Surgeon and cancer centre cleared of negligence

A prominent Malaysian businessman who sued Singapore surgeon London Lucien Ooi and the National Cancer Centre Singapore (NCCS) for being negligent in diagnosing and advising him on his condition has lost his High Court case.

Mr Clement Hii Chii Kok had undergone a complex surgery in August 2010 to remove parts of five organs. He alleged that he had been told by the defendants he suffered from "pancreatic cancer" and that surgery was the only option.

But in a 123-page judgment yesterday, Justice Chan Seng Onn found that this claim was not borne out by the evidence.

There was no mention of cancer in the discussions and conclusions of the NCSS' tumour board, the medical notes recorded by Dr Ooi or the e-mail correspondence between Mr Hii and his doctors.

Instead, Mr Hii's possible diagnoses were referred to as neuroendocrine tumours, pancreatic neuroendocrine tumours or hyperplasia.

Mr Hii, who studied law, is the managing director of the KL public-listed SEGi University group and the executive chairman of investment company HCK Capital Group.

In July 2010, his doctors in Malaysia advised him to go for a gallium scan at NCCS to investigate nodules in his lungs. This test uses a radioactive tracer to look for infection, inflammation and tumours.

Mr Hii was told that the increased uptake of the tracer in two pancreatic lesions could suggest pancreatic neuroendocrine tumours but no definite mass could be seen. A magnetic resonance imaging scan also showed no mass in the lesions.

Mr Hii consulted two oncologists and was referred to Dr Ooi, who specialises in hepatobiliary and pancreatic surgery, as well as surgical oncology.

In his suit, Mr Hii claimed Dr Ooi had told him that he definitely had cancer in the pancreas and that surgery was his only option.

Dr Ooi, who is defended by Senior Counsel Edwin Tong, denies this.

On July 29, 2010, the tumour board discussed Mr Hii's case. Their opinion was that he might have tumours but could also have hyperplasia, a very rare but less serious condition. He was given the options of waiting for six months or surgically resecting the lesions.

After consulting Dr Ooi, Mr Hii decided that he wanted "aggressive treatment" and proceeded with the surgery. After the operation, tests found that he had hyperplasia.

Justice Chan found that Mr Hii was never informed by the defendants that he had cancer.

He dismissed Mr Hii's claim that NCCS, represented by Kuah Boon Theng, was negligent in arriving at the two diagnoses. He noted that the result of Mr Hii's gallium scan, the gold standard in diagnosing neuroendocrine tumours, indicated malignancy.

And while Mr Hii contended that a test using endoscopic ultrasound should have been carried out, the judge found that it would not have helped in differentiating between hyperplasia and tumours.

Based on the diagnoses, it was "proper" for Dr Ooi to recommend surgery, the judge said. He also found that the defendants' advice to Mr Hii was "very thorough".

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