(1 of 3)
Effective August 6, 2020, Dr. Eugenie Tjan does not have an approved supervisor
in her Palliative Care Medicine Practice and therefore must cease to practice
Palliative Care Medicine until a supervisor has been approved.
(2 of 3)
As from May 9, 2018, the following is imposed as a term, condition and
limitation on the certificate of registration held by Dr. Eugenie Ulrica Tjan
in accordance with an undertaking and consent given by Dr. Tjan to the College
of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. EUGENIE ULRICA TJAN
("Dr. Tjan")
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;
"Discipline Committee" means the Discipline Committee of the College;
"NMS" means the Drug Program Services Branch, the Narcotics Monitoring
System implemented under the Narcotics Safety and Awareness Act, 2010;
"OHIP" means the Ontario Health Insurance Plan;
"Public Register" means the College's register that is available to the
public.
(2) I, Dr. Tjan, certificate of registration number 63892, am a member of the
College.
(3) I, Dr. Tjan, acknowledge that the College received a public complaint
bearing File Number 105276 and subsequently initiated an investigation
bearing File Number 7216051 into whether I engaged in professional
misconduct and/or am incompetent in my medical assistance in dying
("MAID") practice.
B. UNDERTAKING
(4) I, Dr. Tjan, undertake to abide by the provisions of this Undertaking,
effective upon the date this Undertaking is approved by the ICR Committee
("Effective Date").
(5) Practice Restrictions
(a) I, Dr. Tjan, undertake that I will not engage in the practice of
MAID in any respect, including, but not limited to assessing
patients for MAID eligibility and the delivery of MAID.
(b) I, Dr. Tjan, acknowledge that, notwithstanding this Undertaking, I
am required to provide patients seeking MAID with an effective
referral, as defined in College Policy #4-16: Medical Assistance in
Dying.
(6) Monitoring
(a) I, Dr. Tjan, undertake to inform the College of each and every
location where I practise or have privileges, including, but not
limited to, hospital(s), clinic(s) and office(s), in any
jurisdiction (collectively my "Practice Location(s)"), within 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. Tjan, undertake that I will submit to, and not interfere
with, unannounced inspections of my Practice Locations and patient
charts by a College representative for the purposes of monitoring
my compliance with the provisions of this Undertaking.
(c) I, Dr. Tjan, 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. Tjan, acknowledge that I have executed the OHIP and NMS
consent forms, attached hereto as Appendix "A" and Appendix "B",
respectively.
C. ACKNOWLEDGEMENT
(7) I, Dr. Tjan, acknowledge that all appendices attached to or referred to
in this Undertaking
form part of this Undertaking.
(8) I, Dr. Tjan, 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.
(9) I, Dr. Tjan, 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.
(10) I, Dr. Tjan, acknowledge that the College will provide this Undertaking
to any Chief of Staff, or a colleague with similar responsibilities, at
any Practice Location ("Chief(s) of Staff").
(11) I, Dr. Tjan, 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.
(12) I, Dr. Tjan, acknowledge that this Undertaking constitutes terms,
conditions, and limitations on my certificate of registration for the
purposes of section 23 of the Code.
(13) Public Register
(a) I, Dr. Tjan, acknowledge that, during the time period that this
Undertaking remains in effect, this Undertaking shall be posted on
the Public Register.
(b) I, Dr. Tjan, acknowledge that, in addition to this Undertaking
being posted in accordance with section (13)(a) above, the
following summary shall be posted on the Public Register during the
time period that this Undertaking remains in effect:
The College received a public complaint and subsequently
initiated an investigation into whether Dr. Tjan engaged in
professional misconduct and/or is incompetent in the practice
of medical assistance in dying. As a result of the
investigation, Dr. Tjan must not engage in the practice of
medical assistance in dying (MAID) in any respect, including,
but not limited to assessing patients for MAID eligibility
and the delivery of MAID.
D. CONSENT
(14) I, Dr. Tjan, give my irrevocable consent to the College to provide all
Chief(s) of Staff with any information the College has that led to the
circumstances of my entering into this Undertaking and/or any information
arising from the monitoring of my compliance with this Undertaking.
(3 of 3)
As from May 8, 2018, the following terms, conditions and limitations are
imposed on the certificate of registration held by Dr. Eugenie Ulrica Tjan, in
accordance with an undertaking and consent Dr. Tjan has given to the College of
Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. EUGENIE ULRICA TJAN
("Dr. Tjan")
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;
"NMS" means the Drug Program Services Branch, the Narcotics Monitoring
System implemented under the Narcotics Safety and Awareness Act, 2010;
"OHIP" means the Ontario Health Insurance Plan;
"Public Register" means the College's register that is available to the
public.
(2) I, Dr. Tjan, certificate of registration number 63892, am a member of the
College. The College has received information regarding my standard of
practice.
(3) I, Dr. Tjan, acknowledge that the College received a public complaint
bearing File Number 105276 and subsequently initiated an investigation
bearing File Number 7216051 into whether I engaged in professional
misconduct and/or am incompetent in my medical assistance in dying
("MAID") practice (the "Investigations").
B. UNDERTAKING
(4) I, Dr. Tjan, undertake to abide by the provisions of this Undertaking,
effective upon the date this Undertaking is approved by the ICR Committee
("Effective Date").
(5) Clinical Supervision
(a) I, Dr. Tjan, undertake to practise under the guidance of a clinical
supervisor(s) acceptable to the College (the "Clinical
Supervisor(s)"), for a minimum of twelve (12) months ("Clinical
Supervision").
(b) I, Dr. Tjan, acknowledge that I have reviewed the Clinical
Supervisor(s)'s undertaking, attached hereto as Appendix "A", and
understand what is required of the Clinical Supervisor(s). The
Clinical Supervisor(s) will, at minimum:
(i) Facilitate the education program set out in the
Individualized Education Plan ("IEP"), attached hereto as
Appendix "B";
(ii) Review the materials provided by the College and have an
initial meeting to discuss practice improvement
recommendations, with a focus on palliative care and end of
life care;
(iii) Meet with me at my Practice Location, or another location
approved by the College, once every month for a minimum of
three (3) months. If my Clinical Supervisor recommends it and
the College approves, meetings shall take place once every
three (3) months thereafter;
(iv) Review at least ten (10) of my palliative care charts at
every meeting. If ten (10) palliative care charts are not
available for review at a given meeting, the Clinical
Supervisor will review every palliative care chart. If fewer
than three (3) palliative care charts are available for
review at a given meeting, an additional meeting during which
at least three (3) palliative care charts are reviewed will
be required to complete the period of Clinical Supervision;
(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(s) deem necessary to my Clinical
Supervision; and
(viii)Submit written reports to the College at least once every
quarter, or more frequently if the Clinical Supervisor(s) has
concerns about my standard of practice.
(c) I, Dr. Tjan, acknowledge that the charts reviewed shall be selected
by the Clinical Supervisor(s) based on the educational needs
identified in the IEP, attached hereto as Appendix "B", as well as
the areas of concern identified in the report(s) of the medical
inspector dated November 13, 2017, December 11, 2017 and January
15, 2018, and concerns that may arise during the period of Clinical
Supervision.
(d) I, Dr. Tjan, undertake to cooperate fully with the Clinical
Supervision of palliative care conducted under the term of this
Undertaking and Appendix "A" to this Undertaking, and to abide by
the recommendations of my Clinical Supervisor(s), including but not
limited to, any recommended practice improvements and ongoing
professional development.
(e) I, Dr. Tjan, undertake to ensure that Appendix "A" to this
Undertaking is signed and delivered to the College within thirty
(30) days of the Effective Date.
(f) I, Dr. Tjan, undertake that if a person who has given an
undertaking in Appendix "A" to this Undertaking is unable or
unwilling to continue to fulfill its provisions, I shall, within
twenty (20) days of receiving notice of same, obtain an executed
undertaking in the same form from a similarly qualified person who
is acceptable to the College and ensure that it is delivered to the
College within that time.
(g) I, Dr. Tjan, undertake that if I am unable to obtain a Clinical
Supervisor on the provisions set out under sections (5)(e) and/or
(f) above, I will cease practising palliative care medicine until
such time as I have obtained a Clinical Supervisor acceptable to
the College.
(h) I, Dr. Tjan, acknowledge that if I am required to cease practicing
palliative care medicine as a result of section (5)(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.
(6) Professional Education
(a) I, Dr. Tjan, undertake to participate in and successfully complete
all aspects of the detailed IEP, attached hereto as Appendix "B",
including all of the following professional education (the
"Professional Education"):
(i) education acceptable to the College and my Clinical
Supervisor in palliative care practice, including end of life
care;
(ii) review and discussion with my Clinical Supervisor of College
Policy #6-16: Planning for and Providing Quality End of Life
Care; and
(iii) any additional professional education recommended by my
Clinical Supervisor(s).
(b) I, Dr. Tjan, 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. Tjan, acknowledge that a report or reports may be provided
to the College regarding my progress and compliance with the
Professional Education.
(d) I, Dr. Tjan, undertake to complete this requirement within twelve
(12) months of the Effective Date.
(7) Reassessment of Practice
(a) I, Dr. Tjan, undertake that, approximately six (6) months after the
completion of the Clinical Supervision set out in section (5) above
and Appendix "A" to this Undertaking, I will submit to a
reassessment of my palliative care practice ("the Reassessment") by
an assessor or assessors selected by the College (the
"Assessor(s)"). 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. Tjan, undertake to co-operate fully with the Reassessment,
conducted under the term of this Undertaking.
(c) I, Dr. Tjan, acknowledge that my Clinical Supervisor(s) may receive
and review the findings of the Assessor(s), and may discuss with
the Assessor(s) any issues or concerns arising from the
Reassessment. I also acknowledge that the results of the
Reassessment will be provided to me and reported to the College and
the report may form the basis of further action by the College.
(d) I, Dr. Tjan, acknowledge that if I am of the view that any of the
Assessor(s)'s recommendations are unreasonable, I will have thirty
(30) days following my receipt of the recommendations within which
to provide the College with my submissions in this regard. I
further acknowledge that thereafter, the ICR Committee will
consider my submissions and make a determination regarding whether
or not the recommendations, or any of them, are reasonable and if
so, whether they, or any of them, constitute limitations or
restrictions on my practice, and that decision will be provided to
me.
(e) I, Dr. Tjan, undertake that, following the decision referenced in
section (7)(d) above, I will abide by those recommendations of the
Assessor(s) that the ICR Committee has determined are reasonable.
(f) I, Dr. Tjan, hereby consent to the following being included on the
public register as terms, conditions or limitations on my
certificate of registration, for the purposes of section 23 of the
Code:
(i) any recommendations of the Assessor(s) which the ICR
Committee has identified in its decision referenced in
section (7)(d) as terms, conditions or limitations on my
practice.
(8) Monitoring
(a) I, Dr. Tjan, undertake to inform the College of each and every
location that I practise or have privileges, including, but not
limited to, hospital(s), clinic(s) and office(s), in any
jurisdiction (collectively my "Practice Location(s)"), within 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. Tjan, undertake that I will submit to, and not interfere
with, unannounced inspections of my Practice Location(s) and
patient records by a College representative for the purposes of
monitoring my compliance with the provisions of this Undertaking.
(c) I, Dr. Tjan, 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. Tjan, acknowledge that I have executed the OHIP and NMS
consent form(s), attached hereto as Appendix "C" and Appendix "D",
respectively.
C. ACKNOWLEDGEMENT
(9) I, Dr. Tjan, acknowledge that all appendices attached to or referred to
in this Undertaking form part of this Undertaking.
(10) I, Dr. Tjan, 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.
(11) I, Dr. Tjan, 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.
(12) I, Dr. Tjan, acknowledge that the College will provide this Undertaking
to any Chief of Staff, or a colleague with similar responsibilities, at
any Practice Location ("Chief(s) of Staff").
(13) I, Dr. Tjan, 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.
(14) I, Dr. Tjan, acknowledge that this Undertaking constitutes terms,
conditions, and limitations on my certificate of registration for the
purposes of section 23 of the Code.
(15) Public Register
(a) I, Dr. Tjan, acknowledge that, during the time period that this
Undertaking remains in effect, this Undertaking shall be posted on
the Public Register.
(b) I, Dr. Tjan, acknowledge that, in addition to this Undertaking
being posted in accordance with section (15)(a) above, the
following summary shall be posted on the Public Register during the
time period that this Undertaking remains in effect:
The College received a public complaint and subsequently conducted
an investigation into whether Dr. Tjan engaged in professional
misconduct and/or is incompetent in the practice of Medical
Assistance in Dying. As a result of the investigation:
With respect to her palliative care practice, Dr. Tjan will
practise under the guidance of a Clinical Supervisor
acceptable to the College for a minimum of 12 months.
Dr. Tjan will engage in professional education in palliative
care practice, including end of life care.
Dr. Tjan's palliative care practice will be reassessed by an
assessor selected by the College within 6 months of the end
of the period of Clinical Supervision.
D. CONSENT
(16) I, Dr. Tjan, 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.
(17) I, Dr. Tjan, give my irrevocable consent to the College to provide all
Chief(s) of Staff with any information the College has that led to the
circumstances of my entering into this Undertaking and/or any information
arising from the monitoring of my compliance with this Undertaking.
(18) I, Dr. Tjan, 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 information:
(a) relevant to this Undertaking;
(b) relevant to the provisions of the Clinical Supervisor's undertaking
set out at Appendix "A" to this Undertaking;
(c) relevant to the Reassessment;
(d) relevant for the purposes of monitoring my compliance with this
Undertaking; and/or
(e) which comes to their attention in the course of providing the
Professional Education and which they reasonably believes indicates
a potential risk of harm to my patients.
Terms and conditions imposed on certificate by: Member
