GP fined S$30,000 for not referring patient with eye condition to specialist

GP fined S$30,000 for not referring patient with eye condition to specialist

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File photo of a doctor. (Photo: AFP/Joe Raedle)

SINGAPORE: A general practitioner was fined S$30,000 for failing to refer a patient with an eye condition to a specialist immediately, the Singapore Medical Council said in a press release on Tuesday (Sep 26).

Dr Sim Kwang Soon, 53, was a GP at Alliance Clinic and Surgery at Jalan Tenaga off Bedok Reservoir Road on Jun 16, 2010, when he diagnosed a woman with a corneal ulcer in her left eye.

However, he did not refer her to an eye specialist, but said that if her condition did not improve, she should return to consult him and he would then refer her to one.

The next day, the patient sought a second opinion from another GP, who referred her to Singapore General Hospital. The patient was hospitalised for more than two weeks and subsequently had to undergo a corneal transplant. She later permanently lost most of the sight in her left eye.

The woman later filed a complaint with the medical council about Dr Sim's treatment.

The medical council's disciplinary tribunal said that Dr Sim's failure to refer the patient to a specialist caused "further aggravation" of her ulcer. "Ultimately, after a therapeutic corneal transplant, the patient suffered permanent disability in her left eye with a decreased rate of functionality of only 20 per cent post-surgery," it said in its grounds of decision.

However, the tribunal said that it was unclear whether Dr Sim's action had led to this, as the patient saw another GP the day after Dr Sim's diagnosis.

"As such, the (tribunal) found that there was there was insufficient evidence to show that the harm caused to the patient was due to Dr Sim’s failure to refer her to a specialist timeously," the medical council said.

NO EVIDENCE OF DISHONESTY, MALICE

Dr Sim pleaded guilty to the charge of failing to refer his patient to a specialist in a timely manner.

Another charge for Dr Sim's failure to exercise due care by not adequately considering his patient's history was taken into consideration by the tribunal.

However, he was not suspended from practising. The medical council said there was insufficient evidence to show that the harm caused to the patient was due to Dr Sim not referring her to a specialist immediately. 

According to the tribunal, experts consulted had different opinions about how Dr Sim had managed his patient - though "it was clear" his decision to observe her for a couple of days was wrong - and there was also no clear causal link between his action and harm to the patient.

Dr Sim had also intended to refer the patient to a specialist if her condition did not improve in the next few days, the tribunal noted, and added that there was also no evidence that Dr Sim had acted out of malice or for personal gain.

The tribunal also gave credit to Dr Sim's guilty plea, and said there was no evidence of dishonesty and no further complaints of possible misconduct after the offence.

It ordered that Dr Sim be fined S$30,000, censured, give a written undertaking to the council not to engage in similar conduct, and pay the costs and expenses for the disciplinary proceedings.

Source: CNA/nc

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