29 June 2017
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Insurance for doctors here not required by law

Straits Times
19 Jun 2017
Salma Khalik

Patient settles for less than half the cost of medical bills over surgery gone awry as surgeon was uninsured for procedure

A man who went for surgery found out when the procedure went awry that doctors in Singapore are not required by law to be insured.

All public-sector doctors are insured and backed by the hospital, but the same is not true in the private sector.

The Singapore Medical Council (SMC) told The Straits Times that while the law allows it "to require that doctors take out and maintain insurance when applying for the grant or renewal of their practising certificates", it has not "exercised this at present".

When asked what happens to patients when things go wrong, the SMC spokesman said the majority of doctors do insure themselves. Patients can also claim from the doctor or clinic "unless the doctor is bankrupt and not covered by his employer".

This was almost the case facing Mr Loh Yuen Chun, 59. The doctor owns the clinic and does not have much money. So the patient ended up settling for less than half the cost of his medical bills.

Obese and diabetic, he thought he had found the perfect solution to tackle both problems at once. He said he was assured by the doctor that bariatric surgery, which reduces the size of the stomach so a person feels full with far less food, would also cure him of his diabetes.

The procedure and recovery was supposed to take only two days. Instead, Mr Loh almost died and spent more than two months in hospital, with most of the time in intensive care. He even needed a hole in his throat to help him breathe. This has since been closed up.

On the advice of his lawyer Kuah Boon Theng of Legal Clinic, Mr Loh settled for $200,000 for the pain he suffered, and a public apology from the doctor, which was published in The Straits Times and two Chinese dailies last month.

Even then, Mr Loh has received only $100,000 so far. He will get the rest in $3,000 monthly instalments over 33 months starting end-August, with $1,000 in the 34th month.

Mr S. Selvaraj of Myint Soe & Selvaraj, the doctor's lawyer, said that given his client's circumstances, he did not charge for his time.

Speaking in Mandarin, Mr Loh said he was not covered by private insurance and had to borrow money to pay his bills. He was very upset that the doctor did not have insurance, so winning the case might cost him more money than settling. He was surprised that such insurance is not a requirement here.

The doctor told The Straits Times that he was insured as a surgeon with the London-based Medical Protection Society.

He claimed not to have known that bariatric surgery required another $10,000 a year in premiums. He has since raised his coverage.

For Mr Loh, then 53, it all started in November 2011 when he went to see the surgeon at Paragon Medical Tower. The doctor recommended the procedure to Mr Loh, who then had a body mass index of 36, putting him in the obese range.

This was done on Dec 2 at Gleneagles Hospital. That was when a straightforward operation turned into a nightmare.

Within days of his surgery, he had pain in the abdomen, a racing heart beat, chest pain, breathlessness, a drop in blood pressure, and blood clots coming through the tube leading from his nose to his stomach. A scan found that he was leaking fluid internally at the surgical site.

On Dec 6, the surgeon tried to repair it through keyhole surgery. This failed and he had to open up the abdomen to stop the leak.

But Mr Loh did not recover. Instead, on the morning of Dec 12, a significant amount of greenish fluid leaked from the wound.

The surgeon then operated a third time. By then, damage was done to his organs, he had septic shock, breathing difficulties and his racing heart almost caused a heart attack.

His condition did not improve and by Dec 24, blood from the operation site was again coming through the tube in his nose. His family asked to transfer him to Singapore General Hospital.

All this while, he needed mechanical aid to breathe. On Dec 29 at SGH, a hole was created in his throat to help him breathe. He was operated on twice at SGH before he was discharged on Feb 20, 2012 for continued home rehabilitation.

He said since then, his health has been poor and he is still diabetic.

On the advice of his lawyer Kuah Boon Theng of Legal Clinic, Mr Loh settled for $200,000 for the pain he suffered, and a public apology from the doctor, which was published in The Straits Times and two Chinese dailies last month.

Source: Straits Times © Singapore Press Holdings Ltd. Permission required for reproduction.