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Highways - Medical Reporting. Jeyaranjan v. Health Professions Appeal and Review Board
In Jeyaranjan v. Health Professions Appeal and Review Board (Ont Div Ct, 2025) the Ontario Divisional Court dismissed a JR, this brought against a decision of the ICRC of the CPSO, confirmed by the HPARB, that required the applicant "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".
Here the court considered whether the ICRC of the CPSO had jurisdiction to address a patient complaint that the applicant improperly made "a medical condition report to the Ministry of Transportation" [HTA s.204(2) - 'General rules respecting medical reports - No liability for compliance']:[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. ...
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[10] .... 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 ....
[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. ....
[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”.
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[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.
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[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.
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