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Liposuction death: Doctor barred from practising medicine, another suspended for 18 months

SINGAPORE — Nearly nine years after he caused the death of a property management firm boss by incompetently using a potent sedative during a liposuction procedure, an aesthetic doctor will be struck off the register of approved medical practitioners.

SINGAPORE — Nearly nine years after he caused the death of a property management firm boss, by incompetently using a potent sedative during a liposuction procedure, an aesthetic doctor will be struck off the register of approved medical practitioners. 

Making the order on Friday (Nov 23), Chief Justice Sundaresh Menon, who delivered the judgment of the Court of Three Judges, said that it was difficult to conceive of a worse case of medical misconduct than how Dr Wong Meng Hang had treated his patient, the late Franklin Heng Ang Tee.

Heng’s death was the first fatality here arising from aesthetic treatment.

The doctor who assisted Dr Wong in the procedure, Dr Zhu Xiu Chun, also known as Myint Myint Kyi, had her suspension from practice increased from six to 18 months.

But this may not be the end of the matter.

The Court of Three Judges has directed that the case be reported to the Public Prosecutor, so that the doctors may be investigated for any relevant criminal offences that may have been committed — including that of causing death by a rash or negligent act.

“While we express no views at all on whether any criminal offence is disclosed on the facts before us, we consider it to be in the public interest that the matter be investigated,” Chief Justice Menon said.

Dr Wong had been suspended from practice for 18 months by a Disciplinary Tribunal last year. But the Singapore Medical Council sought a stiffer sentence of the maximum suspension of three years, and said it would not object if the court decided to strike him off the register.

The judges had harsh words for Dr Wong, saying his treatment of the patient was “grossly unsatisfactory and strikingly deficient in every respect”.

Dr Wong recklessly decided to embark on a risky sedation procedure that he was untrained for, administered the sedative improperly by giving an excessive dosage, and wounded the patient by performing the liposuction improperly, Chief Justice Menon said. He left the patient unattended after the procedure and as a result, the patient became unable to breathe and died.

When Heng was rushed to the hospital, Dr Wong lied that he had been given a pain medication and local anaesthesia, but no sedation.

Chief Justice Menon, who heard the case with Judges of Appeal Andrew Phang and Judith Prakash, said: “In truth, it simply would not even have been contemplated by the patient, who had consulted Dr Wong for an elective aesthetic procedure, that he would not survive the operation.

“It was the doctors’ actions here which were the sole and direct cause of the patient’s death, and we regard this as an extremely serious aggravating factor to be taken into account in sentencing."

Although there had been considerable delay in disciplinary proceedings, Mr Menon said that this factor had no weight in the case. “Where important public interest considerations demand the imposition of a heavier penalty, the existence of prejudicial delay in the proceedings may have no mitigating effect at all in the sentencing of the offender."

Doctors have rarely been struck off here, and Mr Menon said that the court was aware of four cases in the last decade where doctors were struck off for misconduct.

Before Friday, the most recent case was of Dr Winston Lee Siew Boon in June. He was struck off the register by a disciplinary tribunal after being convicted in 2014 of molesting a patient on two occasions.

Factors the judges said may be relevant in deciding whether to strike off a doctor include: Whether there was flagrant abuse of privilege as a doctor, whether grave harm was caused, culpability, whether the misconduct shows a serious defect of character, and whether there was an element of dishonesty.

BACKGROUND TO THE CASE

On Dec 30, 2009, Dr Wong and Dr Zhu performed a liposuction procedure on Heng — then the 44-year-old chief executive of YTL Starhill Global Reit Management — at Reves Clinic on Orchard Road.

Reves Clinic has since been renamed Yume Aesthetic & Medical Clinic.

Dr Wong chose to use Propofol to sedate the patient, with Dr Zhu assisting in the procedure. They later admitted that they were neither anaesthetists nor intensivists, and also administered the sedative using a complex technique.

Heng entered a state of deep sedation to the point of general anaesthesia, after Dr Wong instructed Dr Zhu to increase the dosage of Propofol when Heng showed any signs of movement, discomfort, or responding to pain stimulation.

During the three-hour procedure, Dr Wong inadvertently punctured Heng’s intestines multiple times, but this went unnoticed as Heng was unable to show any signs of pain.

After the procedure, the doctors left him unattended for at least five minutes. His airway collapsed and he was taken to the hospital.

Dr Wong, who accompanied Heng to the hospital, lied to the accident and emergency doctors that he had been given pain medication and local anaesthesia without sedation.

Despite resuscitation attempts, Heng died later that day. The coroner recorded his death as a medical misadventure and that he had “died of the effects of asphyxia due to airway obstruction, secondary to intravenous Propofol administered”.

In 2015, the High Court ordered the two doctors to pay more than S$5 million in damages to Heng’s family. The sum was reduced to S$3.26 million by the apex court in 2016.

Dr Wong was fined S$26,000 and Dr Zhu was fined S$8,000 by the State Courts in 2014, after it emerged that they had failed to follow proper procedures for several other patients.

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