Physicians and other healthcare providers will have strong feelings about this case. Some will say throw the book at her. Others will preach forgiveness and a second chance.

Now for the details. A story from our friend to the north.

“Patient X” was referred from the emergency department to Dr. Theepa Sundaralingam, a 37 year old female oncologist in Toronto. Dr. Sundaralingam ordered bone marrow testing and gave the patient a diagnosis of cancer at his follow up appointment in January 2015.

Sundaralingam treated Patient X 23 times between January and July of 2015. She also saw the patient once in March 2016.

Sundaralingam gave the patient her personal contact information. The two began texting “in a highly personal manner.”

The complaint to the CPSO (Ontario’s equivalent of the Board of Medicine) stated the doctor behaved in a “physical, flirty, and sexual manner” toward the patient during medical appointments. She met with the patient outside of the clinical setting.

One month after receiving his initial diagnosis, Patient X was admitted for chemotherapy. Sundaralingam monitored the patient regularly and administered his blood transfusions.

During his hospitalization, Sundaralingam would stay with the patient for 5 to 7 hours at a time. She befriended his entire family. The report noted their conversations became more sexually intimate including the types of pornography they enjoyed.

They had sex in Patient X’s hospital bed.

They had sex when he was discharged home, where Patient X lived with his family.

Dr. Sundaralingam asked the patient to delete his text messages, expressing concern the CPSO might become aware of their relationship. She also asked the patient to remove her name from the hospital’s visitor log to erase evidence of her visits.

In September 2015, after having sexual intercourse at the patient’s home, Sundaralingam told Patient X she was in love with a colleague and had been dating him. The sexual relationship with Patient X ended. They remained friends.

In November 2015, Sundaralingam refused to see Patient X at all and rejected his attempts to meet when he contacted her again in February 2016. In March, Patient X developed an infection, and Sundaralingam treated him for the last time. When he was admitted to the hospital, Sundaralingam did not visit the patient or provide treatment.

Patient X filed his complaint.

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. I couldn’t see how vulnerable I was and how much power she had over me,” he noted.

Dr. Sundaralingam chose not to contest the Discipline Committee’s report and agreed to fall on a sword. And fall on a sword she did. CPSO revoked her license to practice medicine.

“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.”

While it is possible for Dr. Sundaralingam to apply for a medical license in other Canadian provinces, she likely is considered professionally radioactive for now.

So, what have we learned here?

As they said about Watergate, it wasn’t so much the crime, it was the coverup. Here, what led to the formal investigation and discipline was not so much the sexual relationship; it was the breakup. That said, breakups are not uncommon. They are frequent and predictable. So, a foreseeable breakup should have caused pause for thought.

I do not disagree that a patient newly diagnosed with cancer is in a vulnerable position. And such a person may not be able to properly or formally consent to a romantic or sexual relationship. Still, the two behaved as if they were in love (at least for a while). Likely each received some benefit, until they didn’t. Dr. Sundaralingam was ready to move on, and she did. And the patient did not want to move on. He then complained to the CPSO.

My personal take.

I feel bad for both parties.

Patient X was a vulnerable spurned lover. It can’t be easy fighting cancer and dealing with complicated emotional turmoil.

Dr. Sundaralingam should have formally terminated the doctor-patient relationship allowing reasonable time to lapse before considering any type of relationship. And a strong argument can be made that there was no amount of time that would have made such a relationship kosher.

The CPSO was within its rights to impose discipline. But permanently revoking a license seems harsh. Canada does not have a gazillion practicing oncologists. Removing one from the pool is not insignificant. Surely the doctor can be redeemed and not be constrained to wear a scarlet letter for the rest of her life.

Enough of what I think. What do you think? Comment below.

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Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. Dr. Segal is a Fellow of the American College of Surgeons; the American College of Legal Medicine; and the American Association of Neurological Surgeons. He is also a member of the North American Spine Society. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

Dr. Segal was a practicing neurosurgeon for approximately ten years, during which time he also played an active role as a participant on various state-sanctioned medical review panels designed to decrease the incidence of meritless medical malpractice cases.

Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.

In 2000, he co-founded and served as CEO of DarPharma, Inc, a biotechnology company in Chapel Hill, NC, focused on the discovery and development of first-of-class pharmaceuticals for neuropsychiatric disorders.

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