On January 27, 2020, on the basis of an Statement of Uncontested Facts and Plea of No Contest, the Discipline Committee (the “Committee”) of the College of Physicians and Surgeons of Ontario (“the College”) found that Dr. Karin Elaine Kerfoot (“Dr. Kerfoot”) committed an act of professional misconduct, and set out its penalty and costs order.
Dr. Kerfoot is a 45-year old psychiatrist who received her certificate of registration authorizing independent practice from the College in July 2011. At the relevant time, Dr. Kerfoot practised psychiatry in London, Ontario at the London Health Sciences Centre, on both an in-patient and an out-patient basis.
Patient A was Dr. Kerfoot’s patient at the London Health Sciences Centre between 2015 and 2016.
Dr. Kerfoot’s Treatment of the Patient – 2015 to 2016
In 2015, Patient A attended the Emergency Department at the London Health Sciences Centre. Patient A was admitted voluntarily to the in-patient Adult Mental Health Care Program for just over six weeks. Dr. Kerfoot was his attending physician throughout his admission. Patient A left the hospital but presented at the Emergency Department the following day. Patient A remained on a Form 1 until he was discharged two days later from the Emergency Department by the psychiatry on-call emergency team, with communication to Dr. Kerfoot asking her to follow up with Patient A in the near future in the out-patient setting.
Dr. Kerfoot continued to act as Patient A’s treating psychiatrist on an out-patient basis
following this discharge.
Approximately seven months later, Patient A was re-admitted voluntarily to London Health Sciences Centre’s Adult Mental Health Care Centre after an Emergency Department attendance. Dr. Kerfoot continued as his attending psychiatrist throughout this admission, which lasted over a month.
Shortly after discharge, Patient A entered a twelve-week residential eating disorders treatment program, but was discharged during the second week, after he left the residence in breach of the rules. After his discharge from the program, Dr. Kerfoot continued to treat Patient A on an out-patient basis at the hospital
Patient A was re-admitted voluntarily to London Health Sciences Centre’s Adult Mental Health Care Centre in 2016 after attending at the Emergency Department. Dr. Kerfoot continued to be his attending psychiatrist. Patient A was discharged about a month and a half later, after concerns were raised about his conduct during the admission.
Sexual Contact between Dr. Kerfoot and Patient A – 2015 to 2016
A few months after Patient A’s first 2015 discharge, Dr. Kerfoot and Patient A arranged to get together and go to a bar, which they did. Later that night, they went to a motel and had oral sex and sexual intercourse.
Dr. Kerfoot and Patient A continued to have sexual relations, including sexual intercourse, during the next 13 months. Throughout this period, Dr. Kerfoot was Patient A’s treating psychiatrist.
During this time period, the relationship between Dr. Kerfoot and Patient A included sexual contact, including sexual intercourse, at the following locations:
-Dr. Kerfoot and Patient A attended a hotel. Dr. Kerfoot paid for a room in cash.
-Dr. Kerfoot and Patient A travelled to Toronto. The Committee received records from Via Rail confirming return train travel between London and Toronto on the relevant dates, in the names of Karin Kerfoot and Patient A. The logbook from a hotel in Toronto confirmed that Dr. Kerfoot checked into the room, provided her telephone number and paid for the room with her MasterCard.
-Dr. Kerfoot and Patient A attended a motel. Patient A also stayed at a motel, with Dr. Kerfoot joining him there on approximately two occasions. The Committee received documentation confirming the room bookings for those dates in Patient A’s name.
-Dr. Kerfoot and Patient A attended a Provincial Park on two occasions, using the names of [redacted] and Karin Kerfoot when booking. Records from Ontario Parks of the reservation show the associated vehicle licence. Vehicle registration information shows that the vehicle licence associated with the reservation was registered to Dr. Kerfoot and a second person.
-Dr. Kerfoot and Patient A attended a hotel. Records from the hotel confirmed their booking. The room is booked for “Karen Diamond” (a variation on Dr. Kerfoot’s full name) and includes Dr. Kerfoot’s home address.
-Dr. Kerfoot and Patient A attended a hotel. Records show that the room was originally reserved in Patient A’s name, then changed to that of Dr. Kerfoot on checking in.
-Dr. Kerfoot’s MasterCard records show that Dr. Kerfoot’s credit card was used for:
-Pre-authorization for Dr. Kerfoot’s and Patient A’s hotel attendance on specific dates in 2015;
-Payment for Dr. Kerfoot’s and Patient A’s stay at a hotel on a specific date in
2015;
-Payment for the Parks Ontario booking made for Dr. Kerfoot’s and Patient A’s attendance at the Provincial Park;
-Payment for Dr. Kerfoot’s and Patient A’s hotel attendance on a specific date.
Electronic Communications between Dr. Kerfoot and Patient A
During the relevant times, Dr. Kerfoot’s cell phone number was [redacted]. During the relevant times, Patient A’s cell phone number was [redacted]. Cell phone records for Dr. Kerfoot’s cell phone number obtained from Rogers Communications were used to prepare a summary of the records of contact between Dr. Kerfoot’s cell phone number and Patient A’s cell phone number.
Dr. Kerfoot and Patient A used the messaging app, “WhatsApp”, to communicate. Dr. Kerfoot was given the name “C” by Patient A in his cell phone contacts. A screen shot of Patient A’s WhatsApp contacts, shows Dr. Kerfoot’s cell phone number with an image of Dr. Kerfoot, named as contact “C”. The College obtained the “chat history” of messages exchanged between Dr. Kerfoot and Patient A using WhatsApp, for a period of just under a month in 2016.
Patient A provided his memory cards and his cell phone to the College for forensic examination at the College’s request. Matthew Musters (“Mr. Musters”), a forensic examiner at Computer Forensics Inc., extracted information including photographs of Dr. Kerfoot and Dr. Kerfoot’s garden. Dr. Kerfoot sent these photographs to Patient A.
In the course of his forensic examination of Patient A’s cell phone, after Patient A provided it to the College, Mr. Musters did not locate any written communications, including text (SMS) or WhatsApp messages, to or from Dr. Kerfoot. Any deleted written communications were no longer available for review or analysis.
Dr. Kerfoot advised the College during the investigation that she had deleted messages exchanged with Patient A from her cell phone before the investigation began. Dr. Kerfoot did not provide the College with her cell phone but provided it to her counsel on March 5, 2018. Her counsel provided the cell phone to a computer forensic examiner, Steve Rogers of Digital Evidence Incorporated, on March 5, 2018, and requested that Mr. Rogers create an image of the phone capable of being forensically analysed, then return the phone to Dr. Kerfoot’s counsel. Forensic examination by Mr. Rogers of the image created of Dr. Kerfoot’s cell phone determined that there were no messages still present on the cell phone from prior to March 5, 2018. All messages still present on the cell phone had been sent or received on March 5, 2018, with the exception of one unsent message (no recipient noted) from December 2015. There were 23 messages on Dr. Kerfoot’s phone (all from March 5, 2018), plus four deleted messages. None of the messages on Dr. Kerfoot’s cell phone were to or from Patient A. There were 17,803 deleted messages that were no longer available for review or retrievable. It was not possible to determine when they were deleted.
Dr. Kerfoot’s responses to Patient A’s allegations
In June 2016, Patient A met with hospital staff at London Health Sciences Centre to state that Dr. Kerfoot had engaged in a sexual relationship with him. Dr. Kerfoot denied Patient A’s allegation to the hospital.
In August 2016, Patient A contacted the College to report he had a sexual relationship with Dr. Kerfoot. Patient A made a formal complaint in 2016. In her response to Patient A’s complaint in January 2017, Dr. Kerfoot denied having had a sexual relationship with Patient A.
In August 2017, in the course of the College’s investigation, the College investigator sent Dr. Kerfoot’s counsel the fruits of his investigation to that date. On September 15, 2017, Dr. Kerfoot admitted having had a sexual relationship with Patient A.
Summary
Dr. Kerfoot engaged in sexual abuse of and violated appropriate doctor-patient boundaries with Patient A.
Dr. Kerfoot was dishonest regarding her relationship with Patient A to the hospital and to the College.
FACTS ON PENALTY
Dr. Kerfoot was suspended by the College’s Inquiries, Complaints and Reports Committee on an interim basis pending the completion of its investigation and the conclusion of any resultant discipline referral, effective September 21, 2017.
DISPOSITION
On January 27, 2020, the Discipline Committee ordered that:
The Registrar revoke Dr. Kerfoot’s certificate of registration effective immediately.
- Dr. Kerfoot attend before the panel to be reprimanded.
-Dr. Kerfoot reimburse the College for funding provided to patients under the program required under section 85.7 of the Code, by posting an irrevocable letter of credit or other security acceptable to the College, within thirty (30) days of the date of the Order in the amount of $16,060.00.
-Dr. Kerfoot pay costs to the College in the amount of $10,370.00, within thirty (30) days of the date of this Order.
DECISION AND REASONS
On April 20, 2020, the Committee released its Decision and Reasons in this matter, available on the College’s website.
