CPSO updated decision

So sad to see my own Member of the Provincial Parliament, Steve Clark throw away his moral and ethical integrity, when the party he belongs to regained power at Queen’s Park, in order to obtain a Ministerial position within this government. He appeared to be far more vocal during the Liberal government than now. WHY? The old standard still exists— a politician in opposition or campaigning for re-election will say and do anything but this all changes once being elected!


In the morning of October 31st, 2019 Mr. Jiggens, the administrative assistant to MPP Steve Clark returned my phone call. He informed me MPP Steve Clark and Health Minister Christine Elliott could not do anything with regard to my case with both the CPSO and HPARB as it deals with an individual case--- I pointed out that there are numerous cases involving this surgeon. I told him how disappointed I was and that I do not feel this was true as the Minister does indeed have oversight over both of these institutions. This was merely another “Bull shit” response


Duty of Minister
3. "It is the duty of the Minister to ensure that the health professions are regulated and co-ordinated in the public interest, that appropriate standards of practice are developed and maintained and that individuals have access to services provided by the health professions of their choice and that they are treated with sensitivity and respect in their dealings with health professionals, the Colleges and the Board."

Besides the Health Minister, Christine Elliott and her Ministry failing to uphold her own responsibilities expressed in the Act, she and the Conservative government have also failed to ensure the College of Physicians and Surgeons of Ontario uphold the “Objects of the College” which is expressed within the Act.


The Regulated Health Professions Act, Schedule 2, Section 3, sets out the objects of the College of Physicians and Surgeons of Ontario (CPSO):

Objects of College

3. (1) The College has the following objects (emphasis added):

1. To regulate the practice of the profession and to govern the members in accordance with the health profession Act, this Code and the Regulated Health Professions Act, 1991 and the regulations and by­laws.

2. To develop, establish and maintain standards of qualification for
persons to be issued certificates of registration.

3. To develop, establish and maintain programs and standards of practice to assure the quality of the practice of the profession.

4. To develop, establish and maintain standards of knowledge and skill and programs to promote continuing competence among the members.

5. To develop, establish and maintain standards of professional ethics for
the members.

6. To develop, establish and maintain programs to assist individuals to
exercise their rights under this Code and the Regulated Health
Professions Act, 1991.

7. To administer the health profession Act, this Code and the Regulated Health Professions Act, 1991 as it relates to the profession and to perform the other duties and exercise the other powers that are imposed or conferred on the College.

They have, in fact become accomplices in the cover-up of medical negligence and have therefore put patient safety at severe risk. Once again, there is absolutely “no transparency and accountability within Ontario’s Health Care System.

Further adverse events and possible deaths by this surgeon lay completely at the foot of both Steve Clark and Christine Elliott.

Just one of many “Standards of Care” which was not adhered to by this surgeon and hospital:

–open abdominal surgery to remove a tumor and perform a colon resection without the mandatory antibiotic prophylaxis, no anti-biotics for infected abdominal incision whereby all the staples had been removed and not anti-biotics when test results indicated the “presence of many gram-negative bacilli” (in same category as C Dificille) No antibiotics given during entire hospital stay! How have the Health Minister, Christine Elliott, my MPP, Steve Clark and the Conservative Government ensured that the standards of care are indeed upheld???

Terra Dawn Kilby, age 28, bled to death less than 12 hours after being discharged from Humber River Hospital in Toronto.


One can only hope Karma comes to those MPPs and other parties who failed to act!


PUBLIC SERVICE OF ONTARIO ACT, 2006
Made: June 27, 2007
Filed: July 25, 2007
Published on e-Laws: July 27, 2007


Oath of Office

I, Steve Clark (Christine Elliott) swear (or solemnly affirm) that I will faithfully discharge my duties as a public servant and will observe and comply with the laws of Canada and Ontario and, except as I may be legally authorized or required, I will not disclose or give to any person any information or document that comes to my knowledge or possession by reason of my being a public servant. So help me God. (Omit this phrase in an affirmation.)”
**************************************
An MPP brings the riding’s concerns and needs to the table, and will have a stronger voice if he or she holds a high spot in the government. Cabinet ministers hailing from specific region will be able to shine more light on the area.

NOT IN MY CASE.
As a representative for a particular riding, a MPP is responsible for voicing the concerns of a specific region within Ontario on behalf of the citizens who live within this riding.

*************************************************************

This is not Terra's case but regarding another death.

This reappeared on the CPSO website re: Dr. Klein

https://doctors.cpso.on.ca/DoctorDetails/L-Klein/0117032-70489

*************************************

Concerns

Source: ICR Committee
Active Date:
June 21, 2019
Expiry Date:


Summary:
Specified Continuing Education and Remediation Program:

A summary of a decision of the Inquiries, Complaints and Reports Committee in which the disposition includes a Specified Continuing Education and Remediation Program (“SCERP”) is required by the College By-laws to be posted on the register, along with a note if the decision has been appealed.

A SCERP is one of the dispositions that the College’s Inquiries, Complaints and Reports Committee may make in connection with a matter before it, and this disposition requires the member to complete an education and remediation program specified for the member. A note will also be posted when all the elements of the SCERP have been completed. The summary will be removed from the register if the decision is overturned on appeal or review. Note that this requirement only applies to decisions arising out of a complaint dated on or after January 1, 2015 or if there was no complaint, the first appointment of investigators dated on or after January 1, 2015.

**************************************************************

SUMMARY

Dr. Lazar Victor Klein (CPSO# 70489)

1.Disposition

On March 16, 2018, the Inquiries, Complaints and Reports Committee (the Committee) ordered general surgeon Dr. Klein to complete a specified continuing education and remediation program (SCERP).

The SCERP requires Dr. Klein to:

·Practice under the guidance of a Clinical Supervisor acceptable to the College for six months

·Undergo a reassessment of his practice by an assessor selected by the College approximately six months following completion of the SCERP

·Review relevant Clinical Practice Guidelines, including literature for guidelines on early identification and management of sepsis, as well as College policies on Medical Records and Test Results Management, and provide a written summary of the documents with reference to current standards of practice, how it is applicable to Dr. Klein’s situation, as well as how Dr. Klein has made, or plans to make, changes to his practice.

2.Introduction

A family member of a deceased patient complained to the College that Dr. Klein failed to provide adequate care and treatment to the patient during the patient’s December 2014 hospital admission with a possible small bowel obstruction, in that he failed to respond to or follow up on the patient’s abnormal blood work result (the urinalysis showed >100,000 E.Coli), and failed to follow up on the family’s request for an autopsy (which was ultimately not performed). Prior to this admission, the patient had been self-catheterizing for a few years, but was otherwise well and mobile.

3.Committee Process

In August 2016, a previous panel of the Committee issued advice to Dr. Klein on several aspects of his care. The complainant appealed the Committee’s decision to the Health Professions Appeal and Review Board (the Board). In a decision dated November 7, 2017, the Board confirmed the Committee’s decision to issue advice to Dr. Klein with regard to documenting his care when he is the most responsible physician (MRP), and bringing this case to morbidity and mortality rounds to raise awareness and provide education.

However, it directed the Committee to reconsider its decision to issue advice to Dr. Klein on other aspects of his care relating to test results follow-up and narcotics prescribing.

On March 16, 2018, a Surgical Panel of the Committee, consisting of public and physician members, met again to review the relevant records and documents related to the complaint, following the Board’s review.

The Committee always has before it applicable legislation and regulations, along with policies that the College has developed, which reflect the College’s professional expectations for physicians practising in Ontario. Current versions of these documents are available on the College’s website at www.cpso.on.ca,under the heading “Policies & Publications.”

4.Committee’s Analysis

The Committee was of the view that the urinalysis results, along with the patient’s history of self-catheterization and prior urinary tract infections (UTIs), the significant increase in her white blood cell (WBC) count (from a normal level of 9,000 at admission to 22,000 by 9:00 am on December 4), and her falling oxygen saturation should have alerted Dr. Klein and hospital staff to the strong possibility of sepsis.

The Committee noted that in his response to this complaint, Dr. Klein indicated that he did not consider the possibility of a sepsis diagnosis.

Furthermore, although he claimed to have first seen the patient at approximately 9:00 am on December 4, he failed to document the increased WBC, both at this time and at his subsequent 6:00 pm reassessment.

The Committee was concerned about the significant failure to treat a highly likely UTI with appropriate antibiotics within 12-24 hours of admission, which should have occurred with or without the associated diagnosis of a small bowel obstruction.

Furthermore, even if the patient’s abdominal examination did not suggest a strangulated small bowel obstruction or other acute intra-abdominal condition, the Committee noted that there was no indication that Dr. Klein considered the reason for the patient’s seriously elevated WBC count, which he continued to claim was non-specific.

Given Dr. Klein’s failure to offer any explanation for this concerning information in his various responses to this complaint, the Committee felt he demonstrated a lack of insight regarding his failure to properly manage the patient’s care.

The Committee noted that a prudent physician should have recognized the above mentioned results as highly indicative of an inflammatory response, such as septic shock, and initiated appropriate antibiotics.

The Committee was not in a position to determine what caused the patient’s death, but noted that the dose of narcotics the patient received was minimal, and that there was no information to suggest that the narcotics, which were in fact ordered by a different physician, were inappropriate at the time of the initial order.

With respect to medical record-keeping, the Committee was concerned that Dr. Klein did not write any notes at any time during the patient’s admission, which does not meet the standard of care and does not comply with the College’s policy on Medical Records.

Furthermore, this lack of documentation made it difficult for the Committee to assess the true extent and quality of care that Dr. Klein provided to the patient.

The Committee noted that the involvement of residents or students does not absolve physicians from their own documentation responsibilities.

The Committee noted that Dr. Klein has a significant history with the College, which include cases raising both clinical and record-keeping issues, for which he has received advice and been cautioned.

*****************************************

IMAGINE IF HPARB HAD O ACCEPTED MY REQUEST FOR RECONSIDERATION, DEATHS AFTER TERRA'S MAY VERY WELL HAVE BEEN PREVENTED.

Our newly elected Conservative Government and the Health Minister must step in to correct this injustice!!!

From the College’s magazine “Dialogue” April Issue 2009


“Either party can then make an application to HPARB following which HPARB can direct the ICRC to continue the investigation, make recommendations to the ICRC as HPARB sees appropriate, or take over the investigation.”

This was denied and during the third review the panel appeared surprised that I had mentioned this and also appeared to be unaware of this procedure.

Had they taken over the investigation and/or granted my request for Reconsideration the further deaths occurring and adverse events under this surgeon may well have been averted!

MY Request to HPARB for Reconsideration of their third decision with regard to Procedural Fairness and Principals of Natural Justice --- Denied by HPARB

Ms Vauthier

HPARB

From your letter dated, January 12, 2015

“With respect to the Board’s decision in the matter of 08-CRV-0097, the Board has reviewed your request and can find no basis upon which to reconsider its decision. A reconsideration by the Board is discretionary and will only be undertaken in exceptionally circumstances that demonstrate the Board acted outside of its jurisdiction, did not consider an issue it was mandated to determine, or that its processes were in breach of natural justice or lacked procedural fairness. In 08-CVR-0097 the Board returned your complaints to the Investigations, Complaints and Reports Committee of the College of Physicians and Surgeons of Ontario for further assessment. The Board conducted its review in accordance with its legislated mandate and there is nothing to suggest its review was not carried out in accordance with the principals of natural justice or that is lacked procedural fairness. As such, the Board will not be reconsidering its decision in the matter of 08-CVR-0097.”

What a bullshit response!

NOW MY RESPONSE WITH REGARD TO PROCEDURAL FAIRNESS AND PRINCIPALS OF NATURAL JUSTICE:

THE BASIS FOR RECONSIDERATION IS CLEARLY STATED BELOW:

#1 Having the Chair for the third appeal, who pretty much control the entire proceedings from London, Ontario (Forest City Lawyers - London) as is the College's Independent Opinion Provider, Dr. Brian Taylor.

No problem perhaps, but it certainly explains how this HPARB panel completely came up with their incredible decision and prevented me from giving my oral presentation.

I would have thought the Chair would have excused himself from this panel!

This was extremely unfair and the procedural process was definitely affected negatively.

#2 The contradictory CPSO's opinion with their own expert as well as the factual documentation within Terra's medical records!

This was extremely unfair and the procedural process was definitely affected negatively.

In response to a request for further information from the College, the IO provider also set out the following information:

* The standard of practice for open bowel resections is to provide antibiotic prophylaxis.
However, such administration would not reduce the risk of anastomotic leak.

* The standard of practice would be to administer prophylactic antibiotics in connection with laparoscopic procedures if the bowel were involved; however, in this case, Dr. Klein believed he would be dealing with a cyst only and not opening the bowel, so the standard would not require administration of prophylactic antibiotics for the laparoscopic procedure.

AWKILBY’s Response: The above is pure BS. He knew before he converted to a laparotomy!!

Note the following: This proves that Dr. Klein was going to attempt laparoscopically a colon resection for a mesenteric mass. This was before he converted to a laparotomy!!!

Note the Procedure Desc. In the chart I submitted for the third appeal.

Note the Procedure Desc. In the following chart:

“Laparoscopic Colon Resection Attempted For Mesenteric Mass”

The second Procedure Desc. indicates the laparotomy.

And from Dr. Taylors’(the College’s I.O)letter to Angela Bates May 8th, 2011,

During the surgery on July 11 2006, Dr. Klein realized that the mass was not separable from the colon or retroperitoneum and obtained consultation with a colleague and went ahead with an open right colectomy. This is well documented in the operative note on page 48.”

From Dr Klein’s own notes:

At the time of laparoscopy, a large cyst could be seen in the mesentery of the right colon. It was densely adherent to the bowel as well as densely adherent to the lateral abdominal wall. It felt very solid and not at all in keeping with a simple mesenteric cyst. We therefore made the decision to convert to an open procedure.

The fascia was divided. The peritoneal cavity was entered under direct vision. A 10 mm trocar was inserted. Pneumoperitoneum was obtained. A 5 mm subxiphoid and 5 mm suprapubic port were placed under direct vision. We immediately could see the large mass in the right upper quadrant and the findings were as above. We did not feel that this was at all easily accessible laparoscopically and could not separate the plane from the lateral abdominal wall as well as from the colon. At this point, we made a decision to convert to a laparotomy

From Dr Klein’s letter to Terrra’s Family Doctor

So, he has suspected this was a possibility Three months prior to the operation

TELEPHONE (416)782-2616 960 LAWRENCE AVE WEST

FAX (416) 7*2-5899SUITE 504

TORONTO, ONTARIO M6A 3B5

LAZ V. KLEIN, M.D., M.Sc., F.R.C.S.(C) GENERAL AND LAPAROSCOPIC SURGEON April 4,2006

Dr. Sandra Best 80 King St. East Brockville, ON K6V 1B5

RE: Terra Kilby Dear Dr. Best,

Ms. Kilby has returned to my office today. I have had a chance to review her CAT scan. She likely has a mesenteric cyst or possibly a duplication cyst. It looks amenable to laparoscopic excision and appears to be separate from the bowel, kidney and ureter.

She continues to have symptoms and has a palpable mass in her right abdomen.

1 have therefore recommended a laparoscopic excision of the cystic mass. We discuss potential risks which include infection, bleeding, bowel injury, bladder injury. There is a risk of injury to any nearby organs such as her ureter or major blood vessels.

There is also small risk that she may require a bowel resection.

Certainly, there is a risk that this will need to be done through an open

approach.

She would like to go ahead. I answer any question she had. Consent for surgery was obtained. I will take her to the operating room at the next available opportunity.

Sincerely,

Laz V. Klein, MD, MSc, FRCS(C) LVK

Issue before the Committee

HPARB directed the Committee to reconsider this matter in light of the question of whether Dr. Klein met the standard of practice concerning the use of preoperative antibiotics.

Addendum Report from the IO Provider

The IO provider set out the following information in an addendum to the IO report:

* The issue of antibiotic administration at the time of conversion to an open procedure is really not relevant to the outcome for this patient.

AWKILBY’s Response: The outcome is not part of the complaint!

* Most general and colorectal surgeons administer antibiotics preoperatively prior to laparoscopic or open colorectal surgery, as they have been shown to reduce the incidence of wound infection. Antibiotics, however, have not been shown to decrease the incidence of anastomotic leak.

AWKILBY’s Response: Temporarily forget the anastomotic leak which was not in my complaint.. The above statement indicates the Standard of Care that was not followed by Dr. Klein.

#3 The complaint was about the Standard of Care not my daughter’s death. Interesting to note the College always mentions the tragic outcome. Stick to the Standards of Care not the Death. HPARB got sidetracked away from Standard of Care and somehow interpreted the Standard of Care not resulting in the death. This was not the complaint.

How can HPARB not focus on the actual wording from the Independent Opinion Provider and the College with respect to their statement contained within the Second and Third Decisions?

· "The routine use of antibiotics prior to bowel surgery is an important aspect of care that was neglected by Dr. Klein in this case. The Committee would suggest that Dr. Klein consider the routine use of antibiotics in such circumstances. Having said that, we do not consider this oversight to have contributed to the unfortunate outcome in this case."

Neglected equals Negligence

Notice how the College brings into the discussion my daughter's death from these example below: reason to deflect away from the standards of care to the Terra's death

"The routine use of antibiotics prior to bowel surgery is an important aspect of care that was neglected by Dr. Klein in this case. The Committee would suggest that Dr. Klein consider the routine use of antibiotics in such circumstances. Having said that, we do not consider this oversight to have contributed to the unfortunate outcome in this case."

"The issue of antibiotic administration at the time of conversion to an open procedure is really not relevant to the outcome for this patient."

"He agrees with the IO provider that: The issue of antibiotic administration had no bearing on the outcome of this case,”

“The only benefit of pre-operative prophylactic antibiotics is to prevent a postoperative wound infection, Preoperative antibiotics have no preventative or beneficial effect for an anastomotic leak."

"Further to this clarification, the Committee notes that, as supported by the IO, the lack of antibiotics in this case did not influence the unfortunate outcome, given there was no evidence of sepsis at the time of the discharge from the hospital."

THE STANDARD OF CARE IS THE ADMINISTERING OF THE MANDATORY ANTIBIOTIC PROPHYLAXIS NOT THE OUTCOME!

This was extremely unfair and the procedural process was definitely affected negatively.

#4 It appears this decision was made in record time: two months from the meeting in June my receiving the decision by mail on Aug. 1st.

This was extremely unfair and the procedural process was definitely affected negatively. It makes one wonder whether HPARB had already decided well before, especially considering the following:

--HPARB appears to substantiate the College's opinion that Dr. Klein did not know that a colon resection was to take place until after he converted to an open abdominal surgery. The HPARB panel totally disregarded the operation record that clearly stated that the first procedure attempted was: "laprascopic surgery for colon resection." This clearly indicates that he knew that a colon resection was to be performed before he opened her up.

--No antibiotics what so ever, even after an abdominal incision infection and the presence of "many gram negative bacilli". Again, found in the hospital records. Also, they ignored the letter from then Eastern Ontario Coroner which stated reasons for death also included "complicated by an infection

--Totally ignored my expert's opinions.

--Again, common sense. Not an emergency situation, this was elective surgery supposedly well planned. --- A surgeon is going to make an 9 inch incision in the abdomen, move around some internal organs, remove a tumor and perform a colon resection.----- without the mandatory antibiotic prophylaxis.

#5 The Third HPARB appeal panel had my submission on their laptops but they could not locate the sections I was referring to during my oral presentation. They became so frustrated, the Chair, Thomas Kelly interrupted me and stated that I need not continue as they had read the submission. BUT, I had my presentation prepared to highlight and point out the inconsistencies with regard to the College’s opinion and the medical facts contained within the hospital records and supporting documents. This was extremely unfair and the procedural process was definitely affected negatively.

# 6 How could HPARB be sidetracked away from the "Standards Of Care" issues and be concentrating whether these issues to led to my daughter's death? HPARB should have been dealing with whether the Standards of Care were held up to, or not!

This was extremely unfair and the procedural process was definitely affected negatively.

# 7 And Dr. Klein merely laughs off the College decision: And this was in with the package the CPSO sent to HPARB.


From letter sent to the College by Dr. Klein

July 13, 2011

Ms. Angela Bates Manager, Committee Support Area Investigations and Resolutions

College of Physicians and Surgeons of Ontario 80 College St. Toronto ON M5G2E2

RE: Ms. Terra Dawn Kilbv - Your File #77429

Antibiotics

The independent assessor is correct that Ms. Kilby did not receive preoperative antibiotics. I agree with the independent assessor's opinion in response to your subsequent letter that preoperative antibiotics would not have been a contributing factor to the anastomotic leak. Antibiotics are used to prevent or treat an infection. They have no preventative or beneficial effect for an anastomotic leak. Furthermore, it is not my practice to prescribe antibiotics for a planned laparoscopic surgery with possibility of conversion to an open procedure As I have explained in my initial response, Ms. Kilby did develop a superficial wound infection postoperatively that was treated appropriately. I do not feel that the wound infection 'was in any way related to the outcome of this case.

L. Klein

AGAIN, WE ARE TALKING ABOUT STANDARD OF CARE NOT THE OUTCOME.
Oh, my God!!!! Dr. Klein has not learned a thing from Terra's death and is obviously going to continue as he did!

This is detrimental to the safety of patients that are under his care!!!!!!

********************************************


2020 Reimbusement to CMPA

MOST ONTARIO TAXPAYERS ARE COMPLETELY UNAWARE OF THIS DEAL.

Question your own Ontario MPP and ask if this money should go to far better use=== education, health etc. Imagine how many programs could be funded if our Government did not pay 85% of doctor/surgeons' membership fees into the Canadian Medical Protective Association Do you want to save Ontario taxpayer Millions of dollars per year?

In effect; paying the doctors/surgeons membership fees into their insurance company.
Provincial Money paid for CMPA Reimbursements:

2014/15 $194.8 Million
2015/16 $334.9 Million
2016/17 $256.0 Million
2017/18 $326.0 Million
The total reimbursement for 2018/19 is $297.1 Million.

For the past five years the total cost to Ontario taxpayers is an astounding figure of: $1,412,400,000 -- That's $1 Billion, 412 Million, 400 Thousand Dollars. TALK ABOUT ABUSE!


This is the amount for 2020. Now the question to be answered is how many members fit into each :"work type" multiplied would create a massive amount of money Medical Liability Reimbursement Program Schedule 2020 The reimbursement is what we taxpayers pay.

Medical Liability Reimbursement Program Schedule 2020
The reimbursement is what we taxpayers pay. It was difficult to copy and paste the following but the important number is the last value. Imagine that value is for just one.

Medical Liability Reimbursement Program Schedule 2020
Code -Type of Work - Base - 2020 Annual Fee - 2020 Reimbursement

The first number you see below is the code number not the actual number of persons in that category. The last dollar figure is what we the tax payers pays for each individual

For example using 2018 stats of the 14,374 members of Family Medicine or General Practice this year tax payers would be forking out $58,147,421--- THAT'S 58 MILLION DOLLARS!

12 Interns and Residents (without moonlighting) $300.00 $2,856.00 $2,556.00

13 Clinical Fellows $300.00 $2,856.00 $2,556.00

14 Interns and Residents (with moonlighting) $300.00 $2,856.00 $2,556.00

20 Administrative Medicine $680.00 $2,856.00 $2,176.00

21 Pathology - Anatomic $680.00 $8,484.00 $7,804.00

22 Pathology - General $680.00 $8,484.00 $7,804.00

23 Pathology - Haematological $680.00 $2,856.00 $2,176.00

24 Medical Biochemistry $680.00 $2,856.00 $2,176.00

25 Medical Microbiology $680.00 $2,856.00 $2,176.00

26 Pathology - Neurological $680.00 $2,856.00 $2,176.00

27 Physical Medicine and Rehabilitation $680.00 $2,856.00 $2,176.00

28 Community Medicine (Public Health) $680.00 $2,856.00 $2,176.00

31 Clinical Associates - Medical $965.00 $4,908.00 $3,943.00

32 Clinical Associates - Surgical $965.00 $4,908.00 $3,943.00

33 Assistance at Surgery - no other professional work $965.00 $2,856.00 $1,891.00

35 Family Medicine or General Practice excluding emergency shifts $965.00 $4,908.00 $3,943.00

36 Psychiatry $965.00 $4,908.00 $3,943.00

37 Surgical Practice - without operative treatment $965.00 $4,908.00 $3,943.00

38 Chronic Pain Management-without general or spinal anaesthesia $1,245.00 $8,484.00 $7,239.00

39 Obstetrical Practice - without labour and delivery $1,245.00 $8,484.00 $7,239.00

40 Allergy $1,245.00 $4,908.00 $3,663.00

42 Clinical Immunology $1,245.00 $4,908.00 $3,663.00

44 Dermatology $1,245.00 $4,908.00 $3,663.00

45 Diagnostic Imaging $1,245.00 $8,484.00 $7,239.00

46 Endocrinology $1,245.00 $2,856.00 $1,611.00

47 Gastroenterology $1,245.00 $8,484.00 $7,239.00

48 Genetics $1,245.00 $2,856.00 $1,611.00

50 Haematology $1,245.00 $8,484.00 $7,239.00

51 Occupational Medicine $1,245.00 $2,856.00 $1,611.00

52 Infectious Diseases $1,245.00 $2,856.00 $1,611.00

53 Intensive Care - full time $1,245.00 $8,484.00 $7,239.00

54 Internal Medicine and its specialties not elsewhere noted $1,245.00 $8,484.00 $7,239.00

55 Nephrology $1,245.00 $4,908.00 $3,663.00

56 Neurology $1,245.00 $19,104.00 $17,859.00

58 Nuclear Medicine $1,245.00 $2,856.00 $1,611.00

59 Medical Oncology $1,245.00 $4,908.00 $3,663.00

60 Ophthalmology $1,245.00 $12,696.00 $11,451.00

61 Paediatric - may include shift in Emergency Department $1,245.00 $12,696.00 $11,451.00

62 Respiratory Medicine $1,245.00 $4,908.00 $3,663.00

63 Rheumatology $1,245.00 $4,908.00 $3,663.00

64 Sports Medicine $1,245.00 $4,908.00 $3,663.00

65 Therapeutic Radiology/Radiation Oncology $1,245.00 $4,908.00 $3,663.00

66 Neonatology $1,245.00 $8,484.00 $7,239.00

70 Cardiology $2,075.00 $8,484.00 $6,409.00

73 Family Medicine or General Practice including emergency shifts $1,660.00 $4,908.00 $3,248.00

77 Otolaryngology $2,075.00 $19,104.00 $17,029.00

78 Family/General Practice with Obstetrics $1,660.00 $12,696.00 $11,036.00

79 Family/General Practice with Anaesthesia/Surgery/Emergency Department Work $1,660.00 $12,696.00 $11,036.00

82 Emergency Medicine/Emergentology $2,075.00 $12,696.00 $10,621.00

83 General Surgery $4,835.00 $19,104.00 $14,269.00

84 Gynaecologic Surgery - without labour and delivery $4,835.00 $19,104.00 $14,269.00

85 Paediatric Surgery $4,835.00 $19,104.00 $14,269.00

86 Plastic Surgery $4,835.00 $19,104.00 $14,269.00

87 Thoracic Surgery $4,835.00 $19,104.00 $14,269.00

88 Urology $4,835.00 $19,104.00 $14,269.00

89 Vascular Surgery $4,835.00 $19,104.00 $14,269.00

90 Anaesthesia $6,770.00 $12,696.00 $5,926.00

91 Cardiovascular Surgery $6,770.00 $19,104.00 $12,334.00

92 Neurosurgery $6,770.00 $37,896.00 $31,126.00

93 Obstetrics $6,770.00 $70,452.00 $63,682.00

94 Orthopaedic Surgery $6,770.00 $37,896.00 $31,126.00

THAT IS AN AWFUL LOT OF TAXPAYER'S MONEY PAYING FOR ONTARIO DOCTORS/SURGEONS ETC MEDICAL MALPRACTICE INSURANCE!!!!!!!!!!

I would love to hear what your MPP says to you.

This is why medical malpractice suits are practically extinct in Canada. You and your fellow taxpayers pay for the other side's lawyers! The CMPA has built up a multi-billion dollar reserve fund to defend doctors/surgeons using our own money!

Due to this, the present and past Ontario governments have allow medical negligence to be covered up. My daughter bled out 12 hours after discharge from Humber River Hospital in 2006. This surgeon has had multiple deaths since then. And all the government parties have actively participated in this coverup:

Health Minister


July 21, 2019

Our Darling Terra Dawn;
Thirteen years you’ve been gone.
You departed from us to ascend beyond.

Thinking of you throughout the years,
Bring such joy but also the tears.
Longing to see you, I have no fears.

Our present lives have severely weathered.
Four throbbing hearts bound securely together,
With hugs and kisses we are tethered.

Missing you terribly is so true!
With fond memories we think of you.
At times like these, we’re no longer blue.

As a tiny tot walking hand and hand,
Along the beach upon the sand;
That for me was our wonderland!

The warmth of the sun in the sky;
A rainbow emerges way up high.
“Oh, how I love you” is what I sigh.

We send our love to you.
“Forever Within Our Hearts”
Love Mom, Dad and Brandy

July 21, 2018

****************

TERRA 2018 ©
Twelfth Christmas
Terra, An Angel In Our Lives

Twelve years have gradually passed,
Our enduring love will forever last.
Those cannot possibly understand,
The loss we still can’t comprehend.

Christmas’ just can’t be the same,
Without you present to hear your name.
We still decorate your grave,
As we try so hard to be brave.

But memories of you are all we possess,
Of Christmas’ past and our happiness.
The years go by without you here,
Still releasing many a tear.

We have missed you since you went away,
Your voice; your laughter each and every day.
Our hearts so sadden and fragmented,
And our lives are so segmented.

Our world has fallen utterly apart,
Ever since the day you did depart.
We carry on the Christmas traditions you loved.
Praying you can see them from far above.

Twelve years have gradually elapsed,
Our enduring love we will forever grasp.
Those cannot possibly understand,
The loss we still can’t comprehend.

Merry Christmas our darling daughter dear.

Love Mom, Dad and Brandy
*********************************************

Update as of March 22, 2019.

E-mail from MPP Steve Clark's Office notifying me the Ministry of Health is preparing a response to my numerous e-mails sent to Christine Elliott that were never answered. We will see how long it takes to get this response!

************************************

All the parties/individuals mentioned have prevented me from finding closure and have left my grieving process as follows:

Ms Elliott, Another one to ignore and not respond to.

After reading this, feel free to let our Minister of Health know about your concerns and please share this post if you feel it to be of importance to you friends and relatives.

Our Minister of Health.
christine.elliott@pc.ola.org
christine.elliottco@pc.ola.org

Let us just let this surgeon continue as is, without the public having any opportunity to look into past/present complaints, investigations and decisions with regard to Dr. Laz Klein. He has multiple deaths on his hands.

Ms Elliott is doing absolutely nothing with regard to my concerns nor apparently those of the rest of Ontario's citizens.

Ms Elliott has been well aware of the failings of the CPSO, and HPARB dating back to when she was MPP, then as the Ontario Patient Ombudsman, and now as an elected MPP again, and appointed as Health Minister. Yet, does nothing.

Apparently the Conservative government will not take any action or investigation.



So, I have been screwed over by the CPSO, previous Health Ministers and their ministries, the CCO, HPARB, the DIOC, Patient Ombudsman's Office and Ontario's Ombudsman. How the hell can you all accept was done to my daughter did not prove to be a prime example of medical negligence contributing to the death of an Ontario Citizen. By allowing the College and HPARB's decision to stand you all have negatively impacted on further operations done in the same manner as being acceptable Standards of Care which it clearly is NOT!

Far too many Ontario citizens have been abused by all of the above and a public inquiry should be held with respect to all of them, But of course that would take GUTS. Yes and perhaps you could use the $326 Million dollar Reimbursement Fee we paid last year to the doctors/surgeons to cover their membership fees in the CMPA.

Mr Ford, you save the taxpayers millions every year if you put an end to this practice instead of picking on Education.

An Ontario citizen has no hope of attaining true transparency and accountability when this government obviously puts the medical profession above the interests and safety of its citizens.

E-mails sent to our Health Minister:
March 22, 2019 to go along with all of the ones below:
March 8, 2019 ignored by Ms Elliott
February 18, 2019 ignored by Ms Elliott
January 25, 2019 ignored by Ms Elliott
December 19, 2018 ignored by Ms Elliott
December 13, 2018 ignored by Ms Elliott
November 22, 2018 ignored by Ms Elliott
November 13, 2018 sent by the Premier to Miss Ellliott ignored by Ms Elliott
October 18, 2018 ignored by Ms Elliott
August 11, 2018 ignored by Ms Elliott
July 12, 2018 ignored by Ms Elliott
June 17th, 2018 ignored by Ms Elliott

That makes Twelve ignored e-mails sent with no acknowledgement of receiving them nor replying to them.
*********

From: Jiggins, Michael
Sent: March 26, 2019 11:58 AM
To: Arnold Kilby
Subject: RE: CPSO TRANSPARENCY--bullshit

Good afternoon, Mr. Kilby.

I have been in touch with Minister Elliott’s office today and a response to your inquiries is being prepared.

Regards, Michael Jiggins | Executive Assistant
Office of Steve Clark, MPP
Leeds—Grenville—Thousand Islands and Rideau Lakes
613-342-9522 | 1-800-267-4408
**********
Subject: Re: CPSO TRANSPARENCY--bullshit

Mr.Jiggens, I thank you for your response. WHY DOES IT TAKE SO LONG for the Health Minister to respond?

I can't help but suspect when I receive her response, snow will be falling within my house. I suspect they are carefully drafting "a cover-up" response and tell me nothing can be done.

I sincerely hope I will be wrong. Further deaths by this very same surgeon and others whose negligence is covered up by all will solely rest on all those who know the truth but do nothing to ensure Ontario citizens' rights to transparency and accountability is attained. This would truly be a great objective for the Conservatives to achieve should it choose to do so.

An explanation as to why the lack of response would be greatly appreciated, or at the very least why my e-mails were never acknowledged.

The Minister's close relationship with the CEO of Humber River Hospital where this surgeon is granted hospital privileges should and must not play a role. As well, the fact the past CEO, Dr. Devlin is now a Health Advisor to the Conservative government should not play a role and continue the cover up of medical negligence!

I wish the media would expose all who have maintain to cover up medical negligence contributing to the deaths of so many by this surgeon!