Toronto doctor Suganthan Kayilasanathan has been stripped of his licence to practise medicine for sexually abusing a patient, marking the end of one of the most contentious cases at Ontario’s medical regulator.

Kayilasanathan was a no-show Tuesday at the College of Physicians and Surgeons of Ontario, though his three-person legal team was present to hear a discipline panel order that his licence be immediately revoked following a brief penalty hearing. The doctor must also appear before the panel to be reprimanded and pay the college costs in the amount of $46,220 within 30 days.

The panel found him guilty in September of sexual abuse and unprofessional conduct for having sex with a woman for whom he wrote two medical notes in the span of a week so she could skip exams. The woman is only known as Patient A due to a routine publication ban imposed on her identity.

The panel concluded that by writing the notes, a doctor-patient relationship was established. Sex between health care professionals and patients in Ontario requires the automatic revocation of their licence.

“Dr. Kayilasanathan flagrantly violated Patient A’s trust and engaged in an egregious abuse of his position of power when he engaged in sexual intercourse and oral sex while he was treating her as a patient,” college prosecutor Carolyn Silver told the panel Tuesday.

Silver said that even if revocation was not mandatory in this case, the college believed it would still be the appropriate penalty. That remark drew criticism from one of Kayilasanathan’s lawyers, Andrew Parley.

“In my view, it’s not relevant what would be appropriate if the statute was not in place. It is in place, we accept that the revocation and reprimand are mandatory and as such take no position on those aspects of the penalty sought by the college,” he told the panel.

Kayilasanathan, who was immediately suspended in September pending Tuesday’s penalty hearing, is appealing the discipline panel’s findings in Divisional Court.

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The case against him almost collapsed soon after the discipline hearing began in November 2017, as Patient A refused to testify despite being served with a summons, which created a legal obligation for her to attend. She said she wanted no part in the hearing, pointing out she had never complained about Kayilasanathan to the college.

In fact, she had told another doctor that she and Kayilasanathan had had sex; that doctor was required by law to report it to the college.

The regulator said it would take the unprecedented step of asking a judge for a bench warrant and have Patient A brought to the college by the police to testify if she continued to ignore the summons. Patient A then hired her own lawyer to try to quash the summons, but was unsuccessful.

She ultimately did testify against Kayilasanathan as the key witness in the case, telling the panel she “used him to get a (doctor’s) note.”

It was the second attempt by the college at trying to discipline Kayilsanathan; the regulator was unsuccessful last year in a case involving him and another doctor, Amitabh Chauhan, who were facing unprofessional conduct charges for allegedly drugging and sexually assaulting a woman.

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They had been acquitted in criminal court of gang sexual assault following a high-profile trial, and the complainant told the college she couldn’t bring herself to testify a third time, having already done so at the trial and the preliminary hearing.

Silver, who was also the college prosecutor on that case, said at the time that the regulator would drop the case rather than force the complainant to testify.

“We’re pleased with the result in this case and that Dr. Kayilasanathan’s certificate is revoked immediately, ensuring the protection of the public,” Silver told reporters Tuesday.