Ottawa's medical officer of health said the investigation of an Ottawa laser clinic over surgeries performed without a doctor present has highlighted gaps in how enforcement agencies regulate these clinics and communicate with one another.

In a letter to the city's board of health Wednesday, Dr. Isra Levy said his agency first investigated Eve's Laser Clinic following reports the home personal service was performing surgeries such as rhinoplasty.

Eve Stewart Laser Clinic

Eve Stewart says she's not a doctor, but has been performing cosmetic procedures for the last seven years. She says it's legal because a doctor has delegated her to do it. (Judy Trinh/CBC)

But he said court documents later revealed the College of Physicians and Surgeons of Ontario and Health Canada had both known about the clinic and had been in contact with them as early as April 2013.

"I have since been in contact with the provincial Chief Medical Officer of Health to discuss the challenges with interagency communications that this situation has highlighted," Levy wrote.

Clinic inspected Wednesday

Eve Stewart continues to run a laser clinic out of her Nepean home, even as the College of Physicians and Surgeons of Ontario seeks an injunction ordering her to prevent her from performing certain controlled acts without a license.

She is not a licensed physician, but says she has been delegated to perform these procedures by a doctor, so it’s legal. But court documents filed by the college said it knew of no doctor working with Stewart at her clinic on Viewmount Drive.

The college issued an application with the Ontario Superior Court of Justice seeking a court order directing Stewart to refrain from performing controlled acts, including performing surgery, administering a substance by injection and communicating a diagnosis identifying a disease or disorder as the cause of symptoms.

That injunction request won't be heard, however, until March 6.

Eve's Laser Clinic Ottawa

Eve Stewart says she's been doing cosmetic procedures for seven years. (CBC)

Ottawa Public Health issued a temporary cease and desist order to Stewart for personal services that involve the use of any instruments and items that require sterilization between uses, but it does not apply to single-service instruments that are disposed after one use, such as those used in laser therapy. 

OPH inspectors were at Eve’s Laser Clinic laser clinic for another inspection on Wednesday.

Ottawa Public Health to post inspection reports online

Levy wrote there are a number of challenges — province-wide — with identifying, inspecting and regulating personal service settings.

He wrote that Ottawa Public Health is now taking a look at how it notifies other agencies about possible health concerns, reviewing past inspections to see if the appropriate regulatory agencies were notified and reassessing and re-inspecting all higher-risk personal service settings.

Levy said OPH will also be launching a social media campaign on personal services settings and plans to make inspection reports available online in the summer of 2014.