The Court of Appeal ruled on Tue (26 Feb) that a patient with lung cancer would have been diagnosed and received treatment earlier were it not for the negligence of Changi General Hospital (CGH) and its medical system.
Ms Noor Azlin, was diagnosed with lung cancer in Feb 2012, sued CGH and three doctors who attended to her from 2007 to 2011 in the High Court earlier. She had argued that their negligence in detecting her cancer caused delays in her treatment.
After the High Court dismissed her case, she continued her appeal. Finally she won her case against CGH at the Court of Appeal, which noted that the hospital “did not have a system in place to properly record decisions made” or to ensure that patients get proper follow-up medical care.
While the hospital has a system that routed radiological reports ordered by the emergency department back for review, the Court of Appeal noted that it makes “little sense” as the emergency department focuses on acute episodes.
Additionally, the emergency doctors did not have complete information about a patient’s visit and Ms Noor’s visits were “seemingly treated as an isolated incident” and there was “no evidence of any consolidation of what was already known about her”.
There were two emergency doctors who had reviewed the radiological reports but had decided against a radiologist’s recommendation to follow-up.
The Court of Appeal said that the “sole respiratory specialist had erroneously concluded that the opacity as seen on the chest X-ray was resolving or had resolved. Yet, the system did not alert any of the six doctors.”
As a result, Ms Noor “with a persistent nodule in her lung having been seen by only one respiratory specialist over a period of four years.”
The hospital’s system of reviewing radiological reports did not allow for the comprehensive management of a patient, the Court of Appeal also noted. This system caused a lack of accountability, as both patients and subsequent doctors did not know the decision that was made on their case.
In Ms Noor’s case, she should have been diagnosed and given the appropriate treatment when she had visited the CGH’s emergency department for the third time in July 2011. Judge Andrew Phang said that this delay in diagnosis allowed the aggressive lung cancer to progress.
The Court of Appeal further noted that Ms Noor’s cancer is now at the fourth stage and had encouraged the hospital to consider a settlement with her “in the interests of expediency and resolution”.