Doctor’s suspension for professional misconduct reduced

SINGAPORE — A doctor who was convicted of professional misconduct for performing a Caesarean section (C-section) on a patient without ensuring that she was fully anaesthetised, has managed to get the length of his suspension reduced.

He was, however, ordered, to pay 80 per cent of the Singapore Medical Council’s (SMC) costs, after the council argued that his appeal was “hopelessly devoid of merits”.

The Court of Three Judges yesterday upheld Dr Lee Kim Kwong’s conviction, but reduced his nine months’ suspension to five months, bringing it in line with precedent cases. His fine of S$10,000 also stays.

In August 2010, Dr Lee, an obstetrician and gynaecologist practising at Lee Women’s Clinic and Surgery, was scheduled to perform a C-section at Mount Alvernia Hospital.

Prior to the procedure, the anaesthetist in charge had administered epidural anaesthesia to the patient. After Dr Lee entered the operating theatre, the patient told him that she still had some feeling in her leg, which he acknowledged.

Shortly after, he made a cut on the patient’s abdomen without testing as to whether she was fully anaesthetised. The patient screamed in pain, but Dr Lee continued, delivering the baby three minutes later.

The anaesthetist had, however, sedated her using a face mask, upon hearing her scream.

An SMC Disciplinary Committee in October last year found the gynaecologist guilty of one charge of professional misconduct in relation to the procedure.

It held that while the anaesthetist has to check if the anaesthesia had taken effect, it was the surgeon’s ultimate responsibility and primary obligation to ensure that it was effective before commencing the procedure.

It also found it “completely unacceptable” for Dr Lee to have continued after the patient screamed, given there was no risk to the life of the patient or her baby.

Dr Lee had appealed against his conviction and sentence. His lawyer Lek Siang Pheng argued that the committee failed to give weight to the fact that the patient and her baby were not harmed.

He also pointed to more grevious cases to show that Dr Lee’s “shortcomings do not merit a suspension from practice”.

He cited sentencing in two cases of professional misconduct, such as the three-month suspension of a doctor who referred an infant to a specialist too late, when the infant had already lost vision in one eye.

The SMC argued that a nine-month suspension was fair due to aggravating factors in the case, such as how Dr Lee allegedly asked a nurse to fabricate an endorsement on a Mount Alvernia Hospital operating theatre record when she was not present on the day of the operation — which Mr Lek disputed.

The SMC’s lawyer, Senior Counsel Tan Chee Meng, said Dr Lee’s misconduct was serious and the pain inflicted on the patient was “significant and unjustifiable”.

There is a need for the penalty to send a signal to the public that the medical profession will not allow such serious misconduct to go unpunished, he added.

The Court — comprising Chief Justice Sundaresh Menon, Judge of Appeal Andrew Phang and Justice Quentin Loh — will issue its grounds of decision at a later date.

TODAY understands that, apart from her complaint to the SMC, the patient — whose first child was delivered in the same procedure by Dr Lee — has not commenced a civil suit against him.