Paediatrician suspended 3 months for failing to diagnose child with Kawasaki Disease

SINGAPORE — A paediatrician has been suspended for three months for failing to diagnose and treat a one-year-old boy for a potentially life-threatening childhood disease.

Dr Chia Foong Lin, 56, had allowed the child to have prolonged fever without ordering further tests to see if he had Kawasaki Disease, in which the blood vessels become inflamed, a disciplinary tribunal found. The late diagnosis put the boy at risk of severe cardiac complications, said the Singapore Medical Council (SMC) in a press release.

The tribunal’s decision was upheld by the Court of Three Judges, which dismissed Dr Chia’s appeal against her conviction and sentence on Tuesday (June 27).

The doctor — who practised at Chia Baby and Child Clinic in Clementi — was on paediatric call at Gleneagles Hospital on Feb 25, 2013, when the boy was admitted with high fever for three days. He also had conjunctivitis, a mild cough, poor appetite and vomitting as well as a single episode of diarrhoea.

Dr Chia diagnosed him with a viral infection. Three days later on Feb 28, she considered he might have Kawasaki Disease but did not change her diagnosis, as he did not have the full features of the disease.

The boy was discharged and his parents told her during a March 3 appointment that he continued to have fever. Her diagnosis did not change.

The next day, the boy’s parents sent him to another hospital for a second opinion. He was admitted and treated for five days with high-dose aspirin as well as a mixture of antibodies given through the vein.

The boy’s mother lodged a complaint against Dr Chia.

Kawasaki Disease is the most commonly acquired cardiac condition in children under the age of five. The disciplinary tribunal felt that a paediatrician should be able to diagnose it and provide effective treatment, said the SMC. Dr Chia’s failure to order tests amounted to “serious negligence”, ruled the tribunal.

Viral fever and Kawasaki Disease are two “very different diagnoses”, noted the SMC. “Given the very significant coronary artery complications associated with Kawasaki disease as opposed to a self-limiting viral fever, the disciplinary tribunal was of the view that it would be reasonable to expect a competent physician to either exclude the differential diagnosis or to confirm it.”