DISCIPLINE COMMITTEE OF THE COLLEGE OF PHYSIOTHERAPISTS OF ONTARIO COLLEGE OF PHYSIOTHERAPISTS OF ONTA RIO. - and

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1 CPO File No BETWEEN: DISCIPLINE COMMITTEE OF THE COLLEGE OF PHYSIOTHERAPISTS OF ONTARIO COLLEGE OF PHYSIOTHERAPISTS OF ONTA RIO - and DA VID EVANS, Registration Number NOTICE OF HEARING The Inquiries, Complaints and Reports Committee of the College of Physiotherapists of Ontario has referred specified allegations against David to the Discipline Committee of the College. The allegations were referred in accordance with paragraph 26(1)1 of the Health Professions Procedural Code. The statement of allegations is attached to this notice of hearing. A discipline panel will hold a hearing under the authority of sections 38 to 56 of the Health Professions Procedural Code, as amended, for the purposes of deciding whether the allegations are true. A pre-hearing conference may be held at the offices of the College of Physiotherapists of Ontario at 375 University Avenue, Suite 800, Toronto, Ontario, at a date and time to be fixed by the Registrar. A discipline panel will subsequently convene at the offices of the College of Physiotherapists of Ontario at 375 University Avenue, Suite 800, Toronto, Ontario, also at a date and time to be fixed by the Registrar, for the purposes of conducting the hearing. IF YOU DO NOT ATTEND AT THE HEARING IN ACCORDANCE WITH THE PRECEDING PARAGRAPH, THE DISCIPLINE PANEL MAY PROCEED IN YOUR ABSENCE AND YOU WILL NOT BE ENTITLED TO ANY FURTHER NOTICE IN THE PROCEEDINGS. If the discipline panel finds that you have engaged in professional misconduct, it

2 2 may make one or more of the following orders: 1. Direct the Registrar to revoke the member's certificate of registration. 2. Direct the Registrar to suspend the member's certificate of registration for a specified period of time. 3. Direct the Registrar to impose specified terms, conditions and limitations on the member's certificate of registration for a specified or indefinite period of time. 4. Require the member to appear before the panel to be reprimanded. 5. Require the member to pay a fine of not more than 935,000 to the Minister of Finance. The discipline panel may, in an appropriate case, make an order requiring you to pay all or part of the College's costs and expenses pursuant to section 53.1 of the Health Professions Procedural Code. You are entitled to disclosure of the evidence against you in accordance with section 42(1) of the Health Professions Procedural Code, as amended. You, or your representative, may contact the solicitor for the College, Joanna Birenbaum, in this matter at: Ursel Phillips Fellows Hopkinson LLP 555 Richmond St. West, Suite 1200 Toronto, ON M5V 381 Telephone: (a16) Facsimile: (416) jbirenbaum@upfhlaw.ca

3 - 3 - You must also make disclosure in accordance with section 42.1 of the Health Professions Procedural Code, which states as follows: Evidence of an expert led by a person other than the College is not admissible unless the person gives the College, at least ten days before the hearing, the identity of the expert and a copy of the expert's written report or, if there is no written report, a written summary of the evidence. Date: b, 2D(} She Registrar & CEO College of Physiotherapists of Ontario

4 - 4 - STATEMENT OF ALLEGATIONS 1. At all material times, David Evans was registered as a physiotherapist in the Province of Ontario and was co-owner of We-Fix-U Clinic located in Cobourg Ontario (the "Clinic"). 2. Between July 1, 2013 and August 5, 2016, Mr. Evans engaged in professional misconduct within the meaning of paragraphs 28, 32 and 33 of section 1 of the Professional Misconduct Regulation, 0. Reg. 388/08 (signing or issuing a document containing a statement that the member knows or ought to know contains a false or misleading statement; submitting an account or charge for services that the member knows or ought to know is false or misleading; and failing to take reasonable steps to ensure that any accounts submitted in the member's name and billing number are fair and accurate). 3. Between July 1, 2013 and August 5, 2016, Mr. Evans engaged in professional misconduct within the meaning of paragraph 1 of section 1 of the Professional Misconduct Regulation, 0. Reg. 388/08 (Failure to maintain the standards of the profession), by improperly delegating assessments, development of treatment plans and the discharge of physiotherapy patients to a physiotherapist assistant; and by failing to obtain informed consent from patients to physiotherapist assistants being engaged in their care; 4. Between July 1, 2013 and August 5, 2016, Mr. Evans engaged in professional misconduct within the meaning of paragraph 22 of section 1 of the Professional Misconduct Regulation, 0. Reg. 388/08 by directly or indirectly holding out a nonphysiotherapist as a physiotherapist. 5.. Mr. Evans engaged in professional misconduct within the meaning of paragraph 18 of section 1 of the Professional Misconduct Regulation, 0. Reg. 388/08 in respect of the allegations set out in paragraphs 2, 3 and 4 above.

5 5 PARTICULARS OF THE ALLEGATIONS 1. During the period of July 1,2013 and August 5, 2016, Mr. Evans was a registered physiotherapist in the province of Ontario and the co-owner of We-Fix-U Clinic in Coburg Ontario (the "Clinic"). Failure to Maintain the Standards of the Profession: lmproper Delegation of Assessments and the Development of Treatment Plans 2. The Sfandards for Professional Practice: Physiotheraprsfs Working with Physiotherapist Support Personnel(and the amended Standard: Working with Physiotherapist Assrsfanfs as of June 2016) of the Ontario College of Physiotherapists state that physiotherapists cannot delegate assessments, reassessments or the development of treatment plans to physiotherapist assistants. This Standard has been in place, as amended, since During the period July 1,2013 to August 5, 2016, Mr. Evans delegated to an athletic therapist the assessment and re-assessment of, and the development of treatment plans for, Clinic physiotherapy patients, including for patients: R.A. M.8., J.8., H.C., M.K., L.L., V.M., W.P., M.5., J.GW., R.H.. 4. Mr. Evans failed to perform assessments and to develop treatment plans for the above physiotherapy patients ostensibly under his care. Failure to Maintain the Standards of the Profession: lnformed Consent 5. The Sfandards for Professional Practice: Physiotheraprsfs Working with Physiotherapist Support Personnel(and the amended Standard: Working with Physiotherapist Assrsfanfs as of June 2016) requires physiotherapists who use physiotherapist assistants to obtain informed consent from each patient or his/her substitute decision-maker for the involvement of a physiotherapist assistant in the delivery of the physiotherapy treatment plan. The Standard requires that informed consent includes the patient being advised of the roles and responsibilities of each team member as part of the consent process.

6 6 6. Mr. Evans failed to obtain informed consent from the following patients for the involvement of physiotherapist assistants in the delivery of physiotherapy in their care'. R.A. M.8., J.8., H.C., M.K., L.L., W.P., M.5., J.GW., R.H,. Assrsfing a non-member to hold him or herself ouf as a Member of the College 7. Mr. Evans directly and/or indirectly held out Mr. R.D., an athletic therapist, as a Member of the College to patients of his Clinic and members of the public including by: a. Assigning Mr. R.D. to perform initial physiotherapy assessments on new patients who attended at the Clinic for the purposes of receiving physiotherapy care; b. Assigning to Mr. R.D. the role of developing treatment plans for patients who attended the Clinic for the purposes of receiving physiotherapy care; and c. lnvoicing patients for seruices listed as a physiotherapy "assessment" and physiotherapy "treatment" when R.D., a person who was not a registered physiotherapist, had performed the assessment, and had delivered treatments pursuant to a treatment plan that had been developed by R.D., and not by a registered physiotherapist. False and Misleading lnvoices 8. During the period of July 1, 2013 to August 5, 2016, Mr. Evans submitted invoices to patients that were false, misleading and inaccurate, and which Mr. Evans knew or ought to have known were false, misleading and inaccurate. L ln particular Mr. Evans issued invoices to the following patients for a "Physiotherapy Assessment" under his name and registration number, when a different employee of Mr. Evans' clinic, who is not a registered physiotherapist, performed the assessment: R.A. M.8., J.8., H.C., M.K., L.L., W.P., M.5., J.GW., R.H Further, Mr. Evans issued invoices to the following patients for a "Physiotherapy Treatment" or "Physiotherapy Return Treatment" under his name and registration number,

7 7 despite the fact that Mr. Evans had not performed the assessment or developed a treatment plan in respect of these patients: M.8., H.C., A.F., M.K., L.L., W.P., M Since Mr. Evans had neither assessed nor developed physiotherapy treatment plans for the above patients, the treatment or services provided to these patients did not constitute or qualify as physiotherapy provided by or under the supervision of a registered physiotherapist and could not and should not have been billed to patients as such. Disgraceful, Dishonourable and Unprofessional Conduct 12. On or about January 29,2016, Mr. Evans was sent communication by the College inquiring into patient files retrieved by the Ministry of Health and Long Term Care. One of the issues identified by the Ministry and the College at that time was the patient charts revealed that Athletic Therapists were signing discharge summaries. Three of the patient files in question (S.C., J.GW., R.H.) were patients where assessments and treatment planswere prepared and signed by R.D ln response to the inquiry from the College, Mr. Evans advised the College in or about February 18,2016 that he was the "service provider" for three of the patient records (S.C., J.GW., R.H ). ln or about April 2016, Mr. Evans represented to the College that the treatment plans relating to S.C., J.GW., R.H were his "responsibility." He further represented that he had failed to "sign off" on one of the assessment forms. On these dates, Mr. Evans directly or indirectly misrepresented to the College that he, and not an athletic therapist, had assessed and/or developed the treatment plans for the patients S.C., J.GW. and R.H ln or about ltfiay 25,2016, Mr. Evans advised the College investigator that his practice was for physiotherapist assistants to be present in the assessment room and to take the notes of his assessments. Mr. Evans thereby directly or indirectly misrepresented to the College that he had conducted the assessments of the patients S.C., J.GW. and R.H., when in fact the assessments, treatment plans, and clinical records were completed only by R.D On or about September 6,2016, following the College's ongoing investigation in June, July and August 2016, including interviews with R.H., J.GW. and the mother of S.C., Mr. Evans

8 I admitted that R.D. had in fact assessed and developed treatment plans for patients, which were improperly invoiced as physiotherapy services under Mr. Evans' name and registration number. 16. Mr. Evans engaged in professional misconduct pursuant to paragraph 18 of the Professional Misconduct Regulation by engaging in the conduct referred to in paragraphs 1-15 above.

9 -9- APPENDIX 1 Take notice that the documents that have been and will later be disclosed to you will be tendered as business documents pursuant to the Evidence Act of Ontario. 2 All documents that are disclosed to you in this matter are disclosed on the basis that they are to be used solely for the purpose of this proceeding and for no other purpose.

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