'Medical regulations not complied with'

SINGAPORE - The doctor of the woman who died following a liposuction operation last year may not have fully complied with procedural regulations, her family's lawyer told a coroner's inquiry yesterday.

Dr Edward Foo, who treated Madam Mandy Yeong, 44, at TCS Clinic on June 28 last year to remove fat from her abdomen and smooth out hollows in her thighs, failed to ensure that his patient was monitored properly during the procedure, Ms Kuah Boon Theng charged.

Under the Ministry of Health's licensing conditions for liposuction, a registered nurse or doctor with training in sedation administration and monitoring "must be present during the procedure solely for the purpose of monitoring the patient".

The regulations also stipulate that there should be "at least one person on site to assist the doctor in the procedure".

But according to Dr Foo's case notes, he appeared to have had only one nurse straddling both duties. This led Ms Kuah to accuse him of having neglected the monitoring of Madam Yeong's vitals - such as heart rate, blood pressure and oxygen saturation levels.

There were also discrepancies in Dr Foo's recollection of events and statements taken from other clinic staff, which suggested there may have been an unusually long delay between the first signs of distress and the call for emergency responders, said Ms Kuah.

Shortly after Madam Yeong's two-hour surgery concluded at about 2pm that day, the mother of two sons began to show signs of deterioration, with her oxygen saturation levels plummeting. But an ambulance was called only about 50 minutes later.

For almost all of that period, Madam Yeong's vitals were largely ignored. Dr Foo attributed this to having "all hands on deck" in his efforts to save the patient.

Ms Kuah pointed out, however, that a clinical assistant tasked with keeping records said in her statement that she had, in fact, been standing in the operating theatre simply watching the resuscitation process.

Dr Foo said the employee in question had been on her lunch break and was therefore not required to keep monitoring.

He also insisted that Madam Yeong's actual collapse - the moment he thought she needed emergency attention - and the call for an ambulance occurred "almost simultaneously".

He admitted to several instances of poor recording, including "an oversight" that led him to omit one administration of a local anaesthetic drug from his case notes. The doctor also could not explain why certain photographs of the liposuctioned fat had not been taken, as required by the licensing regulations.

He had also failed to fill out a pre-anaesthesia assessment form for Madam Yeong, pointed out State Counsel Bhajanvir Singh.

The form was instead marked with the letters "NA", which Dr Foo insisted was short for "no abnormalities", meaning Madam Yeong was perfectly healthy.

State Coroner Imran Abdul Hamid is scheduled to present his findings on April 21.

hpeishan@sph.com.sg

This article was published on April 15 in The Straits Times.

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