diff --git a/extensions/cornerstone/src/index.tsx b/extensions/cornerstone/src/index.tsx
index bcc6f785a..1db533696 100644
--- a/extensions/cornerstone/src/index.tsx
+++ b/extensions/cornerstone/src/index.tsx
@@ -132,6 +132,10 @@ const cornerstoneExtension: Types.Extensions.Extension = {
   },
   getPanelModule,
   onModeExit: ({ servicesManager }: withAppTypes): void => {
+    unsubscriptions.forEach(unsubscribe => unsubscribe());
+    // Clear the unsubscriptions
+    unsubscriptions.length = 0;
+
     const { cineService, segmentationService } = servicesManager.services;
     // Empty out the image load and retrieval pools to prevent memory leaks
     // on the mode exits
@@ -150,10 +154,6 @@ const cornerstoneExtension: Types.Extensions.Extension = {
     useToggleOneUpViewportGridStore.getState().clearToggleOneUpViewportGridStore();
     useSegmentationPresentationStore.getState().clearSegmentationPresentationStore();
     segmentationService.removeAllSegmentations();
-
-    unsubscriptions.forEach(unsubscribe => unsubscribe());
-    // Clear the unsubscriptions
-    unsubscriptions.length = 0;
   },
 
   /**
diff --git a/extensions/cornerstone/src/services/SegmentationService/SegmentationService.ts b/extensions/cornerstone/src/services/SegmentationService/SegmentationService.ts
index 3430c15ca..b9e805663 100644
--- a/extensions/cornerstone/src/services/SegmentationService/SegmentationService.ts
+++ b/extensions/cornerstone/src/services/SegmentationService/SegmentationService.ts
@@ -255,7 +255,7 @@ class SegmentationService extends PubSubService {
       this._onSegmentationAddedFromSource
     );
 
-    this.listeners = {};
+    this.reset();
   };
 
   public async addSegmentationRepresentation(
diff --git a/extensions/cornerstone/src/utils/segmentationHandlers.ts b/extensions/cornerstone/src/utils/segmentationHandlers.ts
index 8e233e9cc..b79f30e7c 100644
--- a/extensions/cornerstone/src/utils/segmentationHandlers.ts
+++ b/extensions/cornerstone/src/utils/segmentationHandlers.ts
@@ -9,7 +9,11 @@ export function setupSegmentationDataModifiedHandler({
   customizationService,
   commandsManager,
 }) {
-  const { unsubscribe } = segmentationService.subscribeDebounced(
+  // A flag to indicate if the event is unsubscribed to. This is important because
+  // the debounced callback does an await and in that period of time the event may have
+  // been unsubscribed.
+  let isUnsubscribed = false;
+  const { unsubscribe: debouncedUnsubscribe } = segmentationService.subscribeDebounced(
     segmentationService.EVENTS.SEGMENTATION_DATA_MODIFIED,
     async ({ segmentationId }) => {
       const segmentation = segmentationService.getSegmentation(segmentationId);
@@ -42,7 +46,7 @@ export function setupSegmentationDataModifiedHandler({
         readableText,
       });
 
-      if (updatedSegmentation) {
+      if (!isUnsubscribed && updatedSegmentation) {
         segmentationService.addOrUpdateSegmentation({
           segmentationId,
           segments: updatedSegmentation.segments,
@@ -52,6 +56,10 @@ export function setupSegmentationDataModifiedHandler({
     1000
   );
 
+  const unsubscribe = () => {
+    isUnsubscribed = true;
+    debouncedUnsubscribe();
+  };
   return { unsubscribe };
 }
 
diff --git a/platform/core/src/services/_shared/pubSubServiceInterface.ts b/platform/core/src/services/_shared/pubSubServiceInterface.ts
index 59c41e74f..307d7e049 100644
--- a/platform/core/src/services/_shared/pubSubServiceInterface.ts
+++ b/platform/core/src/services/_shared/pubSubServiceInterface.ts
@@ -54,7 +54,10 @@ function _unsubscribe(eventName, listenerId) {
 
   const listeners = this.listeners[eventName];
   if (Array.isArray(listeners)) {
-    this.listeners[eventName] = listeners.filter(({ id }) => id !== listenerId);
+    this.listeners[eventName] = listeners.filter(({ id, callback }) => {
+      callback?.clearDebounceTimeout?.();
+      return id !== listenerId;
+    });
   } else {
     this.listeners[eventName] = undefined;
   }
@@ -134,6 +137,13 @@ export class PubSubService {
   reset() {
     this.unsubscriptions.forEach(unsub => unsub());
     this.unsubscriptions = [];
+
+    Object.keys(this.listeners).forEach(eventName =>
+      this.listeners[eventName].forEach(({ callback }) => {
+        callback?.clearDebounceTimeout?.();
+      })
+    );
+    this.listeners = {};
   }
 
   /**
diff --git a/platform/core/src/utils/debounce.js b/platform/core/src/utils/debounce.js
index 7a5b2bdf3..5e6d97774 100644
--- a/platform/core/src/utils/debounce.js
+++ b/platform/core/src/utils/debounce.js
@@ -2,9 +2,11 @@
 // be triggered. The function will be called after it stops being called for
 // N milliseconds. If `immediate` is passed, trigger the function on the
 // leading edge, instead of the trailing.
+// The callback function returned is assigned a clearDebounceTimeout function
+// that provides for clearing the timeout/debounced function so that it is not called.
 function debounce(func, wait, immediate) {
   var timeout;
-  return function () {
+  const callback = function () {
     var context = this,
       args = arguments;
     var later = function () {
@@ -20,6 +22,13 @@ function debounce(func, wait, immediate) {
       func.apply(context, args);
     }
   };
+
+  callback.clearDebounceTimeout = () => {
+    clearTimeout(timeout);
+    timeout = null;
+  };
+
+  return callback;
 }
 
 export default debounce;