Interim Orders at the RCDSO: Suspensions, Terms, Conditions, or Limitations on a Dentist’s Certificate of Registration

Where the Inquiries, Complaints, and Reports Committee (“ICRC”) of the Royal College of Dental Surgeons of Ontario (“RCDSO”) receives a complaint and believes that a dentist’s alleged conduct exposes or is likely to expose patients to harm or injury, it may issue an interim order. Under an interim order, the Registrar will suspend, or impose terms, conditions, or limitations on, a dentist’s certificate of registration. Based on our experience, we have prepared this overview of interim orders at the RCDSO.

Pursuant to the Health Professions Procedural Code (“HPPC”), the RCDSO has the ability to impose an interim order without holding a hearing on, or disposing of, the alleged professional misconduct. Dentists will generally receive notice of the RCDSO’s intention to impose an interim order, as well as at least 14 days within which to make submissions. The RCDSO may also impose an interim order without notice where it believes that urgent intervention is required, but must then provide a dentist with a subsequent opportunity to make submissions. As interim orders impose professional restrictions and may also feature some element of public exposure, dentists should consider speaking with legal counsel who are experienced in the area of professional regulation. Lawyers can assist dentists with crafting their submissions to the RCDSO.

 Following the RCDSO’s decision to impose an interim order, a dentist may seek judicial review of that decision. The Judicial Review Procedure Act (“JRPA”) and the Rules of Civil Procedure provide the legislative framework for judicial reviews. Unlike the formal complaints process, in which the majority of an ICRC panel is comprised of dentists, judicial reviews are typically decided by a panel of three judges of the Divisional Court. With the leave of a judge of the Superior Court of Justice, dentists may also apply for judicial review of an interim order before a single judge of the Superior Court. Under the JRPA, such an expedited procedure may be warranted where a case appears to be sufficiently urgent and “the delay required for an application to the Divisional Court is likely to involve a failure of justice”.

Judicial reviews of interim orders typically involve both written and oral argument before the Court. Dentists and the RCDSO are the parties to these reviews, and are typically permitted to introduce evidence and examine witnesses when relevant to previously raised issues. It is prudent for dentists to retain a lawyer in this context, as a judicial review of an interim order will involve legal argument. 

The Court will analyze statutory compliance and procedural fairness, and may quash an interim order if it finds an error in law or a lack of evidence. After the Court disposes of an application for judicial review of an interim order, a dentist or the RCDSO may seek leave to appeal the order before the Court of Appeal.

In the case of Rohringer v. The Royal College of Dental Surgeons of Ontario (2017), Dr. Rohringer applied to the Divisional Court to quash an interim order of the RCDSO which had suspended his certificate of registration. Dr. Rohringer had been criminally charged in Florida for indecent exposure. His judicial review was heard on an expedited basis before a single judge, who found that there was no evidence at that time that Dr. Rohringer’s conduct was likely to expose his patients to harm or injury. More recently, Fingerote v. The College of Physicians and Surgeons of Ontario (2018) further supports the proposition that the ICRC cannot impose interim orders on the basis of mere speculation, but will require evidence of probable harm to patients.

Interim orders at the RCDSO have the potential to subject dentists to professional and personal consequences. Dentists in this position should consult with legal counsel, and respond accordingly.