The Court of Appeal on Wednesday (Mar 6) increased the term of suspension for a negligent Malaysian doctor, Dr Mohd Syamsul Alam Ismail, whose patient later suffered gangrene and had to have part of his scrotum removed.
After an appeal by the Singapore Medical Council (SMC) to lengthen the original three-month suspension, the Court of Appeal raised the term by 10 times to two-and-a-half years. The Malaysian doctor was also fined $40,000.
However, Dr Syamsul did not bother to appear in court. He has already gone back to Malaysia and is currently practising in Johor.
Didn’t bother to examine patient
The case started in 2013, when Dr Syamsul was working at a medical centre in a shipyard in Singapore. On 14 May 2013, he saw a patient who complained about a lump at his buttock and a fever that he had suffered for five days. He also told Dr Syamsul that he was diabetic.
The patient complained that Dr Syamsul failed to conduct a physical examination of his lump, and did not ask him to remove his clothes or lie down on the clinic bed to be examined. Instead, Dr Syamsul just prescribed him antibiotics and other medication before signing a MC for him. Unfortunately, the patient’s condition worsened and was warded in hospital the next day. He was diagnosed with gangrene and had to undergo immediate surgery, which had part of his scrotum removed.
Eventually, the patient lodged a complaint against the Malaysian doctor in 2014. SMC then proceeded to investigate the matter. By 2017, Dr Syamsul became uncontactable despite attempts to contact him by telephone, e-mail and letter. But in October 2017, he e-mailed the SMC asking if he could continue working in Singapore. He said he did not intend to take part in his disciplinary hearing.
SMC proceeded with the tribunal hearing nonetheless and Dr Syamsul was found guilty of failing to undertake adequate clinical evaluation of his patient as well as failing to keep clear and accurate records. The tribunal said Dr Syamsul should have referred the patient to a hospital immediately given the patient’s symptoms and diabetic condition. The tribunal imposed a three-month suspension and a $40,000 fine. Later, SMC appealed to the High Court for a longer suspension against Dr Syamsul.
CJ: Blatant lack of remorse
“This was serious negligence,” said CJ Menon at the proceeding in the Court of Appeal. “Dr Syamsul had failed to perform basic and elementary things that any competent doctor ought to have done.” Also, his blatant lack of remorse was seriously aggravating, said CJ, noting his lack of communications with the SMC and his refusal to participate in his earlier tribunal hearing, as well as the Court of Appeal’s proceedings.
“So far as we can tell, he is no longer practising in Singapore. He has only been contactable by email, but he has replied only intermittently to the SMC and SMC’s counsel whenever they attempted to contact him for the purposes of informing him of the disciplinary proceedings,” the CJ noted. “Even when he deigned to reply, it was evident that he was fixated more on when he would be able to return to Singapore to work rather than to express remorse or in any way to attempt to justify his conduct. This blatant lack of remorse is seriously aggravating.”
CJ Menon said the court maintained the $40,000 fine to send a signal to errant doctors who are able to practise overseas that they cannot simply avoid punishment by waiting out the period of suspension. In addition, Dr Syamsul has to bear the legal costs of the SMC, which were fixed at $25,000 including disbursements. The court also directed the SMC to inform their Malaysian counterparts of the orders it made, as Dr Syamsul is presently still registered to practise in Malaysia.
Indeed, a check on the website of the Malaysian Medical Council shows that he is currently registered to practise back in Malaysia at a clinic in Taman Desa Cemerlang, Johor.