College of Nurses of Ontario v. Sami Adam Ibraham, 2015 CanLII 109141

DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

PANEL: Sarah Corkey, RN Chairperson Grace Fox, NP Member Shiraz Irani, RN Member Abdul Patel Public Member Chuck Williams Public Member

BETWEEN:

COLLEGE OF NURSES OF ONTARIO NICK COLEMAN for College of Nurses of Ontario

• and -

SAMI ADAM IBRAHAM Reg. No. 0017210 NO REPRESENTATION for Sami Adam Ibraham

LUISA RITACCA Independent Legal Counsel

Heard: May 21, 2015

DECISION AND REASONS

This matter came on for hearing before a panel of the Discipline Committee on May 21, 2015 at the College of Nurses of Ontario (“the College”) at Toronto.

The Allegations

The allegations against Sami Adam Ibraham (the “Member”) as stated in the Notice of Hearing dated December 15, 2014, are as follows.

IT IS ALLEGED THAT:

1. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(1) of Ontario Regulation 799/93, in that you contravened a standard of practice of the profession or failed to meet the standard of practice of the profession with respect to the following incidents:

(a) while employed as a Nurse Practitioner at Niagara Falls Community Health Centre in Niagara Falls, Ontario, you performed a controlled act for which you were not authorized when you prescribed a controlled substance, Lorazepam, for [Client “A”], on or about January 18, 2012;

(b) while employed as a Nurse Practitioner and as Clinical Director at Niagara Nurse Practitioner-Led Clinic in Niagara Falls, Ontario, you:

(i) performed a controlled act for which you were not authorized when you prescribed controlled substances for various clients, including:

(A) Codeine for [Client “B”] on or about August 1, 2012;

(B) Lorazepam for [Client “A”] on or about October 3, 2012;

(C) Codeine for [Client “C”] on or about October 31, 2012; January 10, 2013; and/or January 14, 2013;

(ii) misappropriated public funds totalling approximately $19,000 for salaries for [Employee “A”] and [Employee “B”] in or about February-April 2012, when they were not actually employed at the Clinic, and/or for cell phone service for [Employee “C”], [Employee “A”] and [Employee “D”], when such service was not required for any Clinic-related purpose.

2. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(8) of Ontario Regulation 799/93, in that, while employed as Nurse Practitioner and as Clinical Director for the Niagara Nurse Practitioner-Led Clinic in Niagara Falls, Ontario you misappropriated property from a workplace with respect to misappropriating public funds amounting to approximately $19,000 for salaries for [Employee “A”] and [Employee “B”] in or about February-April 2012 when they were not actually employed at the Clinic, and/or for cell phone service for [Employee “C”], [Employee “A”] and [Employee “D”], when such service was not required for any Clinic-related purpose.

3. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(19) of Ontario Regulation 799/93, in that you contravened a provision of the Act, the Regulated Health Professions Act, 1991 or the regulations under either of those Acts, and in particular, section 27(1) of the Regulated Health Professions Act, 1991, S.O. 1991, c. 18; section 5.1(1) of the Nursing Act, 1991, S.O. 1991, c. 32; and/or sections 16(2) and 16(4) of O. Reg. 275/94 under the Nursing Act, 1991, with respect to prescribing controlled substances for various clients, including:

(a) while employed as a Nurse Practitioner at Niagara Falls Community Health Centre in Niagara Falls, Ontario you prescribed Lorazepam for [Client “A”] on or about January 18, 2012; and/or

(b) while employed as a Nurse Practitioner and as Clinical Director at Niagara Nursing Practitioner-Led Clinic in Niagara Falls, Ontario, you prescribed:

(i) Codeine for [Client “B”] on or about August 1, 2012;

(ii) Lorazepam for [Client A”] on or about October 3, 2012;

(iii) Codeine for [Client “C”] on or about October 31, 2012; January 10, 2013; and/or January 14, 2013.

4. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(37) of Ontario Regulation 799/93, in that you engaged in conduct or performed an act, relevant to the practice of nursing, that, having regard to all the circumstances, would reasonably be regarded by members of the profession as disgraceful, dishonourable or unprofessional with respect to the following incidents:

(a) while employed as a Nurse Practitioner at Niagara Falls Community Health Centre in Niagara Falls, Ontario, you performed a controlled act for which you were not authorized when you prescribed a controlled substance, Lorazepam, for [Client “A”], on or about January 18, 2012;

(b) while employed as a Nurse Practitioner and as Clinical Director at Niagara Nurse Practitioner-Led Clinic in Niagara Falls, Ontario, you:

(i) performed a controlled act for which you were not authorized when you prescribed controlled substances for various clients, including:

(A) Codeine for [Client “B”] on or about August 1, 2012;

(B) Lorazepam for [Client “A”] on or about October 3, 2012;

(C) Codeine for [Client “C”] on or about October 31, 2012; January 10, 2013; and/or January 14, 2013;

(ii) misappropriated public funds totalling approximately $19,000 for salaries for [Employee “A”] and [Employee “B”] in or about February-April 2012, when they were not actually employed at the Clinic, and/or for cell phone service for [Employee “C”], [Employee “A”] and [Employee “D”], when such service was not required for any Clinic-related purpose.

Member’s Plea

The Member admitted the allegations set out in paragraphs numbered 1(a), 1(b)(i),1(b)(ii), 2, 3(a), 3(b)(i), 3(b)(ii), 3(b)(iii), 4(a), 4(b)(i) and 4(b)(ii) in the Notice of Hearing. The panel received a written plea inquiry which was signed by the Member. The panel also conducted an oral plea inquiry and was satisfied that the Member’s admission was voluntary, informed and unequivocal.

Agreed Statement of Facts

Counsel for the College advised the panel that an agreement had been reached on the facts and introduced an Agreed Statement of Facts which provided as follows.

THE MEMBER

1. Sami Adam Ibraham (the “Member”) obtained a certificate in nursing from Cambrian College in 1998. He also obtained a diploma in nursing from Cambrian College in 2000. He then obtained a certificate in the Primary Health Care nurse practitioner program from the University of Western Ontario in 2008.

2. The Member registered with the College of Nurses of Ontario (the “College”) as a Registered Nurse (“RN”) in August 2000. He was suspended for non-payment of fees between April 2005 and August 2005. He then registered as an RN in the Extended Class, or Nurse Practitioner (“NP”), in December 2008.

3. At the relevant times, the Member was the President, Secretary and Clinic Director of the Niagara Nurse Practitioner-Led Clinic (the “Clinic”).

THE CLINIC

4. The Clinic is located in Niagara Falls, Ontario.

5. In 2010, the Member made a proposal to the Ministry of Health and Long-Term Care (the “Ministry”) for funding to set up a nurse practitioner-led clinic in his region. The purpose of the Clinic was to provide primary healthcare to the population in the Niagara region who did not have a family physician or primary healthcare provider. This proposal was accepted by the Ministry.

6. The Member incorporated the Clinic as a not-for-profit corporation on September 17, 2010.

7. The Clinic entered into a funding agreement with the Ministry effective April 1, 2012, but signed in July 2012. The agreement was signed by the Member on behalf of the Clinic as President of the Clinic.

8. The Clinic opened to the public in June 2012.

INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT

Prescribing Controlled Substances

9. NPs are legally permitted to prescribe certain drugs pursuant to s. 27 of the Regulated Health Professions Act, s. 5.1(1) of the Nursing Act and Ontario Regulation 275/94.

10. Prior to October 2011, NPs were permitted to prescribe Lorazepam for an emergency purpose, pursuant to s. 19 of Ontario Regulation 275/94. However, this regulation was amended. As of October 1, 2011, all members of this College, including NPs, have been prohibited by law, as set out in ss. 13.2, 16(2) and 16(4) of Ontario Regulation 275/94, from prescribing any controlled substance within the meaning of the Controlled Drugs and Substances Act (“CDSA”).

11. Lorazepam and codeine are controlled substances within the meaning of the CDSA.

Lorazepam

12. On January 18, 2012, the Member prescribed 30 Lorazepam 1mg tabs with directions “for emergency use” to [Client “A”].

13. On October 3, 2012, the Member prescribed another 30 Lorazepam 1mg tabs “for emergency use” to [Client “A”].

Acetaminophen with Codeine

14. The Member prescribed acetaminophen with codeine for two different clients on more than one occasion:

a. [Client “B”]: August 1, 2012; and

b. [Client “C”]: October 31, 2012, January 10, 2013, January 14, 2013 and May 16, 2013.

Misappropriating Public Funds from the Clinic

15. All of the Clinic’s funding came from the Ministry. Any expenses paid by the Clinic were paid for with funds received exclusively from the Ministry.

Staff Payments

16. The Member misappropriated $18,796 of the Clinic’s funds. These funds were characterized as salaries and wages to staff members in the amount of $12,770 for [Employee “A”] and $6,026 for [Employee “B”], for the period between February 15, 2012 and April 12, 2012.

17. [Employee “A”] is the Member’s sister. Between February 15, 2012 and April 12, 2012 she was living in Egypt. She was later employed by the Clinic as Administrative Lead and began performing duties after April 12, 2012.

18. [Employee “B”]is the Member’s friend. [Employee “B”]resided in Alberta and was never employed by the Clinic.

Cell Phone Charges

19. The Member used the Clinic’s funds to pay for three cell phone lines for his wife and two sisters, when they did not require cell phones to carry out their duties. These phones were activated in April 2012.

20. The Member’s wife participated in the set up of the Clinic and was employed as an RN at the Clinic until she was terminated in November 2012. She did not require the use of a cell phone to carry out her duties as an RN between June 1, 2012 (when the Clinic was open to the public) and November 2012 (when she was terminated). However, there was continuous usage of one of the Member’s cell phone lines during that time.

21. [Employee “D”], the Member’s sister, was on the Clinic’s board of directors between September 2010 and May 1, 2012. She was given a cell phone that was activated in April 2012. She did not require a cell phone in order to perform her duties as a director in April 2012 and usage was observed even after she had stepped down as director.

22. [Employee “A”] was also given a cell phone that was activated in April 2012. She did not require a cell phone to carry out her duties as Administrative Lead.

ADMISSIONS OF PROFESSIONAL MISCONDUCT

23. The Member admits that he prescribed 30 Lorazepam 1mg tabs for [Client “A”] on the dates set out above. If the Member were to testify, he would state that he charted a plan to consult with a physician regarding a renewal of the Lorazepam prescription on January 18, 2012 and August 30, 2012. Due to an oversight, these physician consults did not occur. The Member had not intended to prescribe outside his scope of practice.

24. Regardless, the Member acknowledges that Lorazepam is a controlled substance for which he was prohibited in law from prescribing. He further acknowledges that even under the regulatory scheme prior to October 2011, an NP was authorized only to prescribe Lorazepam to deal with an emergency, as assessed by the NP. An NP was not permitted to prescribe quantities of 30 tabs for a client to use when the client believed that it was an emergency.

25. The Member admits that he prescribed codeine for [Client “B”] and [Client “C”] on the dates set out above. If the Member were to testify, he would state that he had spoken to two pharmacists regarding the prescription of acetaminophen with codeine and had come to understand that acetaminophen with codeine was available without a prescription in either tablet or liquid form, as long as 8mg of codeine was not exceeded. Based on this information, he wrote prescriptions for [Client “B”] and [Client “C”] for liquid 160mg acetaminophen-8mg codeine/5mL. When the Member learned from a third pharmacist that this formulation could not be obtained without a prescription, the Member tried to retract the prescription for [Client “C”], but it had already been filled. The Member had no intention to prescribe outside his scope of practice.

26. Regardless, the Member acknowledges that codeine is a controlled substance and he is prohibited in law from prescribing any medication containing codeine, even if it is available without a prescription.

27. As a result of these medication errors, on July 7, 2013, the Member completed a two hour course, “Prevention of Medical Errors” from www.Nurse411.com.

28. The Member admits that he misappropriated $18,796 from the Clinic as salaries or wages to [Employee “A”] and [Employee “B”] between February 15, 2012 and April 12, 2012 and that neither [Employee “A”] nor [Employee “B”] were performing duties for the Clinic during that time period.

29. The Member admits that he used the Clinic’s funds to pay for three cell phone lines for his wife and his two sisters. He acknowledges that neither his wife, nor his two sisters required the use of a cell phone to carry out their duties at the Clinic. He also admits that his sister, [Employee “D”], continued to have use of the cell phone even after she left her position as director of the Clinic.

30. The Member admits that he committed the acts of professional misconduct described above in paragraphs 9 to 29, and as alleged in the Notice of Hearing in paragraphs:

• 1(a), (b)(i) and (b)(ii);

• 2;

• 3(a), (b)(i), (b)(ii) and (b)(iii); and

• 4(a), (b)(i) and (b)(ii) in that the conduct is disgraceful, dishonourable and unprofessional.

Decision

The panel considered the Agreed Statement of Facts and finds that the facts support a finding of professional misconduct and, in particular, finds that the Member committed an act of professional misconduct as alleged in paragraphs 1(a), 1(b)(i,), 1(b)(ii), 2, 3(a),3(b)(i), 3(b)(ii), 3(b)(iii), 4(a), 4(b)(i) and 4(b)(ii) in the Notice of Hearing in that the Member:

1. Performed a controlled act for various clients for which he was not authorized by prescribing controlled substances; and

2. Misappropriated public funds to benefit a friend and family members.

These behaviours constituted a breach of the standards of practice of the profession, and would reasonably be regarded by members as disgraceful, dishonourable and unprofessional.

Reasons for Decision

The panel considered both the Agreed Statement of Facts and the Member’s plea and finds that this evidence supports findings of professional misconduct as alleged in the Notice of Hearing.

Allegation #1(a) in the Notice of Hearing is supported by paragraphs 2, 3, 9, 10, 11, 12, 23, 24 and 30 in the Agreed Statement of Facts.

Allegation #1(b)(i)(A) in the Notice of Hearing is supported by paragraphs 9, 10, 11, 12, 13, 14(a), 23, 25, 26 and 30 in the Agreed Statement of Facts.

Allegation #1(b)(i)(B) in the Notice of Hearing is supported by paragraphs 2, 3, 9, 10, 11, 13, 23, 24 and 30 in the Agreed Statement of Facts.

Allegation #1(b)(i)(C) in the Notice of Hearing is supported by paragraphs 2, 3, 9, 10, 11, 14(b), 25, 26 and 30 in the Agreed Statement of Facts.

Allegation #1(b)(ii) in the Notice of Hearing is supported by paragraphs 5, 7, 15, 16, 17, 18, 5,19, 20, 21, 22, 28, 29 and 30 in the Agreed Statement of Facts.

Allegation #2 in the Notice of Hearing is supported by paragraphs 5, 7, 15, 16, 17, 18, 5, 19, 20, 21, 22, 28, 29 and 30 in the Agreed Statement of Facts.

Allegation #3(a) in the Notice of Hearing is supported by paragraphs 2, 3, 9, 10, 11, 12, 23, 24 and 30 in the Agreed Statement of Facts.

Allegation #3(b)(i) in the Notice of Hearing is supported by paragraphs 2, 3, 9, 10, 11, 12, 13, 14(a), 25, 26 and 30 in the Agreed Statement of Facts.

Allegation #3(b)(ii) in the Notice of Hearing is supported by paragraphs 2, 3, 9, 10, 11, 13, 23, 24 and 30 in the Agreed Statement of Facts.

Allegation #3(b)(iii) in the Notice of Hearing is supported by paragraphs 2, 3, 9, 10, 11, 14(b), 25, 26 and 30 in the Agreed Statement of Facts.

Allegation #4(a) in the Notice of Hearing is supported by paragraphs 2, 3, 9, 10, 11, 12, 23, 24 and 30 in the Agreed Statement of Facts.

Allegation #4(b)(i)(A) in the Notice of Hearing is supported by paragraphs 2, 3, 9, 10, 11, 12, 13, 14(a), 25, 26 and 30 in the Agreed Statement of Facts.

Allegation #4(b)(i)(B) in the Notice of Hearing is supported by paragraphs 2, 3, 9, 10, 11, 13, 23, 24 and 30 in the Agreed Statement of Facts.

Allegation #4(b)(ii) in the Notice of Hearing is supported by paragraphs 5, 7, 15, 16, 17, 18, 19, 20, 21, 22, 28, 29 and 30 in the Agreed Statement of Facts.

Penalty

Counsel for the College advised the panel that a Joint Submission as to the Order had been agreed upon. The Joint Submission as to Order requests that this panel make an order as follows:

1. Requiring the Member to appear before the Panel to be reprimanded within three months of the date that this Order becomes final.

2. Directing the Executive Director to suspend the Member’s certificate of registration for six months. This suspension shall take effect from the date that this Order becomes final and shall continue to run without interruption as long as the Member remains in the practising class.

3. Directing the Executive Director to impose the following terms, conditions and limitations on the Member’s certificate of registration:

a) The Member will attend two meetings with a Nursing Expert (the “Expert”), at his own expense and within six months from the date the Member’s suspension ends. To comply, the Member is required to ensure that:

i. The Expert has expertise in nursing regulation and has been approved by the Director of Professional Conduct (the “Director”) in advance of the meetings;

ii. At least seven days before the first meeting, the Member provides the Expert with a copy of:

1. the Panel’s Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

5. if available, a copy of the Panel’s Decision and Reasons;

iii. Before the first meeting, the Member reviews the following College publications and completes the associated Reflective Questionnaires, online learning modules and online participation forms:

1. Professional Standards,

2. Nurse Practitioner, and

3. RHPA: Scope of Practice, Controlled Acts Model;

iv. At least seven days before the first meeting, the Member provides the Expert with a copy of the completed Reflective Questionnaires, and online participation forms;

v. The subject of the sessions with the Expert will include:

1. the acts or omissions for which the Member was found to have committed professional misconduct,

2. the potential consequences of the misconduct to the Member’s clients, colleagues, profession and self,

3. strategies for preventing the misconduct from recurring,

4. the publications, questionnaires and modules set out above, and

5. the development of a learning plan in collaboration with the Expert;

vi. Within 30 days after the Member has completed the last session, the Member will confirm that the Expert forwards his/her report to the Director, in which the Expert will confirm:

1. the dates the Member attended the sessions,

2. that the Expert received the required documents from the Member,

3. that the Expert reviewed the required documents and subjects with the Member, and

4. the Expert’s assessment of the Member’s insight into his behaviour;

vii. If the Member does not comply with any one or more of the requirements above, the Expert may cancel any session scheduled, even if that results in the Member breaching a term, condition or limitation on his certificate of registration;

b) For a period of 12 months from the date the Member obtains employment in nursing, the Member will notify his employers of the decision. To comply, the Member is required to:

i. Ensure that the Director is notified of the name, address, and telephone number of all employer(s) within 14 days of commencing or resuming employment in any nursing position;

ii. Provide his employer(s) with a copy of:

1. the Panel’s Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

5. a copy of the Panel’s Decision and Reasons, once available;

iii. Ensure that within 14 days of the commencement or resumption of the Member’s employment in any nursing position, the employer(s) forward(s) a report to the Director, in which it will confirm:

1. that they received a copy of the required documents, and

2. that they agree to notify the Director immediately upon receipt of any information that the Member has breached the standards of practice of the profession;

c) The Member shall not practise independently in the community until the conditions in paragraph 3(a) have been satisfied; and

d) The Member shall not hold any managerial, supervisory or any other position of authority until the conditions in paragraph 3(a) have been satisfied.

4. All documents delivered by the Member to the College, the Expert or the employer(s) will be delivered by verifiable method, the proof of which the Member will retain.

Penalty Submissions

College Counsel presented three cases to illustrate that the penalty is appropriate and within the range of reasonable outcomes, in the public interest, and not putting the administration of justice at the College into disrepute.

In CNO v. Desrosiers (Discipline Committee, 2014), the member was an NP who prescribed controlled substances and also failed to participate in the Quality Assurance Program. The member admitted to the allegations and cooperated with the College. The penalty imposed was: a reprimand, a nine month suspension, meetings with a nursing expert, an 18-month period of employer notification, and participation in the next Quality Assurance review.

In CNO v. Campbell (Discipline Committee, 2011), the member misappropriated funds from her workplace in the use of taxi chits totalling $5,500 over the course of over a year. The penalty imposed was: a reprimand, suspension for one month, remedial education and meeting with a nursing expert, employer notification for 12 months and payment of a fine if restitution to the hospital was not made within one year.

In the case of CNO v. Rousseau (Discipline Committee, 2012), the allegations were more serious as the member held a managerial position and misappropriated $25,000 by falsifying expense claims. The member failed to attend the discipline hearing, requiring the review of 42 exhibits and the attendance of 13 witnesses as well as a nursing expert.

College Counsel also reviewed the aggravating and mitigating factors in this case:

Aggravating factors:

1. Prescribing controlled substances is against the law, the Nursing Act, 1991 and the Regulated Health Professions Act;

2. The prescribing acts were not isolated events and illustrate a pattern of conduct from January, 2012 to May, 2013; and

3. The misappropriation of public funds occurred when the Member was the President, Secretary and Clinic Director of the Clinic. Diversion of funds is a breach of public trust and the Clinic’s trust.

Mitigating factors:

1. The Member has no prior discipline findings;

2. The Member has cooperated with the College; and

3. The Member has accepted responsibility for his actions.

Penalty Decision

The panel accepts the Joint Submission as to Order and accordingly orders:

1. The Member shall appear before the panel to be reprimanded within three months of the date that this Order becomes final.

2. The Executive Director is directed to suspend the Member’s certificate of registration for six months. This suspension shall take effect from the date that this Order becomes final and shall continue to run without interruption as long as the Member remains in the practising class.

3. The Executive Director is directed to impose the following terms, conditions and limitations on the Member’s certificate of registration:

a) The Member will attend two meetings with a Nursing Expert (the “Expert”), at his own expense and within six months from the date the Member’s suspension ends. To comply, the Member is required to ensure that:

i. The Expert has expertise in nursing regulation and has been approved by the Director of Professional Conduct (the “Director”) in advance of the meetings;

ii. At least seven days before the first meeting, the Member provides the Expert with a copy of:

1. the Panel’s Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

5. if available, a copy of the Panel’s Decision and Reasons;

iii. Before the first meeting, the Member reviews the following College publications and completes the associated Reflective Questionnaires, online learning modules and online participation forms:

1. Professional Standards,

2. Nurse Practitioner, and

3. RHPA: Scope of Practice, Controlled Acts Model;

iv. At least seven days before the first meeting, the Member provides the Expert with a copy of the completed Reflective Questionnaires, and online participation forms;

v. The subject of the sessions with the Expert will include:

1. the acts or omissions for which the Member was found to have committed professional misconduct,

2. the potential consequences of the misconduct to the Member’s clients, colleagues, profession and self,

3. strategies for preventing the misconduct from recurring,

4. the publications, questionnaires and modules set out above, and

5. the development of a learning plan in collaboration with the Expert;

vi. Within 30 days after the Member has completed the last session, the Member will confirm that the Expert forwards his/her report to the Director, in which the Expert will confirm:

1. the dates the Member attended the sessions,

2. that the Expert received the required documents from the Member,

3. that the Expert reviewed the required documents and subjects with the Member, and

4. the Expert’s assessment of the Member’s insight into his behaviour;

vii. If the Member does not comply with any one or more of the requirements above, the Expert may cancel any session scheduled, even if that results in the Member breaching a term, condition or limitation on his certificate of registration;

b) For a period of 12 months from the date the Member obtains employment in nursing, the Member will notify his employers of the decision. To comply, the Member is required to:

i. Ensure that the Director is notified of the name, address, and telephone number of all employer(s) within 14 days of commencing or resuming employment in any nursing position;

ii. Provide his employer(s) with a copy of:

1. the Panel’s Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

5. a copy of the Panel’s Decision and Reasons, once available;

iii. Ensure that within 14 days of the commencement or resumption of the Member’s employment in any nursing position, the employer(s) forward(s) a report to the Director, in which it will confirm:

1. that they received a copy of the required documents, and

2. that they agree to notify the Director immediately upon receipt of any information that the Member has breached the standards of practice of the profession;

c) The Member shall not practise independently in the community until the conditions in paragraph 3(a) have been satisfied; and

d) The Member shall not hold any managerial, supervisory or any other position of authority until the conditions in paragraph 3(a) have been satisfied.

4. All documents delivered by the Member to the College, the Expert or the employer(s) will be delivered by verifiable method, the proof of which the Member will retain.

Reasons for Penalty Decision

The panel concluded that the proposed penalty is both reasonable and in the public interest. The sanction provides for specific and general deterrence through an oral reprimand, a term of suspension, and the requirement for employer notification. This penalty also provides for remediation by requiring meetings with a nursing expert. The Member has co-operated with the College and, by agreeing to the facts and a proposed penalty, has accepted responsibility for his actions.

I, Sarah Corkey, RN, sign this decision and reasons for the decision as Chairperson of this Discipline panel and on behalf of the members of the Discipline panel as listed below:

Chairperson Date

Panel Members:

Grace Fox, NP

Shiraz Irani, RN

Abdul Patel, Public Member

Chuck Williams, Public Member```