Man with hole in throat case: Tan Tock Seng Hospital says surgery was planned, but patient did not return

This story was first published on Dec 14, 2014

Tan Tock Seng Hospital told The Sunday Times that its medical team was making plans for surgery to close the hole in Mr U. Govindan's throat, but he did not return for his appointment in March 2011.

A spokesman said in an e-mail reply that its doctors wanted to be sure Mr Govindan was cancer-free for five years before closing the hole as such a closure "may have made any local cancer recurrence difficult to detect and treat".

On top of that, "the condition of the skin was not healthy and the blood supply to the operative area was still tenuous".

He added that the team of doctors "adopted a graduated treatment plan to attempt to close the hole - or fistula - in a manner that would be safe for him while also allowing for flexibility of treatment should there be any relapse or spread of cancer".

Nevertheless TTSH doctors had operated on Mr Govindan twice and "managed to significantly minimise the size of the fistula".

The spokesman added that the doctors had planned to close the hole in 2011 as by then, Mr Govindan "would have been considered fully recovered from his cancer". But Mr Govindan did not go for his appointment on March 2, 2011.

By that time, the former security guard had already undergone successful surgery at the Singapore General Hospital (SGH).

Dr Colin Song, the then SGH head of plastic surgery who performed the operation in January 2011, told The Sunday Times that what he did was "a very standard and reliable method of fistula closure posing low risk".

While detecting a recurrence of cancer might be an issue, he said, closing the hole reduced the patient's suffering.

He added: "Since there are other means to detect cancer recurrence, performing fistula closure only after a five-year cancer-free period is a relative contraindication."

He said Mr Govindan was checked before surgery and the supply of blood to his throat was satisfactory.

"This is standard practice for reconstructive plastic surgeons," he added.

In its statement last Friday, the TTSH spokesman said the hospital contacted Mr Govindan this month to clarify questions about his medical treatment, but the meeting was called off because he wanted The Sunday Times present.

"A meeting was scheduled on Dec 10, but it had to be postponed as Mr Govindan had insisted on a member of the press being present at that time. It is not our hospital policy for our doctors to meet with patients and their family under such circumstances, in accordance with our privacy and confidentiality guidelines," the spokesman said.

The hospital also offered "sincere apologies to Mr Govindan and his family if there had been any lapses in communicating our care plans to him".

"We do empathise with him for having to endure a lengthy period of recovery and the many personal challenges he and his family had to go through given his condition," the spokesman said.

"We are happy to have contributed to his treatment and are glad he is well. We will continue to stay in touch with him to offer him support."