On July 17, 2015, the Discipline Committee found that Dr. Javad Peirovy committed acts of professional misconduct in that: he engaged in the sexual abuse of patients; he engaged in conduct or 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; and, he has been found guilty of an offence that is relevant to his suitability to practise.
The Discipline Committee found that Dr. Peirovy sexually abused four patients, Ms. U, Ms. V, Ms. W, and Ms. X.
Regarding Ms. U, the Committee found that Dr. Peirovy placed his stethoscope directly on her nipples and cupped her breasts with his hand, that he did not have consent to touch his patient in this manner and that there was no clinical reason to examine Ms. U in this way. The cupping of her breasts with his hand and the placing of the stethoscope directly on her nipples are actions which, to the objective observer, would be construed as sexual in nature. Regardless of Dr. Peirovy’s motivation, this deliberate touching of the nipples and breasts during a chest examination was a violation of Ms. U’s sexual integrity and constitutes sexual abuse.
Regarding Ms. V, the Committee found that Dr. Peirovy placed his stethoscope directly on her nipples during the course of his examination, that he did not have consent to touch his patient in this manner and that there was no clinical reason to examine Ms. V in this way. The placing of the stethoscope directly on her nipples would, to the objective observer, be construed as sexual in nature. Regardless of Dr. Peirovy’s motivation, this deliberate touching of her nipples during a chest examination was a violation of Ms. V sexual integrity and constitutes sexual abuse.
Regarding Ms. W, the Committee found that Dr. Peirovy touched her nipples with his fingers during the course of his examination, that Dr. Peirovy did not have consent to touch his patient in this manner and that there was no clinical reason to examine Ms. W in this way. The touching of her nipples, to the objective observer, would be construed as sexual in nature. Regardless of Dr. Peirovy’s motivation, the deliberate touching of her nipples during a chest examination was a violation of Ms. W’s sexual integrity and constitutes sexual abuse.
Regarding Ms. X, the Committee found that during the course of his examination Dr. Peirovy cupped her breasts and used his fingers to put pressure on her nipples, which she described as “tweaking”, that Dr. Peirovy did not have consent to touch his patient in this manner and that there was no clinical reason to examine Ms. X in this way. The cupping of her breasts with his hand and “tweaking” of her nipples are actions which, to the objective observer, would be construed as sexual in nature. Regardless of Dr. Peirovy’s motivation, the deliberate touching of her breasts and nipples during a chest examination was a violation of Ms. X’s sexual integrity.
The Committee found that Dr. Peirovy’s conduct with respect to these four patients, Ms. U, Ms. V, Ms. W, and Ms. X, would also reasonably be regarded by members as disgraceful, dishonourable, or unprofessional.
Regarding a fifth patient, Ms. Z, Dr. Peirovy conducted a cardiac examination during which Ms. Z’s breasts were left fully exposed due to a miscommunication between Dr. Peirovy and Ms. Z.
The Committee stated it was Dr. Peirovy’s responsibility as the physician to take steps to ensure effective communication with respect to a sensitive examination of this nature and that he did not discharge this responsibility effectively. Further, when Dr. Peirovy realized that Ms. Z’s breasts were fully exposed, his decision to proceed with the examination without offering her privacy, by way of a gown for example, was a serious lapse of judgment. Regardless of time constraints or other issues, Dr. Peirovy should have recognized the vulnerable and compromised situation of Ms. Z, and responded in a more professional manner by assisting in preserving her modesty. The Committee found his conduct in this regard unprofessional. Following the examination, Dr. Peirovy engaged Ms. Z in conversation which culminated in asking her out on a date. He told her that she would have to sign a note for her chart terminating the doctor/patient relationship, if they were to see each other outside the office. Dr. Peirovy demonstrated egregiously poor judgment in suggesting to Ms. Z that they could see each other socially, in the context of just having compromised her privacy due to the ill-advised fashion in which he had examined her. The Committee found this conduct would reasonably be regarded by members as disgraceful, dishonourable or unprofessional.
The Discipline Committee also found that Dr. Peirovy has been found guilty of offences relevant to his suitability to practise in that he was found guilty of assault on Ms. U and Ms. W. The Court imposed a conditional discharge and eighteen months’ probation, with conditions including that Dr. Peirovy attend counselling with Dr. D, perform community service, make a charitable donation, and have no contact with the six complainants in these proceedings.
PENALTY AND COSTS
On April 27, 2016, The Discipline Committee ordered and directed that:
1. The Registrar suspend Dr. Peirovy’s certificate of registration for a period of six months, effective as of the date of this order at 11:59 pm.
2. The Registrar impose the following terms, conditions and limitation of Dr. Peirovy’s certificate of registration:
Practice Monitor
a) Dr. Peirovy shall not engage in any professional encounters with female patients of any age unless the patient encounter takes place in the presence of a monitor who is a female member of a regulated health profession and who is acceptable to the College (the “Practice Monitor”), to be reconsidered upon application to the Committee by Dr. Peirovy after a minimum of one year following his return to practice once his suspension has ended;
b) At all times, Dr. Peirovy shall ensure that the Practice Monitor shall:
i. Remain in the examination room or consultation room at all times during all professional encounters with all female patients, even if another person is accompanying the patient;
ii. Carefully observe all of his physical examinations (including but not limited to breast and chest examinations) of all female patients, with an unobstructed view of the examination;
iii. Refrain from performing any other functions, except those required in the Practice Monitor’s undertaking attached as Appendix “A” (the “Practice Monitor’s Undertaking”), while observing him in all his professional encounters with female patients;
iv. Keep a patient log in the form attached as Appendix “B” to this Order of all the female patients with whom Dr. Peirovy has an in-person professional encounter in the Practice Monitor’s presence (the “Log”);
v. Initial the corresponding entry in the records of each patient noted in the Log to confirm that the Practice Monitor was in the presence of Dr. Peirovy at all times during each female in-person professional encounter;
vi. Submit the original Log to the College on a monthly basis; and
vii. Provide reports (as described in the Practice Monitor’s Undertaking) to the College on at least a monthly basis.
c) Dr. Peirovy shall maintain a copy of the Log at all times, and shall make it available to the College upon request;
Notification of Practice Locations
d) Dr. Peirovy shall inform the College of each and every location that he practices including, but not limited to, hospital(s), clinic(s) and office(s), in any jurisdiction (collectively the “Practice Location(s)”), within fifteen (15) days of this Order. Going forward, he shall inform the College of any and all new Practice Locations within fifteen (15) days of commencing practice at that location;
Posting a Sign
e) Dr. Peirovy shall post a sign in his waiting room(s) and each of his examination and/or consulting rooms, in all of his Practice Locations, in a clearly visible and secure location, in the form attached hereto as Appendix “C”;
f) Dr. Peirovy shall provide patients with a guide to access the Discipline Committee’s decision in this matter, if requested;
Monitoring
g) Dr. Peirovy shall consent to the College making appropriate enquiries of the Ontario Health Insurance Plan and/or any person or institution who may have relevant information in order for the College to monitor Dr. Peirovy’s compliance with the terms of this Order and shall promptly sign such consents as may be necessary for the College to obtain information from these persons or institutions;
h) Dr. Peirovy shall submit to, and not interfere with, unannounced inspections of his Practice Locations and to inspections of patient charts by the College and to any other activity the College deems necessary, including simulated patients, in order to monitor Dr. Peirovy’s compliance with the terms of this Order;
i) Dr. Peirovy shall consent to the College providing any and all information to the Practice Monitor that the College deems necessary or desirable in order to assist the Practice Monitor in fulfilling her Undertaking and in order to monitor Dr. Peirovy’s compliance with the terms of this Order; and
j) Dr. Peirovy shall consent to all Practice Monitors disclosing to the College, and to one another, any information relevant to this Order, relevant to the terms of the Practice Monitor’s Undertaking and/or relevant for the purposes of monitoring Dr. Peirovy’s compliance with this Order;
Individualized Instruction
k) Dr. Peirovy continue to undergo individualized instruction with Dr. D on issues of consent, the maintenance of boundaries, and doctor/patient communication, and that Dr. D report to the College on Dr. Peirovy’s progress each six months, with a final report to follow prior to her termination of instruction with Dr. Peirovy. Termination of the individualized instruction shall be at the discretion of Dr. D;
Clinical Education Program
l) Dr. Peirovy shall, within 90 days of the commencement of the suspension of his certificate of registration, meet with a physician advisor from the College to establish a clinical education program, directed by a supervisor acceptable to the College, regarding the issue of physical examination, with particular focus on issues of the sexual privacy of and sensitivity to female patients.
m) All the above terms and conditions to be at Dr. Peirovy’s expense.
3. Dr. Peirovy reimburse the College for funding for patients therapy, pursuant to the program required under section 85.7 of the Code, and that he post an irrevocable letter of credit or other security acceptable to the College to guarantee payment, in the amount of $64,240.00.
4. Dr. Peirovy appear before the Committee to be reprimanded, not later than six months from the date this Order becomes final.
5. Dr. Peirovy pay costs to the College in the amount of $35,680.00 within sixty (60) days of the date of this Order.
6. In light of the fact that this Order is different form the penalty proposed by either party, the parties have ten days from the date of this Order to make written submissions with respect to any issues related to the implementation of this Order. To be clear, the Panel is not inviting submissions with respect to the substance of this Order or the start date of the period of suspension, but simply wishes to provide the parties with an opportunity to address any potential difficulties with the implementation of this Order which may not have been apparent to the Committee.
APPEALS
On August 7, 2015, Dr. Peirovy appealed the decision on finding of the Discipline Committee to the Superior Court of Justice (Divisional Court).
On May 24, 2016, the College of Physicians and Surgeons of Ontario appealed the decision on penalty of the Discipline Committee to the Superior Court of Justice (Divisional Court).
On June 27, 2016, Dr. Peirovy abandoned his appeal to the Superior Court of Justice (Divisional Court).
On January 17, 2017, the Divisional Court granted the College’s appeal of the penalty decision, quashed the penalty imposed and remitted the matter to the Discipline Committee to impose a penalty. Pending the disposition of penalty by the Discipline Committee Dr. Peirovy’s undertaking of July 23, 2013, signed in lieu of a s.37 order and consenting to practice restrictions, came back into effect.
On January 30, 2017, Dr. Peirovy filed a motion for leave to appeal the decision of the Divisional Court to the Court of Appeal and for an order staying the decision of the Divisional Court pending leave, and if leave is granted, pending the disposition of the appeal.
On April 13, 2017, the Court of Appeal granted Dr. Peirovy’s motion for leave to appeal. Upon leave being granted by the Court of Appeal, the College consented to the adjournment of the scheduled penalty hearing of September 6 and 7, 2017, until such time as the appeal was determined.
On August 30, 2017, Dr. Peirovy entered into a supplemental undertaking agreeing to only engage in professional encounters at his practice at 298 Sheppard Avenue East, Toronto, in “Exam Room 1”.
On May 3, 2018, the Court of Appeal allowed Dr. Peirovy’s appeal of the Divisional Court decision and restored the decision of the Discipline Committee. Therefore, the decision of the Discipline Committee is in effect.
Terms and conditions imposed on certificate by: Member
