Doc cleared of all allegations of professional misconduct

Last November, a disciplinary tribunal cleared Dr Leslie Lam of two charges of misconduct, but convicted him of the third charge.
Last November, a disciplinary tribunal cleared Dr Leslie Lam of two charges of misconduct, but convicted him of the third charge.ST PHOTO: NG SOR LUAN

Court overturns tribunal's decision to convict him of not getting patient's informed consent

Prominent doctor Leslie Lam has been cleared of all allegations of professional misconduct brought by a patient, whose condition improved after the cardiologist carried out a procedure using stents to open a blocked coronary artery.

The Court of Three Judges yesterday overturned the decision of a disciplinary tribunal to convict Dr Lam of a charge of failing to obtain informed consent before carrying out the procedure, known as percutaneous coronary intervention (PCI), in March 2011.

Dr Lam, 75, had faced three charges of misconduct after the patient complained to the Singapore Medical Council (SMC) in August 2011. The patient did not suffer any harm but alleged that Dr Lam had pressured him into undergoing an unnecessary and poorly done procedure for monetary gain, without telling him the risks.

Last November, a disciplinary tribunal cleared Dr Lam of two charges - of advising the patient to undergo a conventional angiogram and PCI without clinical evaluation, and failing to perform the PCI and stenting with proper skill and care.

But the tribunal convicted him of the third charge of failing to advise the patient of all the risks and alternatives, and imposed a three-month suspension.

Dr Lam, who maintained that the risks and alternatives had been discussed, appealed against the conviction in July.

Yesterday, in a 50-page written judgment, the court, led by Chief Justice Sundaresh Menon, allowed his appeal. The court said the tribunal had failed to consider the patient's overall credibility.

  • Doc 'vindicated' by court decision

  • Dr Leslie Lam said he felt vindicated by the court's decision that he had appropriately obtained his patient's consent before carrying out a medically indicated procedure for him.

    "In my practice, I always aim to advise my patients as best as I can on their treatment options, and it was also pointed out by the Court of Three Judges that my consistent practice in relation to consent-taking was unchallenged evidence," he said in a statement.

    "I certainly would not and did not 'railroad' (the patient) into consenting to the PCI with stenting treatment, as alleged by the Singapore Medical Council's lawyers.

    "Unfortunately, this baseless allegation had adversely affected my reputation and how some of my patients viewed me."

    He noted that the disciplinary tribunal that had earlier cleared him of two other charges noted that his advice for the patient to undergo the procedure was "carefully considered and borne out of a genuine concern for the patient's needs".

    Dr Lam said he sincerely hopes that the patient can now put this incident behind him, and that they can all move on. "I remain dedicated to caring for my patients to the best of my ability," he said.

    Selina Lum

It said it was "improbable" that the patient underwent the procedure without any discussion on the risks and options, in the light of the tribunal's conclusion that he was "a person who was knowledgeable and had his own views".

The court noted that the patient, who had undergone a similar procedure in 2006, initially claimed he did not know the potential complications, but this was shown to be untrue during cross-examination.

The court said that having rejected the patient's testimony on the other two charges, the tribunal did not explain why it accepted his version on the third charge.

It added that the tribunal was wrong to convict Dr Lam almost entirely on the fact that he had failed to document the taking of the patient's consent. "In the present case, we do not find Dr Lam's record-keeping satisfactory, but... failure to maintain proper documentation is not what Dr Lam was charged with," wrote the Chief Justice.

The court noted that while documentation was lacking, the patient did sign a consent form at his third consultation with Dr Lam.

It commented on the sentencing approach, noting that it had taken "an inordinately long time" - more than six years - for the patient's complaint to reach the court.

Reiterating a point it made in June in the case of prominent cancer specialist Ang Peng Tiam, who was served the charges nearly 41/2 years after the complaint was lodged in 2010, the court said a delay of such nature could lead to a reduction in sentence on account of the suffering endured.

"We urge the SMC to scrutinise its procedures to avoid such delays," said the court.

The SMC did not respond to media queries by press time.

A version of this article appeared in the print edition of The Straits Times on October 21, 2017, with the headline 'Doc cleared of all allegations of professional misconduct'. Print Edition | Subscribe