Nichol Moore(Butt)

This matter came before a Panel of the Discipline Committee on June 15, 2001, and November 5, 2001.

Background
In July 1999, the College of Occupational Therapists of Ontario received a formal complaint concerning the practice of Ms. Nichol Moore (Butt). Two additional complaints of a similar nature were received in August 1999 and May 2001. The concerns raised by the three clients were a result of assessments completed by Ms. Moore while she was an employee of a rehabilitation company (“the Company”).

The Complaints Committee was able to review submissions made by both the complainants and Ms. Moore. At the conclusion of their investigation, the Reviewing Panel determined that they would refer the matter to the Executive Committee. The Executive Committee has the ability to initiate practice reviews that are beyond the scope of the complaint. At the conclusion of their review, the Executive Committee determined that Ms. Moore’s actions were of serious concern and the Panel reviewing the case referred the matter to the Discipline Committee for a hearing.

Background Information
Ms. Moore (Butt) started to work at the Company on June 22, 1998. For the first two months (June 22, 1998-August 21, 1998) of Ms. Moore’s contract with the Company, she possessed a Provisional Practising certificate where a registered General Practising therapist provided supervision to her. During the period that Ms. Moore was employed with the Company, she performed assessments and evaluations for third parties. She worked there for a period of approximately 8 months.

The Allegations and Agreed Facts
Ms. Moore (Butt) conducted her assessments in a manner that followed the protocols and tools developed by the Company. She did not sufficiently consider the validity of these protocols and tools, which are not recognized as accepted by the profession. Further, Ms. Moore also failed to properly record, report and, in some cases, conduct the assessments and she omitted subjective observations from her reports at the direction of the Company. Ms. Moore accepted the information, opinions and conclusions of others at the Company even though she had not verified them as being her own. In fact, in some cases, the information, opinion and conclusions were not her own. Ms. Moore confirmed that she is not able to justify them. In short, Ms. Moore permitted her employer to improperly interfere with her independent exercise of professional judgment.

Ms. Moore thus prepared reports that were incomplete and, ultimately, misleading. The reports went out as her reports. Ms. Moore knew that the reports would be considered by those determining the benefits of those she assessed.

The Member’s Plea
Ms. Moore (Butt) agreed that her behaviour described above constituted professional misconduct.

Decision
The Discipline Panel reviewing this matter considered all of the information before them. Counsel representing both the College and Ms. Moore presented an Agreed Statement of Facts and a Joint Submission as to Penalty. The Panel sought additional information prior to making their decision. The Panel confirmed that Ms. Moore’s actions constituted professional misconduct.

Penalty and Costs
The parties presented submissions for penalty and the Panel ordered the following:
  1. Ms. Moore (Butt) shall be reprimanded and the fact of the reprimand shall be entered in the register and published.
  2. It is a term, condition and limitation upon the certificate of Ms. Moore (Butt) that she shall deliver a letter to every client of hers at the Company for whom she did a Functional Abilities Evaluation or signed a report containing a Functional Abilities Evaluation conducted by others. Each letter will note:
    • the date that the assessment was conducted
    • the fact that Ms. Moore relied on another individual who was not an occupational therapist to interpret some of the data for the purpose of arriving at the report’s conclusions
    • the fact that Ms. Moore is not in some cases able to justify the conclusion in the report based on the tests she performed and that she did not detail in her reports the subjective comments which the client may have made concerning their condition during the assessment.
    • the fact that she is writing this letter at the direction of the College of Occupational Therapists of Ontario as a result of a discipline hearing in order to make the client aware of the above limitations in her report.
    • the fact that a summary of this hearing will be available on the College’s website at www.coto.org or by calling College staff who could provide more complete information.
    • the fact that she is no longer employed by the Company and therefore is not in a position to re-do the client’s assessment. If they have any questions, they are to contact either the party who requested the report or the Company, both of whom will be copied with the letter.
The Panel expressed concern that Ms. Moore failed to independently exercise professional judgment, and critically appraise the assessment process, thereby putting the public at risk. Her patients were denied a comprehensive assessment, which impacted on their opportunities for rehabilitation, return to work, benefits and other options.

The Panel acknowledged the mitigating factors in this case: the member’s youth and inexperience; that she left her employer before any complaints arose because of her discomfort with the situation, this being her first finding, her cooperation, her remorse, and the evidence of her current practice standards. Had these factors not been present, the Panel would have considered a more severe penalty.

The sending out of the letter by Ms. Moore is corrective, punitive, and will assist to clarify inaccuracies. The reprimand entered in the public portion of the Register will also have significant consequences to penalize Ms. Moore as well as send a message to other occupational therapists to reflect on their own practice, to maintain appropriate professional standards, and not to abuse professional privileges. The Panel concluded that the proposed amended penalty is reasonable and in the public interest.

In addition to appearing on the website, this summary will be available in the annual report. Please feel free to contact the Manager of Investigations & Resolutions should you require additional information.