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Allan Gordon, formerly a pain specialist at Mount Sinai Hospital, leaves the College of Physicians and Surgeons of Ontario in Toronto in October, 2018.Michelle Siu/The Globe and Mail

A renowned Toronto pain specialist allegedly sexually abused three patients despite restrictions on his medical practice at Mount Sinai Hospital barring him from performing intimate examinations without a staff member present.

The hospital imposed the restrictions on Allan Gordon’s practice in the spring of 2016 after receiving a complaint from a patient, Mount Sinai spokeswoman Barbara McCully said in an e-mail response to The Globe and Mail. Dr. Gordon, a neurologist, was director of the hospital’s Wasser Pain Management Centre at the time.

The hospital retained an external investigator to probe the complaint, Ms. McCully said, and required Dr. Gordon to have a female nurse or clinician present for any exam or discussion of an intimate nature with patients. In February, 2017, Dr. Gordon agreed to stop performing intimate exams altogether, she said.

While he was bound by the restrictions, he allegedly sexually abused three patients between October, 2016, and January, 2017, a Globe investigation has found, raising questions about how the hospital monitored and enforced the measures.

The Globe findings are based on civil lawsuits filed by two of the patients against Dr. Gordon and Mount Sinai, and a confidential report written by the College of Physicians and Surgeons of Ontario summarizing a third patient’s complaint.

Ms. McCully declined to comment on any “violation” of the restrictions by Dr. Gordon due to ongoing legal proceedings. Officials at Sinai Health System, the corporate entity that operates the hospital, declined requests for an interview.

In a statement to The Globe, Maureen Shandling, Sinai Health’s executive vice-president of academic and medical affairs, said the hospital takes every patient concern seriously.

“It is Mount Sinai Hospital’s priority that patients be treated with the highest standard of respect and dignity during every interaction,” Dr. Shandling said. “The women who have come forward with courage to report concerns about Dr. Gordon’s treatment entrusted their care to him, and the hospital is profoundly sorry that this trust was violated.”

The Globe has reported that at least 10 former patients of Dr. Gordon’s complained to the College of Physicians and Surgeons, accusing him of sexually abusing them at the Wasser pain clinic. Three of the patients have also filed civil lawsuits.

‘The College does not care’: How the medical watchdog closed the door on sex-abuse complainants

‘He was the “Pain Guy” ’: A Toronto physician’s ex-patients share their allegations of sexual abuse

As it turns out, the hospital and the college were conducting parallel investigations into Dr. Gordon.

Hospitals in Canada are responsible for overseeing the quality of patient care provided by staff, including doctors, who cannot practise without privileges.

Mount Sinai notified the college on Aug. 2, 2017, that it had suspended Dr. Gordon’s privileges. He has not practised at the hospital since then.

For its part, the college initially accused Dr. Gordon in March, 2017, of sexually abusing one patient, but subsequently dropped the allegation.

At a disciplinary hearing last October, Dr. Gordon pleaded “no contest” to the less serious offence of professional misconduct for failing to obtain a patient’s “informed consent” for a pelvic exam. He agreed to resign and never reapply to practise medicine in Ontario or any other jurisdiction. At the time, he was 73.

The college’s complaints committee investigating multiple allegations of sexual abuse subsequently closed their files, saying the public was safe because Dr. Gordon had resigned.

Dr. Gordon has denied that he abused any of his patients. In college reports sent to his accusers, he asserted through his lawyer that the care he provided was “appropriate and medically necessary.” He also denied doing any medically inappropriate “touching.” His lawyer, Jaan Lilles, told The Globe he “has never been found to have committed an act of sexual impropriety.”

The three patients who have accused Dr. Gordon of sexually abusing them after Mount Sinai restricted his practice highlight the challenges associated with removing a doctor’s hospital privileges, critics say.

Hospitals have few mechanisms for changing a doctor’s practice or behaviour. As a result, disputes between hospitals and doctors over privileges often lead to years of time-consuming and costly proceedings.

Lorian Hardcastle, an assistant professor of law at the University of Calgary and an expert in health-care regulation, says a majority of doctors in Canada do not have employment contracts and instead are granted privileges to admit and treat patients. In a 2017 article published in the Alberta Law Review on the quality of care in Canadian hospitals, she says several factors serve to discourage hospitals from suspending or revoking a doctor’s privileges.

The entity that recommends revoking privileges, a hospital’s medical advisory committee, is comprised of doctors, so they are in essence “booting” one of their colleagues, Prof. Hardcastle said in an interview. Legal costs are also high for a hospital because, under provincial legislation, a doctor is entitled to a hearing before its board of directors and can appeal a decision to an administrative tribunal and the courts.

“I think it’s time to crack open that legislation and reconsider the privileges debate,” Prof. Hardcastle said.

Ontario Auditor-General Bonnie Lysyk has also called for a review of the province’s Public Hospitals Act, the legislation governing removing privileges, in her 2016 annual report. “This legal process is lengthy, cumbersome and costly, and does not put the patients’ interests first,” the report says.

Mount Sinai is a case in point. The hospital suspended Dr. Gordon’s privileges on July 31, 2017, more than a year after a patient complained. On Jan. 16, 2018, it revoked his privileges. Ms. McCully said this was the only time a doctor’s privileges had been revoked at Mount Sinai during the 12 years Dr. Shandling has overseen the medical advisory committee.

A lawsuit filed on behalf of “Jane Doe” in Ontario Superior Court of Justice in February accuses Mount Sinai of “failing to enforce, adequately or at all, any conditions that the Hospital may have imposed on Dr. Gordon.”

The lawsuit alleges that Dr. Gordon sexually abused the patient on Jan. 17, 2017, when she sought treatment for pain in her left hip. While she was lying down on the exam table, Dr. Gordon “repeatedly thrust his crotch against [her] vagina, and repeatedly touched [her] vagina with his hand,” the lawsuit alleges. Neither a nurse nor any other person was present.

Another former patient, a 32-year-old lawyer who has suffered from chronic pain ever since she was a child, alleged that Dr. Gordon abused her during a medical appointment on Oct. 13, 2016, by putting his finger in her anus without her consent, according to her lawsuit filed in September, 2018. She accuses the hospital of failing to have “adequate policies, procedures and guidelines in place to properly monitor” Dr. Gordon.

The complainants were granted anonymity in order to share intimate details of the allegations. The college’s policies also impose a publication ban on naming patients in the course of proceedings.

The allegations have not been tested in court. Dr. Gordon and Mount Sinai have not yet filed statements of defence to those two lawsuits.

In a statement of defence to a third lawsuit against Dr. Gordon and the hospital, Mount Sinai said it is not “in law” responsible for Dr. Gordon’s conduct because he was an independent physician with privileges at the hospital.

The third woman alleges in her complaint to the college that Dr. Gordon sexually stimulated her clitoris while asking questions of a sexual nature at an appointment on Nov. 2, 2016.

David Jensen, a spokesman for the Ontario Ministry of Health, did not comment on the Gordon case but said the ministry is working to address the Auditor-General’s call for a review of the Public Hospitals Act. “The government recognizes the need to ensure that hospitals remain a safe space for all Ontarians.”