A general practitioner who does aesthetic treatments has been suspended for four months by the Singapore Medical Council (SMC) for professional misconduct following a case of aesthetic treatment that went wrong.
In the incident that took place in 2010, a patient of the GP, Dr Kevin Teh, ended up with burns on both her thighs following vaser liposuction treatment to reduce fat. She had to be taken to the Singapore General Hospital's (SGH) emergency department and was hospitalised for more than two weeks.
This is Dr Teh's second run-in with the SMC over aesthetic treatment. He was fined $10,000 in 2014 for a 2009 treatment in which a patient almost lost two fingers. He had then tried to cover his tracks dishonestly.
In the latest case, the patient had fluid-filled blisters and some swelling and bruising on the back of both her thighs a day after the treatment on Oct 14, 2010.
Dr Teh told the patient that the blisters were burns that would heal with proper care. He and his nurse saw her every day to treat the burns and bruises.
But a week after the liposuction, there was purple blotchiness on the thighs, and she had chills and a fever of 39.1 deg C. Dr Teh and his nurses went with her to SGH that night. She was admitted to the burns unit and scheduled for skin graft surgery the next morning.
However, how the burns were caused was not looked into by the disciplinary tribunal chaired by Dr Yap Lip Kee, as it did not form part of the three charges against Dr Teh.
The charges were: that he failed to refer the patient to a specialist in a timely manner; failed to ensure that sedation was properly done; and did not have adequate documentation.
He was found guilty of the first two charges and cleared of the third charge.
The tribunal said that waiting till the patient had "clear signs of infection" before sending her to hospital amounted to "serious negligence".
"Based on the clear medical evidence of the experts for both sides, a referral should have been made much earlier," it added.
On the second charge, Dr Teh was found to have given a higher dosage of propofol, a sedative, than recommended by the manufacturer.
The known side effects of propofol include burning at the site of the injection and a seizure.
The tribunal found that Dr Teh was not aware of the guidelines for safe sedation issued by the Ministry of Health in 2002.
It found this, and the high dosage given, "particularly troubling since it would be incumbent on any doctor who intends to conduct high own sedation to ensure that he is familiar with the prevailing guidelines as well as something as basic as a recommended dosage".
It added that Dr Teh "totally disregarded" the manufacturer's guideline that propofol "is to be administered only by anaesthetists or intensivists".
In deciding the penalty, the tribunal said it did not take the other case for which Dr Teh had been found guilty into account as it had run parallel to this one.
It did take into account the "strong testimonials on his behalf from members of the medical profession, his staff and patients".
It also noted that Dr Teh, whose clinic is the Singapore Lipo, Body and Face Centre at Novena Medical Centre, now engages an anaesthetist to sedate patients.
His four-month suspension started on Jan 12.
He also has to promise not to repeat the offence and to pay the cost of the hearing.