A Toronto doctor again finds himself the subject of discipline proceedings before the College of Physicians and Surgeons of Ontario.

And once again, the CPSO’s case against him could be in jeopardy because the main witness — a former patient — has not appeared to testify.

Dr. Suganthan Kayilasanathan appeared before a five-member panel of the discipline committee Monday, facing allegations of sexually abusing a patient and disgraceful, dishonourable or unprofessional conduct. Through his lawyer, he denied the allegations.

“This will be a relatively straightforward case,” college lawyer Carolyn Silver told the panel in her opening remarks.

The college alleges Kayilasanathan wrote two doctor’s notes for Patient A — whose name is covered by a publication ban — within the span of about a week in December 2010 so she could avoid taking exams, and that the two had sex at a hotel one night during that week.

Kayilasanathan met Patient A several years ago through a mutual friend, and the two became reacquainted through the same friend in 2010, Silver said. One night in December of that year, the three partied in a downtown Toronto club, and then kept the party going at the doctor’s brother’s condo, where Patient A said she was concerned because she had an exam the following Monday, Silver told the panel.

“Dr. Kayilasanathan told her not to worry about the exam because he was a physician and could write her a doctor’s note so she could postpone her exam,” Silver said.

The note was provided that Monday, when Patient A went to the Scarborough clinic where Kayilasanathan worked, Silver said. The discipline panel can expect to hear from the patient that she and Kayilasanathan then had sex at a Mississauga hotel two days later, and that he wrote her another doctor’s note to avoid an exam the following Monday, Silver said.

Kayilasanathan got back in touch with the patient about two months later and she visited him at his condo, where “he made advances toward her, which she rebuffed,” the college alleges. It’s also alleged that when he drove her home, he placed her hand near his genitals and exposed his penis.

Silver told the panel that the college became aware of Patient A through a mandatory report by another physician, and that the patient herself had not complained to the regulatory body. (Doctors are required by law to disclose to the college if they become aware of another health professional having sex with a patient.)

A problem arose during the proceedings Monday when it became apparent that Patient A had not arrived at the college to give her testimony, and the college was unable to communicate with her. This led to the college and defence offering different views as to whether the patient does indeed intend to testify against Kayilasanathan.

Defence lawyer Andrew Parley said that Patient A reached out to his firm last Thursday, and he read an email to the panel in which she said she was “feeling extremely pressured and coerced into testifying,” and that she is not physically or psychologically able to go through with the proceedings.

“I have been threatened with legal action by way of bench warrants and being held in contempt of the law,” read the email Patient A sent to the defence, acknowledging that she had been served with a summons by the college requiring her to testify.

“Attending is not an option for me,” Patient A wrote.

But she then sent an email to the college the following day, parts of which Silver read to the panel, in which she indicated she had spoken with a lawyer and said, “I now understand the importance and ramifications of attending this and any hearing.”

Silver told the panel that she does have instructions from the college to apply to the court to enforce the summons if necessary, which could involve having the police bring the woman to testify. The panel adjourned until Tuesday morning for an update.

The college’s position on the summons is different than in a previous case involving Kayilasanathan this past spring.

Along with another doctor, Amitabh Chauhan, he was facing a discipline proceeding on professional misconduct charges for allegedly drugging and sexually assaulting a woman. (The pair had been acquitted of the same allegations in 2014 following a high-profile judge-alone criminal trial. The burden of proof at the college level is lower than in criminal court.)

Loading... Loading... Loading... Loading... Loading... Loading...

But the alleged victim in that case also did not appear to testify, and in that instance, Silver, who was also the college’s lawyer on that case, said the college would not be enforcing the summons and withdrew the allegations against the two doctors.

“The process of testifying has been gruelling and has had a significant detrimental impact on Ms. X,” said a letter from the woman’s lawyer that Silver read into the record in May. “She is simply not able to subject herself to the psychological, emotional and physical harm of another hearing.”

In that case as well, the woman had not complained to the college. The regulator launched its own investigation in the wake of the criminal trial.