THIS IS UNFAIIR

A Canadian oncologist has been stripped of her license after not contesting allegations that she had a sexual relationship with a patient while she was treating him for cancer. 

Theepa Sundaralingam, MD, a community oncologist at the Rouge Valley Health System in Toronto, Canada, was the subject of a disciplinary hearing held by the College of Physicians and Surgeons of Ontario (CPSO) on January 23.

The panel ruled that Sundaralingam had "engaged in sexual abuse and disgraceful, dishonorable and unprofessional conduct" in respect to a patient.

The 37-year-old oncologist pleaded no contest, which means that while not admitting guilt she still consented to the panel accepting the allegations as fact, the CPSO explained to Medscape Medical News.  

The patient, whose name and age has not been revealed due to a publication ban, filed the complaint against Sundaralingam, explained the CPSO.

Sundaralingam's attorney did not respond to a request for comment on the case.

According to a report on CBC News, Sundaralingam was told she was losing her license after only a short deliberation by the panel. She was also ordered to put up a security of $16,000 to cover any expenses for therapy that the patient might need and was ordered to pay $6000 to cover the cost of the proceedings.

"Your actions are abhorrent and reprehensible. Even if revocation [of license] was not mandatory, the committee would have made such an order," one of the panel members told her. 

The CPSO is responsible for issuing certificates of registration that allow physicians to practice medicine in Ontario. They are also responsible for investigating complaints about doctors on behalf of the public, and conducting discipline hearings when physicians commit an act of professional misconduct or may be incompetent.

Under Ontario law, sexual contact or assault encompasses everything from inappropriate touching to rape, and also includes any sexual contact between a doctor and patient that would otherwise be considered consensual.

"The College considers this to be sexual abuse, and the mandatory penalty is revocation," a spokesperson from CPSO told Medscape Medical News. "She didn't contest any of the facts, and unless there is reason to question the information, there is no opportunity for the College to lessen the decision. They are required to revoke her license."

Similar to the United States, each Canadian province is responsible for the licensing and discipline of physicians, and theoretically, Sundaralingam could still work in Canada (although not in Ontario). But the CPSO emphasized that it cannot speak for other provinces, as far as whether the agency would license a physician under these circumstances. Information is shared among the provinces, and this disciplinary action is on record.

Patient Receives Cancer Diagnosis 

The patient who filed the complaint was initially referred to Sundaralingam in January 2015 from the emergency department. At that time, she ordered bone marrow testing and she was the one who gave him the cancer diagnosis at his follow-up appointment, according to the CPSO report.

Sundaralingam continued to treat "Patient X" on a regular basis, for a total of 23 times between January 2015 and July 2015, and one time in March 2016. 

According to the CPSO report, the day after the patient was diagnosed with cancer, Sundaralingam gave him her personal contact information and Instagram ID. This was considered a breach of appropriate boundaries between physician and patient, as the two immediately began texting "in a highly personal manner."

Over the next several weeks, Sundaralingam continued to breach appropriate boundaries with her patient by frequently texting him, and behaved in a "physical, flirty and sexual manner" toward him during medical appointments. She also met with him outside of the clinical setting. She held hands with him, hugged him for long periods of time, and kissed him, the report notes.

Approximately a month after he was diagnosed with cancer, Patient X was admitted to the hospital for chemotherapy, where Sundaralingam continued to monitor him regularly and administered his blood transfusions. 

Their relationship appeared to become increasingly intimate during his hospitalization. Sundaralingam would visit him and often stayed for 5 to 7 hours at a time. She became friendly with his entire family. However, during these visits, their conversations became more sexually explicit, including discussions about the types of pornography that they enjoyed, the CPSO report notes.  

The situation between the oncologist and her patient continued to heat up, including one after-hours incident in which they reportedly engaged in sexual activity in his hospital bed. The report noted that Sundaralingam had consumed alcoholic drinks before visiting her patient.

Sundaralingam continued to treat Patient X throughout this period, and the relationship continued. They had sex in the hospital on two occasions and also engaged in sexual activities after he was discharged home, where he lived with his family, the CPSO report continues.

However, at the same time, Sundaralingam repeatedly asked the patient to delete their texts and keep their relationship a secret, expressing concern that the CPSO might become aware of their relationship. She also asked the patient to remove her name from the visitor's log at the hospital so as to erase any evidence of her visits. The patient did as requested, the report notes.

"Almost instantly after diagnosing Patient X with a life-altering diagnosis, Dr. Sundaralingam began to breach well-established boundaries between physicians and patients," Amy Block, prosecutor for CPSO, said at the doctor's disciplinary hearing, as reported by the National Post .

"This was all with the knowledge that what she was doing was wrong," said Block. "The evidence makes clear that she asked Patient X to falsify hospital documents in order to conceal her abuse. Only revocation can maintain confidence in the medical profession's ability to regulate itself."

End of the Affair

In September 2015, the sexual relationship between Sundaralingam and Patient X abruptly came to an end, the CPSO report notes. After having sexual intercourse in the patient's home, Sundaralingam told him that she was in love with a colleague and was having an affair with him. They remained friends, but the relationship became nonsexual.

After November 2015, Sundaralingam refused to see the patient at all, and rejected his attempts to meet when he contacted her in February 2016. A month later, he developed an infection and Sundaralingam did treat him, but it was their last formal clinical interaction. When he was subsequently admitted to the hospital, she did not visit him and did not provide his treatment.

According to a news report in the Toronto Sun, Patient X wrote in his victim impact statement:  "I was physically emaciated and emotionally exposed, and the loss of a critical relationship defeated me. What compounded this toll was her refusal to continue providing medical care at the same time."

At the time, I was unable to see the ramifications of dating my treating oncologist. Patient X

"At the time, I was unable to see the ramifications of dating my treating oncologist. I couldn't see how vulnerable I was and how much power she had over me," he noted.

The patient added that he is fighting through this "traumatic experience" just as he fought through cancer.

The Discipline Committee ordered that the Registrar revoke Sundaralingam's certificate of registration effective immediately and that she appear before the panel to be reprimanded.

"From virtually the beginning of your doctor/patient relationship, you crossed boundaries and ultimately sexually abused an extremely vulnerable patient suffering from a life-threatening illness," discipline panel chair John Langs told Sundaralingam during the official reprimand, according to a news report.  "The committee can only hope that this process prompts you to undergo a long, hard searching self-examination of what lies behind your abusive and abhorrent behavior."