Citation

CITATION: Kodsi v. Health Professionals Appeal and Review Board, 2025 ONSC 2502

DIVISIONAL COURT FILE NO.: 308/24

DATE: 20250428

SUPERIOR COURT OF JUSTICE – ONTARIO

DIVISIONAL COURT

RE: IHAB SHERIF KODSI, dds, Applicant

AND:

HEALTH PROFESSIONS APPEAL AND REVIEW BOARD and debby stanley, Respondents

BEFORE: Backhouse, O’Brien, and Kaufman JJ.

COUNSEL: Neil M. Abramson, and Lujza Csanyi, for the Applicant

David P. Jacobs and Barbara E. Warner, for the Respondent, Health Professions Appeal and Review Board

HEARD: April 24, 2025 at Toronto

ENDORSEMENT

[1] The applicant Dr. Kodsi seeks to judicially review a decision of the Health Professions Appeal and Review Board (HPARB) dated April 25, 2024. HPARB upheld the decision of the screening committee, the Inquiries, Complaints and Reports Committee, of the Royal College of Dental Surgeons. Dr. Kodsi is an oral and maxillofacial surgeon. The Committee’s decision arose from a complaint brought by a patient who had been referred to Dr. Kodsi for the extraction of a tooth. She alleged that Dr. Kodsi’s lack of proper follow up care caused two other teeth to deteriorate, leading to their eventual extraction by a different dental surgeon.

[2] Following the College’s investigation into the complaint, which included receiving and considering three responses from Dr. Kodsi, the Committee rendered its decision. It raised several concerns about Dr. Kodsi’s practice. The Committee noted, for example, that the information included in Dr. Kodsi’s responses were not fully supported by the records. The Committee also expressed concern about Dr. Kodsi’s post-surgical management of the patient and his consideration of the pre-surgical CT scan. Finally, the Committee concluded Dr. Kodsi should have followed the patient more closely given the CT findings and her complaints of pain, rather that telling her to return if needed. The Committee ordered Dr. Kodsi to complete a specified continuing education or remediation program (SCERP) in oral surgery, with a mentorship component, and required him to have his practice monitored.

[3] HPARB upheld the Committee’s decision. It found the Committee’s decision to be reasonable and its investigation to be adequate.

[4] In this court, Dr. Kodsi focused on a single submission: that the Committee and HPARB’s decisions should be quashed because the remedy was overbroad and did not reasonably follow from the Committee’s concerns. Dr. Kodsi submits those concerns were primarily about record-keeping and communication. Despite what he describes as the narrow focus of the Committee’s concerns, the SCERP required continuing education and remediation on a wide range of topics relevant to multiple aspects of his practice.

[5] We do not find any basis to interfere in HPARB’s decision. HPARB reasonably rejected the submission that the Committee’s concerns were limited to record-keeping and communication for the following reasons.

[6] First, HPARB explained that the concern about Dr. Kodsi’s record-keeping and communication reflected broader concerns about his practice. At para. 50 of its reasons it emphasized that, in the absence of compelling information, dental records are treated as an accurate reflection of what occurred:

…[D]ental records are legal documents that all dentists are required to make. Dental records provide a contemporaneous record of interactions with a patient, made prior to the commencement of any complaint or legal process. As such, in the absence of compelling information to the contrary, dental records are a reliable source of information as to what occurred during the patient encounter.

[7] HPARB therefore read the Committee’s comments about record-keeping to reflect not only a concern about documentation, but also about Dr. Kodsi’s substantive practice. This was a reasonable reading of the Committee’s decision and a fair reflection of the role and importance of record-keeping.

[8] Second, HPARB upheld the Committee’s concerns about Dr. Kodsi’s post-surgical management, which were not limited to record-keeping and communication. The concerns included, for example, that Dr. Kodsi did not take a post-operative periapical radiograph immediately after the tooth extraction to check for tooth fragments. He also did not alert the family dentist to the CT scan and possibility of infection. He instead said the scan “showed no evidence of pathology.” HPARB reasonably interpreted the Committee’s decision as not just reflecting a concern about communication on this point, but about Dr. Kodsi’s management of the patient post-surgery.

[9] Finally, HPARB upheld the Committee’s finding that Dr. Kodsi should have followed the patient more closely, instead of telling her to “return if needed.” This was not a record-keeping issue. HPARB carefully reviewed the record, which included Dr. Kodsi’s plan on December 16, 2020 that the patient should follow up in March. HPARB contrasted Dr. Kodsi’s approach to the patient’s appointment with her family dentist less than a month later, on January 14, 2021. At that appointment, the family dentist obtained imaging that showed concerns with the two additional teeth that were eventually extracted, documented the patient’s discomfort and sensitivity, and started a course of antibiotics. Eleven days later, another oral surgeon extracted the two teeth. In these circumstances, there was ample support for HPARB’s decision not to interfere in the Committee’s conclusion that Dr. Kodsi should have followed the patient more closely.

[10] In his submissions on remedy, Dr. Kodsi emphasized the Committee did not suggest his conduct affected the patient’s outcome. But the Committee is not tasked with determining the impact of a member’s practice on a patient’s outcome. Its role is to consider potential breaches of the standards of practice. In any event, in this case, the Committee’s concern that Dr. Kodsi should have followed the patient more closely included evidence that she was experiencing pain when she saw her family dentist almost a month later. The record leaves open the inference that Dr. Kodsi’s management caused the patient significant additional pain.

[11] In short, HPARB reasonably concluded the Committee had wide-ranging concerns about Dr. Kodsi’s practice. It concluded at para. 74 of its reasons that the Committee had “multiple areas of concern” regarding Dr. Kodsi’s care and treatment of the patient beyond recordkeeping and communications. On remedy, these concerns “provided the basis for a broader remediation program as set out in the SCERP.”

[12] We would not interfere in this conclusion. The court will show significant deference to the Committee’s choice of remedy, as will HPARB on review: Haddad v. Health Professions Appeal and Review Board, 2024 ONSC 6015, at para. 46. In this case, given the Committee’s broad concerns about Dr. Kodsi’s practice, it was reasonable for HPARB to uphold the SCERP.

[13] The application therefore is dismissed. HPARB does not seeks costs of the application and no costs are awarded.

Backhouse J.

O’Brien J.

Kaufman J.

Date: April 28, 2025