Okafor v. College of Physicians and Surgeons of Ontario, 2023 ONSC 6332
CITATION: Okafor v. College of Physicians and Surgeons of Ontario, 2023 ONSC 6332
DIVISIONAL COURT FILE NO.: 251/21 DATE: 20231114
ONTARIO
SUPERIOR COURT OF JUSTICE DIVISIONAL COURT
Backhouse, D.L. Corbett, Charney JJ.
BETWEEN:
Dr. Innocent Chukwudumebi Okafor
Appellant
– and –
College of Physicians and Surgeons of Ontario
Respondent
Richard Posner, for the Appellant
Elisabeth Widner, for the Respondent
HEARD at Toronto: November 2, 2023
Backhouse J.
AMENDED REASONS FOR JUDGMENT
Overview
[1] The Appellant appeals from a decision of the College of Physicians and Surgeons of Ontario in which a panel of the Discipline Committee (the “Committee”) of the College of Physicians and Surgeons of Ontario (the “College”) revoked the Appellant’s certificate of registration (the “Decision”).[^1]
[2] In its Decision, the Committee found the Appellant to have sexually abused Patient A and rejected the Appellant’s evidence that his relationship with her was restricted to acting as a life coach and mentor and he did not have a sexual relationship with her. The Committee further found that the Appellant committed disgraceful, dishonourable or unprofessional conduct in regard to Patient A by repeatedly crossing boundaries in a personal relationship with her that also involved sexual relations.
[3] The Appellant admitted to exercising poor judgment and crossing boundaries with respect to his dealings with Patient B. The Committee found that the Appellant’s relationship with Patient B constituted disgraceful, dishonourable, and unprofessional conduct in its entirety. The Committee also held that the Appellant’s lack of cooperation with the College’s investigation constituted disgraceful, dishonourable and unprofessional conduct.
[4] The Appellant submits that the Committee made serious palpable and overriding errors in its credibility findings with respect to inconsistencies in Patient A’s evidence, misapprehended evidence and applied uneven scrutiny to the evidence of Patient A and the Appellant. He requests that the findings of misconduct with respect to Patient A be set aside and a new hearing ordered.
[5] For the reasons set out below, I would dismiss the appeal. In summary, the Committee’s credibility determinations are entitled to significant deference and can only be set aside if there is palpable and overriding error. It is not the role of appellate courts to second-guess the weight assigned to items of evidence by the trier. The Committee considered the Appellant’s submissions as to why Patient A’s evidence should be rejected, reviewed the evidence on each of the issues raised and evaluated the consistency of the evidence in the context of the totality of the evidence. Having done what a trier is supposed to do, the Committee found her evidence to be clear, consistent and cogent on core issues and that any inability to recall certain details on her part was due to the passage of time. The ground of palpable and overriding errors in its credibility findings is not made out.
[6] The Appellant has neither demonstrated that the Committee unevenly scrutinized the evidence in the course of its credibility assessments nor that any alleged error in reasoning figured in its ultimate conclusions as to his professional misconduct. The grounds of misapprehension of the evidence and uneven scrutiny are not made out.
Background
[7] The Notice of Hearing alleged that the Appellant committed an act of professional misconduct:
under clause 51(1)(b.1) of the Health Professions Procedural Code which is Schedule 2 to the Regulated Health Professions Act, 1991, S.O. 1991, c.18 (“the Code”) in that he engaged in sexual abuse of a patient; and
under paragraph 1(1)33 of Ontario Regulation 856/93 [made under the Medicine Act, 1991[^2]], in that he has engaged in 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.
[8] “Sexual abuse of a patient” by a member of the College is defined in s. 1(3) of the Code:
Sexual abuse of a patient
(3) In this Code,
“sexual abuse” of a patient by a member means,
(a) sexual intercourse or other forms of physical sexual relations between the member and the patient,
(b) touching, of a sexual nature, of the patient by the member, or
(c) behaviour or remarks of a sexual nature by the member towards the patient.
[9] The term “patient” was not defined in the legislation at the time of the alleged misconduct, and the Committee stated that it was a factual issue for it to determine. The hearing took place over four days in which Patient A and the Appellant both testified. Patient B, the son of Patient A, did not testify.
The Decision
[10] The Committee stated that its task was not to simply accept the evidence of Patient A or the Appellant. The Committee’s stated task was to determine “whether, on the totality of the evidence, viewed as a whole, the College has proved its case, or proven a particular fact, on the balance of probabilities based on clear, cogent and convincing evidence.”
[11] The Committee found that a physician-patient relationship was established by November 2010, at which point Patient A saw the Appellant “for legitimate medical concerns which is well documented in her medical record.” Patient A began receiving late night phone calls from the Appellant in May 2012, as confirmed by cell phone records. It was Patient A’s testimony that the Appellant shared his personal difficulties with her during these calls which the Appellant acknowledged but was found by the Committee to have attempted to downplay it by describing it as mentoring.
[12] The Committee accepted that in early to mid June 2012, the Appellant and Patient A had sex for the first time. The phone records show frequent calls between Patient A and the Appellant in late May and June 2012 (including 22 calls initiated by the Appellant). The Appellant stopped calling Patient A for the rest of 2012. The last incoming call from the Appellant was at 11:55 p.m. on June 28, 2012 which lasted for just over four minutes and is the same day as he deleted Patient A’s chart note. The Appellant acknowledged that at this point he was beginning to worry about boundary crossing. The Committee found that when the Appellant knew that the College was investigating, he involved Patient A’s son in a business venture as an attempt to keep his mother on side in the hope she would not disclose their relationship.
[13] The Committee found Patient A and the Appellant to have had a sporadic sexual relationship which endured for several years. The Appellant also admitted to giving Patient A money.
[14] The Committee acknowledged and addressed inconsistencies in Patient A’s testimony:
• Inconsistencies regarding the name of a hotel at which the first sexual encounter occurred was plausibly explained by an inability to recall the specific hotel name, given that she was not asked about it until four years later; inconsistencies regarding the incidents at the hotel were found not to be fatal to acceptance of her evidence at large.
• Patient A had told the College about taking a semen sample when she made her initial call but said she had lost it by 2018. The Committee found it credible that she could have lost it given the “significant passage of time”. Additionally, the Committee noted that there is no legal requirement for corroborative evidence in allegations of sexual abuse.
• Patient A told the College in March 2018 that she had a recording of a phone call in which the Appellant told her not to respond to and to ignore the College if they called. Patient A subsequently communicated to the College that she thought she may have erased it. While the College found it “likely an exaggeration” for Patient A to say that she feared for her life, her initial claim was unchanged despite vigorous cross-examination, namely that the Appellant called her and told her to ignore the College which evidence the Committee accepted.
[15] With respect to Patient A, the Committee found that the Appellant repeatedly downplayed the physician-patient relationship and the extent of the personal relationship with Patient A. With respect to his cooperation with the College investigation, the Committee noted that he had been asked to provide Patient A’s complete chart, including the appointment record, to the College in 2016 but had failed to do so. It noted that he provided varying explanations and found on a balance of probabilities that the Appellant had intentionally engaged in significant delays with respect to the College’s investigation, which the Committee found to constitute disgraceful, dishonourable and unprofessional conduct.
[16] The Committee found the Appellant’s deletion of the appointment note of the June 28, 2012 visit of Patient A and his ceasing to call her for the rest of 2012, to be consistent with his trying to distance himself from the existing physician-patient relationship after having had sex with her.
[17] The Committee found that the Appellant admitted to exercising poor judgment and crossing boundaries with respect to Patient B, who was Patient A’s son. Patient A testified that Patient B had an idea for a smart phone application (“app”), which the Appellant had promised to help him get up and running. Patient A agreed on cross-examination that she was not privy to the conversations her son had with the Appellant regarding the app. The Appellant confirmed on cross-examination that he began his involvement with Patient B’s app idea in December 2016. The Appellant testified that he paid approximately $700 to a patent lawyer regarding Patient B’s app. The Appellant agreed in testimony that throughout this time, Patient B was his patient. While the Appellant’s counsel suggested that it was insufficient for the College to proceed in the absence of testimony from Patient B, the Committee disagreed, as Patient B’s medical record (which was created and maintained by the Appellant) was entered into evidence, as were text messages between Patient B and the Appellant.
Issues
[18] The Appellant focused on the following issues on this appeal:
Issue 1: Did the Committee err in finding that the Appellant sexually abused Patient A by:
a. failing to meaningfully address significant inconsistencies in Patient A’s evidence; or
b. misapprehending the evidence?
Issue 2: Did the Committee err in assessing the credibility and reliability of the testimony of the Appellant by placing a higher degree of scrutiny upon the Appellant than on Patient A’s testimony?
Court’s Jurisdiction
[19] The Divisional Court is authorized to hear appeals on questions of law or fact or both with respect to decisions of the Discipline Committee: s. 70(1) and (2) of the Code.
Standard of Review
[20] Per Housen v. Nikolaisen[^3], the standard of review is correctness on questions of law, palpable and overriding error on findings of fact, and palpable and overriding error on questions of mixed fact and law (absent an extricable question of law).
Analysis
Issue 1(a): Failing to meaningfully address significant inconsistencies in Patient A’s evidence
[21] The Appellant focuses his argument on three areas of Patient A’s evidence which he says the Committee did not deal with appropriately: 1) Patient A’s evidence about the location of the hotel where she and the Appellant first had sex; 2) a sample of his semen which Patient A said she had when she first contacted the College in 2012 but which she no longer had several years later; and 3) Patient A’s description of having felt threatened by the Appellant because he allegedly told her not to talk to the College during its investigation and then tried to minimize this while agreeing that she had made a recording of it and subsequently erased it.
[22] The Appellant observed that his counsel at the discipline hearing focused on these three areas in his closing submissions as to why the Committee should not accept Patient A’s evidence. The Committee itself in its reasons identified these very areas as constituting the main inconsistencies in Patient A’s evidence, and carefully considered their impact on her credibility and reliability.
The Hotel Encounter
[23] The Appellant submits that the Committee failed to assess the weaknesses in Patient’s A’s account with respect to the alleged hotel encounter in June 2012. It is submitted that Patient A’s testimony shifted from an encounter at a hotel in Windsor, Ontario to a Best Western Hotel in Brampton, Ontario which changed to a hotel with the name of “Courtney or Country” when the single receipt for a Best Western Hotel which the College located was for an entirely different date. The Appellant submitted that the receipt severely damaged Patient A’s account and tended to support the Appellant’s testimony that there was no tryst at a hotel and further no sexual relationship between them. The Appellant submits that there is no requirement that evidence be determinative in order to be relevant, and the Committee’s treatment of the receipt is proof of the application of a higher standard of scrutiny to the Appellant’s evidence.
[24] I do not find the Appellant’s arguments regarding the hotel encounter persuasive for the following reasons.
[25] The Committee accurately reviewed Patient A’s evidence about the hotel where she and the Appellant first had sex in 2012:
[36] Patient A testified that at one point, Dr. Okafor suggested that they meet at his hotel room. Patient A testified that in June 2012, shortly following the initial phone calls from Dr. Okafor, she traveled to his hotel room. In doing so, Patient A stated that she took a bus from Windsor, stopped briefly at her mother’s house which was 20 minutes from where Dr. Okafor was staying, then took a cab to Dr. Okafor’s hotel. Patient A stated that Dr. Okafor paid for the cab trip in cash.
[37] Patient A testified that when at the hotel with Dr. Okafor, they smoked Belmont cigarettes and drank brandy. Patient A said she felt confused. She testified that during that interaction, Dr. Okafor climbed on top of her and pushed his way into her vagina. Patient A testified that he did not use a condom.
[38] On cross-examination, Patient A was questioned on the name and location of the hotel where she met Dr. Okafor. The College investigator’s notes indicated that when she was interviewed, Patient A first indicated that the hotel was in Windsor. However, Patient A denied that she told the College investigator that.
[39] In subsequent email correspondence with the College from June 2018, which was put to Patient A during cross-examination, Patient A indicated that she believed the hotel was the Best Western in Brampton.
[40] Later, during what defense counsel described as a “prep session” with the College held on October 21, 2020, Patient A said the hotel had a different name that included “Courtney” or “Country,” but that she couldn’t remember. On cross examination, Patient A stated that she recalled: ...it being a big hotel, and he was on the bottom floor and…where we could have access to go outside for a smoke.
[41] Patient A maintained under cross-examination that the hotel location was at the border of Mississauga and Brampton.
[26] The Committee made the following findings in regard to the hotel encounter:
[143] Patient A told the College investigator that the hotel she first went to with Dr. Okafor was the Best Western Plus in Windsor. When this was reviewed with her during a subsequent conversation, she corrected this, clarifying that it was a hotel on the border of Brampton and Mississauga. This led the College to conduct further inquiries, and it did find a receipt for Dr. Okafor’s stay on January 27, 2013.
[144] In her testimony, Patient A had said the first hotel encounter was in June 2012. She later stated that she thought the name of the hotel started with Courtney or Country. Dr. Okafor’s counsel suggested that this was a tailoring of her evidence, as a result of the receipt not fitting the timeline of her version of events as previously told.
[145] The Committee acknowledges that there were inconsistencies in these details of Patient A’s evidence. However, the Committee finds that it is plausible that Patient A would not necessarily remember the specific name of the hotel, as she was not asked about it until four years later. Patient A was consistent in her testimony with respect to the incidents that occurred at the hotel, and the Committee finds that any inconsistencies in her evidence in this regard are not fatal to the acceptance of her evidence at large.
[27] The basis for a finding may be evident based on consideration of the record as a whole.[^4] The fact that there were inconsistencies in Patient A’s evidence regarding the hotel encounter and no hotel receipt was found for the timeframe Patient A gave for the sexual encounter was considered by the Committee in the context of all of the evidence. That evidence included:
• Around the timeframe Patient A testified the first sexual encounter occurred, there were extensive telephone calls between the Appellant and Patient A which included late night calls from the Appellant to Patient A where the Appellant acknowledged that he began sharing his personal difficulties with her.
• Contemporaneous with this same timeframe, the Committee found that the Appellant deleted Patient A’s chart note of her June 28, 2012 visit and intentionally did not provide the complete chart to the College when he was asked.
• The Appellant stopped calling Patient A for the rest of 2012 and acknowledged that he was beginning to worry about boundaries.
• The Committee found the Appellant’s deletion of Patient A’s chart note visit and his ceasing to call her for the rest of 2012 to be consistent with his trying to distance himself from the existing physician-patient relationship after having had sex with her.
• The Committee found that the Appellant repeatedly downplayed the physician-patient relationship and the extent of the personal relationship with Patient A.
• The Appellant acknowledged that he gave money to Patient A.
• The Committee found that when the Appellant knew that the College was investigating, he involved Patient A’s son (Patient B) in a business venture as an attempt to keep his mother on side in the hope she would not disclose their relationship.
• The Committee found that the Appellant called Patient A and told her not to cooperate with the College’s investigation.
[28] The Committee considered the Appellant’s counsel’s submissions as to why Patient A’s evidence should be rejected and the suggestion that she had tailored her evidence. However, the Committee found it plausible that she did not remember the specific name of the hotel. The Committee concluded that the inconsistency did not affect its acceptance of her evidence and that any inability to recall certain details on her part was due to the passage of time.
[29] The Committee accepted Patient A's evidence, as it was entitled to do, that in early to mid-June 2012, the Appellant asked her to meet him at a hotel, and they had sex for the first time which provided a credible reason for both the previous phone calls, and the Appellant’s subsequent actions including giving her money. The Committee found her evidence to be clear, consistent, and cogent on core issues, concluding that the Appellant and Patient A had a sporadic sexual relationship which endured for several years.
[30] There was no error in the Committee’s finding that any inconsistencies in her evidence regarding the hotel encounter are not fatal to the acceptance of her evidence at large.
The Semen Sample
[31] The Appellant submits that the Committee failed to fairly or meaningfully address the Appellant’s submissions regarding why Patient A’s testimony should not be accepted with respect to her purported possession of conclusive proof of a sexual relationship, namely a semen sample. The Appellant submitted that Patient A’s shifting explanations for not producing the semen sample that she testified she had taken of the Appellant’s semen in 2012 when they first had sex raised credibility concerns and the Committee erred by treating this as a mere lack of corroboration. The Appellant argued that the real issue was the changing nature of Patient A’s explanation for why she did not still possess the sample.
[32] Patient A’s evidence was that she had taken a swab with a Q-tip after the Appellant had ejaculated inside her. She called the College a few weeks after their first sexual encounter and spoke to an investigator because she was distraught as she felt the Appellant was breaking off their sexual relationship and she felt used. By the time the College followed up, she no longer had the Q-tip. It had been at the place of a friend who moved. In any case, she saw no reason to preserve it once her sexual relationship with the Appellant resumed.
[33] The Appellant submitted that the Committee failed to assess the following. First, Patient A appeared to blame the loss of the evidence on the College. Next, she blamed the loss on the fact that her friend moved away which was inconsistent with the previous claim. A further problem for her credibility was that if she was engaged in an ongoing sexual relationship then she could have acquired a further sample of the Appellant’s semen. When Patient A was confronted with this, her evidence was that the Appellant “pulled out” during every sexual encounter but, coincidentally, the one time that she obtained the semen sample.
[34] I do not accept the Appellant’s argument for the following reasons.
[35] The Committee accurately reviewed Patient A’s evidence with respect to the semen sample, and considered and accepted her explanation that she had taken a swab of the Appellant’s semen in 2012 when they first had sex, but had not kept it over the years as their sexual relationship resumed. The Committee found her explanation credible, as there was a significant passage of time between taking the sample and being asked to provide it. The Committee considered and rejected the contention that Patient A’s “inability…to produce the evidence that she once claimed to have” should negatively impact her credibility and reliability. The Committee noted that there is no legal requirement for corroborative evidence.
[36] It is not the role of appellate courts to second-guess the weight assigned the items of evidence by the trier.[^5] In particular, the fact that an alternative factual finding could be reached based on a different ascription of weight by an appellate court does not mean that a palpable and overriding error has been made.[^6] It is the trier of fact’s discretion to determine what areas of the evidence should be included in their reasons. The trier is not obliged to reconcile every frailty in the evidence.[^7] Failure to mention some aspects of the evidence does not constitute an error, if the trier has grappled with the substance of the live issues.[^8]
[37] I find no palpable and overriding error.
The Threat
[38] The Appellant submitted that the Committee failed to address significant inconsistencies in Patient A’s evidence regarding a threat she alleged the Appellant made to her and then tried to minimize while agreeing that she had made a recording of it and subsequently erased it. The Appellant argued that Patient A offered varying explanations as to why she did not produce the recording: leaving it at home during a meeting with the College investigator; and intentionally erasing it. The Appellant submitted that the Committee failed to explain why Patient A’s tendency to “bluff the existence of damning evidence” did not detract from her credibility which was in contrast to the Committee’s treatment of the Appellant’s evidence. The Appellant characterized Patient A’s testimony on this issue as a deliberate fabrication.
[39] I find no merit to this argument for the following reasons.
[40] With respect to the Appellant’s communications to Patient A, the Committee considered the Appellant’s arguments but accepted Patient A’s evidence that the Appellant did indeed call her and tell her to ignore the College’s investigative efforts. In doing so, it considered that she was subject to “vigorous cross-examination” about whether the call occurred, including regarding her evidence about having had but erased a recording of this call because she did not want to hurt him. While the Committee concluded that Patient A’s statement about fearing for her life was likely an exaggeration, it was nonetheless able to conclude that the call itself and the direction to ignore the College did occur.
[41] It was open to the Committee to find that Patient A had deliberately fabricated her evidence on this issue but that was not its finding. A finding that she had likely exaggerated fearing for her life is not the same as lying.
[42] The Appellant’s submissions in regard to the inconsistencies in Patient A’s testimony are the same submissions that were made to the Committee. This court is being asked to consider as palpable and overriding errors three discrete pieces of evidence in isolation from the rest of the evidence. The Committee extensively reviewed the evidence with respect to them and found that on the core issues, Patient A was credible. This ground of appeal should be dismissed.
Issue 1(b): Did the Committee err in finding that the Appellant sexually abused Patient A by misapprehending the evidence
[43] The Appellant argued that Patient A made bizarre comments and outlandish claims and then refused to respond to questions about them, suggesting a casual attitude toward her duty to tell the truth; The Committee failed to mention this in the Decision, though it drew negative inferences from tangential and collateral pieces of the Appellant’s testimony.
[44] There is no merit to this argument. Rather than the Committee drawing negative inferences from parts of the Appellant’s testimony that were “tangential and collateral”, the areas the Committee focused on in making negative inferences regarding his credibility related to how he characterized his relationship with Patient A and how he described his interactions with her. These related to the central issues of whether there was a physician-patient relationship and whether it was concurrent in time to a sexual relationship.
[45] I would dismiss this ground of appeal.
Issue 2: Did the Committee err in assessing the credibility and reliability of the testimony of the Appellant by placing a higher degree of scrutiny upon the Appellant than on Patient A’s testimony?
[46] The Appellant submits that the Committee did not assess the credibility of Patient A in the same overly microscopic and critical fashion as done with respect to the Appellant. The Appellant makes the following arguments: Patient A put forward sensational claims that could not be substantiated; there were also text messages referencing ruining the Appellant’s life; Patient A also contradicted herself on the location of the first alleged sexual encounter; It was improper for the Panel to consider serious inconsistencies in Patient A’s evidence as attributable to the passage of time whereas the Appellant was held to every detail of his dealings with Patient A, despite the fact that their professional relationship spanned over six years; The Committee also illogically determined that the Appellant was attempting to deflect a professional relationship with Patient A, even though he readily admitted that he treated Patient A as a doctor and there was no relevance to the distinction between Patient A being a rostered patient or a walk-in patient at the clinic; It is an error of law to apply a higher standard of scrutiny to the evidence of the defendant.[^9]
[47] There is no merit to the argument that the Committee assessed the Appellant’s evidence in an “overly microscopic fashion” compared to Patient A. Not every inconsistency needs to be resolved.[^10] The Supreme Court of Canada has recently cast serious doubt on “uneven scrutiny” as a helpful tool to demonstrate error in credibility findings.[^11] Claims of uneven scrutiny should not be a meritless opportunity to re-try a case. There must be a demonstration of palpable and overriding error. There was nothing in the reasons or the record that made it clear that the Committee had actually applied different standards in assessing the evidence of the Appellant and Patient A.
[48] In essence, the Appellant asks this court to re-weigh the evidence and reach a different conclusion from the Committee. A trier of fact is not obliged to find that a witness is not credible or reliable due to inconsistencies in their evidence: it is up to them to assess the impact of inconsistencies, if any, on the witness’ credibility or reliability. This requires consideration of whether there is, in fact, an inconsistency on the record, and if so, whether that inconsistency is actually material to the credibility or reliability of the witness.
[49] Even in the criminal context, where the standard of proof is ‘beyond a reasonable doubt’, a conviction can be based on evidence from a witness that contains inconsistencies. It is open to the trier of fact to accept explanations a witness offers for the inconsistencies.[^12]
[50] As described above, the Committee considered inconsistencies in the evidence of Patient A, and determined that in the circumstances of this case, these inconsistencies did not detract from her credibility and reliability on the core issues. By contrast, the Committee found the Appellant’s evidence was illogical and replete with contradictions and variation that were significantly detrimental to his credibility. This was not holding him “to every detail” but rather was assessing the evidence before them as a whole. The Committee explained the basis for and was entitled to reach its conclusions. The Appellant’s argument that the Committee applied uneven scrutiny to the evidence offered by the prosecution and the defense is no more than an invitation to this court to re-try the case.
[51] The Appellant has neither demonstrated that the Committee unevenly scrutinized the evidence in the course of its credibility assessments nor that any alleged error in reasoning figured in the Committee’s ultimate conclusions as to the professional misconduct. I would dismiss this ground of appeal.
Conclusion
[52] The appeal is dismissed. As agreed by the parties the College as the successful party is entitled to costs in the amount of $10,000.
Backhouse J.
I agree: _____________________________
Corbett J.
I agree: _____________________________
Charney J.
Released: November 14, 2023
CITATION: Okafor v. College of Physicians and Surgeons of Ontario, 2023 ONSC 6332
DIVISIONAL COURT FILE NO.: 251/21 DATE: 20231114
ONTARIO
SUPERIOR COURT OF JUSTICE DIVISIONAL COURT
Backhouse, D.L. Corbett, Charney JJ.
BETWEEN:
Dr. Innocent Chukwudumebi Okafor
Appellant
– and –
College of Physicians and Surgeons of Ontario
Respondent
AMENDED reasons for judgment
Backhouse J.
Released: November 14, 2023
Correction Notice
Corrected decision: the text of the original judgment was corrected on December 18, 2023, and the description of the correction is appended.
In the style of proceeding, counsel for the Appellant has been corrected as Richard Posner (not Robert Posner).
Paragraph 1 has been corrected to state that the Appellant’s certificate of registration was revoked (not suspended).
[^1]: College of Physicians and Surgeons of Ontario v. Okafor, 2021 ONCPSD 24, dated February 17, 2021. [^2]: Medicine Act, 1991, S.O.1991, c.30. [^3]: Housen v. Nikolaisen, 2002 SCC 33, [2002] 2 SCR 235. [^4]: R. v. R.E.M., 2008 SCC 51, paras. 66-67. [^5]: Housen v. Nikolaisen, 2002 SCC 33, para. 23. [^6]: Salomon v. Matte-Thompson, 2019 SCC 14 at para. 33. [^7]: R. v. Channani, 2020 ONSC 7168, para. 30. [^8]: R. v. T.C., 2020 ONCA 469 para. 25. [^9]: R. v. Kiss, 2018 ONCA 184 at paras. 82-83; R. v. Howe, 2005 253 (ON CA) at para. 59; R. v. Aird, 2013 ONCA 447 at para. 39; R. v. Rhayel, 2015 ONCA 377 at paras. 96, 106; R. v. Gravesande, 2015 ONCA 774 at paras. 19, 43; R. v. G.F., 2021 SCC 20 at paras. 99-101. [^10]: Takashima v. Ontario College of Teachers, 2015 ONSC 3125. [^11]: R. v. G.F., 2021 SCC 20 at para. 100. [^12]: R. v. Sidhu, 2004 BCCA 59, paras. 42-43, 46-49; R. v. Francois, 1994 52 (SCC), pp. 838-841.