Dr. Gideon Koren has agreed to never practise medicine again in Ontario in the face of an investigation by the province’s medical regulator into whether he committed “professional misconduct or was incompetent” while he was in charge of the Hospital for Sick Children’s Motherisk laboratory.

The promise to relinquish his licence is laid out in what is known as an “undertaking,” posted on Koren’s profile on the College of Physicians and Surgeons of Ontario’s website. In the document, signed by Koren this month in Tel Aviv, he also promises not to reapply for a license in this province.

An independent review sparked by a Star investigation into Motherisk concluded in 2015 that the lab’s drug and alcohol hair tests, used in thousands of child protection cases and several criminal cases, were “inadequate and unreliable.” The Star’s investigation revealed that prior to 2010, Motherisk’s testing process was using a methodology that experts described as falling short of the “gold-standard test.”

“In the circumstances, I have concluded that the laboratory’s flawed hair-testing evidence had serious implications for the fairness of child protection and criminal cases,” said independent reviewer Susan Lang, a retired Court of Appeal judge, in 2015.

In March 2017, the college first confirmed to the Star it was investigating Koren, who was in charge of the now-shuttered Motherisk lab until retiring in 2015.

Koren has had an active license to practise medicine in Ontario since 1982. In recent years, he has been living and working in Israel.

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Koren and his Toronto-based lawyer did not return requests for comment Thursday. The undertaking means that the college’s investigation into Koren will cease. Had the probe continued, one potential outcome could have seen the college referring allegations of professional misconduct to its discipline committee to hold a public hearing.

It’s unclear when the regulator first began its investigation into Koren. Sick Kids previously told the Star that it forwarded results of its internal investigation into Motherisk to the college in 2015.

That internal probe found the laboratory was at times operating without appropriate oversight or proper quality assurance checks and had misled the hospital over its testing process — which was relied upon in many child protection cases across the country.

“We deeply regret that the practices in the Motherisk drug testing laboratory didn’t meet the high standard of excellence that we have here at Sick Kids, and we extend our sincere apologies to children, families and organizations who feel that they may have been impacted in some negative way,” former Sick Kids CEO, Dr. Michael Apkon, told the Star in an interview in 2015.

This was not Koren’s first time in the college’s crosshairs. He was suspended for five months, two of which without pay, for professional misconduct in 2003 for writing so-called anonymous “poison pen letters” to Dr. Nancy Olivieri and her supporters at Sick Kids, calling them “a bunch of pigs” among other things.

The pair had worked on a drug study for generic drug maker Apotex, but ended up disagreeing on the drug’s effectiveness, with Olivieri wanting to go public with her concerns about potentially harmful side-effects. Apotex terminated her clinical trials, but she published her findings anyway in the New England Journal of Medicine.

“It defies belief that an individual of Dr. Koren’s professed character and integrity could author such vicious diatribes against his colleagues as he did in the ‘poison pen letters,’” reads the 2003 decision. “His actions were childish, vindictive and dishonest.”

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A separate Star investigation published last year also identified what appear to be problems in more than 400 of Koren’s papers. That prompted Sick Kids to announce in December a review of his vast body of published work.

The Star’s investigation found these papers had been inadequately peer-reviewed, fail to declare, or perhaps even obscure, conflicts of interest and, in a handful of cases, contain lies about the methodology used to test hair for drugs.

With files from Rachel Mendleson and Michele Henry

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