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Surgeon at Raffles Hospital convicted of “professional misconduct”

A doctor at Raffles Hospital has been convicted of professional misconduct and suspended for six months.

He was convicted in High Court yesterday (27 July) for failure to comply with the "applicable standard of conduct" in the management of a patient.

The patient, Mr Fan Mao Bing, a Chinese national - was brought to Dr Wong Him Choon on 3 September 2011 by his supervisors after an accident at the construction site, where he suffered an injury to his right hand.

Dr Wong (51) diagnosed that the patient had sustained a distal radius fracture and a metacarpal fracture, and performed a surgery on his hand early the next day.

He then issued a medical certificate for two days - which covered Mr Fan’s hospital stay from 3 to 4 September 2011.

Dr Wong also certified his patient fit for light duties for one month from 5 September – the day after his surgery. He reviewed the patient on 7 September 2011, and scheduled a further review on 5 October 2011.

However, on 1 September 2011, the patient went to the Accident & Emergency department of Changi General Hospital as he continued experiencing pain and was hospitalised for 19 days.

Migrant worker group Humanitarian Organisation for Migration Economics (HOME) later filed a complaint with medical watchdog Singapore Medical Council (SMC).

The Singapore Medical Council (SMC) in a press release on 10 May said that Dr Wong Him Choon's conduct was an "intentional and deliberate departure from the standards observed or approved by members of the profession of good repute and competency".

A disciplinary tribunal hearing was then held on 15 and 22 to 25 Jun 2015; and 15 September 2015.

The doctor faced one charge of professional misconduct, in that he had failed to exercise due care in the management of the patient by certifying insufficient hospitalisation leave and inappropriately certifying the patient to be fit for light duties at work.

Dr Wong pleaded not guilty to the charge.

The tribunal accepted expert testimony that the applicable standard for someone with a distal radius fracture that had been fixed and a metacarpal fracture that had been treated conservatively was two weeks of medical leave.

It also agreed that Dr Wong had failed in his duty to discuss with the patient and establish if there were adequate conditions for his rest and rehabilitation, or the ability of light duty in his job before certifying him fit for light duties.

However, the tribunal initially acquitted Dr Wong on the basis that there was insufficient proof that his actions were intentional and deliberate.

The SMC then filed an appeal to the High Court against the tribunal's decision, and the Court subsequently overturned the tribunal's acquittal of Dr Wong and convicted Dr Wong of professional misconduct.

The Court noted that Dr Wong had considered "irrelevant factors" in issuing the medical certificate and "disregarded the patient's well being", said SMC.

Justice Phang said Dr Wong’s failure to grant Mr Fan medical leave, at the very least till his post-operative review three days after surgery, showed a “wilful disregard for (Mr Fan’s) welfare and interests, and in particular, his need for proper rest and rehabilitation”.

This is despite the fact that he said the hospital granted patients medical leave until the post-operative appointment.

When asked why he did not do so for Mr Fan, Dr Wong “suggested — incredibly, in our view — that this was because he wanted to give the patient the chance to try whether there was anything he could do at work and not give the patient the impression that his condition was serious”, noted Justice Phang.

Dr Wong, who also certified Mr Fan fit for light work without establishing if such duties were available at the firm where he worked, showed an “indifference” to Mr Fan’s welfare by leaving it to the employer to decide the extent to which he should rest, and appeared keen in “maximising the value that the employer could extract” from him, Justice Phang said.

Justice Phang also said the disciplinary tribunal, in acquitting Dr Wong, had “slipped into error” by focusing on whether the surgeon had knowledge that light duties were unavailable at his workplace.

Citing aggravating factors, SMC asked for a suspension of four months, and the High Court sentenced Dr Wong to suspension from practice for a period of six months, according to the statement.

Aside from the suspension, Dr Wong will be censured and will give SMC an undertaking to abstain from the same or similar conduct. He will also cover SMC's costs for the legal proceedings.