgeons of Ontario:

UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")

of

DR. CHOLEMKERIL KUNCHERIA THOMAS
("Dr. Thomas")

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;

"Narcotic Drugs" means from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19, as amended;

"Narcotic Preparations" means from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19, as amended;

"Controlled Drugs" means from Part G of the Food and Drug Regulations under the Food and Drugs Act, S.C., 1985, c. F-27, as amended;

"Benzodiazepines and Other Targeted Substances" means from the Benzodiazepines and Other Targeted Substances Regulations made under the Controlled Drugs and Substances Act., S.C., 1996, c. 19, as amended;

(A summary of the above-named drugs [from Appendix I to the Compendium of Pharmaceuticals and Specialties] is attached hereto as Schedule "A"; and links to the current regulatory lists are attached hereto as Schedule "B")

"Monitored Drugs" means as defined under the Narcotics Safety and Awareness Act, 2010, S.O. 2010, c. 22, as amended, with a link to the current regulatory list attached hereto at Schedule "C";

"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. Thomas, certificate of registration number 54092, am a member of the College.

(3) I, Dr. Thomas, acknowledge that the College conducted an investigation bearing File Number 1100121 (the "Investigation") into whether I engaged in professional misconduct and/or am incompetent in my family practice.

(4) I, Dr. Thomas, acknowledge that I am the subject of an Order of the Discipline Committee of the College dated June 19, 2019 which provides for the supervision and reassessment of my practice. I, Dr. Thomas, acknowledge that the supervision and reassessment components of this Undertaking operate in addition to, though run concurrently with, those
set out in the Order of the Discipline Committee dated June 19, 2019.

B. UNDERTAKING

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

(6) Practice Restrictions

(a) I, Dr. Thomas, undertake to restrict my practice to Emergency Medicine only, at a hospital where I hold privileges to so practice. For greater clarity, I, Dr. Thomas, may practise in an Urgent Care clinic or centre at a hospital where I hold privileges to practice Emergency Medicine. I, Dr. Thomas, shall not practice Family Medicine in any capacity or at any location including a Walk-In clinic.

(b) I, Dr. Thomas, shall not prescribe greater than a five (5) days' supply, with no repeats or refills, of any Narcotic Drug, Narcotic Preparation, Controlled Drug, Benzodiazepine and Other Targeted Substance or Monitored Drug to any patient.

(c) I, Dr. Thomas, shall keep a Log of all prescriptions for Narcotic Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other Targeted Substances and Monitored Drugs, in the form attached as set out in Appendix "A", which will include at least the following information (the "Prescribing Log"):

(i) the date of the appointment;
(ii) the name of the patient and chart/file number;
(iii) the name of the medication prescribed, dose, direction, number of tablets to be dispensed and frequency;
(iv) the clinical indication;
(v) whether the prescription is for a new medication and/or different dose or frequency than currently prescribed to the patient (Y/N);
(vi) Dr. Thomas's signature;
(vii) the date of the Clinical Supervisor's review (if applicable, as set out below); and
(viii)the Clinical Supervisor's signature (if applicable, as set out below).

(d) I, Dr. Thomas, undertake to keep a copy of all prescriptions I write for Narcotic Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other Targeted Substances and Monitored Drugs, in the corresponding patient chart.

(e) I, Dr. Thomas, acknowledge that the practice restrictions set out at sections 6(b), (c) and (d) above, shall remain in effect until the College determines that I have successfully completed the Reassessment described at section 9 below.

(7) Clinical Supervision

(a) I, Dr. Thomas, undertake to practise under the guidance of a clinical supervisor or clinical supervisors acceptable to the College (the "Clinical Supervisor" or "Clinical Supervisors"), for seven (7) months ("Clinical Supervision").

(b) I, Dr. Thomas, acknowledge that I have reviewed the Clinical Supervisor's undertaking, attached hereto as Appendix "B", 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 hereto as Appendix "C";
(ii) Review the materials provided by the College and have an initial meeting in August 2019 to discuss practice improvement recommendations;
(iii) Meet with me at my Practice Location, or another location approved by the College once in November 2019, and once in February 2020;
(iv) At the meetings in November 2019 and February 2020, review the charts of all patients listed in the Prescribing Log, including the associated prescriptions;
(v) Discuss any concerns arising from the chart reviews;
(vi) Make recommendations to me for practice improvements and ongoing professional development and inquire into my compliance with the recommendations;
(vii) Perform any other duties, such as reviewing other documents or conducting interviews with staff or colleagues, that the Clinical Supervisor deems necessary to my Clinical Supervision; and
(viii) Submit written reports to the College after every meeting, or more frequently if the Clinical Supervisor has concerns about my standard of practice.

(c) I, Dr. Thomas, acknowledge that the charts reviewed shall be selected by the Clinical Supervisor based on the educational needs identified in the IEP, attached hereto as Appendix "C", as well as the areas of concern identified in the reports of the assessors dated October 8, 2018 and March 29, 2019, and concerns that may arise during the period of Clinical Supervision.

(d) I, Dr. Thomas, undertake to cooperate fully with the Clinical Supervision of my practice, conducted under the term of this Undertaking and Appendix "B" to this Undertaking, and to abide by the recommendations of my Clinical Supervisor, including but not limited to, any recommended practice improvements and ongoing professional development.

(e) I, Dr. Thomas, undertake to ensure that Appendix "B" to this Undertaking is signed and delivered to the College within twenty (20) days of the date I execute this Undertaking.

(f) I, Dr. Thomas, undertake that if a person who has given an undertaking in Appendix "B" 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.

(g) I, Dr. Thomas, undertake that if I am unable to obtain a Clinical Supervisor on the provisions set out under sections (7)(e) and/or (f) above, I will cease practising medicine until such time as I have obtained a Clinical Supervisor acceptable to the College.

(h) I, Dr. Thomas, acknowledge that if I am required to cease practise as a result of section (7)(g) 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.

(8) Professional Education

(a) I, Dr. Thomas, undertake to participate in and successfully complete all aspects of the detailed IEP, attached hereto as Appendix "C", including all of the following professional education (the "Professional Education"):

(i) University of Toronto Faculty of Medicine program in Safe Opioid Prescribing (all three webinars and in-person workshop): www.cepd.utoronto.ca/opioidprescribing;
(ii) Review and discuss with my Clinical Supervisor the following resources:

1. 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain: http://nationalpaincentre.mcmaster.ca:opioid;

2. CPSO Policy "Prescribing Drugs": http://www.cpso.on.ca/Policies-Publications/Policy/Prescribing-Drugs;

3. the Centre for Effective Practice Management of Chronic Non-Cancer Pain Tools:

(i) https://thewellhealth.ca/wp-content/uploads/2017/03/CEP_CNCP_Main_V1.pdf
(ii) https://www.cfpc.ca/centre-effective-practice-updates-opioid-manager-tool/; and
(iii) any additional professional education recommended by my Clinical Supervisor.

(b) I, Dr. Thomas, 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. Thomas, undertake to complete the Professional Education within three (3) months of signing this Undertaking.

(d) I, Dr. Thomas, acknowledge that a report or reports may be provided to the College regarding my progress and compliance with the Professional Education.

(9) Reassessment of Practice

(a) I, Dr. Thomas, undertake that, approximately six (6) months after the completion of the Clinical Supervision set out in section (7) above and Appendix "B" to this Undertaking, I will submit to a reassessment of my practice ("the Reassessment") by an assessor or assessors selected by the College (the "Assessor" or "Assessors"). I acknowledge that the Reassessment may include a chart review, direct observation of my care, interviews with colleagues and co-workers, feedback from patients and any other tools deemed necessary by the College.

(b) I, Dr. Thomas, undertake to co-operate fully with the Reassessment, conducted under the term of this Undertaking.

(c) I, Dr. Thomas, acknowledge that my Clinical Supervisor may receive and review the findings of the Assessor, and may discuss with the Assessor any issues or concerns arising from the Reassessment.

(d) I, Dr. Thomas, acknowledge that the results of the Reassessment will be provided to me and reported to the College and the Reassessment may form the basis of further action by the College.

(10) Monitoring

(a) I, Dr. Thomas, 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. Thomas, 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. Thomas, give my irrevocable consent to the College to make appropriate enquiries of OHIP, NMS 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. Thomas, acknowledge that I have executed the OHIP and NMS consent forms, attached hereto as Appendix "D" and Appendix "E", respectively.

C. ACKNOWLEDGEMENT

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

(12) I, Dr. Thomas, 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. Thomas, 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. Thomas, 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. Thomas, 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.

(16) I, Dr. Thomas, 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. Thomas, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.

(b) I, Dr. Thomas, 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:

A College investigation was conducted into whether Dr. Thomas engaged in professional misconduct and/or is incompetent in his family medicine practice. As a result of the investigation:

Dr. Thomas shall practice Emergency Medicine only, at a hospital where he holds privileges to so practice, and shall not practice Family Medicine including at a walk-in clinic.

Dr. Thomas shall not prescribe greater than a five (5) days' supply, with no repeats or refills, of any Narcotic Drug, Narcotic Preparation, Controlled Drug, Benzodiazepine and Other Targeted Substance or Monitored Drug to any patient.

Dr. Thomas will practise under the guidance of a Clinical Supervisor acceptable to the College for seven (7) months.

Dr. Thomas will engage in professional education in the prescribing of narcotics and controlled substances.

Dr. Thomas's practice will be reassessed by an assessor selected by the College approximately six (6) months following the period of Clinical Supervision.

D. CONSENT

(18) I, Dr. Thomas, 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.

(19) I, Dr. Thomas, 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.

(20) I, Dr. Thomas, give my irrevocable consent to any persons who facilitate my completion of the Professional Education, and to all Clinical Supervisors, Chiefs of Staff and Assessors, to disclose to the College, and to one another, any of the following:

(a) any information relevant to this Undertaking;

(b) any information relevant to the provisions of the Clinical Supervisor's undertaking set out at Appendix "B" to this Undertaking;

(c) any information relevant to the Reassessment;

(d) any information relevant for the purposes of monitoring my compliance with this Undertaking; and/or

(e) 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.

(3 of 3)

As from 4:00 p.m., June 19, 2019, by order of the Discipline Committee of the College of Physicians and Surgeons of Ontario, the following terms, conditions and limitations are imposed on the certificate of registration held by Dr. Cholemkeril Kuncheria Thomas:

i. Dr. Thomas shall comply with the College Policy #2-07 "Practice Management Considerations for Physicians Who Cease to Practise, Take an Extended Leave of Absence or Close Their Practice Due to Relocation", a copy of which is attached at Schedule "A" to this Order;

Clinical Supervision

ii. For a period of nine (9) months from the date of this Order, Dr. Thomas shall practice medicine only under the supervision of a clinical supervisor approved by the College (the "Clinical Supervision").

iii. Within ten (10) days of this Order, Dr. Thomas shall have a College-approved clinical supervisor (the "Clinical Supervisor") sign an Undertaking in the form attached hereto as Schedule "B".

iv. Dr. Thomas shall meet with the Clinical Supervisor once in August 2019, once in November 2019, and once in February 2020. At each meeting, the Clinical Supervisor shall:

i. Review a minimum of twenty (20) patient charts, to be selected by the Clinical Supervisor in accordance with the educational needs identified in the Individualized Education Plan attached hereto at Schedule "C" (the "IEP");

ii. Discuss with Dr. Thomas any concerns the Clinical Supervisor may have arising from the chart reviews;

iii. Make recommendations to Dr. Thomas for practice improvements and inquire into Dr. Thomas' compliance with the recommendations; and

iv. Keep a log of all patient charts reviewed along with patient identifiers.

v. The Clinical Supervisor shall submit written reports to the College promptly after every meeting with Dr. Thomas, or immediately if the Clinical Supervisor has concerns about Dr. Thomas' standard of practice or that Dr. Thomas' patients may be exposed to harm or injury.

vi. Dr. Thomas shall fully cooperate with the Clinical Supervision and shall abide by all recommendations of the Clinical Supervisor.

vii. If a person who has given an Undertaking in Schedule "B" to this Order is unable or unwilling to continue to fulfill its provisions, Dr. Thomas 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.

viii. If Dr. Thomas is unable to obtain a Clinical Supervisor as set out in this Order, he shall cease practising medicine until such time as he has obtained a Clinical Supervisor acceptable to the College.

ix. If Dr. Thomas is required to cease practise as a result of section 4.(viii) above, this will constitute a term, condition or limitation on his certificate of registration and that term, condition or limitation will be included on the public register.

Reassessment

x. Approximately six (6) months following completion of the Clinical Supervision, Dr. Thomas shall undergo a reassessment of his practice by a College-appointed assessor (the "Reassessment").

xi. The Reassessment shall focus on the educational needs addressed during the period of Clinical Supervision as set out in the IEP and may include a review of Dr. Thomas's patient charts, direct observations, and interviews with staff and/or patients and any other tools deemed necessary by the College. The Assessor shall report the results of the Reassessment to the College.

Monitoring

xii. Dr. Thomas shall inform the College of each and every location where he practices, in any jurisdiction (his "Practice Location(s)") within fifteen (15) days of this Order and shall inform the College of any and all new Practice Locations within fifteen (15) days of commencing practice at that location.

xiii. Dr. Thomas shall consent to the sharing of information between the Clinical Supervisor, the Assessor and the College as any of them deem necessary or desirable in order to fulfill their respective obligations.

xiv. Dr. Thomas shall consent to the College making enquiries of the Ontario Health Insurance Program, the Narcotics Monitoring System and/or any person or institution that may have relevant information, in order for the College to monitor his compliance with this Order and shall promptly sign such consents as may be necessary for the College to obtain information from these persons or institutions.

xv. Dr. Thomas shall co-operate with unannounced inspections of his office practice and patient charts by the College for the purpose of monitoring and enforcing his compliance with the terms of this Order.

xvi. Dr. Thomas shall notify any employer, or any hospital at which he may have privileges, about this Order.

xvii. Dr. Thomas shall be responsible for any and all costs associated with implementing the terms of this Order.

VIEW DETAILS chevron-down icon
(1 of 3)

As from February 28, 2024 by order of the Ontario Physicians and Surgeons Discipline Tribunal, the following terms, conditions and limitations are imposed on the certificate of registration held by Dr. Cholemkeril Kuncheria Thomas:

i. Dr. Thomas will, at his own expense, successfully complete the PROBE Ethics & Boundaries Program offered by the Centre for Personalized Education for Professionals or one-to-one instruction in professionalism with an instructor approved by the College.

(a) If Dr. Thomas proceeds with the PROBE course, he must receive a passing evaluation or grade, without condition or qualification. Dr. Thomas will complete the PROBE program within six (6) months of the date of this Order or, if it is not available within that timeframe, will complete it at the earliest availableopportunity. Dr. Thomas will provide proof to the College of his completion, including proof of registration and attendance and participant assessment reports, within one (1) month of completing it.

(b) If Dr. Thomas proceeds with one-on-one instruction, the instructor will submit a report to the College and the College will determine in its sole discretion if the instruction has been completed satisfactorily. The one-on-one instruction will be completed within six (6) months of the date of this Order.

(2 of 3)

As from August 13, 2019, the following terms, conditions and limitations are imposed on the certificate of registration held by Dr. Cholemkeril Kuncheria Thomas, in accordance with an undertaking and consent Dr. Thomas has given to the College of Physicians and Surgeons of Ontario:

UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")

of

DR. CHOLEMKERIL KUNCHERIA THOMAS
("Dr. Thomas")

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;

"Narcotic Drugs" means from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19, as amended;

"Narcotic Preparations" means from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19, as amended;

"Controlled Drugs" means from Part G of the Food and Drug Regulations under the Food and Drugs Act, S.C., 1985, c. F-27, as amended;

"Benzodiazepines and Other Targeted Substances" means from the Benzodiazepines and Other Targeted Substances Regulations made under the Controlled Drugs and Substances Act., S.C., 1996, c. 19, as amended;

(A summary of the above-named drugs [from Appendix I to the Compendium of Pharmaceuticals and Specialties] is attached hereto as Schedule "A"; and links to the current regulatory lists are attached hereto as Schedule "B")

"Monitored Drugs" means as defined under the Narcotics Safety and Awareness Act, 2010, S.O. 2010, c. 22, as amended, with a link to the current regulatory list attached hereto at Schedule "C";

"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. Thomas, certificate of registration number 54092, am a member of the College.

(3) I, Dr. Thomas, acknowledge that the College conducted an investigation bearing File Number 1100121 (the "Investigation") into whether I engaged in professional misconduct and/or am incompetent in my family practice.

(4) I, Dr. Thomas, acknowledge that I am the subject of an Order of the Discipline Committee of the College dated June 19, 2019 which provides for the supervision and reassessment of my practice. I, Dr. Thomas, acknowledge that the supervision and reassessment components of this Undertaking operate in addition to, though run concurrently with, those
set out in the Order of the Discipline Committee dated June 19, 2019.

B. UNDERTAKING

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

(6) Practice Restrictions

(a) I, Dr. Thomas, undertake to restrict my practice to Emergency Medicine only, at a hospital where I hold privileges to so practice. For greater clarity, I, Dr. Thomas, may practise in an Urgent Care clinic or centre at a hospital where I hold privileges to practice Emergency Medicine. I, Dr. Thomas, shall not practice Family Medicine in any capacity or at any location including a Walk-In clinic.

(b) I, Dr. Thomas, shall not prescribe greater than a five (5) days' supply, with no repeats or refills, of any Narcotic Drug, Narcotic Preparation, Controlled Drug, Benzodiazepine and Other Targeted Substance or Monitored Drug to any patient.

(c) I, Dr. Thomas, shall keep a Log of all prescriptions for Narcotic Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other Targeted Substances and Monitored Drugs, in the form attached as set out in Appendix "A", which will include at least the following information (the "Prescribing Log"):

(i) the date of the appointment;
(ii) the name of the patient and chart/file number;
(iii) the name of the medication prescribed, dose, direction, number of tablets to be dispensed and frequency;
(iv) the clinical indication;
(v) whether the prescription is for a new medication and/or different dose or frequency than currently prescribed to the patient (Y/N);
(vi) Dr. Thomas's signature;
(vii) the date of the Clinical Supervisor's review (if applicable, as set out below); and
(viii)the Clinical Supervisor's signature (if applicable, as set out below).

(d) I, Dr. Thomas, undertake to keep a copy of all prescriptions I write for Narcotic Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other Targeted Substances and Monitored Drugs, in the corresponding patient chart.

(e) I, Dr. Thomas, acknowledge that the practice restrictions set out at sections 6(b), (c) and (d) above, shall remain in effect until the College determines that I have successfully completed the Reassessment described at section 9 below.

(7) Clinical Supervision

(a) I, Dr. Thomas, undertake to practise under the guidance of a clinical supervisor or clinical supervisors acceptable to the College (the "Clinical Supervisor" or "Clinical Supervisors"), for seven (7) months ("Clinical Supervision").

(b) I, Dr. Thomas, acknowledge that I have reviewed the Clinical Supervisor's undertaking, attached hereto as Appendix "B", 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 hereto as Appendix "C";
(ii) Review the materials provided by the College and have an initial meeting in August 2019 to discuss practice improvement recommendations;
(iii) Meet with me at my Practice Location, or another location approved by the College once in November 2019, and once in February 2020;
(iv) At the meetings in November 2019 and February 2020, review the charts of all patients listed in the Prescribing Log, including the associated prescriptions;
(v) Discuss any concerns arising from the chart reviews;
(vi) Make recommendations to me for practice improvements and ongoing professional development and inquire into my compliance with the recommendations;
(vii) Perform any other duties, such as reviewing other documents or conducting interviews with staff or colleagues, that the Clinical Supervisor deems necessary to my Clinical Supervision; and
(viii) Submit written reports to the College after every meeting, or more frequently if the Clinical Supervisor has concerns about my standard of practice.

(c) I, Dr. Thomas, acknowledge that the charts reviewed shall be selected by the Clinical Supervisor based on the educational needs identified in the IEP, attached hereto as Appendix "C", as well as the areas of concern identified in the reports of the assessors dated October 8, 2018 and March 29, 2019, and concerns that may arise during the period of Clinical Supervision.

(d) I, Dr. Thomas, undertake to cooperate fully with the Clinical Supervision of my practice, conducted under the term of this Undertaking and Appendix "B" to this Undertaking, and to abide by the recommendations of my Clinical Supervisor, including but not limited to, any recommended practice improvements and ongoing professional development.

(e) I, Dr. Thomas, undertake to ensure that Appendix "B" to this Undertaking is signed and delivered to the College within twenty (20) days of the date I execute this Undertaking.

(f) I, Dr. Thomas, undertake that if a person who has given an undertaking in Appendix "B" 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.

(g) I, Dr. Thomas, undertake that if I am unable to obtain a Clinical Supervisor on the provisions set out under sections (7)(e) and/or (f) above, I will cease practising medicine until such time as I have obtained a Clinical Supervisor acceptable to the College.

(h) I, Dr. Thomas, acknowledge that if I am required to cease practise as a result of section (7)(g) 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.

(8) Professional Education

(a) I, Dr. Thomas, undertake to participate in and successfully complete all aspects of the detailed IEP, attached hereto as Appendix "C", including all of the following professional education (the "Professional Education"):

(i) University of Toronto Faculty of Medicine program in Safe Opioid Prescribing (all three webinars and in-person workshop): www.cepd.utoronto.ca/opioidprescribing;
(ii) Review and discuss with my Clinical Supervisor the following resources:

1. 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain: http://nationalpaincentre.mcmaster.ca:opioid;

2. CPSO Policy "Prescribing Drugs": http://www.cpso.on.ca/Policies-Publications/Policy/Prescribing-Drugs;

3. the Centre for Effective Practice Management of Chronic Non-Cancer Pain Tools:

(i) https://thewellhealth.ca/wp-content/uploads/2017/03/CEP_CNCP_Main_V1.pdf
(ii) https://www.cfpc.ca/centre-effective-practice-updates-opioid-manager-tool/; and
(iii) any additional professional education recommended by my Clinical Supervisor.

(b) I, Dr. Thomas, 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. Thomas, undertake to complete the Professional Education within three (3) months of signing this Undertaking.

(d) I, Dr. Thomas, acknowledge that a report or reports may be provided to the College regarding my progress and compliance with the Professional Education.

(9) Reassessment of Practice

(a) I, Dr. Thomas, undertake that, approximately six (6) months after the completion of the Clinical Supervision set out in section (7) above and Appendix "B" to this Undertaking, I will submit to a reassessment of my practice ("the Reassessment") by an assessor or assessors selected by the College (the "Assessor" or "Assessors"). I acknowledge that the Reassessment may include a chart review, direct observation of my care, interviews with colleagues and co-workers, feedback from patients and any other tools deemed necessary by the College.

(b) I, Dr. Thomas, undertake to co-operate fully with the Reassessment, conducted under the term of this Undertaking.

(c) I, Dr. Thomas, acknowledge that my Clinical Supervisor may receive and review the findings of the Assessor, and may discuss with the Assessor any issues or concerns arising from the Reassessment.

(d) I, Dr. Thomas, acknowledge that the results of the Reassessment will be provided to me and reported to the College and the Reassessment may form the basis of further action by the College.

(10) Monitoring

(a) I, Dr. Thomas, 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. Thomas, 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. Thomas, give my irrevocable consent to the College to make appropriate enquiries of OHIP, NMS 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. Thomas, acknowledge that I have executed the OHIP and NMS consent forms, attached hereto as Appendix "D" and Appendix "E", respectively.

C. ACKNOWLEDGEMENT

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

(12) I, Dr. Thomas, 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. Thomas, 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. Thomas, 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. Thomas, 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.

(16) I, Dr. Thomas, 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. Thomas, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.

(b) I, Dr. Thomas, 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:

A College investigation was conducted into whether Dr. Thomas engaged in professional misconduct and/or is incompetent in his family medicine practice. As a result of the investigation:

Dr. Thomas shall practice Emergency Medicine only, at a hospital where he holds privileges to so practice, and shall not practice Family Medicine including at a walk-in clinic.

Dr. Thomas shall not prescribe greater than a five (5) days' supply, with no repeats or refills, of any Narcotic Drug, Narcotic Preparation, Controlled Drug, Benzodiazepine and Other Targeted Substance or Monitored Drug to any patient.

Dr. Thomas will practise under the guidance of a Clinical Supervisor acceptable to the College for seven (7) months.

Dr. Thomas will engage in professional education in the prescribing of narcotics and controlled substances.

Dr. Thomas's practice will be reassessed by an assessor selected by the College approximately six (6) months following the period of Clinical Supervision.

D. CONSENT

(18) I, Dr. Thomas, 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.

(19) I, Dr. Thomas, 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.

(20) I, Dr. Thomas, give my irrevocable consent to any persons who facilitate my completion of the Professional Education, and to all Clinical Supervisors, Chiefs of Staff and Assessors, to disclose to the College, and to one another, any of the following:

(a) any information relevant to this Undertaking;

(b) any information relevant to the provisions of the Clinical Supervisor's undertaking set out at Appendix "B" to this Undertaking;

(c) any information relevant to the Reassessment;

(d) any information relevant for the purposes of monitoring my compliance with this Undertaking; and/or

(e) 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.

(3 of 3)

As from 4:00 p.m., June 19, 2019, by order of the Discipline Committee of the College of Physicians and Surgeons of Ontario, the following terms, conditions and limitations are imposed on the certificate of registration held by Dr. Cholemkeril Kuncheria Thomas:

i. Dr. Thomas shall comply with the College Policy #2-07 "Practice Management Considerations for Physicians Who Cease to Practise, Take an Extended Leave of Absence or Close Their Practice Due to Relocation", a copy of which is attached at Schedule "A" to this Order;

Clinical Supervision

ii. For a period of nine (9) months from the date of this Order, Dr. Thomas shall practice medicine only under the supervision of a clinical supervisor approved by the College (the "Clinical Supervision").

iii. Within ten (10) days of this Order, Dr. Thomas shall have a College-approved clinical supervisor (the "Clinical Supervisor") sign an Undertaking in the form attached hereto as Schedule "B".

iv. Dr. Thomas shall meet with the Clinical Supervisor once in August 2019, once in November 2019, and once in February 2020. At each meeting, the Clinical Supervisor shall:

i. Review a minimum of twenty (20) patient charts, to be selected by the Clinical Supervisor in accordance with the educational needs identified in the Individualized Education Plan attached hereto at Schedule "C" (the "IEP");

ii. Discuss with Dr. Thomas any concerns the Clinical Supervisor may have arising from the chart reviews;

iii. Make recommendations to Dr. Thomas for practice improvements and inquire into Dr. Thomas' compliance with the recommendations; and

iv. Keep a log of all patient charts reviewed along with patient identifiers.

v. The Clinical Supervisor shall submit written reports to the College promptly after every meeting with Dr. Thomas, or immediately if the Clinical Supervisor has concerns about Dr. Thomas' standard of practice or that Dr. Thomas' patients may be exposed to harm or injury.

vi. Dr. Thomas shall fully cooperate with the Clinical Supervision and shall abide by all recommendations of the Clinical Supervisor.

vii. If a person who has given an Undertaking in Schedule "B" to this Order is unable or unwilling to continue to fulfill its provisions, Dr. Thomas 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.

viii. If Dr. Thomas is unable to obtain a Clinical Supervisor as set out in this Order, he shall cease practising medicine until such time as he has obtained a Clinical Supervisor acceptable to the College.

ix. If Dr. Thomas is required to cease practise as a result of section 4.(viii) above, this will constitute a term, condition or limitation on his certificate of registration and that term, condition or limitation will be included on the public register.

Reassessment

x. Approximately six (6) months following completion of the Clinical Supervision, Dr. Thomas shall undergo a reassessment of his practice by a College-appointed assessor (the "Reassessment").

xi. The Reassessment shall focus on the educational needs addressed during the period of Clinical Supervision as set out in the IEP and may include a review of Dr. Thomas's patient charts, direct observations, and interviews with staff and/or patients and any other tools deemed necessary by the College. The Assessor shall report the results of the Reassessment to the College.

Monitoring

xii. Dr. Thomas shall inform the College of each and every location where he practices, in any jurisdiction (his "Practice Location(s)") within fifteen (15) days of this Order and shall inform the College of any and all new Practice Locations within fifteen (15) days of commencing practice at that location.

xiii. Dr. Thomas shall consent to the sharing of information between the Clinical Supervisor, the Assessor and the College as any of them deem necessary or desirable in order to fulfill their respective obligations.

xiv. Dr. Thomas shall consent to the College making enquiries of the Ontario Health Insurance Program, the Narcotics Monitoring System and/or any person or institution that may have relevant information, in order for the College to monitor his compliance with this Order and shall promptly sign such consents as may be necessary for the College to obtain information from these persons or institutions.

xv. Dr. Thomas shall co-operate with unannounced inspections of his office practice and patient charts by the College for the purpose of monitoring and enforcing his compliance with the terms of this Order.

xvi. Dr. Thomas shall notify any employer, or any hospital at which he may have privileges, about this Order.

xvii. Dr. Thomas shall be responsible for any and all costs associated with implementing the terms of this Order.

Current Tribunal Proceedings (1)

Proceeding Type: Discipline referral to OPSDT
Date of Referral or Application: 02 Oct 2024
Summary:
Allegations of Dr. Thomas’ professional misconduct have been referred to the Ontario Physicians and Surgeons Discipline Tribunal.  It is alleged that Dr. Thomas  was found guilty of an offence that is relevant to his suitability to practice. It is further alleged that Dr. Thomas engaged in disgraceful, dishonourable or unprofessional conduct and conduct unbecoming a physician based on the conduct underlying the criminal charges and finding of guilt.  
For more details please visit the OPSDT website

Past Tribunal Proceedings (2)

Date of Decision: 27 Feb 2024
Summary of Decision:
On February 27, 2024, the Tribunal found that Dr. Thomas engaged in disgraceful, dishonourable or unprofessional conduct by not disclosing, on his 2012 Annual Renewal form, that he had been charged with a criminal offence in the previous year, specifically dangerous operation of a motor vehicle. Additionally, Dr. Thomas failed to report to the College when he was found guilty of this charge in 2014.

The Tribunal ordered that: 
  1. Dr. Thomas attend before the panel to be reprimanded; 
  2. the Registrar suspend Dr. Thomas’s certificate of registration for five (5) months commencing February 28, 2024, at 12:01 a.m.; 
  3. the Registrar place terms, conditions and limitations on Dr. Thomas’s certificate of registration; 
  4. Dr. Thomas pay the College costs in the amount of $6,000 by August 27, 2024.
More detail can be found in the reasons for decision linked below. OPSDT reasons are also available at www.opsdt.ca and https://www.canlii.org/en/on/onpsdt/. The exhibits, including the Agreed Statement of Facts and Plea of No Contest, can be obtained by contacting the Tribunal Office at [email protected] 
 
Reasons for Decision: Download Full Decision (PDF)
Hearing Date(s): Merits, Penalty, Reprimand: February 27, 2024

Date of Decision: 19 Jun 2019
Summary of Decision:
On June 19th, 2019, the Discipline Committee found that Dr. Thomas committed an act of professional misconduct in that he has engaged in 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.
 
Facts
 
Dr. Thomas is a 64 year-old family physician who received his certificate of registration authorizing independent practice from the College of Physicians and Surgeons of Ontario in 2001.
Dr. Thomas currently practices Emergency Medicine in Iroquois Falls, Ontario and previously practiced Emergency Medicine and Family Medicine in Espanola, Ontario.
 
Background
 
On April 19, 2017, the Inquiries, Complaints and Reports Committee of the College (the “ICRC”) directed that Dr. Thomas attend the College to be cautioned and required that Dr. Thomas complete a specified continuing education and remediation program with the following components:
 
(a) Courses: Attend and complete the next available session of the following courses (with proof of attendance to be provided):
1. The Medical Record-Keeping Course, through a course provider indicated by the College;
2. The Safe Opioid Prescribing Course, through a course provider indicated by the College (three webinars and workshop);
3. ATLS (Advanced Trauma Life Support) (https://www.facs.org/quality- programs/trauma/atls/about); and
4. An Emergency Medicine Review Course (for example, the National Capital Conference on Emergency Medicine at http://www.emottawa.ca/eng/60-nccem.html).
 
(b) One-on-one instruction: Complete one-on-one instruction in collaboration and professionalism (including respect for colleagues and co-workers, punctuality, responsiveness to calls for patient care and responsiveness to requests from the College).
 
(c) Self-directed learning with written summaries: Review and prepare written summaries of up to 2000 words (2-4 pages) of each of the following documents with reference to current standards of practice (where applicable), how it is applicable to Dr. Thomas’ situation, as well as how Dr. Thomas has made, or plans to make changes, to his practice. The written summaries were to be submitted within 4 months of receipt of the decision.
1. Clinical Practice Guidelines regarding vaginal bleeding during pregnancy;
2. Choosing Wisely Canada Recommendations for Emergency Medicine;
3. The College’s policy on Medical Records;
4. The College’s policy on Physician Behaviour in the Professional Environment; and
5. The College’s Practice Guide.
 
(d) Clinical Supervision: Engage a Clinical Supervisor acceptable to the College to engage in focused educational sessions as set out in an Individualized Education Plan. The Clinical Supervisor was required to sign an undertaking with the College within 30 days’ of Dr. Thomas’ receipt of the April 19, 2017 ICRC Decision. Dr. Thomas was required to meet with the Clinical Supervisor for a period of 12 months, no less than monthly for six months, and then quarterly for six months; and review at least 20 Emergency Department charts at each meeting.
(e) Reassessment: Approximately six months following the completion of the education and remediation set out above, Dr. Thomas’ Emergency Department practice is to be reassessed.
 
Dr. Thomas’ Failure To Comply With The April 2017 SCERP
 
On May 16, 2017, the College’s Compliance Case Manager wrote to Dr. Thomas’ counsel about the implementation of the April 2017 SCERP. The Compliance Case Manager asked that a Clinical Supervisor be identified to him by June 1, 2017.
Dr. Thomas proposed potential Clinical Supervisors on June 12, 2017 and June 27, 2017. The two Clinical Supervisors proposed by Dr. Thomas were not approved by the College. 
On July 11, 2017, the Compliance Case Manager advised that he had located a potential Clinical Supervisor for Dr. Thomas. Dr. Thomas confirmed that he would be willing to work with the College’s proposed Clinical Supervisor.
 
On August 2, 2017, the Compliance Case Manager confirmed that the College’s proposed Clinical Supervisor (“Clinical Supervisor A”) had been approved by the College. The Compliance Case Manager urged Dr. Thomas to contact Clinical Supervisor A shortly to begin the supervision meetings. On August 4, 2017, Clinical Supervisor A signed a Clinical Supervisor Undertaking to the College.
 
On September 15, 2017, Dr. Thomas, through his counsel, wrote to the Compliance Case Manager requesting an extension for completing the written summaries for the self-directed learning portion of the April 2017 SCERP to October 9, 2017. At the same time, he advised that Dr. Thomas had registered for the Medical Record-Keeping Course, the Safe Opioid Prescribing Course and an Emergency Medicine Review Course. He did not indicate whether Dr. Thomas had registered for a course in ATLS (Advanced Trauma Life Support). The College granted Dr. Thomas’ request for an extension for completion of his written summaries to October 9, 2017.
 
In October of 2017, the Compliance Case Manager contacted Clinical Supervisor A to inquire about the status of her first supervision report, which had yet to be submitted to the College. Between October 17, 2017 and October 27, 2017, in an email exchange and in a telephone conversation, Clinical Supervisor A indicated to the Compliance Case Manager that she had had difficulty connecting and scheduling a meeting with Dr. Thomas.
 
On November 6, 2017, the Compliance Case Manager reminded Dr. Thomas, through his counsel, that it was Dr. Thomas’ responsibility to ensure that he meets monthly with his Clinical Supervisor and that Dr. Thomas is in breach of his undertaking.
 
On December 7, 2017, Dr. Thomas’ counsel wrote to provide an update regarding Dr. Thomas’ compliance with the April 2017 SCERP. Dr. Thomas’ counsel indicated that Dr. Thomas had attended the Medical Record-Keeping Course, the Safe Opioid Prescribing Course and an Emergency medicine Review Course and that he intended to complete a course in ATLS (Advanced Trauma Life Support) in early 2018. He also indicated that Dr. Thomas had completed an initial meeting with his one-on-one instructor, and that he had not yet completed the self-study with written summaries of 5 policies/guidelines (for which he had previously been granted an extension to October 9, 2017), but that these would be completed by December 15, 2017. As well, he indicated that Dr. Thomas had met with his Clinical Supervisor on September 16, 2017 and October 29, 2017.
On December 15, 2017, Dr. Thomas sent several emails to the Compliance Case Manager requesting that he be exempted from preparing written summaries for his self-directed learning as required by the April 2017 SCERP. In response, the Compliance Case Manager reminded Dr. Thomas that he had already been provided with two extensions and stated that the written summaries must be provided to the College by December 22, 2017.
 
On December 19, 2017, in response to a follow-up email from the Compliance Case Manager, Clinical Supervisor A advised the Compliance Case Manager that the meeting she had been scheduled to have with Dr. Thomas on December 12, 2017 had not occurred due to bad weather.
Clinical Supervisor A had suggested that she could spend the day with Dr. Thomas in the emergency room but he had not been willing to do so. Given that Clinical Supervisor A had not been able to meet with Dr. Thomas in accordance with the terms of the April 19, 2017 ICRC Decision, the Compliance Case Manager advised that Clinical Supervisor A was no longer approved to act as Dr. Thomas’ Clinical Supervisor.
 
On December 21, 2017, the Compliance Case Manager wrote to Dr. Thomas’ counsel advising that the name of a new proposed Clinical Supervisor should be forwarded to her by January 12, 2018.
 
On January 3, 2018, the Compliance Case Manager wrote to Dr. Thomas’ counsel advising that she had received an email from Dr. Thomas requesting yet another extension of time to complete his self-directed learning written summaries. She advised that she would grant one final extension to January 12, 2018. The Compliance Case Manager also stated that Dr. Thomas was required to have a College-approved Clinical Supervisor by January 12, 2018.
 
On January 15, 2018, the Compliance Case Manager wrote to Dr. Thomas’ counsel and advised that Dr. Thomas had not submitted his self-directed learning written summaries, nor had she received the name of a proposed Clinical Supervisor. In her letter, the Compliance Case Manager indicated that she would grant an extension to January 26, 2018, failing which the matter would be returned to Committee for further direction.
 
On March 27, 2018, the Compliance Case Manager wrote to Dr. Thomas’ counsel informing him that Dr. Thomas’ matter would be returning to ICRC on April 3, 2018 for consideration of action due to his failure to complete the terms of the April 2017 SCERP.
 
As of April 3, 2018, when this matter was referred to the Discipline Committee by the ICRC, Dr. Thomas had failed to complete the terms of the April 2017 SCERP.
 
Status of Compliance at Date of Referral to the Discipline Committee
 
In particular, as of April 3, 2018, the status of Dr. Thomas’ compliance with the terms of the
April 2017 SCERP was as follows:
(a) Courses: Incomplete. Dr. Thomas had completed some, but not all, of his coursework.
(b) One-on-one instruction: Incomplete. Dr. Thomas had attended an initial meeting with his one-on-one instructor but then failed to attend follow-up sessions.
(c) Self-directed learning with written summaries: Incomplete. On multiple occasions, Dr. Thomas had requested and received extensions from the College to submit his written summaries.
(d) Clinical Supervision: Incomplete.
Clinical Supervisor A ceased being Dr. Thomas’ Clinical Supervisor on December 20, 2017, as Dr. Thomas failed to meet with her in accordance with the terms of the April 2017 SCERP. Dr. Thomas failed to identify a new Clinical Supervisor.
(e) Reassessment: Incomplete.
 
Current Status of Dr. Thomas’ Compliance with the April 2017 SCERP
 
Following the ICRC’s referral of Dr. Thomas’ matter to the Discipline Committee, Dr. Thomas
made some further efforts to comply with the April 2017 SCERP.
As of June 12, 2019, the status of Dr. Thomas’ compliance with the terms of the April 2017 SCERP is as follows:
(a) Courses: Complete.
(b) One-on-one instruction: Complete.
(c) Self-directed learning with written summaries: Complete.
(d) Clinical Supervision: Incomplete. Dr. Thomas retained a new Clinical Supervisor in December of 2018.
 
Dr. Thomas attended Clinical Supervision meetings on the following dates:

- January 12, 2019
- February 17, 2019
- March 16, 2019
- May 10, 2019
 
Dr. Thomas was scheduled to meet with his Clinical Supervisor in mid-April of 2019. However, Dr. Thomas cancelled the meeting. Therefore, Dr. Thomas did not meet with his Clinical Supervisor in April of 2019.
Dr. Thomas was also scheduled to meet with his Clinical Supervisor on May 31, 2019.
However, on May 31, Dr. Thomas requested that the meeting be rescheduled. Thus, the May 31, 2019 meeting was rescheduled to June 2, 2019. On June 2, 2019, Dr. Thomas again requested that the meeting be rescheduled. The meeting was then rescheduled to June 3, 2019. On June 3, 2019, approximately one hour before the scheduled meeting time, Dr. Thomas called the Clinical Supervisor and advised that he forgot the time, would be late, and asked to start the meeting one hour later. Dr. Thomas’s Clinical Supervisor was not able to accommodate this third rescheduling request. Dr. Thomas’s next meeting with his Clinical Supervisor is scheduled for June 14, 2019. 
 
Subject to any further delays, Dr. Thomas is scheduled to complete his Clinical Supervision in February of 2020.
 
(e) Reassessment: Incomplete. Dr. Thomas’ reassessment is to be scheduled approximately 6
months’ following completion of Dr. Thomas’ Clinical Supervision.
 
Admission
 
Dr. Thomas admits to the facts above, and admits that, based on these facts, he engaged in professional misconduct under paragraph 1(1)33 of O Reg. 856/93, in that he engaged in acts or omissions relevant to the practice of medicine that would be regarded by members as disgraceful,
dishonourable or unprofessional by failing to comply with the April 19, 2017 decision of the Inquiries, Complaints and Reports Committee requiring that he complete a specified continuing education or remediation program.
 
Agreed Statement of Facts Relevant to Penalty
 
Relevant College History
 
In June 2014, the Inquiries, Complaints and Reports Committee of the College considered a complaint from a prior employer of Dr. Thomas in Ottawa. That employer complained that Dr. Thomas left his position without any notice or follow-up plans for his patients, did not respond to efforts by clinic staff to contact him, and took some patient records with him. In addition, Dr. Thomas failed to respond to a letter from the College’s investigator with questions regarding the matter. The ICRC issued a written caution to Dr. Thomas regarding his lack of appropriate management upon leaving a practice.
 
Additional Relevant History
 
In August 1996, a complaint was received by the College of Physicians and Surgeons of Nova Scotia from the Nova Scotia Prescription Monitoring Program that Dr. Thomas failed to respond to their requests for information concerning his prescribing of controlled substances to patient X. After investigation of the matter, Dr. Thomas was counseled with respect to not responding promptly and appropriately to the Prescription Monitoring Program. The investigation Committee also suggested that he review the organization of his office to ensure that all mail was dealt with appropriately.
 
Disposition
 
The Discipline Committee ordered that:
 
- Dr. Thomas attend before the panel to be reprimanded.
 
- The Registrar suspend Dr. Thomas’s certificate of registration for a period of one (1) month, commencing from July 3, 2019 at 12:01 a.m.
 
-The Registrar place the following terms, conditions and limitations on Dr. Thomas’s certificate of registration: 
 
a. Dr. Thomas shall comply with the College Policy #2-07 “Practice Management Considerations for Physicians Who Cease to Practise, Take an Extended Leave of Absence or Close Their Practice Due to Relocation”, a copy of which is attached at Schedule “A” to this Order;
 
Clinical Supervision
 
b. For a period of nine (9) months from the date of this Order, Dr. Thomas shall practice medicine only under the supervision of a clinical supervisor approved by the College (the “Clinical Supervision”).
 
c. Within ten (10) days of this Order, Dr. Thomas shall have a College-approved clinical supervisor (the “Clinical Supervisor”) sign an Undertaking in the form attached hereto as Schedule “B”.
 
d. Dr. Thomas shall meet with the Clinical Supervisor once in August 2019, once in November 2019, and once in February 2020. At each meeting, the Clinical Supervisor shall:
 
i. Review a minimum of twenty (20) patient charts, to be selected by the Clinical Supervisor in accordance with the educational needs identified in the Individualized Education Plan attached hereto at Schedule “C” (the “IEP”);
 
ii. Discuss with Dr. Thomas any concerns the Clinical Supervisor may have arising from the chart reviews;
 
iii. Make recommendations to Dr. Thomas for practice improvements and inquire  into Dr. Thomas’ compliance with the recommendations; and
 
iv. Keep a log of all patient charts reviewed along with patient identifiers.
 
e. The Clinical Supervisor shall submit written reports to the College promptly after every meeting with Dr. Thomas, or immediately if the Clinical Supervisor has concerns about Dr. Thomas’ standard of practice or that Dr. Thomas’ patients may be exposed to harm or injury.
f. Dr. Thomas shall fully cooperate with the Clinical Supervision and shall abide by all recommendations of the Clinical Supervisor.
 
g. If a person who has given an Undertaking in Schedule “B” to this Order is unable or unwilling to continue to fulfill its provisions, Dr. Thomas 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.
 
h. If Dr. Thomas is unable to obtain a Clinical Supervisor as set out in this Order, he shall cease practising medicine until such time as he has obtained a Clinical Supervisor acceptable to the College.
 
i. If Dr. Thomas is required to cease practise as a result of section 4.(viii) above, this will constitute a term, condition or limitation on his certificate of registration and that term, condition or limitation will be included on the public register.
Reassessment
 
j. Approximately six (6) months following completion of the Clinical Supervision, Dr. Thomas shall undergo a reassessment of his practice by a College-appointed assessor (the “Reassessment”).
 
k. The Reassessment shall focus on the educational needs addressed during the period of Clinical Supervision as set out in the IEP and may include a review of Dr. Thomas’s patient charts, direct observations, and interviews with staff and/or patients and any other tools deemed necessary by the College. The Assessor shall report the results of the Reassessment to the College.
Monitoring
 
l. Dr. Thomas shall inform the College of each and every location where he practices, in any jurisdiction (his “Practice Location(s)”) within fifteen (15) days of this Order and shall inform the College of any and all new Practice Locations within fifteen (15) days of commencing practice at that location.
 
m. Dr. Thomas shall consent to the sharing of information between the Clinical Supervisor, the Assessor and the College as any of them deem necessary or desirable in order to fulfill their respective obligations.
 
n. Dr. Thomas shall consent to the College making enquiries of the Ontario Health Insurance Program, the Narcotics Monitoring System and/or any person or institution that may have relevant information, in order for the College to monitor his compliance with this Order and shall promptly sign such consents as may be necessary for the College to obtain information from these persons or institutions.
 
o. Dr. Thomas shall co-operate with unannounced inspections of his office practice and patient charts by the College for the purpose of monitoring and enforcing his compliance with the terms of this Order.
 
p. Dr. Thomas shall notify any employer, or any hospital at which he may have privileges, about this Order.
 
q. Dr. Thomas shall be responsible for any and all costs associated with implementing the terms of this Order.
- Dr. Thomas pay costs to the College in the amount of $6,000.00 within 30 days of the date of this Order.
 
Reasons for Decision: Download Full Decision (PDF)
Hearing Date(s): June 19, 2019 at 1:00 p.m.

Other Notifications (5)

Source: Other
Effective Date: 12 May 2022
Summary:
Finding of Guilt

Dr. Cholemkeril Thomas was found guilty of the following offence:

1.  Failing to comply with an undertaking, contrary to s.145(4)(a) of the Criminal Code.

Date:  May 12, 2022
SENTENCE:  Conditional sentence of 12 months probation.


Source: Member
Effective Date: 02 Jul 2021
Summary:
Summary of the Undertaking given by Dr. Cholemkeril Kuncheria Thomas to the College of Physicians and Surgeons of Ontario, effective July 2, 2021:

A College investigation was conducted into whether Dr. Thomas engaged in professional misconduct and/or was incompetent in his Emergency Medicine and prescribing practice, and in his compliance with an undertaking to the College dated August 13, 2019 (“August 2019 undertaking). As a result of the investigation, the prescribing restriction in paragraph B(6)(b) of Dr. Thomas’ August 2019 undertaking is varied as follows:
Dr. Thomas shall only prescribe Narcotic Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other Targeted Substances or Monitored Drugs in the following circumstances:
(i) He may write hospital orders for the above-noted medications to be administered to patients during the course of their stay in the emergency department, to be dispensed through the hospital pharmacy; and/or
(ii) He may prescribe no more than a three-day supply, with no repeats or refills, of the above-noted medications to any patient upon discharge from the emergency department.
For further clarity, Dr. Thomas shall not prescribe the above medications for the treatment of chronic pain, but only for acute conditions.
 
 


Source: Inquiries, Complaints and Reports Committee
Effective Date: 16 Jun 2021
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: 


Source: Member
Effective Date: 13 Aug 2019
Summary:
Summary of the Undertaking given by Dr. Cholemkeril Kuncheria Thomas to the College of Physicians and Surgeons of Ontario, effective August 13, 2019:
A College investigation was conducted into whether Dr. Thomas engaged in professional misconduct and/or is incompetent in his family medicine practice. As a result of the investigation:

Dr. Thomas shall practice Emergency Medicine only, at a hospital where he holds privileges to so practice, and shall not practice Family Medicine including at a walk-in clinic.

Dr. Thomas shall not prescribe greater than a five (5) days’ supply, with no repeats or refills, of any Narcotic Drug, Narcotic Preparation, Controlled Drug, Benzodiazepine and Other Targeted Substance or Monitored Drug to any patient.

Dr. Thomas will practise under the guidance of a Clinical Supervisor acceptable to the College for seven (7) months.

Dr. Thomas will engage in professional education in the prescribing of narcotics and controlled substances.

Dr. Thomas’s practice will be reassessed by an assessor selected by the College approximately six (6) months following the period of Clinical Supervision. 


Source: Inquiries, Complaints and Reports Committee
Effective Date: 19 Apr 2017
Summary:
Caution-in-Person and Specified Continuing Education and Remediation Program

A summary of a decision of the Inquiries, Complaints and Reports Committee (“ICRC”) in which the disposition includes a "caution-in-person" or a Specified Continuing Education and Remediation Program (“SCERP”) 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 ICRC. A SCERP is one of the dispositions that the College’s ICRC may make in connection with a matter before it, and this disposition requires the member to complete an education and remediation program specified for the member. A note will also be posted when all the elements of the SCERP have been completed.

Summaries will be removed from the register if the decision is overturned on appeal or review. This posting 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 and a SCERP:

Current Tribunal Proceedings (1)

Proceeding Type: Discipline referral to OPSDT
Date of Referral or Application: 02 Oct 2024
Summary:
Allegations of Dr. Thomas’ professional misconduct have been referred to the Ontario Physicians and Surgeons Discipline Tribunal.  It is alleged that Dr. Thomas  was found guilty of an offence that is relevant to his suitability to practice. It is further alleged that Dr. Thomas engaged in disgraceful, dishonourable or unprofessional conduct and conduct unbecoming a physician based on the conduct underlying the criminal charges and finding of guilt.  
For more details please visit the OPSDT website

Past Tribunal Proceedings (2)

Date of Decision: 27 Feb 2024
Summary of Decision:
On February 27, 2024, the Tribunal found that Dr. Thomas engaged in disgraceful, dishonourable or unprofessional conduct by not disclosing, on his 2012 Annual Renewal form, that he had been charged with a criminal offence in the previous year, specifically dangerous operation of a motor vehicle. Additionally, Dr. Thomas failed to report to the College when he was found guilty of this charge in 2014.

The Tribunal ordered that: 
  1. Dr. Thomas attend before the panel to be reprimanded; 
  2. the Registrar suspend Dr. Thomas’s certificate of registration for five (5) months commencing February 28, 2024, at 12:01 a.m.; 
  3. the Registrar place terms, conditions and limitations on Dr. Thomas’s certificate of registration; 
  4. Dr. Thomas pay the College costs in the amount of $6,000 by August 27, 2024.
More detail can be found in the reasons for decision linked below. OPSDT reasons are also available at www.opsdt.ca and https://www.canlii.org/en/on/onpsdt/. The exhibits, including the Agreed Statement of Facts and Plea of No Contest, can be obtained by contacting the Tribunal Office at [email protected] 
 
Reasons for Decision: Download Full Decision (PDF)
Hearing Date(s): Merits, Penalty, Reprimand: February 27, 2024

Date of Decision: 19 Jun 2019
Summary of Decision:
On June 19th, 2019, the Discipline Committee found that Dr. Thomas committed an act of professional misconduct in that he has engaged in 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.
 
Facts
 
Dr. Thomas is a 64 year-old family physician who received his certificate of registration authorizing independent practice from the College of Physicians and Surgeons of Ontario in 2001.
Dr. Thomas currently practices Emergency Medicine in Iroquois Falls, Ontario and previously practiced Emergency Medicine and Family Medicine in Espanola, Ontario.
 
Background
 
On April 19, 2017, the Inquiries, Complaints and Reports Committee of the College (the “ICRC”) directed that Dr. Thomas attend the College to be cautioned and required that Dr. Thomas complete a specified continuing education and remediation program with the following components:
 
(a) Courses: Attend and complete the next available session of the following courses (with proof of attendance to be provided):
1. The Medical Record-Keeping Course, through a course provider indicated by the College;
2. The Safe Opioid Prescribing Course, through a course provider indicated by the College (three webinars and workshop);
3. ATLS (Advanced Trauma Life Support) (https://www.facs.org/quality- programs/trauma/atls/about); and
4. An Emergency Medicine Review Course (for example, the National Capital Conference on Emergency Medicine at http://www.emottawa.ca/eng/60-nccem.html).
 
(b) One-on-one instruction: Complete one-on-one instruction in collaboration and professionalism (including respect for colleagues and co-workers, punctuality, responsiveness to calls for patient care and responsiveness to requests from the College).
 
(c) Self-directed learning with written summaries: Review and prepare written summaries of up to 2000 words (2-4 pages) of each of the following documents with reference to current standards of practice (where applicable), how it is applicable to Dr. Thomas’ situation, as well as how Dr. Thomas has made, or plans to make changes, to his practice. The written summaries were to be submitted within 4 months of receipt of the decision.
1. Clinical Practice Guidelines regarding vaginal bleeding during pregnancy;
2. Choosing Wisely Canada Recommendations for Emergency Medicine;
3. The College’s policy on Medical Records;
4. The College’s policy on Physician Behaviour in the Professional Environment; and
5. The College’s Practice Guide.
 
(d) Clinical Supervision: Engage a Clinical Supervisor acceptable to the College to engage in focused educational sessions as set out in an Individualized Education Plan. The Clinical Supervisor was required to sign an undertaking with the College within 30 days’ of Dr. Thomas’ receipt of the April 19, 2017 ICRC Decision. Dr. Thomas was required to meet with the Clinical Supervisor for a period of 12 months, no less than monthly for six months, and then quarterly for six months; and review at least 20 Emergency Department charts at each meeting.
(e) Reassessment: Approximately six months following the completion of the education and remediation set out above, Dr. Thomas’ Emergency Department practice is to be reassessed.
 
Dr. Thomas’ Failure To Comply With The April 2017 SCERP
 
On May 16, 2017, the College’s Compliance Case Manager wrote to Dr. Thomas’ counsel about the implementation of the April 2017 SCERP. The Compliance Case Manager asked that a Clinical Supervisor be identified to him by June 1, 2017.
Dr. Thomas proposed potential Clinical Supervisors on June 12, 2017 and June 27, 2017. The two Clinical Supervisors proposed by Dr. Thomas were not approved by the College. 
On July 11, 2017, the Compliance Case Manager advised that he had located a potential Clinical Supervisor for Dr. Thomas. Dr. Thomas confirmed that he would be willing to work with the College’s proposed Clinical Supervisor.
 
On August 2, 2017, the Compliance Case Manager confirmed that the College’s proposed Clinical Supervisor (“Clinical Supervisor A”) had been approved by the College. The Compliance Case Manager urged Dr. Thomas to contact Clinical Supervisor A shortly to begin the supervision meetings. On August 4, 2017, Clinical Supervisor A signed a Clinical Supervisor Undertaking to the College.
 
On September 15, 2017, Dr. Thomas, through his counsel, wrote to the Compliance Case Manager requesting an extension for completing the written summaries for the self-directed learning portion of the April 2017 SCERP to October 9, 2017. At the same time, he advised that Dr. Thomas had registered for the Medical Record-Keeping Course, the Safe Opioid Prescribing Course and an Emergency Medicine Review Course. He did not indicate whether Dr. Thomas had registered for a course in ATLS (Advanced Trauma Life Support). The College granted Dr. Thomas’ request for an extension for completion of his written summaries to October 9, 2017.
 
In October of 2017, the Compliance Case Manager contacted Clinical Supervisor A to inquire about the status of her first supervision report, which had yet to be submitted to the College. Between October 17, 2017 and October 27, 2017, in an email exchange and in a telephone conversation, Clinical Supervisor A indicated to the Compliance Case Manager that she had had difficulty connecting and scheduling a meeting with Dr. Thomas.
 
On November 6, 2017, the Compliance Case Manager reminded Dr. Thomas, through his counsel, that it was Dr. Thomas’ responsibility to ensure that he meets monthly with his Clinical Supervisor and that Dr. Thomas is in breach of his undertaking.
 
On December 7, 2017, Dr. Thomas’ counsel wrote to provide an update regarding Dr. Thomas’ compliance with the April 2017 SCERP. Dr. Thomas’ counsel indicated that Dr. Thomas had attended the Medical Record-Keeping Course, the Safe Opioid Prescribing Course and an Emergency medicine Review Course and that he intended to complete a course in ATLS (Advanced Trauma Life Support) in early 2018. He also indicated that Dr. Thomas had completed an initial meeting with his one-on-one instructor, and that he had not yet completed the self-study with written summaries of 5 policies/guidelines (for which he had previously been granted an extension to October 9, 2017), but that these would be completed by December 15, 2017. As well, he indicated that Dr. Thomas had met with his Clinical Supervisor on September 16, 2017 and October 29, 2017.
On December 15, 2017, Dr. Thomas sent several emails to the Compliance Case Manager requesting that he be exempted from preparing written summaries for his self-directed learning as required by the April 2017 SCERP. In response, the Compliance Case Manager reminded Dr. Thomas that he had already been provided with two extensions and stated that the written summaries must be provided to the College by December 22, 2017.
 
On December 19, 2017, in response to a follow-up email from the Compliance Case Manager, Clinical Supervisor A advised the Compliance Case Manager that the meeting she had been scheduled to have with Dr. Thomas on December 12, 2017 had not occurred due to bad weather.
Clinical Supervisor A had suggested that she could spend the day with Dr. Thomas in the emergency room but he had not been willing to do so. Given that Clinical Supervisor A had not been able to meet with Dr. Thomas in accordance with the terms of the April 19, 2017 ICRC Decision, the Compliance Case Manager advised that Clinical Supervisor A was no longer approved to act as Dr. Thomas’ Clinical Supervisor.
 
On December 21, 2017, the Compliance Case Manager wrote to Dr. Thomas’ counsel advising that the name of a new proposed Clinical Supervisor should be forwarded to her by January 12, 2018.
 
On January 3, 2018, the Compliance Case Manager wrote to Dr. Thomas’ counsel advising that she had received an email from Dr. Thomas requesting yet another extension of time to complete his self-directed learning written summaries. She advised that she would grant one final extension to January 12, 2018. The Compliance Case Manager also stated that Dr. Thomas was required to have a College-approved Clinical Supervisor by January 12, 2018.
 
On January 15, 2018, the Compliance Case Manager wrote to Dr. Thomas’ counsel and advised that Dr. Thomas had not submitted his self-directed learning written summaries, nor had she received the name of a proposed Clinical Supervisor. In her letter, the Compliance Case Manager indicated that she would grant an extension to January 26, 2018, failing which the matter would be returned to Committee for further direction.
 
On March 27, 2018, the Compliance Case Manager wrote to Dr. Thomas’ counsel informing him that Dr. Thomas’ matter would be returning to ICRC on April 3, 2018 for consideration of action due to his failure to complete the terms of the April 2017 SCERP.
 
As of April 3, 2018, when this matter was referred to the Discipline Committee by the ICRC, Dr. Thomas had failed to complete the terms of the April 2017 SCERP.
 
Status of Compliance at Date of Referral to the Discipline Committee
 
In particular, as of April 3, 2018, the status of Dr. Thomas’ compliance with the terms of the
April 2017 SCERP was as follows:
(a) Courses: Incomplete. Dr. Thomas had completed some, but not all, of his coursework.
(b) One-on-one instruction: Incomplete. Dr. Thomas had attended an initial meeting with his one-on-one instructor but then failed to attend follow-up sessions.
(c) Self-directed learning with written summaries: Incomplete. On multiple occasions, Dr. Thomas had requested and received extensions from the College to submit his written summaries.
(d) Clinical Supervision: Incomplete.
Clinical Supervisor A ceased being Dr. Thomas’ Clinical Supervisor on December 20, 2017, as Dr. Thomas failed to meet with her in accordance with the terms of the April 2017 SCERP. Dr. Thomas failed to identify a new Clinical Supervisor.
(e) Reassessment: Incomplete.
 
Current Status of Dr. Thomas’ Compliance with the April 2017 SCERP
 
Following the ICRC’s referral of Dr. Thomas’ matter to the Discipline Committee, Dr. Thomas
made some further efforts to comply with the April 2017 SCERP.
As of June 12, 2019, the status of Dr. Thomas’ compliance with the terms of the April 2017 SCERP is as follows:
(a) Courses: Complete.
(b) One-on-one instruction: Complete.
(c) Self-directed learning with written summaries: Complete.
(d) Clinical Supervision: Incomplete. Dr. Thomas retained a new Clinical Supervisor in December of 2018.
 
Dr. Thomas attended Clinical Supervision meetings on the following dates:

- January 12, 2019
- February 17, 2019
- March 16, 2019
- May 10, 2019
 
Dr. Thomas was scheduled to meet with his Clinical Supervisor in mid-April of 2019. However, Dr. Thomas cancelled the meeting. Therefore, Dr. Thomas did not meet with his Clinical Supervisor in April of 2019.
Dr. Thomas was also scheduled to meet with his Clinical Supervisor on May 31, 2019.
However, on May 31, Dr. Thomas requested that the meeting be rescheduled. Thus, the May 31, 2019 meeting was rescheduled to June 2, 2019. On June 2, 2019, Dr. Thomas again requested that the meeting be rescheduled. The meeting was then rescheduled to June 3, 2019. On June 3, 2019, approximately one hour before the scheduled meeting time, Dr. Thomas called the Clinical Supervisor and advised that he forgot the time, would be late, and asked to start the meeting one hour later. Dr. Thomas’s Clinical Supervisor was not able to accommodate this third rescheduling request. Dr. Thomas’s next meeting with his Clinical Supervisor is scheduled for June 14, 2019. 
 
Subject to any further delays, Dr. Thomas is scheduled to complete his Clinical Supervision in February of 2020.
 
(e) Reassessment: Incomplete. Dr. Thomas’ reassessment is to be scheduled approximately 6
months’ following completion of Dr. Thomas’ Clinical Supervision.
 
Admission
 
Dr. Thomas admits to the facts above, and admits that, based on these facts, he engaged in professional misconduct under paragraph 1(1)33 of O Reg. 856/93, in that he engaged in acts or omissions relevant to the practice of medicine that would be regarded by members as disgraceful,
dishonourable or unprofessional by failing to comply with the April 19, 2017 decision of the Inquiries, Complaints and Reports Committee requiring that he complete a specified continuing education or remediation program.
 
Agreed Statement of Facts Relevant to Penalty
 
Relevant College History
 
In June 2014, the Inquiries, Complaints and Reports Committee of the College considered a complaint from a prior employer of Dr. Thomas in Ottawa. That employer complained that Dr. Thomas left his position without any notice or follow-up plans for his patients, did not respond to efforts by clinic staff to contact him, and took some patient records with him. In addition, Dr. Thomas failed to respond to a letter from the College’s investigator with questions regarding the matter. The ICRC issued a written caution to Dr. Thomas regarding his lack of appropriate management upon leaving a practice.
 
Additional Relevant History
 
In August 1996, a complaint was received by the College of Physicians and Surgeons of Nova Scotia from the Nova Scotia Prescription Monitoring Program that Dr. Thomas failed to respond to their requests for information concerning his prescribing of controlled substances to patient X. After investigation of the matter, Dr. Thomas was counseled with respect to not responding promptly and appropriately to the Prescription Monitoring Program. The investigation Committee also suggested that he review the organization of his office to ensure that all mail was dealt with appropriately.
 
Disposition
 
The Discipline Committee ordered that:
 
- Dr. Thomas attend before the panel to be reprimanded.
 
- The Registrar suspend Dr. Thomas’s certificate of registration for a period of one (1) month, commencing from July 3, 2019 at 12:01 a.m.
 
-The Registrar place the following terms, conditions and limitations on Dr. Thomas’s certificate of registration: 
 
a. Dr. Thomas shall comply with the College Policy #2-07 “Practice Management Considerations for Physicians Who Cease to Practise, Take an Extended Leave of Absence or Close Their Practice Due to Relocation”, a copy of which is attached at Schedule “A” to this Order;
 
Clinical Supervision
 
b. For a period of nine (9) months from the date of this Order, Dr. Thomas shall practice medicine only under the supervision of a clinical supervisor approved by the College (the “Clinical Supervision”).
 
c. Within ten (10) days of this Order, Dr. Thomas shall have a College-approved clinical supervisor (the “Clinical Supervisor”) sign an Undertaking in the form attached hereto as Schedule “B”.
 
d. Dr. Thomas shall meet with the Clinical Supervisor once in August 2019, once in November 2019, and once in February 2020. At each meeting, the Clinical Supervisor shall:
 
i. Review a minimum of twenty (20) patient charts, to be selected by the Clinical Supervisor in accordance with the educational needs identified in the Individualized Education Plan attached hereto at Schedule “C” (the “IEP”);
 
ii. Discuss with Dr. Thomas any concerns the Clinical Supervisor may have arising from the chart reviews;
 
iii. Make recommendations to Dr. Thomas for practice improvements and inquire  into Dr. Thomas’ compliance with the recommendations; and
 
iv. Keep a log of all patient charts reviewed along with patient identifiers.
 
e. The Clinical Supervisor shall submit written reports to the College promptly after every meeting with Dr. Thomas, or immediately if the Clinical Supervisor has concerns about Dr. Thomas’ standard of practice or that Dr. Thomas’ patients may be exposed to harm or injury.
f. Dr. Thomas shall fully cooperate with the Clinical Supervision and shall abide by all recommendations of the Clinical Supervisor.
 
g. If a person who has given an Undertaking in Schedule “B” to this Order is unable or unwilling to continue to fulfill its provisions, Dr. Thomas 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.
 
h. If Dr. Thomas is unable to obtain a Clinical Supervisor as set out in this Order, he shall cease practising medicine until such time as he has obtained a Clinical Supervisor acceptable to the College.
 
i. If Dr. Thomas is required to cease practise as a result of section 4.(viii) above, this will constitute a term, condition or limitation on his certificate of registration and that term, condition or limitation will be included on the public register.
Reassessment
 
j. Approximately six (6) months following completion of the Clinical Supervision, Dr. Thomas shall undergo a reassessment of his practice by a College-appointed assessor (the “Reassessment”).
 
k. The Reassessment shall focus on the educational needs addressed during the period of Clinical Supervision as set out in the IEP and may include a review of Dr. Thomas’s patient charts, direct observations, and interviews with staff and/or patients and any other tools deemed necessary by the College. The Assessor shall report the results of the Reassessment to the College.
Monitoring
 
l. Dr. Thomas shall inform the College of each and every location where he practices, in any jurisdiction (his “Practice Location(s)”) within fifteen (15) days of this Order and shall inform the College of any and all new Practice Locations within fifteen (15) days of commencing practice at that location.
 
m. Dr. Thomas shall consent to the sharing of information between the Clinical Supervisor, the Assessor and the College as any of them deem necessary or desirable in order to fulfill their respective obligations.
 
n. Dr. Thomas shall consent to the College making enquiries of the Ontario Health Insurance Program, the Narcotics Monitoring System and/or any person or institution that may have relevant information, in order for the College to monitor his compliance with this Order and shall promptly sign such consents as may be necessary for the College to obtain information from these persons or institutions.
 
o. Dr. Thomas shall co-operate with unannounced inspections of his office practice and patient charts by the College for the purpose of monitoring and enforcing his compliance with the terms of this Order.
 
p. Dr. Thomas shall notify any employer, or any hospital at which he may have privileges, about this Order.
 
q. Dr. Thomas shall be responsible for any and all costs associated with implementing the terms of this Order.
- Dr. Thomas pay costs to the College in the amount of $6,000.00 within 30 days of the date of this Order.
 
Reasons for Decision: Download Full Decision (PDF)
Hearing Date(s): June 19, 2019 at 1:00 p.m.

Other Notifications (5)

Source: Other
Effective Date: 12 May 2022
Summary:
Finding of Guilt

Dr. Cholemkeril Thomas was found guilty of the following offence:

1.  Failing to comply with an undertaking, contrary to s.145(4)(a) of the Criminal Code.

Date:  May 12, 2022
SENTENCE:  Conditional sentence of 12 months probation.


Source: Member
Effective Date: 02 Jul 2021
Summary:
Summary of the Undertaking given by Dr. Cholemkeril Kuncheria Thomas to the College of Physicians and Surgeons of Ontario, effective July 2, 2021:

A College investigation was conducted into whether Dr. Thomas engaged in professional misconduct and/or was incompetent in his Emergency Medicine and prescribing practice, and in his compliance with an undertaking to the College dated August 13, 2019 (“August 2019 undertaking). As a result of the investigation, the prescribing restriction in paragraph B(6)(b) of Dr. Thomas’ August 2019 undertaking is varied as follows:
Dr. Thomas shall only prescribe Narcotic Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines and Other Targeted Substances or Monitored Drugs in the following circumstances:
(i) He may write hospital orders for the above-noted medications to be administered to patients during the course of their stay in the emergency department, to be dispensed through the hospital pharmacy; and/or
(ii) He may prescribe no more than a three-day supply, with no repeats or refills, of the above-noted medications to any patient upon discharge from the emergency department.
For further clarity, Dr. Thomas shall not prescribe the above medications for the treatment of chronic pain, but only for acute conditions.
 
 


Source: Inquiries, Complaints and Reports Committee
Effective Date: 16 Jun 2021
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: 


Source: Member
Effective Date: 13 Aug 2019
Summary:
Summary of the Undertaking given by Dr. Cholemkeril Kuncheria Thomas to the College of Physicians and Surgeons of Ontario, effective August 13, 2019:
A College investigation was conducted into whether Dr. Thomas engaged in professional misconduct and/or is incompetent in his family medicine practice. As a result of the investigation:

Dr. Thomas shall practice Emergency Medicine only, at a hospital where he holds privileges to so practice, and shall not practice Family Medicine including at a walk-in clinic.

Dr. Thomas shall not prescribe greater than a five (5) days’ supply, with no repeats or refills, of any Narcotic Drug, Narcotic Preparation, Controlled Drug, Benzodiazepine and Other Targeted Substance or Monitored Drug to any patient.

Dr. Thomas will practise under the guidance of a Clinical Supervisor acceptable to the College for seven (7) months.

Dr. Thomas will engage in professional education in the prescribing of narcotics and controlled substances.

Dr. Thomas’s practice will be reassessed by an assessor selected by the College approximately six (6) months following the period of Clinical Supervision. 


Source: Inquiries, Complaints and Reports Committee
Effective Date: 19 Apr 2017
Summary:
Caution-in-Person and Specified Continuing Education and Remediation Program

A summary of a decision of the Inquiries, Complaints and Reports Committee (“ICRC”) in which the disposition includes a "caution-in-person" or a Specified Continuing Education and Remediation Program (“SCERP”) 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 ICRC. A SCERP is one of the dispositions that the College’s ICRC may make in connection with a matter before it, and this disposition requires the member to complete an education and remediation program specified for the member. A note will also be posted when all the elements of the SCERP have been completed.

Summaries will be removed from the register if the decision is overturned on appeal or review. This posting 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 and a SCERP:

Training

Medical School: University of Kerala, 1981

Registration History

DETAILS DATE
Suspension of registration removed. Effective: 28 Jul 2024
Suspension of registration imposed: Ontario Physicians and Surgeons Discipline Tribunal Effective: 28 Feb 2024
Terms and conditions amended by Ontario Physicians and Surgeons Discipline Tribunal. Effective: 28 Feb 2024
Suspension of registration removed. Effective: 01 Sep 2023
Suspension of registration imposed: Inquiries, Complaints and Reports Committee Effective: 23 Jun 2020
Terms and conditions amended by Member. Effective: 13 Aug 2019
Suspension of registration removed. Effective: 03 Aug 2019
Suspension of registration imposed: Discipline Committee Effective: 03 Jul 2019
Transfer of class of registration to: Restricted Certificate Effective: 19 Jun 2019
Subsequent certificate of registration issued: Independent Practice Certificate Effective: 20 Feb 2001
Expired: Terms and conditions of certificate of registration Effective: 21 Sep 1998
Subsequent certificate of registration issued: Postgraduate Education Certificate Effective: 19 Aug 1997
Expired: Terms and conditions of certificate of registration Effective: 17 Jun 1985
First certificate of registration issued: Postgraduate Education Certificate Effective: 11 Jun 1984
DETAILS: Suspension of registration removed.
Date: Effective: 28 Jul 2024

DETAILS: Suspension of registration imposed: Ontario Physicians and Surgeons Discipline Tribunal
Date: Effective: 28 Feb 2024

DETAILS: Terms and conditions amended by Ontario Physicians and Surgeons Discipline Tribunal.
Date: Effective: 28 Feb 2024

DETAILS: Suspension of registration removed.
Date: Effective: 01 Sep 2023

DETAILS: Suspension of registration imposed: Inquiries, Complaints and Reports Committee
Date: Effective: 23 Jun 2020

DETAILS: Terms and conditions amended by Member.
Date: Effective: 13 Aug 2019

DETAILS: Suspension of registration removed.
Date: Effective: 03 Aug 2019

DETAILS: Suspension of registration imposed: Discipline Committee
Date: Effective: 03 Jul 2019

DETAILS: Transfer of class of registration to: Restricted Certificate
Date: Effective: 19 Jun 2019
DETAILS: Terms and conditions imposed on certificate by: Discipline Committee
Date: Effective: 19 Jun 2019

DETAILS: Subsequent certificate of registration issued: Independent Practice Certificate
Date: Effective: 20 Feb 2001

DETAILS: Expired: Terms and conditions of certificate of registration
Date: Effective: 21 Sep 1998

DETAILS: Subsequent certificate of registration issued: Postgraduate Education Certificate
Date: Effective: 19 Aug 1997

DETAILS: Expired: Terms and conditions of certificate of registration
Date: Effective: 17 Jun 1985

DETAILS: First certificate of registration issued: Postgraduate Education Certificate
Date: Effective: 11 Jun 1984