On April 11, 2005, the Discipline Committee found that Dr. Brett Lennox Ferdinand committed professional misconduct in that he committed acts or omissions relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional. The Discipline Committee also found that Dr. Ferdinand is incompetent.
The Discipline Committee directed the following terms, conditions and limitation be imposed on Dr. Ferdinand s certificate of registration:
1) Nature
Dr. Ferdinand may only practise surgery in accordance with the supervisory and other provisions in the rest of the Order.
2) Objectives
The objective of the Traineeship and practice experience authorized by this Order is to assist Dr. Ferdinand to improve and/or obtain the requisite skills necessary to practice in Ontario, in particular, those skills related to insight, decision-making and professional judgment.
3) Duration
Up until July 1, 2005, Dr. Ferdinand is specifically restricted from performing all surgery except:
(a) as a surgical assistant;
(b) endoscopies (except laparoscopies); and
(c) minor office or out-patient procedures that require at most local anaesthesia
After July 1, 2005, Dr. Ferdinand may only practice as part of the Traineeship described below, or under the supervision provisions following the Traineeship. The one full year of clinical traineeship (hereinafter the Traineeship ) authorized by this Order must be completed by Dr. Ferdinand by June 30th, 2007.
4) Structure
1. For the one-year Traineeship portion of this Order, Dr. Ferdinand may only practice in a public hospital with a teaching affiliation with a Canadian Medical School under the supervision of that university s residency training program in general surgery, such program to be approved by the College;
2. During the one full year Traineeship, the following terms, conditions and limitation shall be imposed on Dr. Ferdinand s certificate of registration:
(a) Dr. Ferdinand is only permitted to practice under the supervision of active staff general surgeons of the hospital according to the principles of graded responsibility set out by the Royal College of Physicians and Surgeons of Canada. He cannot be the primary surgeon in any case and is precluded from providing any primary surgical care including any post-operative care without such oversight.
(b) Dr. Ferdinand is not permitted to have admitting privileges at any health facility;
(c) Dr. Ferdinand is not permitted to operate on a patient unless the decision to operate has been approved by the staff surgeon in any case.
3. Following the successful completion of the Traineeship as evidenced by the supervisor s report to the Director of Professional Enhancement at the College, the following terms, conditions and limitations shall be imposed on Dr. Ferdinand s certificate of registration:
(a) For a period of at least two years, following the Traineeship, Dr. Ferdinand shall be assisted by another surgeon licensed to practise in Ontario during any surgery or operation except endoscopies (excluding laparoscopies) and minor office or out-patient procedures that require at most local anaesthesia;
(b) For a period of at least three years, following the Traineeship, Dr. Ferdinand shall not make any decision to operate in any case without such decision having received prior approval from another surgeon licensed to practise in Ontario.
4. Dr. Ferdinand s practice will be reviewed on an ongoing basis, at Dr. Ferdinand s expense, by a certified surgeon agreeable to Dr. Ferdinand and acceptable to the Registrar.
5. Supervision Methods
1. The supervisor for the period following the Traineeship need not be the person who supervises during the Traineeship. There shall however be a supervisor approved by the College during the duration of the Order.
2. During the term of this Order, the supervisor will review every two weeks a random sample of a reasonable number of cases in which Dr. Ferdinand was involved in any surgical intervention;
3. The random sample of cases will be representative of Dr. Ferdinand s whole scope of practice;
4. The review of the cases will consist of considering all clinical information pertinent to the patient, a review of Dr. Ferdinand s report and other work product, and a discussion with Dr. Ferdinand of the case;
5. Each review will include attention to Dr. Ferdinand s assessment, problem-solving, professional judgment, documentation and follow-up recommendations, as well as a mortality and morbidity review of Dr. Ferdinand s patients
6. Dr. Ferdinand shall not start the next two weeks work until the review of his prior two weeks work has been completed;
7. If the supervisor is unable to perform the review at the end of any two week period, the supervisor will seek an extension from the Director of Professional Enhancement;
8. The supervisor will promptly inform the Director of Professional Enhancement of any circumstances indicating the Dr. Ferdinand is not practising in accordance with the standards of surgery in Ontario.
9. Shortly before the end of the Traineeship period and once a year thereafter, the supervisor will report in detail to the Director of Professional Enhancement and indicate the degree to which Dr. Ferdinand s practice is in accordance with the standards of surgery in Ontario and provide observations in support of the conclusion.
6) Contingencies
1. If Dr. Ferdinand completes the Traineeship and subsequent 3-year practice experience required by this Order to the satisfaction of the Director of Professional Enhancement, all terms, conditions and limitation will be removed from his certificate of registration without any further appearance before this Committee.
2. If the terms, conditions and limitations imposed upon Dr. Ferdinand s certificate of registration are not removed under 6(1) but Dr. Ferdinand completes the authorized Traineeship and practice experience to the satisfaction of the Discipline committee, the Committee upon application, the Discipline Committee may remove all terms, conditions and limitations from his certificate of registration, unless the Committee reasonably concludes that another period of transitional practice experience is warranted.
3. If, on application to the Committee, the Committee forms the opinion that Dr. Ferdinand is not progressing satisfactorily, or that different methods of supervision are necessary to accomplish the objectives of the practice experience, the Committee may amend the terms, conditions and limitation imposed on his certificate of registration.
4. If the supervisor is of the opinion that Dr. Ferdinand s performance is placing his patients at risk, the supervisor will notify Dr. Ferdinand and the Director of Professional Enhancement and Dr. Ferdinand will immediately stop practising.
5. If Dr. Ferdinand loses his hospital privileges or is suspended from the public hospital, he will immediately notify the Director of Professional Enhancement.
6. If on application the Committee forms the opinion that Dr. Ferdinand is not practising in accordance with the standards of surgery in Ontario, the Committee may imposed such further terms, conditions nd limitations on Dr. Ferdinand s certificate of registration as the Committee considers necessary to serve and protect the public interest.
7. If on application the Committee determines that there has been a breach of any of the terms, conditions and limitation in this Order, it will take whatever steps it considers advisable in the interest of the public, including the revocation of Dr. Ferdinand s certificate of registration.
7) Other Conditions
The following must occur prior to the commencement of the one-year Traineeship program:
1. A certified surgeon agreeable to Dr. Ferdinand and acceptable to the Registrar will be designated as the supervisor for the purposes of this Order;
2. Dr. Ferdinand will authorize the College to inform, and the College shall inform, the head of the medical school residency training program and any other supervisor of Dr. Ferdinand, of his full professional history known to the College, including the decision and reasons of the Discipline Committee in this matter.
3. Dr. Ferdinand will inform any public hospital in which Dr. Ferdinand is practising of all such professional history during the period of 1999 through present.
4. Dr. Ferdinand and the supervisor will execute a document indicating that each has read, understood and agreed to abide by this Order and by its terms, conditions and limitations;
5. The supervisor will execute a document indicating his/her undertaking to comply with the requests, directions or other obligations on his/her part mentioned in this Order.
8) Courses
Dr. Ferdinand shall take at his own expense and successfully complete the record keeping and communications courses offered by the College within two years of the date of this order.
9) The Discipline Committee directs the results of this proceeding to be included in the Register.
Terms and conditions imposed on certificate by: Executive Committee