(1 of 2)
As from March 31, 2026, the following are imposed as terms, conditions and limitations on the certificate of registration held by Dr. Siva Subramaniam Murugappan in accordance with an undertaking and consent given by Dr. Murugappan to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
(“Undertaking”)
of
DR. SIVA SUBRAMANIAM MURUGAPPAN
(“Dr. Murugappan”)
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 Tribunal” means the Ontario Physicians and Surgeons Discipline Tribunal of the College;
“ICRC” means the Inquiries, Complaints and Reports Committee of the College;
“IEP” means Individualized Education Plan;
“Ontario Physicians and Surgeons Discipline Tribunal” means the Discipline Committee established under the Code;
“Public Register” means the College’s register that is available to the public.
(2) I, Dr. Murugappan, certificate of registration number 82089, am a member of the College.
(3) I, Dr. Murugappan, acknowledge that following a public complaint, the College conducted an investigation bearing File Number CAS-494930-R4J4Q4 (the “Investigation”) into my care of a patient in my general surgery practice.
(4) I, Dr. Murugappan, acknowledge that I entered into an undertaking with the College, dated April 1, 2025 (the “April 2025 undertaking”), which restricted my practice. This Undertaking does not replace or supersede the April 2025 undertaking.
B. UNDERTAKING
(5) I, Dr. Murugappan, undertake to abide by the provisions of this Undertaking, effective immediately.
(6) Professional Education
(a) I, Dr. Murugappan, undertake to participate in and successfully complete all aspects of the detailed IEP, attached hereto as Appendix “A”, including all of the following professional education (the “Professional Education”):
(i) Review, reflection, and a written summary of the following policies and other self-study:
1. Rampinelli V, Pinacoli A, Piazza C. Head and neck nonmelanoma skin cancers: surgical management and debated issues. Curr Opin Otolaryngol Head Neck Surg. 2024;32(2):62-70;
2. Consent to Treatment, College policy;
3. Medical Records Documentation, College policy;
(ii) Medical Record-Keeping Workshop, University of Toronto.
(b) I, Dr. Murugappan, 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. Murugappan, undertake to complete this requirement within three (3) months, or, if no satisfactory program is available by that time, by the first possible opportunity thereafter.
(d) I, Dr. Murugappan, acknowledge that a report or reports may be provided to the College regarding my progress and compliance with the Professional Education.
(e) I, Dr. Murugappan, acknowledge that if any of the programs and/or self-study resources listed above become unavailable, substitution requests will be reviewed by the College and the College will determine in its sole discretion whether substitution is appropriate.
(7) Monitoring
(a) I, Dr. Murugappan, 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.
C. ACKNOWLEDGEMENT
(8) I, Dr. Murugappan, acknowledge that all appendices attached to or referred to in this Undertaking form part of this Undertaking.
(9) I, Dr. Murugappan, 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.
(10) I, Dr. Murugappan, 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.
(11) I, Dr. Murugappan, 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”).
(12) I, Dr. Murugappan, 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 Tribunal of the College.
(13) I, Dr. Murugappan, acknowledge that this Undertaking constitutes terms, conditions, and limitations on my certificate of registration for the purposes of section 23 of the Code.
(14) Public Register
(a) I, Dr. Murugappan, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. Murugappan, acknowledge that, in addition to this Undertaking being posted in accordance with section (14)(a) above, the following summary shall be posted on the Public Register during the time period that this Undertaking remains in effect:
Following a public complaint, a College investigation was conducted into Dr. Murugappan’s care of a patient in his general surgery practice. As a result of the investigation:
Dr. Murugappan will engage in professional education in medical record-keeping, having appropriate consent discussions with patients, and the appropriate evaluation, operative planning, specialist consultation, and management of non-simple skin lesion excisions for those requiring a flap or graft reconstruction.
(c) I, Dr. Murugappan, acknowledge that this Undertaking remains in effect until the College determines its terms are satisfied.
D. CONSENT
(15) I, Dr. Murugappan, 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:
(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.
(16) I, Dr. Murugappan, 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.
(17) I, Dr. Murugappan, give my irrevocable consent to any persons who facilitate my completion of the Professional Education, and to all Chiefs of Staff, to disclose to the College, and to one another, any of the following:
(a) any information relevant to this Undertaking;
(b) any information relevant for the purposes of monitoring my compliance with this Undertaking;
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.
(2 of 2)
As from April 1, 2025, the following is imposed as a term, condition and limitation on the certificate of registration held by Dr. Siva Subramaniam Murugappan in accordance with an undertaking and consent given by Dr. Murugappan to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
(“Undertaking”)
of
DR. SIVA SUBRAMANIAM MURUGAPPAN
(“Dr. Murugappan”)
to
COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
(the “College”)
A. PREAMBLE
(1) In this Undertaking:
“Clinical Services” means consultations, office clinics, follow-up visits, case conferences, and telephone calls with patients;
“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 Tribunal” means the Ontario Physicians and Surgeons Discipline Tribunal of the College;
“Major Surgery/Surgeries” means open and laparoscopic procedures and inguinal hernia repairs;
“Minor Surgery/Surgeries” means the excision of lumps and bumps, closure of skin wounds and lacerations, dressings and dressing changes and procedures under local anesthesia;
“OHIP” means the Ontario Health Insurance Plan;
“Ontario Physicians and Surgeons Discipline Tribunal” means the Discipline Committee established under the Code;
“Public Register” means the College’s register that is available to the public.
(2) I, Dr. Murugappan, certificate of registration number 82089, am a member of the College.
(3) I, Dr. Murugappan, acknowledge that I entered into an undertaking with the College dated May 14, 2024 (the “May 2024 undertaking”) further to my intention to change the scope of my general surgery practice to include Major Surgeries.
(4) I, Dr. Murugappan, acknowledge that I was unable to complete the May 2024 undertaking.
(5) I, Dr. Murugappan, acknowledge that this Undertaking replaces and supersedes the May 2024 undertaking.
B. UNDERTAKING
(6) I, Dr. Murugappan, undertake to abide by the provisions of this Undertaking, effective immediately.
(7) Practice Restrictions
(a) I, Dr. Murugappan, undertake that my practice will be restricted to:
(i) Clinical Services;
(ii) Minor Surgery/Surgeries;
(iii) Endoscopy, excluding endoscopic retrograde cholangiopancreatography (ERCP). I will ensure that for any endoscopy procedure I perform, in the event of a complication requiring surgical intervention, I will not perform the surgery and instead, will refer the patient to the appropriate service.
(8) Monitoring
(a) I, Dr. Murugappan, undertake to inform the College of each and every location that 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. Murugappan, 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. Murugappan, give my irrevocable consent to the College to make appropriate enquiries of OHIP 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. Murugappan, acknowledge that I have executed the OHIP consent form, attached hereto as Appendix “A”.
C. ACKNOWLEDGEMENT
(9) I, Dr. Murugappan, acknowledge that all appendices attached to or referred to in this Undertaking form part of this Undertaking.
(10) I, Dr. Murugappan, 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. Murugappan, 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. Murugappan, 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”).
(13) I, Dr. Murugappan, 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 Tribunal of the College.
(14) I, Dr. Murugappan, 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. Murugappan, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. Murugappan, 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:
Dr. Murugappan’s practice is restricted to:
• Clinical services;
• Minor surgery; and
• Endoscopy, excluding endoscopic retrograde cholangiopancreatography (ERCP).
D. CONSENT
(16) I, Dr. Murugappan, 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.
(17) I, Dr. Murugappan, give my irrevocable consent to all Chiefs of Staff to disclose to the College, and to one another, any of the following:
(a) any information relevant to this Undertaking;
(b) any information relevant for the purposes of monitoring my compliance with this Undertaking; and/or
(c) any information which they reasonably believe indicates a potential risk of harm to my patients.
Terms and conditions imposed on certificate by: Member