SINGAPORE: A doctor has been suspended from practising for three months, after he was convicted of "serious negligence" in his treatment of a private shuttle bus driver who had an eye condition.
The Singapore Medical Council (SMC) said in a press release on Friday (Jul 28) that Dr Sanjay Srinivasan diagnosed the patient with a mild cataract and posterior vitreous detachment in his right eye on Oct 16, 2013, after conducting various clinical examinations.
The senior resident physician at the Department of Ophthalmology and Visual Sciences at Khoo Teck Puat Hospital gave the driver one day of medical leave for the day of the consultation, and allowed him to continue his normal activities, including driving, after that.
As part of the management plan, the 45-year-old doctor asked his patient to return in six weeks’ time for another evaluation or to return earlier if new symptoms occurred.
He also gave the driver the option of making spectacles and said that if the patient's vision did not improve after making the spectacles, the follow-up evaluation would seek to address it.
HE ENDANGERED PATIENT, PASSENGERS AND ROAD USERS: TRIBUNAL
A Disciplinary Tribunal (DT) inquiry was held for Dr Sanjay from Oct 17 to 21, 2016 and on Feb 17 this year in response to the complaint made by the bus driver on Jan 28, 2014.
It convicted the doctor of two charges, both of which he had contested.
The first related to his failure to provide adequate clinical evaluation when he failed to conduct an optical coherence tomography and/or further examination before reaching his diagnosis.
The DT found that Dr Sanjay's diagnosis did not satisfactorily account for all of the driver's signs and symptoms, and he should have explored alternative diagnoses and examined the patient further.
Dr Sanjay should also have re-taken the patient's history when he realised that the patient needed a Mandarin interpreter to understand the management plan and diagnosis.
"The DT noted that it was for the doctor to properly integrate, assimilate and assess the information obtained from the patient and through a thorough examination before arriving at a diagnosis and Dr Sanjay clearly fell below the standards expected of him," the SMC said.
The second charge Dr Sanjay was convicted of was that he did not provide "competent and appropriate care", when he allowed the patient to continue driving instead of putting him on medical leave during the six weeks between the consultation and the next clinical review.
The doctor was aware of his patient's vocation and that medical guidelines on fitness to drive required such bus drivers to have visual acuity of at least 6/12 in each eye. With his condition, the patient did not meet this standard and he should not have been permitted to drive, the SMC said.
Instead of making it compulsory for the driver to make a pair of spectacles before resuming driving after his medical leave expired, the doctor assumed that the patient would be able to make a pair of prescription glasses in less than half a day after his consultation, the DT found.
He also assumed that the driver could meet this standard with spectacles without conducting the proper tests, and failed to provide any instruction on making spectacles except that the patient could obtain a pair at any optical shop.
While the DT noted that Dr Sanjay was "remorseful" and that it was his first offence, it said it was important to send a message that the proper and careful clinical evaluation of a patient is vital for the proper standard of care rendered and should not be treated lightly.
The tribunal also said Dr Sanjay had endangered the driver, passengers and other road users when he allowed the patient to resume driving despite knowing he did not meet the 6/12 visual standard.
"The DT was of the unanimous view that this was simply unacceptable and given the public safety implications, the professional misconduct was sufficiently serious to warrant a suspension," the SMC said.
Dr Sanjay's suspension runs from Thursday to Oct 26 this year.