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MOH seeks review of doc's case with wide implications

This article is more than 12 months old

Singapore Medical Council had earlier fined him the maximum amount for not telling patient of possible complications of a common steroid injection

In a move that could have wide-ranging implications for both doctors and patients, the Ministry of Health (MOH) has, for the first time ever, asked the Singapore Medical Council to apply to the High Court to review a judgment by its disciplinary tribunal.

The tribunal had fined orthopaedic surgeon Lim Lian Arn the maximum $100,000 for not telling his patient of possible complications from a commonly used steroid injection.

This had caused a huge uproar within the medical profession and raised fears that doctors would start practising "defensive medicine" to safeguard themselves instead of making prescriptions in the patients' best interests.

Senior Minister of State for Health Lam Pin Min had earlier ruled out reopening the case, as both the SMC and the doctor concerned had accepted the judgment.

In an about-turn yesterday, the MOH said that it has requested the SMC to apply to the Court to review that decision.

It said: "Sentences have to be commensurate with the circumstances of each case."

The SMC submitted its application yesterday, asking the High Court to review the case and the tribunal's judgment - and make revisions if necessary - even though the usual time frame for such an appeal has passed.

Explaining its decision to ask for the review, the ministry said "the decision in this case carries with it much wider professional practice implications and also has an impact on future cases."

It added: "We are concerned that this case should not be viewed as or lead to the practice of defensive medicine, which would have an adverse impact on patient and clinical safety.

"There have also been questions raised about the liability imposed in this case."

PRECEDENT

The tribunal's decision had sent a chill among doctors as many of them give the steroid jab in question without telling patients of the side effects - which are both transient and rare. They also felt the quantum of the fine imposed had set a precedent.

Dr Desmond Wai, a gastroenterologist in private practice, said: "As a result of that judgment, some GPs have stopped giving their patients steroid injections and are sending them to specialists instead. This will only push up costs for patients."

He had earlier written to The Straits Times to point out that even the widely used painkiller paracetamol has side effects.

More than 5,000 people had signed an appeal, started by another doctor, Dr Tho Kam San, to share their concerns with Health Minister Gan Kim Yong. The subject was also raised in Parliament.

Meanwhile, doctors welcomed MOH's decision to have the case reviewed.

Dr Tho, who started the petition to Health Minister Gan,told The Straits Times: "It is heartening to know that MOH understands and is aware of the concerns of many doctors and allied healthcare professionals, which was voiced out at many forums and platforms."

MEDICAL & HEALTH