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Changi General Hospital (CHG) has come under fire after online users slammed the hospital for stating that late diagnosis of a lung cancer patient had little impact on the outcome of her condition as well as the effectiveness of the treatment she received.

This statement was made by CGH’s lawyers at a hearing in the High Court on Monday (24 August). The hearing, which is set to run from 24 August till 4 September, is being conducted to assess the damages that the hospital has to pay to the family of Noor Azlin Abdul Rahman, the patient.

Ms Azlin passed away in April last year at the age of 39 after winning a legal battle against CGH. Her brother, Mr Azmi bin Abdul Rahman, who is the executor of her estate, is continuing her fight in court to claim nearly S$6.75 million in damages.

While giving an opening speech in court on Monday, the hospital asserted that any damages that will be given would be “very limited”. It pointed out that its negligence was not the reason for the patient’s death, adding that the course of her disease would have been the same even if she had a diagnosis a few months earlier.

If that’s not all, CGH also argued that a lot of the claims, such as future medical expenses, are no longer valid given that she has already passed away.

It all started in 2007 when Ms Azlin visited CGH a number of times between October that year and December 2011 for chest pains. She was finally diagnosed with lung cancer in February 2012.

Following her diagnosis, she went through surgery to remove part of her right lung in March 2012, and later found out that she was suffering from Stage IIA lung cancer.

She then underwent chemotherapy.

Unfortunately, in August 2014, she suffered a relapse and her biopsy confirmed that her cancer had progressed to Stage IV.

The following year, in January 2015, Ms Azlin sued CGH and three doctors for the delay in diagnosing her illness. However, the High Court dismissed her case in February 2018.

Then a year later, in February 2019, the Court of Appeal found CGH guilty of negligence for not having a system for proper follow-up of radiological results and patient management.

The apex court stated that Ms Azlin had Stage I lung cancer in July 2011 and if the negligence did not happen from the hospital side, then Ms Azlin would have gotten a proper diagnosis and be treated.

Although radiological reports done in April 2010 and July 2011 recommended a follow-up, but none was conducted on Ms Azlin.

The case was transferred back to the High Court for assessment of damages.

The Court of Appeal also asked to consider looking into a settlement on the quantum to help Ms Azlin get closure and allow her to concentrate on recovering from her disease. Unfortunately, Ms Azlin lost her life to the disease on 1 April, just five weeks after the court’s verdict.

On Monday’s hearing, her lawyer Vijay Kumar Rai, stated in court that an attempt to get in touch with CGH’s lawyers on the possibility of a settlement had been “rebuffed”.

Citing the Court of Appeal’s finding, he said that if CGH had diagnosed her in July 2011, part of her lung would have been removed before March 2012 and her cancer would most likely not have progressed.

However, CGH’s lawyer, Senior Counsel Kuah Boon Theng, argued that the real period of delay was not from July 2011 to February 2012, but in fact for a shorter period of time from August 2011 to December 2011.

She pointed out that the four-month delay did not have any material impact on Ms Azlin’s prognosis, treatment efficacy or risk of relapse.

Over on social media, netizens criticised CGH for thinking that late diagnosis of Ms Azlin had no impact on her condition. Penning their comments in the Facebook page of The Straits Times, online users said that it not right for the hospital to “avoid responsibility”, adding that it has “no class” as it is still in “denial” even after the court’s ruling.

“How can there a little impact on the outcome, even a blind person knows if you don’t seek treatment asap the condition will worsen,” said a user named Liang Jie Wei Kenneth.

Many other online users highlighted their personal experience that they encountered at CGH. They said that they will now avoid the hospital at all cost due to the bad experience that they went through. Some of them even shared a similar situation like Ms Azlin where their loved ones received a delayed diagnosis at CGH, and unfortunately passed away later on.

Others urged the Ministry of Health to look into the lapses to avoid more future deaths, as well as to conduct “a periodic check on how an hospital performance as a whole”.

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