Hand surgeon cleared of failing to give enough medical leave to foreign worker
A hand surgeon has been cleared by Singapore's highest court of any wrongdoing after a tribunal earlier convicted him of professional misconduct for failing to give adequate medical leave to a foreign worker injured at a shipyard.
SINGAPORE — Amid intense scrutiny over medical disciplinary procedures here, a hand surgeon who faced six months’ suspension for professional misconduct has been cleared of any wrongdoing, more than seven years after the complaint was lodged.
Singapore’s highest court on Monday (May 27) quashed Dr Looi Kok Poh’s conviction for failing to ensure that he had given adequate medical leave to a welder, Mr Vadamodulu Tata Rao, whose finger was crushed at a shipyard. Dr Looi had given Mr Vadamodulu one day’s medical leave, and light duties for seven days.
The Court of Three Judges also rejected an appeal by the Singapore Medical Council (SMC), which had been trying to have Dr Looi’s suspension increased to two years.
The SMC and its disciplinary tribunals have been in the spotlight in recent months, after imposing penalties on doctors regarded by critics as too harsh.
Last week, the SMC announced that it will apply to the Court of Three Judges to overturn psychiatrist Dr Soo Shuenn Chiang’s conviction for failing to maintain patient confidentiality.
Earlier this month, the Court of Three Judges heard the SMC’s appeal to reduce orthopaedic surgeon Dr Lim Lan Arn’s fine for failing to inform a patient of the risks or complications that could arise from a steroid injection.
In March, the Ministry of Health said it had formed a workgroup to review the SMC’s disciplinary processes.
In the latest case, Dr Looi had performed surgery on Mr Vadamodulu’s hand on Aug 7, 2011, after a steel plate fell on the worker’s right hand, crushing the tip of his middle finger.
After Mr Vadamodulu — who was then in his early 30s and has since returned to India — was discharged from hospital the next day, Dr Looi gave him one day of medical leave and certified him fit for seven days of light duties.
Last year, the doctor was found guilty of two charges of professional misconduct by the SMC’s disciplinary tribunal. The penalty imposed was six months’ suspension.
In coming to the decision to allow Dr Looi’s appeal against his conviction, Judge of Appeal Judith Prakash, who delivered the judgment, said that the SMC failed to establish that Dr Looi had strayed from the “applicable standard of conduct”.
The SMC had also argued that Dr Looi failed to actually determine if Tellus Oceanic Pro — Mr Vadamodulu's employer — could arrange for light duties for the worker.
However, the three judges ruled that when Dr Looi certified Mr Vadamodulu fit for light duties, he had taken a medically appropriate course of action, given what he knew of the patient at the time.
Dr Looi had testified that he was aware of the general working conditions at a typical shipyard. He also knew that Tellus had systems in place to ensure those assigned with light duties would be given simple duties that would not aggravate their injuries, such as tasks in the office or guardhouse.
The doctor had indeed discussed the availability of light duties with someone from Tellus, and Mr Vadamodulu also carried out light duties when he returned to work, the judges noted.
Given these circumstances, they ruled that Dr Looi had ascertained that there were adequate conditions for the worker’s rest and rehabilitation. “We do not see how Dr Looi can be said to have been seriously negligent by disregarding the patient’s interests or by failing to obtain a detailed history from the patient,” they said.
This is not also Dr Looi’s first brush with the SMC. In 2014, he was fined S$10,000, suspended and censured for failing to obtain a patient’s consent before surgery and falsifying medical records in 2006.
THE CASE
On Aug 7, 2011, Dr Looi performed the first part of the two-stage procedure on Mr Vadamodulu at West Point Hospital.
Mr Vadamodulu was discharged the next day, and Dr Looi gave him one day of medical leave and certified him fit for seven days of light duties.
Dr Looi then reviewed the patient five days later and ordered light duties until the next review on Aug 22.
Before the next review, Mr Vadamodulu ended up going to Singapore General Hospital (SGH) on Aug 20. He complained of pain and was given medical leave for two days.
He went back to Dr Looi on Aug 22 for his second review, where he refused Dr Looi’s offer of one week of medical leave. He did not return to Dr Looi, but instead went back to SGH to complete the second stage of the surgery.
In October 2011, the SMC received a complaint about Dr Looi from the Humanitarian Organisation for Migration Economics, alleging that he was in collusion with the worker’s employer.
Dr Looi was notified of the complaint on May 24, 2012. On July 7, 2012, Dr Looi submitted his explanation to the SMC, which issued the notice of inquiry to Dr Looi on Jan 27, 2016.
