Medical Justice provides free consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a free consultation – or use the tool shared below.
"Can Medical Justice solve my problem?" Click here to review recent consultations...
We’ve been protecting doctors from medico-legal threats since 2001. We’ve seen it all. Here’s a sample of typical recent consultation discussions…
- Former employee stole patient list. Now a competitor…
- Patient suing doctor in small claims court…
- Just received board complaint…
- Allegations of sexual harassment by employee…
- Patient filed police complaint doctor inappropriately touched her…
- DEA showed up to my office…
- Patient “extorting” me. “Pay me or I’ll slam you online.”
- My carrier wants me to settle. My case is fully defensible…
- My patient is demanding an unwarranted refund…
- How do I safely terminate doctor-patient relationship?
- How to avoid reporting to Data Bank…
- I want my day in court. But don’t want to risk my nest egg…
- Hospital wants to fire me…
- Sham peer review inappropriately limiting privileges…
- Can I safely use stem cells in my practice?
- Patient’s results are not what was expected…
- Just received request for medical records from an attorney…
- Just received notice of intent to sue…
- Just received summons for meritless case…
- Safely responding to negative online reviews…
We challenge you to supply us with a medico-legal obstacle we haven’t seen before. Know you are in good hands. Schedule your consultation below – or click here to visit our booking page.
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.
Medical Justice provides free consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a free consultation – or use the tool shared below.
"Can Medical Justice solve my problem?" Click here to review recent consultations...
We’ve been protecting doctors from medico-legal threats since 2001. We’ve seen it all. Here’s a sample of typical recent consultation discussions…
- Former employee stole patient list. Now a competitor…
- Patient suing doctor in small claims court…
- Just received board complaint…
- Allegations of sexual harassment by employee…
- Patient filed police complaint doctor inappropriately touched her…
- DEA showed up to my office…
- Patient “extorting” me. “Pay me or I’ll slam you online.”
- My carrier wants me to settle. My case is fully defensible…
- My patient is demanding an unwarranted refund…
- How do I safely terminate doctor-patient relationship?
- How to avoid reporting to Data Bank…
- I want my day in court. But don’t want to risk my nest egg…
- Hospital wants to fire me…
- Sham peer review inappropriately limiting privileges…
- Can I safely use stem cells in my practice?
- Patient’s results are not what was expected…
- Just received request for medical records from an attorney…
- Just received notice of intent to sue…
- Just received summons for meritless case…
- Safely responding to negative online reviews…
We challenge you to supply us with a medico-legal obstacle we haven’t seen before. Know you are in good hands. Schedule your consultation below – or click here to visit our booking page.
Jeffrey Segal, MD, JD
Chief Executive Officer and Founder
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.
Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.
It is indeed harsh. To take away her livelihood that she has worked all her life at is uncalled for.
Psychological counseling with a short suspension of license would have been sufficient.
I think punishment was way too harsh. If the male was in his 30’s, I don’t buy his ´innocence’ due to disease. He didn’t suffer brain surgery and his libido was not affected was it? I would say that would have been the first side effect – impotency. Dr was foolish but punishment doesn’t fit this breaking of rules. Leniency is called for.
Discipline her, don’t revoke her licence.
A doctor wishing to pursue a romantic relationship with a patient should terminate his/her professional relationship with the patient and enter a consensual only relationship AFTER the patient is established with another provider.
I agree poll
I agree. Sounds a bit harsh. He didn’t receive ANY benefits??? C’mon. Let’s get real. He got SOME benefits! Yea, they were interested in each other, until they weren’t. Things happen. I certain NEVER condone any doctor having ANY sexual relationship while s/he is the practicing physician. Once the doctor-patient relationship is severed and enough time has elapsed, then things can happen.
I agree. Way too harsh. Revenge was the patient’s aim and he got it. Shame on him.
Intercourse with a patient in their hospital bed?! revoking a license sounds appropriate. Inappropriate, disrespectful and likely neglecting other patients care.
this is appropriate to revoke her license. what she did is inappropriate, in united states she would have a legal lawsuit hanging over her and she would loose lot of money.
here she looses a license and what i hear can move to another province and practice medicine.
i feel in United States she would not only loose her license but would be have a significant legal battle in front of her.
I live in South Carolina where we are told the only recourse for a sexual relationship with a person with him you have an ongoing physician patient relationship is permanent revocation of one’s license. I do not know what the regulations are on the providence of Ontario , at least we are forewarned.
I believe disciplinary action was appropriate but not necessarily revocation. Unfortunately, the doctor did not offer a defense and let her license be revoked. The Medical Board may have considered a plan of rehabilitation had it been pursued. Such an outcome is not uncommon in Arizona.
The Hippocratic oath defines the physician-patient relationship and the consequences to be borne.
I enjoy your columns but you need someone to edit the grammar, as it often sounds like someone uneducated is writing them. Your use of the word “salient” before the word “expert” is wrong, and you can’t feel “badly” for both parties , you feel “bad. “ We physicians should be as proficient in the written word as in the practice of medicine ! Sorry to sound like a curmudgeon, but…..
First, and most importantly, thanks for your general praise of the blogs.
Next, you are absolutely correct. I should have written “I feel “bad” for both parties.” Not “badly.” My bad. (Now or soon to be corrected.) Unfortunately, I relied on the less than authoritative treatise How to Write Good.
I could not find the words “salient” or “expert” in this post, so I’m not sure how to respond. Perhaps they were used in a prior post.
Regarding your critique… “as it often sounds like someone uneducated is writing them” – Grammar Girl would argue the correct usage should be “as it often sounds AS IF someone uneducated is writing them.”
And, I’ll let the extra space before one comma and one exclamation point go.
It’s a blog. Blogs are informal. If I had unlimited time, I would spend more time editing the pieces. I wish I had the time. Most doctors have the same challenge writing office or operative notes. Anyway, point taken.
While we are are on the topic of grammar: it should be “as if someone uneducated WERE writing them”. Credit to my HS English teacher Mrs Ehrenreich in Germany. 😉
I am puzzled why she completely disavowed him. They remained friends, yet she did not see him in the hospital. Understandably he was hurt and angered. A volatile combination. Is there more to the story?
I believe the correct grammatical phrasing is “…someone who is uneducated…”
1) We all agree that this relationship was wrong.
2) In most medical licensure environments, personal relationships are held to be punishable by license revocation at least in the US and Canada.
3) The physician disregarded the training that she had in such matters knowing full well the risk to her license.
4) The physician did an absolutely terrible job of ending the relationship. If she had tapered off the personal relationship but maintained a treating relationship it is likely that the patient might not have turned her in.
5) These two were carrying on in a very public and flagrant way. It would have been impossible to cover this up given all of the cavorting around.
6) While the patient may have been in a vulnerable position, he was also a consenting adult. He bears some culpability in this. However, he would not necessarily know that a relationship with a treating physician was not appropriate.
7) What about medical objectivity in such a relationship? Were the best interests of the patient preserved in all of this, during the relationship and after.
8) I hope that this patient survived his cancer ordeal.
9) While it is unlikely that this physician will ever be licensed again, it is still a pity that someone that is as highly educated would have to suffer lifelong punishment by licensure revocation.
10) It seems to me that if murderers can be let out of prison after 4 years, then medical board punishments of physicians in most cases that last a lifetime are overly harsh and punitive. Reeducation after a time off from practice would seem a more appropriate punishment, along with ongoing monitoring. Medical boards look at their job as protecting the public by showing how tough they are but that is not necessarily fair to the physician.
I would like to hire Ellen Gendler! I write blogs to myself every week and I fear publishing will expose my literary skill!
Insightful comments by all.
Why did the doctor not contest this administrative action? There are other reasons well-trained physicians walk away from the profession. I suspect that there were other reasons she no longer cared to practice medicine. To many physicians exit patient care after the sizable investments into their education.
Early physician retirement is too common, and I’m not aware of any substantial efforts to screen for those at high risk for leaving patient care. Individual physicians, organized medicine and legislatures bear some responsibility for eroding the clinical care environment. The doctor-patient relationship has been transformed to the doctor-government-lawyer-payor-clerk-EMR-patient relationship.
Any multiple circumstances can require a physician hiatus, but then reestablishing a clinical practice can be made very difficult by the licensing boards. (Ask Dr Segal)
Too many physicians become part of the bloated government bureaucracy and the administrative commercial sector.
In the end, it is the patient that loses with the loss of competent practicing physicians.
Submitted with trepidation.
Ellen, please reach out.
I agree with everything “retired” has said. And I think this statement by John Langs, the board chair “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” is incredibly revealing. It is almost as if he had put on the black hood and pronounced a death sentence, as this is certainly the death of her career in a country that is not oversupplied with ANY type of specialist because of its exclusionary and anticompetitive policies towards physicians trained elsewhere. This board was making an example of this physician, revelling in the harsh punishment meted out so that they could pat themselves on the back and say “we are great at protecting the public.” And they did so I’m willing to bet with impunity, because of the stupidity of having pursued the affair on a hospital campus, and probably also because she is a woman. Boys will be boys, but we must be sure to be politically correct in Canada and penalize women equally if not more harshly—they should not transgress!
And also, because they need to prove that they do something worthwhile using taxpayer money. I know of no state or province whose regulations explicitly state that a doctor WILL lose their license for this type of indiscretion. It is all discretionary with the board, and this board took their privilege to the limit. I hope it gave them as much prurient satisfaction as it gives her pain. Only hers is permanent.
This is a classic example of the transactional analysis (TA) game, RAPO, which occurs in several degrees. In this one, two people enter into a consensual relationship, both having a good time. One hurts the other by ending the relationship, so he/she cries “rape.” OK, he didn’t say she actually raped him, but that was the thrust of the accusation.
It’s a TA game, and it’s a very dirty game. We aren’t told how old patient X is, but assuming he’s of age, and he’s well enough to have sex under some fairly demanding circumstances, he’s not so sick that he’s that vulnerable.
He was just trying to hurt her. And he did.
This is a physician, not a murderer, her decisions are her responsibility. And if the rules are clear, the consequences apply. Although I am disappointed by her ‘crime ,’ I admire her ability to face and accept the punishment.
Dr. Horton has it exactly correct. Transactional Analysis is a dispassionate, accurate and meaningful way to discuss the Drama Triangle and its effect on people who make a choice to “enter it.” As soon as you enter the Triangle, you are switching roles in the most destructive manner possible.
When you study TA, you can recognize the Drama Triangle from “miles away” and sense when you are being “forced” to enter into this destructive behavior pattern.
When we cut-away traditional morality, which the Left has abolished, we made sex “transactional.” There is no morality connected with it. This is very confusing for everyone, except for people who believe in God and traditional morality.
The Left, absent morality, has tried to make sex into strictly a power issue. Obviously they are having a very hard time with that new definition. Everything for the Left is POWER.
Given that backdrop, the Medical Boards, who have bought into Leftist ideology, finds it as confusing as everyone else. It is no surprise that they took away her license. If I were advising her, I would suggest that she try to get a license under Locum tenens aegis. She can prostrate herself on the open streets and try to get “rehabilitated.”
I think she has a good shot at that. The Center for Peer Review Justice has had success at getting back licenses that appeared defunct. I suggest she contact the director.
She has nothing to lose.
Michael M. Rosenblatt, DPM
It is important to take a step back and recognize that she is, in addition to being a physician (and perhaps a stressed out out, vulnerable in her own way), a human. He had no culpability, as a sober adult? My general take is that licensing boards, as political entities, are more interested in the optics of looking tough on “rogue” physicians, with very little interest in rehabilitation or redemption. Did she have a long history of these behaviors? Or was this quite out of keeping with her character? The most likely outcome of all this is that she will never work as a physician again, or at least not in any meaningful way. All that education, all that effort, and now patients will not derive benefit from her care. Did she mess up? Yes. Should she undergo counseling, courses on boundaries? Yes. Should she be a pariah and lose her job? No. I know others who have been in similar situations and the punishment well outweighs the “crime”; it is a transgression with roots likely in the stress and vulnerability inherent in medicine, but it is not a crime, yet she will be treated as a criminal.
I think that many of us do not recognize how vulnerable we are, how fragile our job/license security is. From my experience with others, if she had indeed “fought” this, the outcome would be the same, possibly worse.
Licensing boards claim to protect the public. In some cases they do. In many others, they exist solely to point out that we do not close ranks and protect our own. My heart goes out to her.
I’m sorry. I don’t feel it’s ever appropriate to date a patient or sleep with a patient. You have too much knowledge of intimate details of their life which always creates a power differential. When I was single, I personally left a practice because I was seeing too many people from my community (I’m an out gay man) , and I felt I was rapidly narrowing down dating prospects.
The waiting room is not a place to find a date. Having sex with a patient directly under your care (in the hospital, no less) is abhorrent. She should be considered a sex offender and deserves to lose her license. There is a lot of career paths she can still do as an MD with her degree, but she should not be allowed to be alone with a patient. Would you be okay with a sex offender teaching your children? If not, why do you think she shouldn’t lose her job and her license. She can be rehabilitated, but she should not be allowed to continue to see patients.
To answer the questions. The oncologist was reasonably young, with many years of productive life left in her career. She fell on a sword (no defense) likely because of the negative publicity surrounding this case.
Here’s a question. What if the narrative had played out as a romantic comedy and not a tragedy? What if the oncologist and the patient fell in love, married, and lived happily ever after? The patient (now the happy husband) would never have filed a complaint. But what if a prior jilted lover notified the Board? Or a competitor? Would the same penalty be warranted? Is the outcome worth considering as much as the process?
Originally I thought, yes, she should lose her license. Until it was pointed out that Canada has fairly few oncologists. So I reconsidered. IMHO, the proper course of action probably should have been discipline and license suspension for a period of time, with re-education (especially a course or two in morality and ethical behavior), and after doing her time and penance, reinstatement. It’s almost as though the Medical Board bit off their collective noses to spite their faces. If there was an overabundance of oncologists, perhaps I’d be less forgiving . But then again…
If there are relatively few oncologists and she refused to treat a patient strictly because she had entered into a relationship which she then ended, where does that leave the patient insofar as patient care? The issue was not consent which others alluded to- it was that the patient was vulnerable- he relied on the doctors’ care.
My understanding is this patient filed a complaint NOT when the romantic relationship ended, but when she refused to treat the patient.
It seems to me that this doctor blurred the lines terribly- so much so she was incapable of ensuring patient care came first.
I feel terrible for this doctor and I know the there was emotional turmoil for the patient. She had a lot of training and a lot of patients stand to benefit from her seeing patients. Mistakes will always be made as long we’re human. The medical board can treat her like an infallible robot but both patients and doctors will lose out. The phrasing the medical board used was also rather emotional, which highlights the bias in handing down such a punishment. I am not in a position to say whether that doctor should/shouldn’t have had her license revoked. But if I make such a mistake then I want to be offered the kind of help and love needed for me to learn from my mistakes and have the chance to continue to be a productive member of society.
If the genders were reversed, revoking his license would be deemed not harsh enough, so no we have not achieved gender equality.
She was my oncologist as well in 2015. And I personally don’t believe a word this patient has said. She is kind, compassionate the best doctor I ever encountered. Very caring and friendly. Perhaps he took her kindness the wrong way? She is Indian and seems to have very high morals and values and I don’t believe any of this happened. I believe she just wanted this over with so didn’t fight the case. It’s an embarrassment to her family. I was re diagnosed in 2019 and found out she was no longer practicing because of some idiot so I changed clinics all together , if I couldn’t have her as an oncologist then I’d go elsewhere. I wish her only the best and revoking her license is crazy.