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Woman in vegetative state after surgery: High Court clears NUH and surgeon of negligence

SINGAPORE — Madam Goh Guan Sin has been in a permanent vegetative state since 2014 after undergoing brain surgery at the National University Hospital (NUH). Now, her family has lost a civil suit against the hospital and the lead surgeon who worked on her case at the time.

Madam Goh Guan Sin pictured a few days before she underwent brain surgery in 2014.

Madam Goh Guan Sin pictured a few days before she underwent brain surgery in 2014.

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SINGAPORE — Madam Goh Guan Sin has been in a permanent vegetative state since 2014 after undergoing brain surgery at the National University Hospital (NUH). Now, her family has lost a civil suit against the hospital and the lead surgeon who worked on her case at the time.

They also have to pay the hospital and the doctor the costs of the legal proceedings and their mother’s hospital bill that is still running at NUH to this day.

On Wednesday (Nov 27), the High Court ruled that there was no negligence on the part of NUH and Associate Professor Yeo Tseng Tsai, as alleged by the family of Mdm Goh — who is now 70 years old and a mother of six.

The civil suit was filed through one of her daughters, Ms Chiam Yu Zhu, who is represented by lawyers from Providence Law Asia and Virginia Quek Lalita & Partners, led by Mr Abraham Vergis.

The lawyers said that NUH and Dr Yeo jointly committed a “critical failure” in wrongly interpreting a CT scan. The medical team had assessed that the patient’s brainstem was bleeding substantially hours after a successful surgery and a second major surgery would be futile. They opted instead for a procedure to drain the brain fluids to deal with the complication, instead of stemming the bleeding. 

The family alleged that the doctors at NUH had prematurely written off the patient and given up trying to save her.

Giving his reasons for his ruling on Wednesday, Justice Tan Siong Thye said that the plaintiff had failed to show that the hospital and surgeon materially contributed to Mdm Goh’s deterioration, even if NUH and Dr Yeo had failed to do a follow-up CT scan or advise the family on the choices that they could take to stem Mdm Goh’s bleeding. 

A plaintiff must show that the loss of chance is above 50 per cent, he said, referring to the law of torts.

One of the plaintiff’s arguments was that the hospital had failed to conduct hourly monitoring, and one of the things that they might have missed were signs of deterioration, such as limb weakness or change in pupil size, that could lead to internal bleeding being discovered when the haemorrhage was still at a more manageable stage. 

This line of reasoning was speculative, the judge said.

On another allegation that a CT scan was not ordered the moment a nurse recorded a complete lack of motor power over Mdm Goh’s right limbs, the judge also said that it was speculative what the scan would have shown, even though the plaintiff’s lawyers claim that an actively growing haematoma (swelling of clotted blood) would have been discovered. 

While Justice Tan said that he deeply empathises with the family’s frustration and disappointment with the surgical team led by Dr Yeo, he added: “Justice must be meted out according to the rule of law and not the feelings of the heart in order to reach a fair outcome based on the merits and facts of the case.”

FAMILY ORDERED TO SETTLE UNPAID HOSPITAL FEES

With the ruling, Mdm Goh’s family will not be getting the estimated S$2.5 million in compensation that they had sought when they launched the suit.

They were also ordered to pay NUH and Dr Yeo the costs of the trial proceedings, which were heard in court from April this year.

Related to this, NUH won a counterclaim to recover Mdm Goh’s unpaid hospital fees.

The court thus ordered the family to pay the medical bill of S$397,478.78 incurred before July 26 this year. They owe an unstated sum that was incurred from July 27 until Wednesday as well.

Mdm Goh remains in a vegetative state to this day at NUH.

While these are hard-hitting realities, Justice Tan said: “I hope, one day, a miracle will wake up the plaintiff from her deep slumber like the case of the mother in the (United Arab Emirates who woke up from a coma 27 years later).”

He also conveyed his “heartfelt sympathy” to Mdm Goh and her family.

NO REGRETS OVER DECISION TO SUE

Following the judgement, the family issued a statement through their lawyers, stating that they might appeal the outcome, which they felt was disappointing.

They are waiting to get a copy of the written judgement so that they can discuss the prospects of an appeal with their lawyers.

Mdm Goh’s children said: “Our mother was the pillar of our family. She went to NUH in 2014 for an elective surgery to remove a brain tumour.

“It pains us that till today, she is in a persistent vegetative state and dependent on life support.”

They stand by their decision to seek action against the hospital and Dr Yeo.

“We did this to create awareness because we do not want any other family to go through what we have gone through the past five years,” they said.

They added that their family is grateful for the support and concern that they have received from people who had wished them well, and a team of doctors and lawyers who had stepped forward to help them “unconditionally” during this period. 

Related topics

court sue negligence NUH Surgery brain patient

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