Representing victims of medical malpractice across Ontario

CPSO v. Karim – Non-Resident OHIP Use Ends in Suspended License

OPSDT

On August 24, 2023, the Ontario Physicians and Surgeons Discipline Tribunal (“OPSDT”) ordered a 5 month medical license suspension to a family doctor, Dr. Sadiqa Karim, because she accessed Ontario healthcare services for herself while living out of country over a period of three years.

FACTS

In 2015, Dr. Karim applied for Ontario Health Insurance Plan (OHIP) coverage. OHIP is publicly funded health coverage available only to Ontario residents. At the time of her application, she used her family medicine practice address in Ontario. In the application, she expressly verified that the following information was true and accurate, and confirmed that she:

  • would be physically present in Ontario for at least five (5) months (153 days) in any 12-month period;
  • must not be absent from Ontario for more than 30 days within the first 183 days immediately after establishing residency in Ontario; and
  • makes and intends to continue to make Ontario her primary place of residence.

Based on this application, Dr. Karim was given OHIP coverage. However, as it turned out, she did not reside in Ontario but in fact lived in New York. Between 2015 and 2017, while living out of country, she received publicly funded Ontario healthcare in the sum of  $1,795.38 for various services and $3,920.00 for a hospital visit.

Dr. Karim acknowledged that she knew or ought to have known that she was not entitled to OHIP coverage.

In exchange for immunity from criminal prosecution, Dr. Karim made restitution to the Crown in Right of Ontario in the amount of $16,636.00.

DECISION

Based on the above, the OPSDT suspended Dr. Karim’s medical license for a period of five (5) months. The OPSDT further ordered Dr. Karim to participate at her own expense in ethical retraining. She furthermore had to file proof of payment of restitution to the Crown. Finally, Dr. Karim was ordered to pay costs of $6,000 to the College of Physicians and Surgeons of Ontario.

Decision Date: August 24, 2023

Jurisdiction: Ontario Physicians and Surgeons Discipline Tribunal

Citation: College of Physicians and Surgeons of Ontario v. Karim, 2023 ONPSDT 18

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Paul Cahill

Paul is a partner at Davidson Cahill Morrison LLP. He has proven himself a fearless advocate by a number of successful trial outcomes over the years, including a $11.5 million judgment for medical malpractice causing cerebral palsy against a negligent doctor as well as a recent judgment against a negligent emergency room physician who caused the death of a 34 year-old mother of 4 young children.

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