File # 20-CRV-0656  
HEALTH PROFESSIONS APPEAL AND REVIEW BOARD  
PRESENT:  
Bonita Thornton, Designated Vice-Chair, Presiding Member  
Anna-Marie Castrodale, Board Member  
Yasmeen Siddiqui, Board Member  
Review held on January 13, 2022 in Ontario (by teleconference)  
IN THE MATTER OF A COMPLAINT REVIEW UNDER SECTION 29(1) of the Health  
Professions Procedural Code, Schedule 2 to the Regulated Health Professions Act, 1991, Statutes  
of Ontario, 1991, c.18, as amended  
B E T W E E N:  
ROYA TAGHINEZHAD and AMIRHOSSEIN FAMILROUSHENA  
Applicant  
and  
MANIJEH BAKHSHI KAHNAMOUEI, MD  
Respondent  
Appearances:  
The Applicants:  
For the Respondent:  
Roya Taghinezhad and Amirhossein Familroushena  
Kathleen Glowach, Counsel  
DECISION AND REASONS  
I.  
DECISION  
1.  
The Health Professions Appeal and Review Board confirms the decision of the Inquiries,  
Complaints and Reports Committee of the College of Physicians and Surgeons of Ontario  
to state its expectation that all physicians ensure their communications are always  
professional and respectful and to take no further action.  
2.  
This decision arises from a request made to the Health Professions Appeal and Review  
Board (the Board) by Roya Taghinezhad (Applicant #1) and Amirhossein Familroushena  
(Applicant #2) to review a decision of the Inquiries, Complaints and Reports Committee  
(the Committee) of the College of Physicians and Surgeons of Ontario (the College). The  
decision concerned a complaint regarding the conduct and actions of Manijeh Bakhshi  
Kahnamouei, MD (the Respondent). The Committee investigated the complaint and  
decided to state its expectation as set out above, and to take no further action.  
II.  
BACKGROUND  
3.  
The Respondent was family physician to the Applicants (who are spouses).  
4.  
The Applicants had concerns about the Respondent’s care during the COVID-19 global  
pandemic.  
The Complaint and the Response  
The Complaint  
5.  
The Applicants complained:  
regarding Applicant #1, that the Respondent:  
• failed to call for a scheduled telephone appointment on July15 and July  
23, 2020;  
• failed to call to cancel the appointments;  
• dismissed missed appointments by saying “these things happen”;  
• failed to provide any follow-up after the missed appointments;  
• failed to provide and discuss results of a breast ultrasound;  
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• fails to see patients at scheduled times and often has wait times of at least  
three hours; and  
• refused to renew prescriptions unless an appointment was made, but  
when the Applicant called to make an appointment the secretary indicated  
that an appointment could be made for 1:00 but there could be a two-hour  
wait to receive the call, and  
regarding Applicant #2, that the Respondent:  
• failed to maintain his privacy when setting up online test result  
management by using his sister’s email address instead of his;  
• dismissed his concerns about his weight and failed to make any  
suggestions to assist him with his weight loss goals, which contributed to  
his developing gallstones; and  
• failed to call in a prescription despite being given the pharmacy  
information.  
The Response  
6.  
The Respondent provided the College with letters in response to the complaint. She  
described her professional background, along with the information regarding the changes  
she was required to make to her practice due to the COVID-19 pandemic.  
7.  
The Respondent addressed the concerns raised in the complaint regarding Applicant #1,  
summarized as follows:  
the Respondent acknowledged that COVID-19 pandemic had made it  
difficult to keep to her patient’s schedule as closely as she liked, and she  
noted that she temporarily lost her administrative support and that visiting  
“urgent” patients and managing telephone consultations made it difficult to  
stick to her booking schedule;  
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the Respondent consulted with Applicant #1 on April 16 and July 2, 2020,  
discussed her mood, management of her ongoing hair loss and  
contraception;  
the Respondent had to postpone a scheduled July16 appointment with the  
Applicant due to a personal matter, and her next appointment was for July  
23, not July15, however due to urgent walk-in patients and other phone  
consultations she was unable to do the consultation at 2 pm and she asked  
staff to phone the Applicant;  
later the same day, the Respondent attempted to phone the Applicant three  
times, then left a voice-mail apologizing for missing the appointment and  
requesting that she phone and re-book the consultation;  
the Respondent denied saying “these things happen”;  
when the Respondent received the Applicant’s laboratory tests and  
ultrasound results, her staff phoned the Applicant to schedule an  
appointment to discuss the results, and the next appointment was scheduled  
for August 13 however Applicant #1 phoned to re-schedule;  
prior to the new appointment to discuss the results, on September 2, the  
Applicant advised she had obtained a new family doctor;  
in regard to the renewal of prescriptions, the Respondent indicated that the  
Applicant received a three-month supply of Citalopram and a three-month  
supply of Alesse 2; and  
the Respondent indicated that the Applicant was scheduled several times to  
review her response to these treatments but, unfortunately, either she could  
not reach her, or the Applicant cancelled the appointments.  
8.  
The Respondent also addressed concerns raised in the complaint regarding Applicant #2,  
including that the Respondent:  
described the electronic medical record (EMR) system she used for  
maintaining a confidential and secure email platform and indicated that she  
used the email provided by Applicant #2 when he registered;  
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she further indicated that the secure email system required the patient to  
create a password when they register their email, so even if it was sent to the  
wrong address, it could only be opened by the patient;  
that while she had emailed his test requisitions, she had never emailed any  
test results;  
denied ever being dismissive about Applicant #2 ‘concerns with weight loss;  
explained that the Applicant #2 had chronic ulcerative colitis for years and  
that they had discussed diet, where she had emphasized the importance of  
following a low carbohydrate and low-fat diet, and suggested he engage in  
more cardiovascular exercise;  
recommended that the Applicant speak to a specialized dietician under the  
supervision of his gastroenterologist;  
indicated the Applicant visited her office on August 7, he called her staff  
and provided a fax number for his preferred pharmacy, and on August 10  
she used that number to fax his prescription for folic acid, however the fax  
failed because the wrong number was provided; and  
with respect to renewing Applicant #2’s prescription, she advised the  
Applicant that folic acid was available over-the-counter without a  
prescription, and all the Applicant’s other prescriptions were managed by  
his gastroenterologist.  
The Committee’s Decision  
9.  
The Committee investigated the complaint and decided to note that it expects all  
physicians to ensure their communications are always professional and respectful and to  
take no further action.  
10.  
The Committee considered the complaint by addressing the concerns about each of the  
Applicants separately.  
Committee’s decision with respect to concerns related to Applicant #1  
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11.  
The Committee noted that the care in this case unfortunately occurred when physicians  
were mostly conducting appointments remotely, due to the COVID-19 pandemic.  
Concern that the Respondent failed to call the Complainant for a scheduled telephone  
appointment on July 15 and July 23  
12.  
The Committee referred to the Respondent’s explanation to the College, as summarized  
above, and stated that, in this instance, the medical record, made at the time,  
corresponded with the Respondent’s explanation that she was not able to call the  
Applicant on time due to an emergency, and that she phoned the Applicant, who was not  
available, and left a message.  
Concern that the Respondent failed to call the Applicant to cancel the appointment  
13.  
The Committee stated that the Respondent had explained that due to the pandemic and  
scheduling issues, she was unable to telephone the Applicant at the agreed upon time.  
Concern that the Respondent dismissed missed appointments by saying “these things happen”  
14.  
The Committee noted that the Respondent denied making the statement. The Committee  
stated that its review is paper-based and therefore in situations, like this matter, where it  
only has the parties’ different recollections of what happened, it was unable to know with  
certainty what the Respondent did or did not say at the time.  
15.  
16.  
The Committee stated that medical practice during the pandemic has created a steep  
learning curve for all physicians, and with virus cases being the norm, it was important  
that physicians put communications skills at the top of their list of priorities.  
The Committee added that patients need personal communication so that they do not feel  
isolated in dealing with health concerns.  
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17.  
The Committee stated its expectation that all physicians ensure their communications are  
always professional and respectful.  
Concern that the Respondent failed to provide any follow up after the missed appointments  
18.  
The Committee noted the Respondent’s explanation that they tried to contact the  
Applicant several times following a review of the Applicant’s laboratory tests and  
ultrasound results. The Committee stated that the record aligned with the Respondent’s  
information and indicated that the Applicant was either unavailable, declined  
appointments or cancelled appointments.  
Concern that the Respondent failed to provide and discuss results of the breast ultrasound  
19.  
The Committee observed that the Applicant’s ultrasound was originally ordered on July  
2, but the Applicant did not have the test until July 23. The Committee noted the  
Respondent’s explanation of attempts to set up the appointment, that the appointment was  
eventually cancelled by the Applicant, and that the Applicant then found a new doctor.  
20.  
The Committee stated that it was reasonable for the Respondent to then email the test  
results to the Applicant.  
Concern that the Respondent fails to see patients at scheduled times and often has wait times of  
at least three hours  
21.  
The Committee accepted the Respondent’s explanation, as summarized above, about how  
the pandemic had an impact on her practice. The Committee stated that it was satisfied  
the medical records suggest that the Respondent did attempt to do her best to provide  
virtual care in a timely fashion.  
Concern that the Respondent refused to renew prescriptions unless an appointment was made,  
but when the Complainant called to make an appointment the secretary indicated that an  
appointment could be made for 1:00 but there could be a two-hour wait to receive the call  
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22.  
The Committee reviewed the Respondent’s explanation related to the renewal of the  
Applicant’s prescriptions. The Committee stated that it was satisfied with the  
Respondent’s explanation, which it observed was supported by the medical records. The  
Committee also noted that the prescriptions could have been renewed by the pharmacist  
under their expanded scope of practice.  
Committee’s decision with respect to concerns related to Applicant #2  
Concern that the Respondent failed to maintain privacy when setting up online test  
result management by using [Applicant #2]’s sister’s email address instead of his  
23.  
The Committee reviewed the Respondent’s explanation of her EMR medical system and  
the use of HealthMail, a confidential and secure email platform, including referring to the  
Respondent’s information that: the email she used was the email that the Respondent  
provided when he registered; she does not believe she sent the email to the wrong  
address; and that she sent labortory test requristions to Applicant #2, but never emailed  
test results. The Committee stated that it accepted the Respondent’s explanations around  
the issue of the Applicant’s email address that the Applicant was the one who provided  
the email in question.  
Concern that the Respondent dismissed concerns about [Applicant #2]’s weight and failed to  
make any suggestions to assist him with his weight loss goals, which  
contributed to his developing gallstones  
24.  
The Committee considered the Respondent’s information with respect to her discussions  
with the Resondent about diet and exercise, and her recommendations. The Committee  
also observed that the Applicant is followed by gastroenterology at Sunnybrook, and that  
the gastroenterologist had suggested that the Applicant see a licenced dietician. The  
Committee noted that the medical record appeared to indicate he was attending a clinic in  
this regard.  
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25.  
The Committee concluded that there was nothing in the medical record to support that the  
Respondent dismissed the Applicant’s concerns or failed to make appropriate  
suggestions.  
Concern that the Respondent failed to call in a prescription despite being given the  
pharmacy information  
26.  
The Committee considered the Respondents explanation about the failed fax to the  
Applicant’s pharmacy. The Committee stated that it was satisfied that the medical records  
corresponded with the information that the Respondent provided. The Committee also  
noted that pharmacists have expanded their scope of practice to renew prescriptions for  
six months, notwithstanding that folic acid is an over the counter drug.  
The Committee’s Final Observations  
27.  
The Committee observed that many of the concerns in this case surround how the  
Respondent runs her practice. While the Committee took no further action on all of the  
concerns, it noted that the complaints were similar to several other complaints the  
College has received regarding the Respondent, and the Respondent might give some  
thought to how she can improve patient satisfaction in terms of administrative aspects of  
the practice.  
28.  
The Committee also noted that ideally, appointment changes and telephone conversations  
should be part of the EMR, although it recognized that this becomes very challenging  
when there are so many changes (as in this case) and even more so in COVID times.  
III.  
REQUEST FOR REVIEW  
29.  
In a letter dated Dec 8, 2020, the Applicants requested that the Board review the  
Committee’s decision.  
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IV.  
POWERS OF THE BOARD  
30.  
After conducting a review of a decision of the Committee, the Board may do one or more  
of the following:  
a) confirm all or part of the Committee’s decision;  
b) make recommendations to the Committee;  
c) require the Committee to exercise any of its powers other than to request a  
Registrar’s investigation.  
31.  
The Board cannot recommend or require the Committee to do things outside its  
jurisdiction, such as make a finding of misconduct or incompetence against the member  
or require the referral of specified allegations to the Discipline Committee that would not,  
if proved, constitute either professional misconduct or incompetence.  
V.  
ANALYSIS AND REASONS  
32.  
Pursuant to section 33(1) of the Health Professions Procedural Code (the Code), being  
Schedule 2 to the Regulated Health Professions Act, 1991, the mandate of the Board in a  
complaint review is to consider either the adequacy of the Committee’s investigation, the  
reasonableness of its decision, or both.  
The Parties’ Submissions  
33.  
The Applicants provided the Board with written submissions and documentation and  
made oral submissions at the review. Some of the documents were new information that  
was not provided to the Committee, including: a screen shot, which appears to be taken  
from a google website, showing an image of an electronic message sent from the sister of  
Applicant #2; a phone bill for July 8, 2020, with two phone calls highlighted, one from  
the Applicants’ number and one from the Respondent’s office; and a print out from a  
Costco pharmacy, with the pharmacy phone number highlighted.  
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34.  
The Applicants submitted the screen shot shows a Gmail message that was forwarded to  
Applicant #2 from his sister. Applicant #2 explained that his sister’s Gmail address uses  
the correct spelling of their shared last names, while his Gmail address removes one  
letter, the letter “u”, from their shared surname. The Applicants submitted that the email  
address as shown in this image is not the email address that he provided to the  
Respondent. The Applicants also noted that the subject line was “[the Respondent] sent  
you a secure message in Medeo.” The Applicants’ submitted this email was an activation  
email, that the recipient could open, and proof that the Respondent disclosed Applicant  
#2’s confidential medical information.  
35.  
The Applicants’ submitted that the email to the sister “was not the only neglect from the  
Respondent” related to the release of confidential information, The Applicants submitted  
a phone record to the Board, highlighting various phone numbers, which the Applicant  
submitted was further proof that the Respondent breached the Applicants’ privacy. The  
Applicants’ submissions included that:  
The Respondent contacted and referred Applicant #1 to two specialist  
however Applicant #1 did not ask for and did not want these referrals.  
Applicant #2 received a phone call from the Respondent’s office asking  
for 30 dollars for transferring medical records to the new family physician,  
however the Respondent had not yet found a new doctor. When the  
Respondent was questioned about who had sent this request, the  
Respondent said, “we don’t know.” The Applicant submitted that the only  
reason the Respondent had not shared his confidential medical information  
with this new physician was that they need the 30 dollar transfer fee. The  
Applicants’ submitted that the copy of the September phone record is  
proof of this phone call from the Respondent.  
36.  
The Applicants submitted that the Costco pharmacy receipt was proof that the  
Respondent had previously faxed a prescription to the Applicants’ pharmacy and  
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therefore proof that the Respondent made a false statement when she indicated that she  
was provided with the incorrect pharmacy fax number.  
37.  
With respect to the concerns related to Applicant #1, the Applicants’ disputed  
information in the decision, and submitted, in part, that:  
the Applicant’s appointment of July 15, 2020, was set and communicated by the  
Respondent’s office, and they find it strange and surprising that the Respondent  
completely denied this;  
the huge delay waiting for the Respondent on July 23 was not due to COVID 19,  
the pandemic only made the Respondent more careless about peoples’ time, so  
instead of a 2 hour delay it became a 6-hour delay;  
they disputed that the Respondent said anything to suggest she was sorry or  
apologized;  
they never said they were getting another physician, it was the Respondent who  
indicated that they should get a new physician;  
prescription renewals were only an issue when they were with the Respondent and  
there were no delays with receiving prescriptions from Applicant #1’s  
psychiatrist;  
38.  
With respect to concerns related to Applicant # 2, the focus of the Applicants’  
submissions related to the complaint that the Respondent failed to protect, and did not  
care about, the privacy of their health information. The Applicants submitted examples of  
“neglect from the Respondent” with confidential information. As noted above, the  
Applicant referred to the screen shot of an electronic message to support his submission.  
The Applicants submitted that the Respondent did not bother to look at her records or pay  
attention and sent information to the wrong person. The Applicants submitted that  
Applicant #2’s sister received this email from the Respondent containing his personal  
health information, and that she therefore knows everything about his medical health  
information.  
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39.  
In summarizing, the Applicants submitted that the Committee did not take the right action  
to address all their concerns, and that the “light disposition” of recommendations and  
advice was insufficient to address the really serious concern with the Respondent’s  
sharing of confidential information.  
40.  
41.  
Counsel for the Respondent submitted that the Committee’s investigation was adequate  
and its decision to state its expectations and take no further action, was reasonable.  
Counsel commenced her submissions by providing background information about  
Respondent’s professional qualifications, and an overview of her care of the Applicants,  
and also reviewed the Respondent’s explanation of her practice during the pandemic.  
Counsel reviewed the Committee’s decision in detail. With respect to the new  
information provided by the Applicants to the Board, specifically the information relating  
to the email from the sister, Counsel submitted that even if the sister was the recipient of  
this email, which she did not concede, she would not have a password to activate and  
open this email and that there was therefore no breach of confidentiality.  
42.  
In reply to the submissions from the Counsel for the Respondent, the Applicant disputed  
the Counsel’s view of the email he provided. He submitted that the email was proof of a  
breach of his medical information. He submitted that the email provided to the Board was  
an activation email and that the recipient of the email merely had to create a password,  
and then they were able to access his confidential medical information.  
43.  
The Board has considered the submissions of the parties, examined the Record of  
Investigation (the Record), and reviewed the Committee’s decision.  
Adequacy of the Investigation  
44.  
An adequate investigation does not need to be exhaustive. Rather, the Committee must  
seek to obtain the essential information relevant to making an informed decision  
regarding the issues raised in the complaint.  
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45.  
The Committee obtained the following documents and information:  
the complaint and subsequent communications with the Applicants, with  
enclosures;  
the Respondent’s response to the complaint;  
the Respondent’s clinical notes and records for the Applicants;  
appointment log summaries, activity summaries and handwritten record of  
voicemails, from the Respondent’s office; and  
the Respondent’s College physician profile and complaints history.  
46.  
47.  
The Applicants did not make specific submissions with respect to the adequacy of the  
investigation, however, as set out above, the Applicants submitted new documentary  
information to the Board, in particular the screen shot of an email, phone bills and a copy  
of a fax to the Costco Pharmacy.  
Counsel for the Respondent submitted that the investigation was adequate, that the  
Committee obtained the relevant available information, and that the new documents  
submitted to the Board by the Applicants would not likely change the Committee’s  
determination.  
48.  
49.  
The Board finds that the Committee’s investigation was adequate for the reasons that  
follow.  
As noted above, the Applicants provided additional information to the Board that was not  
provided to the Committee. The Board notes that the Applicants made no submissions as  
to why any of the new documents and information were not provided to the Committee  
during the course of the investigation. Regarding the Applicants’ submission of phone  
records that they indicated supported additional examples of breach of confidential  
information, the Board notes that the Applicants had several interactions with the  
Committee investigator and could have provided these additional concerns to the  
Committee when the Committee’s investigator confirmed their concerns. As well, the  
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Board finds it received no compelling submission from the Applicants to support that the  
number for the pharmacy that appears in the fax submitted to the Board, was the same fax  
number Applicant #2 provided to the staff on August 7, 2020.  
50.  
With respect to the screen shot of an email provided to the Board by the Applicants, the  
Board observes that the email image appears to be a screen shot from google mail that  
shows an email forwarded to Applicant #2 from a recipient with the Applicant #2’s last  
name in their email address, identified in submissions as his sister. The Board notes that  
the subject line reads “Fwd: [the Respondent] sent you a secure message in Medeo” and  
in the text of the email it instructs that in order to read the message the recipient needs to  
sign in using their Medeo account. The Board received no submissions showing that the  
recipient of that email received a password, or that the recipient was able to create a  
password, and no information or image showing the that the attachment was opened or  
what information the attachment contained. The email address in the screen shot,  
purported to be his sister’s email address, uses the correct spelling of Applicant #2’s last  
name and is almost identical, with the exception of one missing letter to Applicant #2’s  
email address.  
51.  
The Board notes that in its investigation the Committee obtained the Respondent’s  
response wherein she described that her EMR system generates emails using the address  
provided by Applicant #2 when he registered to generate emails, and that even if an email  
address had been incorrectly typed when it was entered, only Applicant #2 had the  
password as the system required the patient to create the account password when he  
provided his email. The Committee also received the screen shot of the Respondent’s  
EMR system that records Applicant #2’s correct email address.  
52.  
The Board observes that the only personal information released in the screen shot  
submitted as new information was that the Respondent was a physician who was sending  
a secure message from Medeo to Applicant #2. The Board concludes that there is no  
compelling information to indicate that the email recipient was able to access any of  
Applicant #2’s confidential information.  
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53.  
The Board finds that the new information of the email screen shot, had it been provided  
to the Committee, would not have affected its conclusion that it accepted that the  
Respondent’s belief that the email she used was the email that Applicant #2 provided;  
that she did not believe she had sent the email to the wrong address; and that even if it  
was sent to the wrong address, it could only be opened by the patient who created a  
password.  
54.  
55.  
The Board therefore finds that the Committee investigation is not inadequate because it  
did not obtain the new information provided by the Applicants or consider the two new  
concerns regarding confidentiality.  
The Board notes that the Committee received the original complaint and the  
Respondent’s letter of response. In addition, the Committee obtained the Respondent’s  
copies of the medical records for both Applicants, along with appointment and phone  
records from the Respondent’s office. The parties were offered opportunities to submit  
information to the Committee. Both parties did so, and the Applicant #2 provided  
additional clarifications of his concerns. The Committee had the Respondent’s College  
Physician Profile.  
56.  
There is no indication of further information that might reasonably be expected to have  
affected the decision, should the Committee have acquired it. Accordingly, the Board  
finds that the Committee’s investigation was adequate.  
Reasonableness of the Decision  
57.  
In determining the reasonableness of the Committee’s decision, the question for the  
Board is not whether it would arrive at the same decision as the Committee. Rather, the  
Board considers the outcome of the Committee’s decision in light of the underlying  
rationale for the decision, to ensure that the decision as a whole is transparent, intelligible  
and justified. That is, in considering whether a decision is reasonable, the Board is  
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concerned with both the outcome of the decision and the reasoning process that led to  
that outcome. It considers whether the Committee based its decision on a chain of  
analysis that is coherent and rational and is justified in relation to the relevant facts and  
the laws applicable to the decision-making process.  
58.  
The Applicants made extensive submissions regarding the reasonableness of the decision.  
With respect to Applicant #1, they disputed the accuracy of the information provided by  
the Respondent and submitted she made false statements. As discussed above, the  
Applicants felt strongly that the Respondent had released Applicant #2’s confidential  
personal health information.  
59.  
Counsel for the Respondent submitted that the decision was reasonable.  
The Board’s Analysis  
60.  
The Board notes that the circumstances of this complaint required the Committee, which  
included three professional members, to rely on its medical knowledge and expertise  
related to the standards of the profession in assessing the Respondent’s conduct and  
actions. In the Board’s view, this includes the Committee’s initial statement in its  
decision commenting on the impact of the COVID-19 pandemic on care, that medical  
practice was on a steep learning curve, and that virtual appointments became the norm  
with physicians mostly conducting appointments remotely.  
61.  
With respect to the Applicants’ concern that the Respondent failed to call Applicant #1 to  
schedule telephone appointments, failed to cancel appointments and was dismissive of  
missed appointments, the Committee’s decision made specific reference to information in  
the Record. For example, the Committee relied on Applicant #1’s medical record and  
noted it corresponded with the Respondent’s explanation that, in regard to the first  
concern, she was not able to phone Applicant #1 on time due to an emergency and that  
the Respondent did try to reach out several times to follow up on the ultra-sound results  
and on booked appointments.  
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62.  
The Board notes that after reviewing the divergent information from the Applicants and  
the Respondent as to how these missed and cancelled appointments and phone calls were  
handled, the Committee applied its expertise and commented that with virtual care it was  
more important than ever that physicians put communication skills at the top of their list  
of priorities. The Board finds that it was therefore reasonable for the Committee to draw  
attention to the importance of this issue and decide to state its expectation that all  
physicians ensure their communications are always professional and respectful.  
63.  
Regarding the concern that the Respondent refused to renew Applicant #1’s prescription,  
the Board notes that the Committee relied on the contemporaneous information in the  
Record that supported the Respondent had scheduled Applicant#1 several times to review  
the response to the treatment and that the Respondent had documented several attempts to  
reach Applicant #1. The Board observes that the Committee relied on its medical  
knowledge to note that the prescription could have been renewed by a pharmacist.  
64.  
With respect to the concerns related to Applicant #2, the Committee first considered the  
complaint, discussed above in relation to adequacy, that the Respondent failed to  
maintain Applicant #2’s privacy by using Applicant #2’s sister’s email address. The  
Board notes that the Committee made specific reference to information in the Record. For  
example, the Committee noted the Respondent’s explanation as to how the EMR system  
used HealthMail, that the email address used was the one provided by Applicant #2; that  
she did not believe she had sent the email to the wrong address; that even if it was sent to  
the wrong address, it could only be opened by the patient; and that she only sent a  
requisition and not test results. The screen-shot of the EMR with the Respondent’s email  
address was included in the Record. The Board finds that it was reasonable for the  
Committee to take no further action on this concern and to conclude that it accepted the  
Respondent’s explanation of the steps to maintain privacy, the security of the email  
system, and that the email address provided by the Respondent, was reasonable.  
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65.  
Regarding the aspects of the complaint that the Respondent dismissed concerns around  
Applicant #2’s weight; failed to suggest weight loss goals, contributing to the  
development of ulcers; and failed to call in a prescription for Applicant #2 despite being  
given the pharmacy information the Board finds that the Committee’s conclusion to take  
no further action on these concerns falls within its expertise and is grounded in the  
information in the Record. The Board observes that the Committee referred to the  
medical records and found support for the Respondent’s explanation that Applicant #2  
had chronic ulcerative colitis for years, that she had suggested a low-fat diet and that  
Applicant #2 was seeing a gastroenterologist and attending a medical clinic. As well, the  
Committee relied on its medical knowledge and determined that there was nothing in the  
record to suggest that the Respondent failed to make appropriate suggestions for  
Applicant #2’s care. The Board notes the Committee also reviewed the medical records  
and found support for the Respondent’s explanation about the prescription and accepted  
that her staff used a fax number provided by Applicant #2 on August 7, 2020. The Board  
finds that the Committee conclusions are supported by the contemporaneous records.  
Conclusion  
66.  
The Board finds the Committee conducted an adequate investigation and reached a  
reasonable decision that is supported by the information in the Record. The Committee’s  
decision demonstrates a coherent and rational connection between the relevant facts, the  
outcome of the decision and the reasoning process that led it to that outcome. The  
Committee decision as a whole is transparent, intelligible and justified.  
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VI.  
DECISION  
67.  
Pursuant to section 35(1) of the Code, the Board confirms the Committee’s decision to  
state its expectation that all physicians ensure their communications are always  
professional and respectful and to take no further action.  
ISSUED July 6, 2022  
___________________________  
Bonita Thornton  
___________________________  
Anna-Marie Castrodale  
__________________________  
Yasmeen Siddiqui  
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