Doctor struck off register for wrongly certifying cause of death

A doctor has been struck off the Register of Medical Practitioners for wrongly certifying the cause of death. This is the fourth time he has been found guilty of doing this.

On March 17, 2013, following a call from the dead person's mother, Dr Kwan Kah Yee went to the home of the dead person, who had been found face down on the mattress in the master bedroom.

This was after the person had been declared dead by paramedics. The police had also been called in.

He declared the death was caused by ischaemic heart disease and that the condition had started three years previously.

Following an examination, he told the police that the bruises over the neck, chest and upper limb were consistent with his diagnosis.

In June that year, the police wrote to the Singapore Medical Council (SMC). As a result, the watchdog lodged a complaint against the doctor with the chairman of the Complaints Committee.

Some 5½ years later, in May last year, Dr Kwan was served a notice of inquiry. No reason was given for the delay.

Dr Kwan, who is in his late 60s, pleaded guilty to wrongfully certifying the cause of death.

During the course of the inquiry, he claimed that a police officer had handed him a report from National University Hospital (NUH) stating that the dead person had been treated for ischaemic heart disease. 

But investigations proved this to be a lie, as there had been no such report nor had the person been treated at the NUH.

Dr Kwan then said he had been told by the dead person's mother that the dead person had suffered non-specific weakness, which he said supported his diagnosis.

But the disciplinary tribunal did not accept this, as Dr Kwan had earlier written that the mother had "incoherent speech and medical condition of vascular dementia".

The tribunal said that a doctor should obtain clinical and medical information to verify the cause of death, or refer the case to a coroner if there is insufficient information.

It said: "The issuance of false death certificate is a very grave breach of a doctor's ethical and professional duties."

Such behaviour, it said, is sufficiently egregious to amount to professional misconduct.

Dr Kwan had twice previously been suspended and fined - also for wrongly certifying the cause of death. 

In 2009, he also certified a death as ischaemic heart disease, which he said the dead person had suffered from for six years. The person's daughter lodged a complaint following problems with an insurance claim.

The disciplinary committee found he "had effectively plucked from the air a figure of six years for the patient's alleged ischaemic heart disease".

He was suspended for three months and fined $5,000 in 2011 for the offence.

The second time he was hauled before a disciplinary committee was for two similar offences that had taken place in March 2010 and March 2011. 

In October 2014, he was suspended for three months for each offence, with the two suspensions running concurrently.  

Finding the penalty too lenient, the SMC appealed to the Court of Three Judges which, in July 2015 increased Dr Kwan’s suspension to 18 months for each offence, with the suspension to run consecutively, resulting in a total suspension of three years. He also had to pay the SMC $6,000 in legal costs. 

The Court of Three Judges said unnatural deaths need to be investigated, and in a rare move referred the case to the Attorney-General, resulting in a nine-month jail term for Dr Kwan in July 2016.

This article has been edited for clarity.