As from July 16, 2021, the following are imposed as terms, conditions and limitations on the certificate of registration held by Dr. Paul Maxwell Irwin in accordance with an undertaking and consent given by Dr. Irwin to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
(“Undertaking”)
of
DR. PAUL MAXWELL IRWIN
(“Dr. Irwin”)
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;
“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. Irwin, certificate of registration number 57194, am a member of the College.
(3) I, Dr. Irwin, acknowledge that the College conducted an investigation bearing File Number 1106914 (the “Investigation”) into whether I engaged in professional misconduct and/or am incompetent.
(4) I, Dr. Irwin, acknowledge that, in addition to accepting this Undertaking, the College will also deliver a verbal caution in person.
B. UNDERTAKING
(5) I, Dr. Irwin, undertake to abide by the provisions of this Undertaking, effective immediately.
(6) Practice Restriction
a) I, Dr. Irwin, acknowledge that my practice is restricted to providing small surgical procedures requiring local anaesthesia and surgical consultations and that, for further specificity, I will not engage in any of the following areas of practice:
i) Primary Care.
ii) Palliative care.
iii) Chronic pain management.
(7) Resignation of Prescribing Privileges
(a) I, Dr. Irwin, acknowledge that I have executed the Prescribing Resignation Letter to Health Canada, which is attached hereto as Schedule “A” (the “Resignation Letter”).
(b) I, Dr. Irwin, consent to the College sending the Resignation Letter to Health Canada on my behalf.
(c) I, Dr. Irwin, undertake that I will not issue new prescriptions or renew existing prescriptions for or administer any of the following substances:
(i) Narcotic Drugs (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
(ii) Narcotic Preparations (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
(iii) Controlled Drugs (from Part G of the Food and Drug Regulations under the Food and Drugs Act, S.C., 1985, c. F-27);
(iv) Benzodiazepines and Other Targeted Substances (from the Benzodiazepines and Other Targeted Substances Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
(A summary of the above-named drugs [from Appendix I to the Compendium of Pharmaceuticals and Specialties] is attached hereto as Schedule “B”; and links to the current regulatory lists are attached hereto as Schedule “C”)
(v) Monitored Drugs (as defined under the Narcotics Safety and Awareness Act, 2010, S.O. 2010, c. 22, with a link to the current regulatory list attached hereto as Schedule “D”);
and as amended from time to time.
(d) I, Dr. Irwin, undertake to immediately notify my patients to whom I am prescribing any of the substances described in section 7(c), above of my prescribing restrictions and that they will require another physician for their assessment and care.
(e) I, Dr. Irwin, additionally undertake to make reasonable efforts to provide my patients to whom I am prescribing any of the substances described in section 7(c), above with a referral to another physician for assessment and care.
(f) I, Dr. Irwin, undertake to keep a log of all patients referenced in section (7)(d) above (the “Log”). I, Dr. Irwin, undertake to include in the Log details of all reasonable efforts I have made to refer the patient including, where applicable, the name of each patient referred, the name of the physician referred to, and the date of referral.
(g) I, Dr. Irwin, undertake that where a patient requires any of the substances described in section 7(c) above prior to or immediately following a small surgical procedure that I will perform, I will request that a colleague in the Clinic where I practice, or that the patient’s referring physician prescribe to this patient.
(8) I, Dr. Irwin, undertake that I will return any supplies of the substances referred to in section (7)(c) above that are presently in my possession, in any place, to a pharmacy in a safe and secure manner, as stipulated in the College’s Policy “Prescribing Drugs.”
(9) I, Dr. Irwin, undertake to inform the College of each and every location at which I practice, delegate, or have privileges, including, but not limited to, any hospitals, clinics, offices, and any Out-of-Hospital Premises and 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.
(10) Posting a Sign
(a) I, Dr. Irwin, undertake that I shall post a sign in all waiting rooms and in each examination and consulting room, in all my Practice Locations, in a clearly visible and secure location, at all times whether or not I am physically present at the Practice Location, in the form set out at Schedule “E.” For further clarity, this sign shall state as follows:
IMPORTANT NOTICE
Dr. Irwin’s practice is restricted to providing small surgical procedures requiring local anesthesia and surgical consultations. For further clarity he does not practice any of the following: primary care, palliative care or chronic pain management.
Dr. Irwin has agreed not to prescribe or administer any of the following:
- Narcotic Drugs
- Narcotic Preparations
- Controlled Drugs
- Benzodiazepines and Other Targeted Substances
- Monitored Drugs
Further information may be found on the College of Physicians and Surgeons of Ontario website at www.cpso.on.ca
(b) I, Dr. Irwin, undertake to post a certified translation in any language in which I provide services, of the sign described in section (10)(a) above, in all waiting rooms and in each examination and consulting room, in all my Practice Locations, in a clearly visible and secure location, in the form set out at Schedule “E.”
(c) I, Dr. Irwin, undertake to provide the certified translation described in section (10)(b), to the College within thirty (30) days of executing this Undertaking.
(d) I, Dr. Irwin, undertake that if I elect, after the execution of this Undertaking, to provide services in any other language, I will notify the College prior to providing any such services.
(e) I, Dr. Irwin, undertake to provide to the College the certified translation described in section (10)(c) prior to beginning to provide services in any language described in section (10)(d).
C. ACKNOWLEDGEMENT
(11) I, Dr. Irwin, acknowledge that all schedules attached to or referred to in this Undertaking form part of this Undertaking.
(12) I, Dr. Irwin, 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. Irwin, 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. Irwin, 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. Irwin, 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.
(16) I, Dr. Irwin, 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. Irwin, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. Irwin, 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. Irwin engaged in professional misconduct and/or was incompetent in the practice. As a result of the investigation, in addition to the College delivering a verbal caution to Dr. Irwin:
Dr. Irwin’s practice is restricted to providing small surgical procedures requiring local anaesthesia and surgical consultations. For further clarity he does not practice any of the following: primary care, palliative care or chronic pain management.
Dr. Irwin must not issue new prescriptions or renew existing prescriptions for or administer any of the following substances:
(i) Narcotic Drugs (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
(ii) Narcotic Preparations (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
(iii) Controlled Drugs (from Part G of the Food and Drug Regulations under the Food and Drugs Act, S.C., 1985, c. F-27);
(iv) Benzodiazepines and Other Targeted Substances (from the Benzodiazepines and Other Targeted Substances Regulations made under the Controlled Drugs and Substances Act., S.C., 1996, c. 19);
(v) Monitored Drugs (as defined under the Narcotics Safety and Awareness Act, 2010, S.O. 2010, c. 22);
and as amended from time to time.
Dr. Irwin must post a clearly visible sign in the waiting rooms and each examination and consulting room, in all Practice Locations, which states as follows:
IMPORTANT NOTICE
Dr. Irwin’s practice is restricted to providing small surgical procedures requiring local anaesthesia and surgical consultations. For further clarity he does not practice any of the following: primary care, palliative care or chronic pain management.
Dr. Irwin has agreed not to prescribe or administer any of the following:
- Narcotic Drugs
- Narcotic Preparations
- Controlled Drugs
- Benzodiazepines and Other Targeted Substances
- Monitored Drugs
Further information may be found on the College of Physicians and Surgeons of Ontario website at www.cpso.on.ca
D. CONSENT
(18) I, Dr. Irwin, undertake that I will submit to, and not interfere with, unannounced inspections of my Practice Locations and patient charts by the College and to any other activity the College deems necessary in order to monitor my compliance with the provisions of this Undertaking.
(19) I, Dr. Irwin, give my irrevocable consent to the College to make appropriate enquiries of OHIP, NMS, and 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.
(20) I, Dr. Irwin, acknowledge that I have executed the OHIP and NMS consent forms, attached hereto as Schedule “F” and Schedule “G”, respectively.
(21) I, Dr. Irwin, 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 any information arising from the monitoring of my compliance with this Undertaking.
Terms and conditions imposed on certificate by: Inquiries, Complaints and Reports Committee