SINGAPORE — A doctor has been fined S$10,000, suspended and censured by the Singapore Medical Council (SMC) for administering treatment that has not been generally accepted by the medical profession except when conducted in approved clinical trials.

Dr Pang Ah San, a 57-year-old general surgeon who practises at Mount Alvernia Hospital, had allegedly inserted a loop percutaneous endoscopic gastrostomy (PEG) tube — an external feeding device that is inserted into the stomach and used by patients who are unable to swallow — into three patients outside the context of approved clinical trials, said the SMC.

An SMC disciplinary committee inquiry was launched after a complaint was lodged with the council in September 2010.

The committee found Dr Pang guilty of three charges of professional misconduct. It said the surgeon was guilty of recommending and carrying out the loop PEG tube insertion on the three patients outside an approved clinical trial. It also found that the loop PEG tube differed in terms of design and inserted position from a standard PEG tube, and therefore, was not generally accepted by the profession.

Dr Pang had, therefore, breached Clause 4.1.4 of the Ethical Code and Ethical Guidelines, which stipulates, among other guidelines, that a doctor should not administer to patients treatments that are not generally accepted by the profession, except when carried out in an approved clinical trial, said the SMC.

The disciplinary committee found that the loop PEG tube “added new and unknown risks into the equation” because of its potential for rotation and the need for a double stoma.

It said the treatments administered had “no positive act of acceptance from the medical profession”, noting that Dr Pang had himself admitted that the loop PEG tube had, to his knowledge, never been used by another doctor before.

The treatments were also performed by Dr Pang with a motive to gather data to validate the tube as a form of treatment, the committee found.

In light of these findings, the committee ordered that Dr Pang be suspended for six months, fined S$10,000 and censured. In addition, he is to give written undertakings to the SMC to comply with the Ethical Code and Ethical Guidelines and abstain from providing such treatments outside approved clinical trials unless given an exemption by the authorities from the need to seek approval.

The committee also ordered Dr Pang to pay the full legal costs of the case on an indemnity basis.