SINGAPORE - The death of 44-year-old Mandy Yeong after liposuction last year was ruled a misadventure by the State Coroner yesterday.
Still, he was critical of the "unacceptable delay" in calling for an ambulance after the mother of two developed problems, and highlighted how the large amount of sedation given was of concern to experts who testified.
Coroner Imran Abdul Hamid also rapped surgeon Edward Foo and the cosmetic surgery clinic for going against Ministry of Health directives regarding liposuction.
These included offering the procedure at a promotional price, collecting money early and not giving Ms Yeong the cooling-off period which is compulsory, even though it was not her first such treatment.
"I leave it to the family and the state to take whatever steps they think appropriate," he said.
The family's lawyer, Ms Kuah Boon Theng, said they will sue Dr Foo for negligence.
State Counsel Bhajanvir Singh also said that he will send the findings to the Singapore Medical Council for its action.
Ms Yeong, an executive with pharmaceutical company Roche Diagnostic Asia Pacific, had wanted fat from her abdomen to be used to smooth depressions in her thighs. At the time, she weighed 68kg.
The treatment at TCS at Central Clinic on June 28 lasted two hours, from noon till 2pm. At 2.05pm, the staff stopped keeping records on her case.
At the end of the surgery, Ms Yeong sat up, coughed a few times and collapsed. After the clinic's doctors and nurses failed to resuscitate her, an ambulance was called at 2.54pm.
The coroner said he was concerned that the poor recordkeeping "unfortunately corresponded with the most crucial time" leading to Ms Yeong's collapse and death. He said it was possible that she had been hypoventilating "for several minutes".
He also criticised how the time Ms Yeong collapsed was changed more than once in the clinic's records. He said timing the collapse - one version of the records put it at 2.45pm - closer to 2.54pm, when the ambulance was called, was "self-serving".
Still, while poor records do not cause adverse outcomes, "adverse outcomes might result in poor recordkeeping", said Mr Imran.
He believed staff who said Ms Yeong collapsed at 2.30pm and the ambulance was called "after a while".
He ruled out foul play and accepted the autopsy report that Ms Yeong's death was caused by pulmonary fat embolism, a known risk in liposuction treatments.
This means that fat, which was loosened during the treatment, had blocked the blood vessels in the lungs, causing difficulty in breathing.
The autopsy found several pieces of fat blocking the arteries.
Dr Chow Yuen Ho, the clinic's medical director, had told the media a week after Ms Yeong's death that "we're very careful people. We follow all the guidelines".
"It's unfortunate that despite all the precautions, something like this happened."
But Ms Kuah, who specialises in medical litigation, said the coroner's inquiry has shown this was not so, adding that the family will "certainly pursue the matter".
This article by The Straits Times was published in MyPaper, a free, bilingual newspaper published by Singapore Press Holdings.Get a copy of The Straits Times or go to straitstimes.com for more stories.