A man is suing Tan Tock Seng Hospital (TTSH) and three of its medical personnel over claims that they misdiagnosed and neglected his mother while she was warded there, such as by allowing an untrained intern nurse to shower her against the family’s instructions.

On Monday (Aug 15), the court heard on the first day of the civil trial that Mr Chia Soo Kiang’s mother Tan Yaw Lan, then aged 74, collapsed from a cardiac arrest during the shower, while the nurse left her side in order to get help.

She died about three weeks later on May 13, 2018 after sustaining new injuries from her fall.

Mr Chia, 48, alleged that his mother's death would have been prevented if the doctors were not negligent in caring for her. The damages that he is claiming for include Tan’s pain and suffering, reduction in life expectancy, loss in amenity and her subsequent death.

He is seeking S$800,000 in damages for their alleged medical negligence.

The doctors listed in the case are:

Dr Doraj Raj Appadora, an internal medical specialist who was working as the department of general medicine’s consultant on overnight call when Tan was admitted

Dr Lee Wei Sheng, the house officer on call when Tan was admitted. He was undergoing residency training during which he was rotated to various healthcare institutions

Dr Ranjana Acharya, who was the consultant-in-charge of reviewing new admissions to the general medicine department

They are represented by solicitors from law firm Dentons Rodyk & Davidson.

In their opening statement, Mr Chia’s lawyers from Fervent Chambers, led by Mr Clarence Lun, argued that the defendants’ negligent misdiagnosis and medical treatment caused Tan’s severe cardiac arrest, leading to her “untimely demise” which was “entirely preventable”.

They added that the defendants “acted in a callous manner to a high-risk and vulnerable person”.

Outlining the factual issues to be determined during the trial, his lawyers said they would elaborate on:

Whether the defendants misdiagnosed Tan and prescribed inappropriate treatment methods

Whether they had obtained Tan’s informed consent before changing her prevailing prescription for her existing conditions

Whether they acted reasonably in attending to Tan and performing cardiopulmonary resuscitation (CPR) on her when she collapsed in the shower

HEART MEDICATIONS WITHDRAWN

Tan’s past documented medical issues include diabetes, hypertension, heart failure, ischaemic heart disease, chronic kidney disease and anaemia.

She was admitted to TTSH on April 20, 2018 after suffering from a fever, cough and lethargy. She was noted to have sepsis, poorly controlled diabetes, anaemia and kidney issues.

Mr Chia’s lawyers allege that Dr Doraj then approved a treatment plan to withhold her primary heart medications — aspirin, a painkiller which reduces fever; furosemide, which is used to reduce extra fluid in the body; and losartan, which lowers blood pressure.

The lawyers argued that Dr Doraj did not advise Tan or get her informed consent, and could have at least informed her next-of-kin of the intended treatment plan.

Dr Lee then reviewed Tan during his ward rounds and amended the treatment plan to include referring her to the cardiology department. He also ordered the withdrawal of Mixtard insulin from her pre-existing medications.

However, two hours later, Dr Ranjana reviewed the plan and cancelled the referral.

The following evening, Tan’s daughter visited her and told the nurses that her mother should not be showered because she was prone to fainting.

These instructions were not conveyed to the relevant medical staff the next morning, Mr Chia’s lawyers said.

An 18-year-old student, who was undergoing a two-week attachment at the hospital's nursing internship programme, then took Tan to shower without being supervised by other nurses.

The elderly woman collapsed and the nurse, who did not have the requisite training in basic cardiac life support and automated external defibrillator courses, left her side to look for help, despite there being an emergency distress call button in the shower room.

After about six to nine minutes, trained nurses arrived. Tan was transferred to her ward bed before CPR was performed on her. She came around but suffered new injuries, including a form of permanent paralysis.

She was taken to the intensive care unit before dying from complications on May 13, 2018.

DEFENCE'S ARGUMENTS

The defendants’ lawyers argued in their opening statement that all aspects of Tan’s treatment and management were appropriate and met the required standard of care.

The lawyers said that Dr Doraj did not owe a legal duty of care to Tan because he did not personally review her and was not consulted on matters relating to her.

They added that another doctor temporarily withheld Tan’s heart medications because aspirin could increase the risk of bleeding, and losartan and furosemide could worsen her kidney injury.

As for Dr Lee, he had withheld Mixtard insulin upon feeling there was a risk of low blood glucose. Dr Ranjana agreed with this.

About an hour before her shower, Tan was observed to be alert, comfortable and cheerful. Her parameters were stable as well.

On Monday, her son, who works as a public servant at the National Library Board, was the sole plaintiff witness to take the stand.

The trial continues on Tuesday with several medical experts expected to testify over the next few days. A total of 30 witnesses are scheduled for the whole trial.

Source:
courtesy of TODAY

by LOUISA TANG

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