A 51-year-old woman is suing Singapore General Hospital (SGH) and two of its doctors for $8 million, claiming their negligence caused her to lose her legs at the knee, her hands and part of her arms.
Ms Sarina Kaur alleges that one of the doctors went ahead with a simple procedure to treat a urinary condition, even though pre-treatment tests showed she was carrying a bacterial infection. This, the former receptionist claims, led to blood poisoning, gangrene and the loss of all her limbs.
But SGH's chair of surgery, Professor London Lucien Ooi, yesterday said the complications could have been a result of her multiple underlying conditions.
Ms Kaur, who is single and lives with her 78-year-old mother, was diagnosed with multiple sclerosis about 25 years ago, for which she has been receiving steroid treatment at SGH.
In 2008, she was diagnosed with vesico-ureteric reflux, a condition in which her urine would flow back from the bladder to her kidneys. She also had a recurring urinary tract infection.
In 2012, she was referred to Dr Ng Lay Guat, who was head of urology at SGH. She was recommended a deflux procedure to stop the backflow. According to Ms Kaur's statement of claim filed with the High Court on Wednesday, Dr Ng told her that the procedure "was simple, straightforward and low-risk".
It was scheduled for Nov 20, 2012. But pre-admission test results on Nov 17 showed the presence of multi-resistant Escherichia Coli bacteria in her urine.
Ms Kaur believes that Dr Ng, whom she is suing, should have treated the infection before doing the procedure, which was not urgent and could have been postponed. Instead, Dr Ng gave her an injection of a broad-spectrum antibiotic, went ahead with the procedure, and put her on a daily dose of the medication the day after.
But that night, Ms Kaur developed a fever of 38.7 deg C. Dr Du Jingzeng, the other doctor in the suit, was the medical officer on duty at the time. He diagnosed "likely sepsis" or blood poisoning, but did not call for a more senior doctor to examine her.
The next morning, during her rounds, Dr Ng and her team did an ultrasound scan and found that Ms Kaur's right kidney was swollen.
According to court papers, they did not, "in accordance with standard management", immediately relieve the swelling, drain the infected urine, or effectively treat the infection.
Later that day, Ms Kaur's fever rose to 39.3 deg C. In the evening, she was in "severe septic shock" and was moved to intensive care. Over the next few days, she developed multiple complications, including respiratory distress, multi- organ failure and gangrene. As a result, all four limbs had to be amputated.
On Dec 1, 2012, both her legs were cut off at the knee. Both hands were amputated on Jan 7. At the end of the month, her lower right forearm was cut off. Before the end of 2013, dead tissue on her left forearm stump had to be removed.
She had to quit her job and is no longer working.
Her claims include a report by orthopaedic surgeon Lee Soon Tai, which states: "The absence of wrist/hands and legs/feet deterred Sarina from carrying out her daily self-care and physical activities. She relied on her domestic helper to do the simplest things."
Giving SGH's side, Prof Ooi said in a statement issued by the hospital that the presence of bacteria in urine is not conclusive of an infection in the absence of other symptoms. He explained that Ms Kaur was given a suitable antibiotic "to cover any possible infection".
He said the "serious complication of septic shock following a routine procedure" could possibly be the result of her multiple underlying conditions.
He stressed that the hospital had given her its "full support throughout her treatment as we understand that the complication has been devastating for her and her family".
Ms Kaur has since turned to Tan Tock Seng Hospital for prosthetics.