Judge rules against family of dead corporal

last SG · 2005-10-18T18:16:03+00:00

another case appeared in the papers today. a 26 year old mother was two consulted a GP for fever. she was given medication on three occasions. she died due...

BillyBong SG

It is with great dismay and surprise that the case of the family of the late Chua Ya Ta versus the NUH Doctors has resulted in the court ruling against the family.

In delivering his verdict, the judge ruled that no 'criminal negligence' had been committed by the doctors. Yet in his summary, he delibrated on the following:

a. the judge agreed that Dr Tey "had harboured in his mind the possibility that Cpl Chua was not in pain", posing questions over his professionalism and raising the issue of whether Dr Tey indeed believed Cpl Chua was 'malingering'.

b. reservations over whether Dr Wong had examined Cpl Chua as thoroughly as he claimed.

c. Quote..."Not withstanding the evidence of Dr Lingaraj and Dr Wong, given the paucity of the medical notes recorded, I have no option but to note that there are clearly some doubts as to how thos examination was conducted."....

With such lingering doubts in his mind, one must be surprised as to how the judge considered his verdict of 'not criminally negilgent'.

It has been clearly defined that the doctors did not:

1. discharge their professional duties as required.

2. properly examine the blood sample taken from Cpl Chua, which would have possibly led them to suspect that some infection far more sinister than a common fever was engulfing the victim.

Even the doctors themselves on testimony did not deny 'failing to diagose or treat Cpl Chua', clearly indicating that their planned defence stemmed from convincing the judge that the infection symptoms were 'so atypical' and rare that they could not be faulted for failing to save his life.

From a doctor's point of view, is that a fair assessment? Worst, from a neutral's point of view, isn't that a blatant excuse?

We are not asking doctors to be omnipotent lifesavers, nor are we saying that they are infallible, but were all avenues to prevent it happening explored? Were the doctor's providing their due dilligence and professionalism in examining the patient? Did they even express concern and reassurance?

This stinks of an ellaborate scheme to close ranks and protect themselves from medical negligence. There are clear indications of gross miscommunication between doctors involved in the case and of a medical system that seems more bureaucratic than efficient. A sanctioned neutral examination of the NUH medical system is likely to reveal more skeletons in the closets than what has been learnt in this courtroom.

As in the case of the korean family who was killed while crossing the road, no portion of the guilt was pinned on the expatriate driver. Surely we are not saying the family was not to blame but how can the driver be completely absolved of guilt in the accident?

The manner in which the outcome has been presented seems to indicate subtle nudging towards a civil suit.

bila_prem SG

My condolences to our dear corporal Chua. It seems like its the negligence of the NUH doctors. Being a patient in a government hospital, it is the responsibilities of the doctors to respond to his deterioration of his medical condition. Genuine-ill NSFs who visit government clinics are often given attend B which requires them to return back to their camp. These doctors will examine them with a mentality of them malingering. These genuine cases are being dismissed as malingerers often ended up in government hopitals. While these doctors gave them a cold shoulder as long as they are NSFs. Such mentality should be erased as NSFs are being unpaid and only given little allowance to serve the country. Professional medical service should be improved. Medical Officers should be professional in their pratice in the medical field. Where is the care for soldier value as so called pledged by the SAF?

oxford mushroom SG

You have to understand how our legal system works. The Coroner's inquiry is only an inquest and the scope of his investigation is very limited. You may not realize this but his job is not to apportion blame but to discover what happened. Occasionally when he discovers that the death is the result of negligence to a degree that would amount to 'manslaughter' under Sect 304A, he will refer his findings to the AG Chambers to decide on prosecution.

Remember that the burden of proof in a criminal case is 'beyond reasonable doubt'. The Coroner's findings do not stop the family from taking up a civil suit, where the standard of proof is much lower, just on the balance of probability.

An error of judgment by the medical doctors is not sufficient to constitute negligence. We do not know the details of the case unlike the Coroner and so we are not in a position to make a judgment. However, from what the press has reported, it does seem to me that it would be difficult to make a legal case for negligence.

Some actions of the junior doctors in question appear to fall below the standard of a reasonable doctor, according to the press reports, such as the failure to read the lab reports and act on clearly abnormal results. However, the experts in this case have said that even if the results had been acted upon, the disease was so virulent that they would not have been able to save him at that point in time anyway.

Again many of us may not realize that even if a 'negligent act' had been committed, if you cannot prove that the act directly led to the damage, there is no negligence. You cannot prove causation. So if the underlying disease is so virulent that he would have died anyway at the time the abnormal lab report was wrongly ignored, that negligent act did not cause death and so there is no negligence.

If I were to advise the family, I will threaten a civil suit but settle out of court for an undisclosed sum. It is difficult to win such a case unless I can find experts that can convince the court otherwise.

Quincey SG

My deepest sympathy to the family and love ones of the CPL. All I can do now like all of us here is to remember them all in our thoughts and prayers.

cornyfish2000 SG

Agreed. We can't expect our doctors to be God and be able to reach the right diagnosis and save the patient every time.

Yes, if the doctor were to miss a common condition that any other doctor with the same level of training and experience would reasonably be expected to diagnose, he would be guilty of negligence. But in this case, even the eminent expert (Prof Leo Yee Sin) in the field of infectious disease has admitted that this particular infection is so uncommon, and that his symptoms were so atypical that this doctor in question cannot be blamed.

I don't think it'll be fair for us to conclude that this houseman (who was only in his first year of practice then) is negligent if even the experts would have difficulty picking up the disease.

lighthand SG

Let’s just see what happens in the civil court (if it goes there). No point chewing over it, after all the report did not indicate the docs is completely in the clear.

oxford mushroom SG

I wouldn't advise taking it all the way to trial though....the chances of success are not particularly good and if you lose the case, you are likely to be 50k poorer, since the trial will take at least a week and the legal fees are about 10k a day.

ShutterBug SG

All that CRAP, is just CRAP! That's all there is to be said, about the "verdict".

I say that there is a total lack of Human Rights here.

Everything gets burried in a heap of worded technical kaka.

freeNeasy SG

This is another perfect example of government's disregard for the rights of its NSmen or citizens even.

Has anyone ever won any big legal suit, in courts, against the singapore government ?

The government doesnt even publicly tell how much they award NSmen who died in service !

BillyBong SG

What really disappointed the public (and me) was that doctors would hide behind excuses that the virus was too uncommon for even a senior doctor to accurately establish.

No one is claiming that doctors are gods. But what disturbs me greatly is the manner in which the whole incident was handled. (no i mean bungled)

If a doctor had indeed performed to his utmost to try and determine the root cause of infection right up to his death, the family would certainly be unlikely to take the case further, knowing all that could have been done was done. Unfortunately, that apparently was not the case.

The bitterness stems from the poor and nonchalant treatment of the family and patient by NUH doctors and nurses during and after the hospitalization of CPL Chua, which was widely publicised in the media. In addition, the unprofessional conduct of Dr Tey in assuming that CPL Chua may have 'malingered' hardly endeared him to family and public after his death.

What happened to benefit of doubt? Or do doctors continue to apply their contemptuous 'know-it-all' attitude to the utter disgust of the public?

BillyBong SG

Whatever the findings of the coroner, we can be sure that mistakes were made.

Mistakes that should not have otherwise occured were committed by professionals in the course of their work. It was not a single glaring error that resulted in CPL Chua's death but a sequence of events which indicate mismanagement on the part of the doctors.

How else would one describe their case? Instead of assuring the court that all procedures and efforts were performed in the course of diagnosing CPL Chua, the defence chose to rely solely on the argument of an uncommon virus so rare that it would have been almost impossible for even the most experience doctors to identify?

Surely the use of both would have strengthened the case? We Singaporeans are, after all, very quick to remind others that it is not the end product but the effort leading to it that counts most of the time.

The only reason i can see is that the defence knew that the prosecution would have certainly poked gaping holes in that strategy, knowing that the doctors had not discharged their duties by covering all the bases.

One wonders whether this is an everyday occurance instead of a one-off affair in NUH?

Game1980 SG

This is indeed a sad case but ultimately NS men who malinger are to blame for this as their actions have caused those who are really sick to be doubt by SAF MO

BillyBong SG

Should the malingers take sole responsibility in this case? Are they ultimately the ones who should be fingered for this mess?

Or have the overzealous nature of doctors intent on catching malingers red-handed gotten to them? In the past, when faced with a 50-50 case, doctors would err on the side of caution and issue a medical certificate.

Now, by letting their warped perception get in the way of medical duty, they have inadvertently taken a 'malingering-first' mentality. Genuine cases have taken a beating as a result. People are now afraid to report sick.

The end result is we now have a new generation of doctors incapable of proper diagnosis and with a poor judge of character to ascertain truth.

LazerLordz SG

Blame it on the insidious culture of catching malingerers in their time as SAF MOs that have left them with the inability to apply the Hippocratic Oath when they have ORDed.

Blame it on the weakness of character of some of these MOs who cannot stand up for their diagnosis and let rank rule over their head while in NS.Furthermore, this superior-is-always-right mentality is carried over into govt practice and registrarship.It's no secret that some of us have to lecture these doctors when we go for our appointments because frankly, there are incompetent ones out there who will hoodwink the ignorant.Many a confused and scared NSF have been victim to this mentality and culture of fear.

Spirit of Fire SG

The NSFs need to be persistent & pluck up more courage, if they're really injured, then there's nothing for them to be scared, since there's nothing to be hide. We're responsible for our own health, if we've no choice but really need to report sick a few more times, so go ahead & just do it. If need to confirm if the diagnosis is real or not, can go for a further check-up, & that's nothing wrong in doing that.
During a training, I landed on 1 of my foot 1st, & I heard a 'crack' sound. Then my leg became injured. I went to my unit's MO, he told me that no bone was broken, the injury only involved the muscles. To further clear my doubts, I requested for an X-ray, & the MO agreed. After that, my X-ray showed that the bones in that injured leg weren't broken.
If the MO didn't give in to my request, really, I'll resort to anything to make sure that I can get an X-ray of my injured leg to clear my doubts.
U see, we've to overcome this fear if we don't want anything to happen to us.

Alfresco coffeeshop SG

all r fucking cheebai Mo lah,......always listen to CO..

av98m SG

The MOs really have only 2 approaches to this problem.

One will allow some malingerers to abuse the system, but will provide better care overall.

The other will allow less malingerers to get away compared to the first approach, but will likely cause a few deaths along the way.

Our SAF culture encourages the practise of the latter option.

Conclusion: SAF Medical Officers renounce the hippocratic oath when they carry out their duties. Those that sign on as regulars give it up permanently. Of course, it doesn't help that its usually the bottom of the barrel of med school graduates that signs on with the SAF

hisoka SG

why not ultimately balme the person who decided to introduce the ns and thus created the NS men who malinger?

oxford mushroom SG

My time our PC had a very effective way to deter malingeres. If you have 2 days’ attend B or 1 day attend C, he will confine you that weekend for ‘additional training’ or guard duty. After that nobody wanted to take MC unless really ill.

BillyBong SG

Effective? Or the use of a scare tactic to make people fearful of reporting sick?

Seems like your PC was a shortsighted person who hardly knew his men if he had to resort to such means.

His actions would therefore be no different from an MO out to catch malingering soldiers.