CITATION: Jeyaranjan v. Health Professions Appeal and Review Board, 2025 ONSC 6152
DIVISIONAL COURT FILE NO.: DC-24-672-JR
DATE: 2025/12/19
ONTARIO
SUPERIOR COURT OF JUSTICE
DIVISIONAL COURT
Backhouse, Shore and Tranquilli JJ.
BETWEEN:
APUTHANATHAN RICHARD JEYARANJAN
Applicant
– and –
HEALTH PROFESSIONS APPEAL AND REVIEW BOARD, COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO, and DS
Respondents
Jeffrey E. Feiner and Hilary A. Brown, for the Applicant
Ruth Ainsworth, for the Respondent, the College of Physicians and Surgeons of Ontario
Steven G. Bosnick, for the Respondent, the Health Professions Appeal and Review Board
HEARD: September 18, 2025
Introduction
[1] D.S. and her mother saw their medical specialist for an appointment. Their meeting with Dr. Jeyaranjan escalated to conflict and ended in confrontation between D.S. and the applicant physician. Dr. Jeyaranjan called D.S.’s father about the incident. The applicant also made a medical condition report to the Ministry of Transportation about D.S.’s “violent outburst” due to a “Psychiatric Illness”.
[2] D.S. complained to the College of Physicians and Surgeons of Ontario (“CPSO”) about Dr. Jeyaranjan. Her concerns included that Dr. Jeyaranjan made a baseless medical condition report to the Ministry of Transportation (“MTO”) and breached patient confidentiality by speaking with her father.
[3] The Inquiries, Complaints and Reports Committee of the College of the CPSO (the “Committee”) required Dr. Jeyaranjan to complete an education program to address professionalism, patient confidentiality and MTO reporting and then to attend before the Committee to be cautioned with respect to professional behaviour and maintaining patient confidentiality. The Health Professions Appeal and Review Board (“the Board”) reviewed the Committee decision at Dr. Jeyaranjan’s request. The Board confirmed the Committee’s decision, finding the investigation adequate and decision reasonable.
[4] Dr. Jeyaranjan asks this court to set aside the decisions of the Board and by implication, the Committee, as unreasonable. He contends the College did not have jurisdiction to consider the complaint because the Highway Traffic Act bars actions or “other proceedings” for MTO medical condition reports made in good faith. He also submits the decisions are unreasonable because the record in any event did not support the College’s concerns about the MTO report or his discussions with the complainant’s father.
[5] These reasons will explain why the application for judicial review is dismissed. In summary, the Committee had jurisdiction to consider the MTO report and did not exceed its screening function in expressing its concerns about the report. Both the Board and Committee decisions demonstrate a coherent and rational connection between the relevant facts, the outcome of the decision and the reasoning process that led each decision maker to that outcome. The decisions are transparent, intelligible and justified. There is no basis on which this court should intervene.
Issues
[6] The application gives rise to the following questions for determination:
Does the statutory immunity for medical condition reports under the Highway Traffic Act oust the College’s jurisdiction?
Was the decision that the physician’s rationale for reporting the patient to MTO was “unsupportable” reasonable?
Was the decision that the physician’s breached confidentiality reasonable?
[7] This court’s jurisdiction is limited to judicial review: Judicial Review Procedure Act, R.S.O. 1990, c. J.1, ss. 2, 6(1). There is no appeal from a Board’s decision upon its review of a Committee decision: Regulated Health Professions Act, 1991, S.O. 1991, c. 18, Schedule 2, s. 35 (“the Code”).
[8] This review necessarily involves consideration of the Committee decision because the Board decision rests on a finding that the Committee decision was reasonable: Haddad v. Health Professions Appeal and Review Board, 2024 ONSC 6015 at para. 17: Williams v. Health Professions Appeal and Review Board, 2022 ONSC 2217 at para. 18.
[9] The standard of review of the Board’s and by implication, the Committee’s decision, is reasonableness: Canada (Minister of Citizenship and Immigration) v. Vavilov, 2019 SCC 65, [2019] 4 S.C.R. 653.) The court must consider the outcome of the decision in light of its underlying rationale in order to ensure that the decision as a whole is transparent, intelligible and justified in relation to the facts and law that constrain the decision maker: Vavilov, at paras. 15, 85.
[10] As a preliminary matter, the College submitted the applicant failed to raise this jurisdictional argument in his submissions, to both the Committee and the Board, and therefore this issue should not be subject to review by the Court. The College notes the applicant incorrectly relied on the earlier version of the Highway Traffic Act immunity provision in his submissions to both the College and the Board. Section 204(2) of the Highway Traffic Act provides:
No action or other proceeding shall be brought against a prescribed person required or authorized to make a report under section 203 for making such a report or for reporting to the Registrar in good faith with the intention of reporting under that section
[11] The College submits that the applicant failed to raise the question of whether a College complaint was an “other proceeding” within the meaning of the current section. The decision therefore cannot be found to be unreasonable on the basis that neither the Committee nor the Board failed to address an argument that was not raised before it. The applicant submits he raised this jurisdictional issue when he submitted to the Board that the “entire process needs to be redone” to uphold the protection afforded by the Highway Traffic Act.
[12] I accept that the nature of the applicant’s submission to the College and Board was that he had the protection of the immunity clause; not that the College had no jurisdiction to consider the complaint at all. However, I find that this submission should be considered as it goes to the threshold question of whether the College and its Committee were correct to have assumed jurisdiction over the complaint.
Background
[13] D.S., her mother and her father were Dr. Jeyaranjan’s patients up until the time of the incident that triggered the College complaint. Dr. Jeyaranjan and the respondent complainant have different accounts of their last encounter. The following overview arises from the record of the Board and College and provides the salient context for the concerns before each decision maker.
The Incident
[14] D.S. and her mother attended Dr. Jeyaranjan’s office for their appointments together in February 2022. D.S. and her mother became upset with Dr. Jeyaranjan’s responses to their treatment requests. D.S. and Dr. Jeyaranjan argued. D.S. and her mother told the applicant they would find a new physician and left his clinic. The departure was marked by a further heated exchange between the physician and D.S. at the office door. Dr. Jeyaranjan described D.S.’s conduct as verbally abusive and violent. He claimed she pushed against the locked office door with sufficient force to damage it. D.S. claimed she pulled at the door that he had locked behind her because she was trying to retrieve her wallet.
[15] Dr. Jeyaranjan then called D.S.’s father. He denied that he shared any of D.S.’s personal health information with her father and said her father already knew of the incident when they spoke. The physician acknowledged he spoke with the father on a few occasions after the incident, but explained it was to defuse the situation, to get input and to advise that he would be making a report to the MTO.
[16] Dr. Jeyaranjan completed and submitted a report to the MTO concerning D.S.’s driving privileges pursuant to the Highway Traffic Act, R.S.O. 1990, c. H.8, as amended, and its regulations (“MTO Report”).
[17] The reporting regime established by the Highway Traffic Act and its regulations, relevant to this application, are summarized as follows:
a. The Highway Traffic Act requires every “prescribed person” to report every person who in the opinion of the prescribed person, has or appears to have a prescribed medical condition, functional impairment or visual impairment. This is known as a mandatory report: s. 203(1).
b. A “prescribed person” also has the discretion to report a person who has or appears to have a similar impairment that may make it dangerous for the person to operate a motor vehicle: s. 203(2). The regulations designate a physician, a nurse practitioner and an optometrist as those “prescribed persons” who are required or authorized to make such reports: Drivers’ Licences, O. Reg. 340/94. s. 14.1.
c. The MTO Report is completed by a “prescribed person” in compliance with the Highway Traffic Act and is used to report either a “mandatory condition” or a “discretionary report of medical condition, functional impairment or visual impairment”: s. 204(1).
d. The MTO Report introduction explains to the person completing the form that: “When a report of a mandatory condition is made it will result in a licence suspension”.
e. The MTO Report describes the mandatory condition of “Psychiatric Illness” as: “This patient has or appears to have a condition or disorder currently involving any of the following: acute psychosis, severe abnormalities of perception, or has a suicidal plan involving a vehicle or an intent to use a vehicle to harm others”.
f. The “prescribed person” completing the form is to flag whether the Psychiatric Illness is due to: “Major Depressive Disorder, Bipolar Disorder, Anxiety Disorder, Personality Disorder Schizophrenia or other Psychotic Disorder or Other (Specify)”. This is consistent with the regulatory definition of Psychiatric Illness under the Highway Traffic Act: Drivers’ Licences, s. 14.1(3) 6.
[18] Dr. Jeyaranjan completed the MTO Report as a mandatory report, on the basis that D.S. had a “Psychiatric Illness”. The applicant reported that D.S.’s “Psychiatric Illness” was due to “Other” and specified: “violent outbursts of emotional instability”.
[19] D.S. received a MTO notice of suspension of her driving privileges due to mental health issues about one month after the incident. Her licence was reinstated about three weeks later, after she found another physician to complete a new report.
[20] Dr. Jeyaranjan acknowledged that the complainant did not have a psychiatric history. He reasoned that the Highway Traffic Act obligated him to report the incident because of the duty to report drivers capable of road rage or vehicular homicide/violence. He explained in his response that the report was remedial in nature, to prevent potential problems in the future and was the inevitable result of the complainant’s actions.
The Complaint
[21] D.S. complained to the College that Dr. Jeyaranjan was rude and arrogant, failed to appropriately address her mother’s needs, inappropriately reported D.S. to the MTO without any basis and breached patient confidentiality in speaking with her father about the incident.
[22] The College interviewed the complainant and her mother, obtained the patient chart and received Dr. Jeyaranjan’s response. The Committee met and originally directed an undertaking and oral caution to address their concerns. However, Dr. Jeyaranjan declined the proposal and questioned their disposition. The College disclosed further particulars of the witness interviews with D.S. and her mother to Dr. Jeyaranjan and accepted further submissions from the physician. The matter returned to the Committee for further consideration.
The Committee Decision
[23] By decision of March 6, 2023, the Committee advised it would take no further action on the treatment concerns. The Committee also took no further action on the allegations concerning the applicant’s rude or condescending manner, noting it could not assess credibility when faced with two divergent accounts.
[24] However, the Committee found the applicant’s rationale for the MTO report was “artificial and unsupportable”. The Committee observed the physician’s documentation of the encounter was limited to: “Was uncontrollably violent on the way [out] after the visit.” The Committee found the report was not based on objective medical evidence but on the physician’s argument with the complainant. The Committee concluded the applicant’s use of the MTO Report could be interpreted as an abuse of the power granted to physicians to ensure public safety.
[25] The Committee noted the applicant had a relevant prior College complaint for an MTO Report and for which he had received a caution in person.
[26] The Committee was also concerned that the applicant considered reporting the incident to the complainant’s hospital employer, where the mother also worked. The applicant drafted a letter for that purpose. The applicant explained he did not send the letter because he was uncertain whether he had a duty as a licensed health care practitioner to report these two former patients to their hospital employer pursuant to the Code. The draft letter described the complainant as violent and criticized her mother as merely standing by and watching the incident. The Committee concluded the letter, even if unsent, was nevertheless unjust, unacceptable, vindictive and reflected concerning attitudes and views about the applicant’s role as a physician.
[27] Notwithstanding the applicant’s insistence that he did not disclose “specific personal details” to the complainant’s father, the Committee found there was no dispute the applicant contacted the complainant’s father and disclosed the applicant’s personal health information without her knowledge or consent.
[28] The Committee concluded the applicant demonstrated a disturbing lack of insight into his behaviour. This gave significant concern about the potential impact on patient safety and the public interest such that remediation and professional education were required, along with an oral caution. His actions had significant repercussions for the complainant and her driving privileges. The applicant declined to provide an undertaking. The opportunity for further reflection had apparently not improved his insight. His conduct was serious enough to warrant a caution. The Committee saw no other option but to order him to complete a Specified Continuing Education or Remediation Program (“SCERP”) to address professionalism, patient confidentiality and MTO reporting program to achieve the appropriate educational goals in this case.
The Board Review
[29] Dr. Jeyaranjan requested a review of the Committee decision by the Board. The Board confirmed the Committee’s decision by reasons dated October 8, 2024.
[30] The applicant contended the investigation was inadequate because the College did not disclose the particulars of the witness interviews before he provided his initial response to the complaint. This deprived him of the opportunity to reply to the false statements. The Board found that the investigation was adequate. The complainant’s concerns were clear. The issues he needed to address would have been evident to the applicant. He had numerous opportunities over the course of the investigation to provide his version of events. The additional complaint details were shared with him, and he had an opportunity to respond to the Committee’s initial findings. There was no indication of what further information might reasonably be expected to have affected the decision.
[31] The applicant also raised several concerns about the reasonableness of the decision.
[32] He submitted the Committee misinterpreted and misapplied the mandatory reporting requirements under the Highway Traffic Act. The Board disagreed, noting the applicant did not provide any reasons to support this position.
[33] The applicant submitted the Committee went beyond its screening function in preferring the complainant’s version of events over his submissions. The Board found the Committee’s conclusions were reasonable as they were based on information in the investigative record. There was no dispute about Dr. Jeyaranjan’s rationale for making the MTO report or that he contacted the complainant’s father on three occasions about the incident.
[34] Finally, the applicant submitted the decision was unreasonable because the disposition was punitive and maligned the applicant. However, the Board was satisfied the disposition logically followed from the Committee’s specific concerns and was consistent with the remedial and educational nature of the Committee’s mandate.
Analysis
1. Does the statutory immunity reporting provision under the Highway Traffic Act oust the College’s jurisdiction?
[35] The Highway Traffic Act precludes an “action or other proceeding” against a physician for an MTO Report made in good faith: Highway Traffic Act, s. 204(2). The applicant submits the provision establishes broad immunity for health care professionals who are required to perform this reporting duty for the protection of the public and it therefore precludes the College from investigating D.S.’s complaint about the report. The applicant concedes the immunity turns on a finding of “good faith” such that the College would have jurisdiction to address a MTO Report made in bad faith.
[36] The College submits the applicant’s interpretation of “other proceeding” would produce an absurdity. This aspect of a physician’s medical practice would be immune from regulatory oversight. This would put patients at risk and undermine the public protection function of both the Highway Traffic Act and the Regulated Health Professions Act. The “modern principle” of statutory interpretation requires the provision to be read in their entire context: Ruth Sullivan, Construction of Statutes, 7th ed. LexisNexis Canada Inc.: June 2022, ss. 2.01[1]; 2.01[4].
[37] In any event, the College notes the Committee expressed concern the applicant did not base his report on objective medical evidence but instead “weaponized” his authority to report his patient to the MTO. The College submits those concerns are consistent with a conclusion the report was not made in good faith, in the sense the report was the result of “serious carelessness or recklessness” and implied a fundamental breakdown of the orderly exercise of authority, to the point that absence of good faith can be deduced and bad faith presumed: Finney v. Barreau du Québec, 2004 SCC 36, at para. 39. Therefore, if the immunity provision can apply to College complaints, the applicant does not have the benefit of this protection as his report was not made in “good faith”.
[38] To this, the applicant contends the Committee’s limited statutory function precludes it from making the factual findings necessary to determine if a report was made in “good faith”. The College cannot rely on any such finding because it would exceed the Committee’s jurisdiction. Rather, such fact-finding functions would be within the purview of the College’s Discipline Committee.
[39] Analysis of this issue begins with consideration of the function and purpose of the reporting regime established by the Highway Traffic Act. Amongst the conditions necessary for individuals to have the privilege of a driver’s licence, the Highway Traffic Act and its regulations provide the holder of a driver’s licence must not suffer from any mental, emotional, nervous or physical condition or disability likely to significantly interfere with his or her ability to drive a motor vehicle: Drivers’ Licences, s. 14(1)(a).
[40] The Highway Traffic Act establishes a regime for the mandatory and discretionary reporting of fitness to drive concerns to the Registrar of Motor Vehicles. The Act requires mandatory reporting of a prescribed medical condition, functional impairment or visual impairment and permits discretionary reporting where the person has or appears to have a medical condition, functional impairment or visual impairment that may make it dangerous for the person to operate a motor vehicle: ss. 203, 204. The legislature adopted the current version of this statutory regime in the Transportation Statute Law Amendment Act (Making Ontario’s Roads Safer), 2015 S.O. 1015, c. 14, which came into force July 1, 2018.
[41] As previously reviewed, only a “prescribed person” such as a physician may make either a mandatory or discretionary report. The “prescribed person” must have met the reported person for an examination or for the provision of medical or other services: Highway Traffic Act, s. 203(4). Section 204(2) sets out the statutory immunity that arises for a prescribed person who makes a mandatory or discretionary report in those circumstances:
No action or other proceeding shall be brought against a prescribed person required or authorized to make a report under section 203 or for reporting to the Registrar in good faith with the intention of reporting under that section. [emphasis added]
[42] The phrase “other proceeding” did not appear in the previous version of this immunity provision, which provided: No action shall be brought against a qualified medical practitioner for complying with this section: s. 203(1), as repealed by the Transportation Statute Law Amendment Act, s. 55. The Highway Traffic Act also does not define “proceeding”.
[43] The applicant notes the term “proceeding” is long recognized as having a very wide meaning that includes steps or measures which are not in any way connected with actions or suits: Markevich v. Canada, 2003 SCC 9 at para. 24. He submits this is consistent with the broad application also given to the term “proceeding” under the College’s own governing statute; the Regulated Health Professions Act: F.(M.) v Dr. Sutherland, 2000 5761 (ON CA), at para. 29.
[44] The applicant submits that consistent with the rules of statutory interpretation, the addition of the broadly interpreted term “other proceeding” to the term “action” in the amended immunity section signifies an intention to expand the scope of immunity to include proceedings such as College complaints. This would be consistent with the legislature’s intention to ensure healthcare professionals are not discouraged from making such reports for fear of a lawsuit or a College complaint. The applicant notes the Highway Traffic Act is public welfare legislation designed to protect those who use the roads of the province: Abara v Registrar of Motor Vehicles, 2024 ONSC 7085 (Div. Ct.) at para. 53. The applicant urges that the ordinary and grammatical meaning of “proceeding” within the context, purpose and scheme of the Highway Traffic Act therefore leads to the logical conclusion that the immunity extends to the College’s regulatory activities, such as when the Committee determines a complaint pursuant to the Code: s. 26.
[45] The College disagrees and submits that consideration of a similar immunity provision in the Coroner’s Act RSO 1990, c C.37 is relevant to the appropriate interpretation of this immunity provision. The comparison demonstrates that whatever the scope of the meaning of “other proceeding” within the Highway Traffic Act, this phrase cannot include a College regulatory proceeding like a complaint.
[46] Like the Highway Traffic Act, recent Coroner’s Act amendments also contain an immunity clause precluding: “No action or other proceeding” for duties performed by regulated health professionals under that legislation. That immunity provision was part of a package of amendments adopted by the legislature expressly accepting the recommendations of the “Commission of Inquiry into Pediatric Forensic Pathology in Ontario”: Report, Commissioner: The Honourable Justice Stephen Goudge (“Goudge Report”).
[47] The Goudge Report identified that one the systemic factors that contributed to the lack of oversight of forensic pathologists such as Dr. Charles Smith and the resultant wrongful convictions and child apprehensions was the College’s historical practice declining jurisdiction and forwarding complaints about coroners and pathologists acting under the Coroner’s Act to the Office of the Chief Coroner. Justice Goudge noted the College properly reasserted its jurisdiction over physicians working for the Office of the Chief Coroner and recommended that the concurrent jurisdiction of both the College and the Office of the Chief Coroner be legislatively enshrined.
[48] Given the legislature’s adoption of the Goudge Report recommendations, including that the College exercise its regulatory jurisdiction over coroners and pathologists, the College submits that the statutory immunity from an “other proceeding” for performing a duty pursuant to the Coroner’s Act cannot mean a College regulatory proceeding. Applying the presumption of consistent expression within this context, it follows that the statutory immunity under the Highway Traffic Act for making a report also cannot mean a College regulatory proceeding.
[49] The court accepts that the phrase “action or other proceeding” is expansive and that the term “proceeding” eludes an exhaustive definition. However, that broad meaning cannot include a regulatory proceeding by the College concerning a MTO Report. This interpretation of “other proceeding” advocated by the applicant would produce absurd consequences.
[50] The applicant’s interpretation would immunize the physician or other regulated health professional from professional regulation within this sphere of practice. This would convey the ironic message that this is one area of practice where the regulated health professional cannot be regulated. The legislature cannot have intended such an outcome. It also begs the question as to how compliance with the reporting regime would be governed, if at all. Can a physician’s declaration that he or she made the report in good faith logically end a complaint inquiry? Such a result is antithetical to public safety and public protection, the very purposes of the Regulated Health Professions Act and the Highway Traffic Act: Sazant v. The College of Physicians and Surgeons of Ontario, 2012 ONCA 727, leave to appeal refused, (2013) 320 OAC 387; Abara, at para. 53.
[51] This interpretation would also create a further absurdity where the Committee would not perform its statutory screening function and instead refer MTO Report complaints to the Discipline Committee because of the statutory immunity and the Committee’s lack of fact-finding powers to determine if the report was made in good faith. It does not make sense that such complaints would go to the Discipline Committee for an alleged act of professional misconduct rather than first being initially screened like all complaints by the Committee, which may use its expertise and discretion to consider lesser dispositions such as education, remediation, or to take no further action, based upon its review of the record.
[52] In contrast, it is entirely consistent with the purpose and context of both the Highway Traffic Act and the Regulated Health Professions Act if the College complaint process is not an “other proceeding” subject to statutory immunity. The regulatory oversight offered by the College of its licensed physicians, as members of a regulated health profession, is inherent to the efficacy of the reporting regime and the promotion of its legislative purpose.
[53] The Highway Traffic Act contemplates that the reporting scheme is implemented by a regulated health professional in accordance with the standards of the practitioner’s governing profession. The reporting regime authorizes only a “prescribed person” to submit a medical condition report to the MTO. The regulation designates certain regulated health professionals, including physicians as those “prescribed persons”: Drivers’ Licences, ss. 14.1(1), 14.2. The regulation refers the “prescribed person” to the Canadian Medical Association publication, “Determining Medical Fitness to Operate Motor Vehicles (9th edition), as a resource when considering the duty to report in respect of a person: Drivers’ Licences, s. 14.1(6); (“CMA Drivers’ Guide”).
[54] The reporting regime accordingly relies on professional standards external to the Act for the management of fitness to drive assessments and the duty to report to the MTO. A regulated health professional like a physician is subject to the standards of practice and professionalism that are established and implemented by the College in accordance with its duties and objects under the Regulated Health Professions Act. Those standards of practice and professionalism as it relates to reporting fitness to drive are addressed in College Policy, such as “Mandatory and Permissive Reporting”.
[55] Beyond imposing the reporting obligation, the Highway Traffic Act does not provide a framework or procedure for oversight of the practitioner’s compliance with the duty. The integrity of the regime therefore necessarily relies on the oversight by regulated health professions who govern those “prescribed persons”.
[56] The College’s jurisdiction in respect of a complaint about a MTO Report is therefore consistent with and essential to the reporting scheme established by the Highway Traffic Act and promotes the statutory purposes of the protection of the public that both statutes promote, from quality of care and road safety perspectives.
[57] As I have concluded the statutory immunity provided by the Highway Traffic Act does not apply to a College complaint, the question of whether the report was not made in good faith, need not be considered.
[58] That said, the applicant’s submissions suggested that irrespective of the relevance of “good faith” to the College’s jurisdiction over this complaint, the College’s concern that the physician had “weaponized” his authority to report was nevertheless the result of improper fact-finding by the Committee. I do not agree.
[59] The Committee is a statutory committee of the College. Its function is to screen complaints and investigation reports to determine whether further action is necessary. The Committee cannot make findings of fact or binding legal conclusions. The Committee reviews documentary evidence to decide whether allegations should be referred to the Discipline Committee for a hearing: Schuur v. Sas, 2023 ONSC 2852 at para. 35. The Committee has broad discretion under the Code to decide what action to take, including referral to the Discipline Committee on an allegation of professional misconduct or requiring the physician to attend the College for a caution or to complete a remedial program: Code, s. 26; King v. Gannage, 2020 ONSC 7967 at para. 21.
[60] The Committee therefore did not exceed its screening function in stating its concern the applicant had “weaponized” his authority. The Committee was explaining its basis for requiring Dr. Jeyaranjan to appear for a caution and to complete a remedial program. The Committee did not issue any declarations or orders, did not purport to make findings of professional misconduct or findings in the context of disputed facts, and did not refer this matter to a Discipline Committee. The Committee’s concern that the applicant had “weaponized” his authority was within its jurisdiction on the record before it: Doe v. College of Physicians and Surgeons of Ontario, 2022 ONSC 2920 at paras. 16-19; Bernstein v. Health Professions Appeal and Review Board, 2025 ONSC 6724 at para. 10.
[61] While there is a factual dispute about the relative roles of D.S. and the applicant in the conflict, the Committee did not need to resolve that controversy to appropriately identify its concerns about the MTO Report. Their concerns were based on their review of the record and consideration of Dr. Jeyaranjan’s submissions and his rationale for making the report. The Committee referred to the limited documentation of the encounter in the patient chart, sparse details of the “Psychiatric Illness” flagged in the MTO Report and that Dr. Jeyaranjan knew the complainant’s medical record showed no psychiatric history. He claimed the report was made to prevent potential problems and risks to the public in the future such as road rage but also professed to be confused by his reporting obligations under the Highway Traffic Act and acknowledged that he could have done better. In any event, he made no referral for the mental health issue, did not document his concern or his rationale for making the report, made no effort to advise the complainant he was making the report, and went so far as to draft a letter to the complainant’s hospital employer to also report the incident. The Committee opined this reflected a concerning attitude and views by the applicant about his role as a physician. This opinion was demonstrably based upon the Committee’s assessment of the medical record and the physician’s own submissions.
2. Was the decision that the physician’s rationale for reporting the patient to MTO was “unsupportable” reasonable?
[62] The applicant submits that the Committee’s decision that his rationale for reporting the complainant was “unsupportable” was unreasonable. The applicant formed the bona fide opinion that the complainant appeared to be suffering from a psychiatric condition that was dangerous to other drivers, because of her impulsive and violent outburst, therefore triggering his duty to report. He notes that professional standards emphasize that in general, physicians should err on the side of reporting any potentially medically unfit driver and anger, hostility and aggression while driving are associated with a range of mood and personality disorders. Emotional fitness is recognized as an important component of safe driving: CMA Drivers’ Guide. Even if Dr. Jeyaranjan was mistaken in his opinion, his belief was nevertheless sincerely held and therefore made in good faith: Groia v. Law Society of Upper Canada, 2018 SCC 27 at paras. 94, 122, 123, 132. Therefore, even if the Committee could reasonably conclude that he misinterpreted his reporting duties, the applicant submits the Committee unreasonably escalated and amplified the applicant’s honestly held belief into something more serious without the necessary evidentiary record to make such a severe conclusion.
[63] I disagree. A reasonable decision is one that is both based on an internally coherent reasoning and justified in light of the legal and factual constraints that bear on the decision: Vavilov, at paras. 99-106.
[64] The Committee had considerable information before it from the complaint investigation on which to reach its conclusion that Dr. Jeyaranjan’s rationale for making the report was “artificial and unsupportable”. In addition to the previously noted concerns, such as the lack of charting and lack of a psychiatric history, the following information was also relevant to the Committee’s decision and available to it on this record:
a. Dr. Jeyaranjan relied on the repealed version of the Highway Traffic Act immunity clause in his responses and admitted to confusion about his reporting obligation yet insisted he had grounds to make a mandatory report of Psychiatric Illness;
b. Dr. Jeyaranjan purported to make a “mandatory report” of a “Psychiatric Illness” to the MTO, which results in an automatic suspension of the patient’s licence. He insisted he made the report to “prevent road rages and accidents.” However, Dr. Jeyaranjan did not document any findings consistent with having undertaken a psychiatric assessment or diagnosis of an applicable condition and did not appear to consider whether in the circumstances he ought to have at most made a discretionary report under s. 203(2) of the Highway Traffic Act, which does not result in an automatic suspension.
c. Notwithstanding his admitted confusion about his reporting obligations, Dr. Jeyaranjan claimed to rely on the CMA Drivers’ Guide in forming his rationale to make the report. However, the Guide advises that the physician should consider arranging a consultation with an appropriate specialist if undecided about a person’s fitness to drive.
d. Dr. Jeyaranjan also had a previous relevant complaint in his College history also related to MTO reporting, from 2015. The College noted he received a caution in person with respect to providing adequate objective information when reporting to the MTO, documenting his decision and reporting rationale in the chart, and, if possible, informing the patient that a report was made to the MTO. The Committee expressed its disappointment that despite this previous caution, Dr. Jeyaranjan again demonstrated similar conduct in this complaint.
[65] The Committee’s finding that Dr. Jeyaranjan’s rationale for making the MTO report was “unsupportable” was reasonable. The Committee’s decision provides reasons that set out a clear line of analysis, is supported by the legislation, relevant professional standards and the totality of the information before the Committee. Notwithstanding Dr. Jeyaranjan’s insistence of his sincerity in making the report, the evidence before the Committee could reasonably lead it to the opposite conclusion.
3. Was the decision that the physician breached confidentiality reasonable?
[66] Dr. Jeyaranjan’s responses did not explain the particulars of the multiple conversations between him and the complainant’s father about the incident. Dr. Jeyaranjan submitted that the father already knew about the incident when the physician first called the father, and that Dr. Jeyaranjan spoke to the father “to defuse the situation and the next day about my requirement to make a mandatory MTO report about the incident. There were no specific personal details discussed at any time. I believed if the father can be of any help with reasoning about the matters, it is better to seek his input than not.”
[67] Dr. Jeyaranjan submits he did not breach patient confidentiality because the circumstances of D.S.’s violent outburst did not constitute personal health information. He submits the Committee alternatively failed to consider whether the disclosure to D.S.’s father was permissible in the interest of public safety such that its decision was unreasonable.
[68] I disagree. The Committee’s conclusion that it was “very concerned by this breach in patient confidentiality” arises from a rational and logical line of reasoning that was available to it on this record. The Personal Health Information Protection Act, 2004, S.O. 2004, c. 3 (“PHIPA”) prohibits the disclosure of personal health information unless it is with the individual’s consent or is otherwise permitted by the Act: PHIPA, s. 29. “Personal health information” is defined as including “identifying information about an individual in oral or recorded form if the information is related to the physical or mental health of the individual or relates to the providing of health care to the individual, including the identification of a person as provider of health care to the individual”: PHIPA, s. 4(1). The MTO Report purported to contain a diagnosis of a mental health condition. This apparent condition fell within the definition of personal health information that Dr. Jeyaranjan was required to keep confidential.
[69] I am not persuaded the Committee failed to consider that Dr. Jeyaranjan’s disclosure was permissible in the interest of safety. PHIPA certainly provides that personal health information may be disclosed if the custodian believes on reasonable grounds that the disclosure is necessary for the purpose of eliminating or reducing a significant risk of serious bodily harm to a person or group of persons: s. 40(1). However, such a consideration did not reasonably arise on the record before the Committee. Although Dr. Jeyaranjan’s responses refer to his concern of preventing road rage, at no point did he claim that he spoke with the complainant’s father to reduce a significant risk of harm to the father or other members of the family or to the public, nor did he take other steps consistent with addressing the apprehension of such a risk. To the contrary, Dr. Jeyaranjan reasoned that disclosure was made to “defuse” the situation and to appeal for the father’s “help with reasoning”, not to address the safety of the patient, her family or the public.
[70] As noted by the Board, the Committee did not exceed its screening function in reaching its conclusions on this issue. Its decision logically arose the line of reasoning flowing from Dr. Jeyaranjan’s’s undisputed actions in repeatedly calling D.S.’s father.
Disposition
[71] The Committee had jurisdiction to consider the MTO Report complaint. Its decision to caution Dr. Jeyaranjan in person and to require the physician to complete an education and remediation program was reasonable. In turn, the Board considered each of his concerns about the Committee’s decision and concluded the Committee applied its knowledge and expertise to the information before it, considered the expected standards of the profession and that its conclusions were reasonable as they were based on information in the record. It follows that the Board’s decision confirming the Committee’s decision was also reasonable.
[72] I note Dr. Jeyaranjan has been particularly concerned with what he considers to be a “punitive” response by the College with the dispositions for a caution and education and remediation program. Cautions and educational or remedial directions are not meant as sanctions or penalties but are intended to benefit the practitioner and the patients by avoiding future complaints of a similar nature: Geris v. Ontario College of Pharmacists, 2020 ONSC 7437 (Div. Ct.) at paras. 33-41.
Costs
[73] As between Dr. Jeyaranjan and the College, the parties agreed that the successful party is entitled to $7,500 in costs. I find this amount to be fair and reasonable given the issues on the application. The College is entitled to costs in the amount of $7,500, payable by Dr. Jeyaranjan. The Board does not seek its costs of this application, and none are ordered.
Justice K. Tranquilli
I agree
Justice N. Backhouse
I agree
Justice S. Shore
Released: December 19, 2025
CITATION: Jeyaranjan v. Health Professions Appeal and Review Board, 2025 ONSC 6152
ONTARIO
SUPERIOR COURT OF JUSTICE
DIVISIONAL COURT
Backhouse, Shore and Tranquilli JJ.
BETWEEN:
APUTHANATHAN RICHARD JEYARANJAN
Applicant
– and –
HEALTH PROFESSIONS APPEAL AND REVIEW BOARD, COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO, and DS
Respondents
REASONS FOR JUDGMENT
Released: December 19, 2025