Singh, Padamjit Mohan (CPSO#: 67232)

Current Status: Active Member as of 15 Jul 1993

CPSO Registration Class: Restricted as of 03 Jun 2013

Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Female

Languages Spoken: English, Hindi, Panjabi/Punjabi

Education:University of Pune, 1970

Practice Information

Primary Location of Practice
Suite 205
222 King Street East
Bowmanville ON  L1C 1P6
Phone: (905) 623-2758
Fax: (905) 623-7558
Electoral District: 05

Hospital Privileges

Hospital Location
Lakeridge Health,Oshawa General Site Oshawa

Specialties

Specialty Issued On Type
Obstetrics and Gynecology Effective: 30 Jun 1993 RCPSC Specialist

Registration History

Action Issue Date
First certificate of registration issued: Independent Practice Certificate Effective: 15 Jul 1993
Transfer of class of certificate to: Restricted certificate Effective: 03 Jun 2013
Terms and conditions imposed on certificate by Discipline Committee Effective: 03 Jun 2013

Practice Restrictions

Imposed By Effective Date Expiry Date Status  
Discipline Committee Effective: 03 Jun 2013 Active View Details [+]
            As from 11:59 p.m., June 3, 2013, by order of the Discipline Committee of the
            College of Physicians and Surgeons of Ontario, the following terms, conditions
            and limitations are imposed on the certificate of registration held by Dr.
            Padamjit Mohan Singh:

            a)    Dr. Singh shall not engage in any labour and delivery practice; 

            b)    Except as otherwise specified in this Order, Dr. Singh shall not engage
                  in any hospital-based obstetrical/gynaecological practice;

            c)    Dr. Singh is permitted to perform colposcopy in the Colposcopy clinic two
                  days per month;

            d)    Dr. Singh is permitted to perform the following minor procedures
                  ("Permitted Procedures"), none of which entail intra-abdominal surgery:
                  i)    Insertion of IUDS;
                  ii)   Cone biopsy;
                  iii)  D&C;
                  iv)   Removal of polyps and vaginal cysts;
                  v)    Vulvar, vaginal, cervical and endometrial biopsies;
                  vi)   Incision drainage (vulvar, vaginal lesions);
                  vii)  Hysteroscopy;
                  viii) Hysterosalpingogram;
                  ix)   Examination under anesthesia;
                  x)    Endometrial ablation;
                  xi)   Cauterization; and
                  xii)  Vulvar/vaginal suture and repair (this does not include vaginal
                        hysterectomy, cystocele or rectocele repairs).
                  
            e)    Dr. Singh shall provide the College with 14 days' notice if she intends
                  to commence performing of any one of the Permitted Procedures itemized in
                  paragraph 3(d) above, under general anaesthesia. Dr. Singh shall agree to
                  undergo an assessment(s) of such practice(s) by an assessor appointed by
                  the College of Physicians and Surgeons of Ontario within one year of
                  commencing any Permitted Procedure under general anaesthesia, at the
                  College's expense; and

            f)    In the event that an urgent or emergency situation arises while Dr. Singh
                  is performing any of the Permitted Procedures, Dr. Singh shall
                  immediately refer and transfer the care of the patient to the
                  obstetrician/gynaecologist on call. 

Previous Discipline Hearings

Committee: Discipline
Decision Date: 03 Jun 2013
Summary:

On June 3, 2013, Dr. Padamjit Mohan Singh admitted before the Discipline Committee that she 
is incompetent and that she failed to maintain the standard of practice of the profession in respect 
of three patients. On the basis of an Agreed Statement of Facts, the Discipline Committee found 
that Dr. Singh is incompetent and engaged in professional misconduct, in that she failed to 
maintain the standard of practice of the profession.  
 
Dr. Singh is an Obstetrician and Gynaecologist. After concerns were raised regarding Dr. Singh's 
ability to cope in emergency situations while on call at the hospital where she worked, Dr. Singh 
entered into an agreement with the hospital, the terms of which included the following: 
a)    Dr. Singh withdraws her reapplication for Active Staff privileges and applies for Courtesy 
      Staff privileges only; 
b)    Dr. Singh will be granted privileges to work as a surgical assistant at the hospital; 
c)    Dr. Singh will be granted privileges to work in the Colposcopy Clinic two days  per 
      month; 
d)    Dr. Singh will be granted privileges to perform specified minor procedures under general 
      anaesthesia where appropriate. The minor procedures include: inserting IUDS; cone 
      biopsy; D&C; removal of polyps and vaginal cysts; biopsies; incision drainage; 
      hysteroscopy; hysterosalpingogram; examination under anaesthesia; balloon ablation; 
      cauterization; and suture and repair 
e)    In the event an urgent or emergency situation should arise while performing any of the 
      specified procedures, Dr. Singh agrees to immediately refer and transfer care of the 
      patient to the obstetrician on call.  
 
On the basis of this information, the College commenced an investigation under s.75(1)(a).  
 
On November 19, 2009, the Department of Anaesthesiology determined that no current member 
of the department will be made available to provide anaesthesiology coverage to Dr. Singh. As a 
result, since at least November 2009, Dr. Singh has not been performing: D & C; hysteroscopy; 
examination under anaesthesia; and balloon ablation.  
 
The College retained an expert, Dr. X, to provide an opinion on the care provided by Dr. Singh. 
With regard to Patient 1, Dr. X opined that Dr. Singh failed to demonstrate the appropriate 
knowledge, skill and judgment expected of a specialist, in that: 
a)    Dr. Singh failed to appreciate the significance of the fetal heart rate tracing and allowed 
      the anaesthetist to perform an elective epidural elsewhere instead of dealing with the 
      patient's need for an urgent C-section; 
b)    Once in the operating room, Dr. Singh's difficulty in extracting the baby resulted in 
      further delay of newborn resuscitation.   Dr. Singh was unable to perform in an 
      emergency situation; 
c)    The theme of panic and poor communication with colleague/team members was evident 
      from the interview of those present; 
d)    The nurses felt that they had to push Dr. Singh to perform the C-section on a stat basis. 
 
 
 
With regard to Patient 2, Dr. X opined that Dr. Singh failed to meet the expected standard with 
respect to obstetrical care, in that: 
a)    Dr. Singh failed to communicate the urgency to her colleagues and permitted the 
      anaesthesiologist to provide an elective epidural instead of focusing his attention on the 
      high risk mother; 
b)    Dr. Singh had recognized the gravity of the situation by calling for the Sick Kids 
      Transport Team instead of transferring the mother to a tertiary centre.  However, Dr. 
      Singh failed to act in a timely fashion to "deliver" the infant when there was a loss of fetal 
      heart rate, as an emergency section would have been taken by a reasonable physician at 
      that point in time under epidural or general anaesthetic.  
 
In respect of Patient 3 case, Dr. X opined that: Again, another surgical complication arose for a 
thin patient as Dr. Singh had difficulty with insertion of the Veress needle or Hasson trocar for 
laparoscopy. Major blood loss for a minor procedure and benign state begs the question as to Dr. 
Singh's judgment as well as her surgical skills once more. 
 
In response, Dr. Singh provided the report of Dr. Y, who was asked to provide an opinion in 15 
cases in which the College experts were critical of Dr. Singh.  He was prepared to provide a 
supportive opinion of only 11 of those cases and did not provide a supportive opinion in respect 
of Patient 1, Patient 2 or Patient 3.    
 
With respect to Dr. Singh's colposcopy practice, Dr. Singh provided a report from Dr. Z. At the 
request of the hospital, Dr. Z reviewed Dr. Singh's colposcopy practice and concluded that she 
appears to practice within the standard of the profession and did not demonstrate any lack of 
knowledge, skill or judgment or disregard for the safety of her patients.    
 
The Committee ordered and directed that: 
 
      Dr. Singh attend before the Panel to be reprimanded. 
      the Registrar impose the following terms, conditions and limitations on Dr. Singh's 
      certificate of registration: 
a)    Dr. Singh shall not engage in any labour and delivery practice;  
b)    Except as otherwise specified in this Order, Dr. Singh shall not engage in any 
      hospital-based obstetrical/gynaecological practice; 
c)    Dr. Singh is permitted to perform colposcopy in the Colposcopy clinic two days per 
      month; 
d)    Dr. Singh is permitted to perform the following minor procedures ("Permitted 
      Procedures"), none of which entail intra-abdominal surgery: 
      i)    Insertion of IUDS; 
      ii)   Cone biopsy; 
      iii)  D&C; 
      iv)   Removal of polyps and vaginal cysts; 
      v)    Vulvar, vaginal, cervical and endometrial biopsies; 
      vi)   Incision drainage (vulvar, vaginal lesions); 
      vii)  Hysteroscopy; 
      viii) Hysterosalpingogram; 
      ix)   Examination under anesthesia; 
      x)    Endometrial ablation; 
      xi)   Cauterization; and 
      xii)  Vulvar/vaginal suture and repair (this does not include vaginal hysterectomy, 
            cystocele or rectocele repairs). 
e)    Dr. Singh shall provide the College with 14 days' notice if she intends to commence 
      performing of any one of the Permitted Procedures itemized in paragraph 3(d) above, 
      under general anaesthesia. Dr. Singh shall agree to undergo an assessment(s) of such 
      practice(s) by an assessor appointed by the College of Physicians and Surgeons of Ontario 
      within one year of commencing any Permitted Procedure under general anaesthesia, at the 
      College's expense; and 
f)    In the event that an urgent or emergency situation arises while Dr. Singh is performing 
      any of the Permitted Procedures, Dr. Singh shall immediately refer and transfer the care 
      of the patient to the obstetrician/gynaecologist on call.  
      Dr. Singh pay costs to the College in the amount of $3,650.00 within (60) days from the 
      date of this Order. 
 
 

Decision: Download Full Decision (PDF)
Appeal: No Appeal
Hearing Date(s): June 3, 2013