• About Us
    • Fact Checking Policy
    • Ownership & funding information
  • Volunteer
    • Internship with The Online Citizen
  • Donation
  • Subscription
  • Letter submission
    • Submissions Policy
  • Contact Us
The Online Citizen Asia
  • Opinion
    • Editorial
    • Commentaries
    • Comments
  • Current Affairs
    • Malaysia
    • Indonesia
    • China
    • ASEAN
    • Asia
    • International
  • Finance
    • Economics
    • Labour
    • Property
    • Business
  • Community
    • Civil Society
    • Arts & Culture
    • Consumer Watch
    • NGO
  • Politics
    • Parliament
    • Transport
    • Education
    • Environment
    • Health
    • Housing
  • Law & Order
    • Legislation
    • Court Cases
  • Lifestyle
    • Travel
No Result
View All Result
  • Opinion
    • Editorial
    • Commentaries
    • Comments
  • Current Affairs
    • Malaysia
    • Indonesia
    • China
    • ASEAN
    • Asia
    • International
  • Finance
    • Economics
    • Labour
    • Property
    • Business
  • Community
    • Civil Society
    • Arts & Culture
    • Consumer Watch
    • NGO
  • Politics
    • Parliament
    • Transport
    • Education
    • Environment
    • Health
    • Housing
  • Law & Order
    • Legislation
    • Court Cases
  • Lifestyle
    • Travel
No Result
View All Result
The Online Citizen Asia
No Result
View All Result

High Court orders Changi General Hospital to pay S$326,620 to estate of cancer-stricken woman who died after diagnosis delay

by The Online Citizen
19/01/2021
in Court Cases, Health
Reading Time: 5 mins read
19
High Court orders Changi General Hospital to pay S$326,620 to estate of cancer-stricken woman who died after diagnosis delay

After being found liable for negligence against a patient for its delay in diagnosing her lung cancer, Changi General Hospital (CGH) on Tuesday (19 January) was ordered to pay S$326,620 in damages to her estate.

The sum was awarded by the High Court to the late Noor Azlin Abdul Rahman’s estate as general damages encompassing claims for pain, suffering, loss of amenity and dependency.

Justice Belinda Ang also ordered CGH to pay Ms Azlin’s estate an additional S$22,620 for special damages, including medical expenses.

CGH to date has paid an interim sum of S$200,000.

Ms Azlin’s estate had sought about S$1 million in damages for Ms Azlin’s pain, suffering and loss of amenity, which Justice Ang said “is manifestly excessive” and “completely at odds with the precedents”.

CGH asked for S$10,000, which the judge said was also “out of line with the precedents”, noting also that CGH did not appeal against the decision to award S$200,000 in interim payment.

Ms Azlin passed away in April 2019 at the age of 39 — months after winning the legal battle against CGH in February that year after making an appeal. She was in Stage Four of her lung cancer.

She was first diagnosed with lung cancer in February 2012, following which she went through surgery to remove part of her right lung in March 2012.

Ms Azlin later found out that she was suffering from Stage 2A lung cancer.

Justice Ang in her judgement remarked that Stage 2A is often still considered “a relatively “early” stage” from a medical perspective, which would have given her the opportunity to be cured of her cancer — that is, to have no relapse or recurrence over a given period of time.

Referencing CGH’s expert witness, Professor Goh Boon Cher’s explanation on why Ms Azlin’s cancer relapsed in 2014 despite having part of her right lung removed, Justice Ang noted that Prof Goh’s testimony “provides an explanation to the missing link of whether CGH’s delay in diagnosis caused Ms Azlin’s relapse and death: the answer must be yes”.

“The Court of Appeal had already found that CGH’s negligence caused a delay in diagnosing Ms Azlin with lung cancer in July 2011, which caused her to suffer from nodal metastasis and a progression of the lung cancer from stage I to stage IIA,” she said.

Prof Goh’s explanation, said Justice Ang, highlights how nodal metastasis “resulted in a higher risk of relapse even with a lobectomy that removed both the tumour and the affected lymph node”.

Nodal metastasis refers to cancer cells from another part of the body entering lymph nodes, leading to cancer growing within the lymph node.

“In this case, the removal of both the tumour and affected lymph node in March 2012, coupled with the absence of distant metastasis then, did not stop a relapse of her cancer in 2014,” said Justice Ang.

At Stage 1B, nodal metastasis likely would not have occurred, and thus cancer cells would not have entered the lymphatic system yet, the judge said.

“In other words, on a balance of probabilities, there would have been no microscopic node involvement if Ms Azlin had undergone lobectomy and adjuvant chemotherapy at Stage IB of the disease,” Justice Ang added.

In finding CGH liable of negligence, falling short of its duty of care to Ms Azlin, the Court of Appeal observed that CGH did not provide her with a proper system through which it could adequately follow-up with her radiological results.

The absence of such a system in Ms Azlin’s case had led to the delay in her lung cancer diagnosis.

The apex court also found CGH’s radiological report review system “inadequate”, as it did not permit comprehensive management of patients.

Each visit by Ms Azlin to the Accident & Emergency department was handled in isolation, and the doctors did not corroborate their notes.

While the Court of Appeal found the first CGH doctor Ms Azlin saw in breach of duty of care for failing to set up a follow-up appointment for her, the court did not find such a breach on the part of the two doctors from the A&E department.

Justice Ang rejected CGH’s submission that there was no guarantee that Ms Azlin could make a complete recovery even if she was treated earlier.

“CGH submitted that its breach did not cause Ms Azlin to die in the way that she had because all of the medical literature adduced by both parties’ expert witnesses shows that the survival rate of a lung cancer patient is never 100 per cent at 10 years or even 5 years after treatment, even if the patient was treated at stage IA [1A] or stage IB [1B].

“The statistical evidence showing that there is never any 100 per cent chance of a complete cure is only one factor in the entire mix of factors to consider if Ms Azlin would more likely than not have been ‘cured’ (that is, have no relapse within a specified timeframe) and live to her full life expectancy,” she said.

Background of the case

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.

She went on appeal against the decision, following which 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 that if the negligence did not happen from the hospital’s side, she would have received a proper diagnosis and be treated accordingly.

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

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

The Court of Appeal also ordered parties 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.

Share this:

  • Twitter
  • Facebook
Subscribe
Connect withD
Login
I allow to create an account
When you login first time using a Social Login button, we collect your account public profile information shared by Social Login provider, based on your privacy settings. We also get your email address to automatically create an account for you in our website. Once your account is created, you'll be logged-in to this account.
DisagreeAgree
Notify of
I allow to create an account
When you login first time using a Social Login button, we collect your account public profile information shared by Social Login provider, based on your privacy settings. We also get your email address to automatically create an account for you in our website. Once your account is created, you'll be logged-in to this account.
DisagreeAgree
19 Comments
Oldest
Newest Most Voted
Inline Feedbacks
View all comments

Recent Posts

  • UN experts say deeply disappointed by decision to discharge Fukushima water
  • PM Lee seeking nearly S$130,000 in legal costs and disbursements from blogger Leong Sze Hian; much of disbursements tied to engagement of Hong Kong expert witness
  • Taiwan transport minister resigns over train crash
  • S’pore economy grows 0.2% in first quarter; MAS keeps monetary policy unchanged amid low core inflation outlook
  • Netizens question how woman who abused domestic helper allowed to become prison counsellor
  • Over 100mil devices at risk from NAME:WRECK DNS bugs, CSA advise firms to patch systems immediately
  • Public member highlights lax social distancing control in airport allowing travellers to intermingle
  • 16 new cases of COVID-19 infection in S’pore; all cases are imported

Trending posts

Accident caused by court prison bus that went against road direction for convenience sake

Ho Ching shares not 1, not 2, but 7 Facebook posts by Chan Chun Sing in a row within 15 minutes

Here’s why many Singaporeans aren’t bothered who the ruling party chooses to become PM

PM Lee seeking nearly S$130,000 in legal costs and disbursements from blogger Leong Sze Hian; much of disbursements tied to engagement of Hong Kong expert witness

WP MP Gerald Giam’s intervention helped solve traffic congestion issue at Hougang Capeview

Unqualified supervising lawyer in trainee dispute was once a Deputy Public Prosecutor

FB post criticising Minister Chan Chun Sing’s leadership skills re-emerges in light of recent 4G leadership discussion

MP Poh Li San explains to media why RSAF Super Puma was replaced with Airbus H225M

Netizens question how woman who abused domestic helper allowed to become prison counsellor

Roy Ngerng raises over S$125,000 over 7 days of fund raising to pay for PM Lee’s defamation damage

Load More
January 2021
MTWTFSS
 123
45678910
11121314151617
18192021222324
25262728293031
« Dec   Feb »
  • About Us
  • Volunteer
  • Donation
  • Subscription
  • Letter submission
  • Contact Us

© 2006 - 2021 The Online Citizen

No Result
View All Result
  • Opinion
    • Editorial
    • Commentaries
    • Comments
  • Current Affairs
    • Malaysia
    • Indonesia
    • China
    • ASEAN
    • Asia
    • International
  • Finance
    • Economics
    • Labour
    • Property
    • Business
  • Community
    • Civil Society
    • Arts & Culture
    • Consumer Watch
    • NGO
  • Politics
    • Parliament
    • Transport
    • Education
    • Environment
    • Health
    • Housing
  • Law & Order
    • Legislation
    • Court Cases
  • Lifestyle
    • Travel
  • Subscribers login

© 2006 - 2021 The Online Citizen

wpDiscuz
19
0