A Westport plastic surgeon, who has faced several sanctions from the state Department of Public Health and related agencies in the last 14 years, says he has resolved the most recent issues and received clearance to re-open his Center for Ambulatory Surgery on Imperial Avenue.

The license for Dr. Joel Singer's center, where he performs out-patient surgical procedures, was suspended from June 20 through the end of July this year after state inspectors found additional violations, including rusty equipment and instruments and a fire alarm system that had not worked for five months.

According to a DPH Facility Licensing and Investigations Section Interim Consent Order, signed by Singer on June 19, the DPH "received information regarding CAS' operation which may pose a health risk to the public."

Inspectors had made several surprise visits in March to the center where, according to published reports, they found a rusty autoclave used to sterilize instruments, rusty instruments, an unlocked refrigerator containing medications and worn-out brushes being used to clean instruments.

Singer, a 1966 graduate of Yale University's medical school and former Chief of Plastic Surgery at Norwalk Hospital, denied there was rusty equipment or instruments, but has made changes in "policies, procedures and training." He will re-open CAS later this month.

"As far as rusty instruments, that is really nonsense. We have not had rusty instruments in my operating room ever, ever, ever. I would never tolerate a rusty instrument. It never happened," Singer told the Westport News this week. He admitted there were problems with an autoclave that left some water marks on instrument packs. "We worked very diligently to correct that. There is no issue at all with rust or dirt or non-sterile conditions," he contended.

"My concern is always patient safety and so is the Department of Public Health. Sometimes philosophies clash. Probably, that was an issue here more than anything else. But I have learned that, if I'm going to continue staying in business, I'm going to have to bend my philosophy to meet theirs, and I have," Singer said.

Singer claims the state did not close the surgical arm of his practice. He said the center was closed voluntarily in April as the landlord of the building at 32 Imperial Ave., which houses Singer's Imperial Plastic Surgery and Center for Ambulatory Surgery, made repairs related to damage caused by Superstorm Sandy in October 2012. He continued to see patients in his Westport office, but moved surgical procedures to his practice in Great Neck, N.Y.

"We had damage from Hurricane Sandy that was fairly extensive. We were closed anyway and then they announced that we had to be closed," Singer said. "As the result of various inspections that occurred we had to repair and fix certain deficiencies that existed. A lot of this had to do with construction work that had to be completed in a certain way, according to the state Department of (Public) Health, that related to the operating room."

He said the work done to the electrical, alarm and heating systems involved building permits from the town of Westport and had to be certified and overseen by the state DPH because it is a medical facility.

"It's all been done and the state has approved our re-opening," he said.

There are still a few things that need to be straightened out, Singer said. "We want to make sure that when we do open we're not going to have any issues or concerns that the state might be concerned with," he said.

Problems with Singer's practice date back to 1999 and include citations for unqualified nurses, shoddy record keeping, improper sterilization procedures and unsanitary conditions, according to documents from the DPH. A spokesman at that office said no one could comment on specific cases and that they let the documents speak for them.

According to one document, Singer was fined $25,000 in December 2011 by the state Medical Examining Board for operating the center with sloppy record keeping, and rusty and dirty equipment. In a May 2007 consent order, the state fined him $5,000 for a case of "incompetence/negligence."

"Some of the stuff we did in the past wasn't really up to the same standard that the state wanted, so we've changed. We've improved ourselves. We've gotten better. I'm certain that when they come back (for inspection) they're going to be very happily impressed that we've done the job. What we've done is quite a change over previous years and they'll be very satisfied with all of the policies, procedures and training, all the things they had concerns over," Singer said.

In all his years of practice, Singer said he has never had a serious reaction in any patient and has only had to send patients to the hospital three times in the more than 12,000 surgeries he has performed in Connecticut and New York.