An austrian heart and lung surgeon who injected a two-year-old patient with the undiluted form of a drug used to stop the heart during an operation, has been cleared of professional misconduct.
A three-judge court, in written grounds published yesterday, allowed the appeal of Dr Uwe Klima against two misconduct charges, overturning the nine-month suspension handed down by a Singapore Medical Council (SMC) disciplinary committee last year.
In 2007, Dr Klima performed a scheduled operation on the boy, who was born with a rare heart condition.
During the operation at the National University Hospital (NUH), a drug called cardioplegia was administered to stop his heart so it could be safely operated on.
Cardioplegia can be used only after it is diluted; the undiluted form is potentially fatal.
When Dr Klima was handed a syringe after he asked for cardioplegia, he assumed that the drug had been diluted and gave it to the patient. But the clear solution was in fact neat cardioplegia.
After the surgery, the boy's condition deteriorated. An emergency operation saved his life but he was left with medical complications that crippled his ability to lead a normal life. Now 10, he attends a special school and needs help with daily activities.
In its judgment, the court said that this was a case in which the system comprising two layers of safeguards against the administration of neat cardioplegia had failed as a result of a breakdown in communications between members of the surgical team.
While Dr Klima should have checked what type of cardioplegia he had been given, the supporting staff who prepared the drug should also have told him that it was neat, said the court.
Noting the adverse medical consequences to the patient, the court said it sympathised fully with the patient and his parents.
However, the current issue was whether Dr Klima was guilty of professional misconduct for these consequences - which the court found he was not.
The court also suggested that hospitals and Dr Klima may want to revisit current protocols on the administering of cardioplegia.
The court ordered the SMC to pay half of Dr Klima's legal costs for the appeal, noting that its decision to bring charges was honest, reasonable and on what appeared to be sound grounds.
The boy's 42-year-old father, a construction worker, said through lawyer Adeline Chong that he was disappointed with the court's decision.
He complained to the SMC in 2008 after he received an anonymous letter detailing the treatments given to his son at NUH.
He also engaged a law firm to seek compensation based on medical negligence.
Yesterday, he said he hoped all hospitals and surgeons will learn from this case. "No child should have to go through what my son has been subjected to."
This article was first published on April 16, 2015.
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