SINGAPORE - The family of a pharmaceutical company executive, who died at the age of 44 following a liposuction procedure in 2013, was awarded damages of about $5.6 million by the High Court on Thursday (Nov 26).
Surgeon Edward Foo Chee Boon, who was sued by the family of Madam Mandy Yeong Soek Mun, was ordered to pay the damages after the court found that he was negligent in performing the procedure at his TCS at Central Clinic.
In a written judgment, Justice Choo Han Teck said: "Dr Foo, who may well be a competent general surgeon, was not adequately trained to perform the liposuction and fat transfer procedures.
"Unfortunately, Dr Foo believed himself capable and thus did not manage this case as a competent surgeon in this field should have done."
The judge also found that Dr Foo's delay in sending for an ambulance after Madam Yeong collapsed at his clinic was an act of negligence.
"Dr Foo should have pounded the alarm; and should have done so much earlier," said the judge.
Dr Foo initially deflected liability by blaming the doctors at the Singapore General Hospital's accident and emergency department for failing to resuscitate her, but dropped his case against the hospital doctors midway through the trial.
On June 28, 2013, Madam Yeong underwent a procedure at the TCS at Central Clinic to remove fat from her abdominal flanks, followed by a fat transfer to smooth the unevenness in her thighs.
It was her third liposuction procedure at the clinic.
She first underwent liposuction in 2010, which resulted in hollows and surface irregularities in her thighs.
In 2011, she visited the clinic again to transfer fat from her abdomen to her thighs.
She returned in 2013 to further correct the irregular contours.
After a two-hour operation, she developed complications and was taken to SGH, where she died 2½ hours later.
A coroner's inquiry found that she had died from pulmonary fat embolism, in which blood flow is blocked by fat particles.
They alleged Dr Foo was negligent in his failure to obtain informed consent from her by telling her about the risks, in the way he performed the procedure, and in his post-operative care by, among other things, failing to call for an ambulance in time.
Dr Foo denied all three allegations.
Justice Choo said in his judgment that Dr Foo had not adequately drawn Madam Yeong's attention to the risk of fat embolism.
But the judge said Dr Foo could not be said to have caused her death in this regard because the evidence pointed to the inference that she would probably have gone ahead nonetheless.
Turning to the procedure itself, Justice Choo said the evidence supported a finding that the fat embolism occurred as a result of Dr Foo inserting a blunt tip cannula into Madam Yeong's thigh and directly injecting fat molecules into her bloodstream.
"All things considered, it was more likely than not that Dr Foo had inadvertently punctured a blood vessel as he was injecting the fat into Mandy Yeong's thigh," said Justice Choo.
As for the events after the procedure, the judge noted that after Madam Yeong's oxygen saturation level fell, the evidence from those present was "neither clear nor consistent".
"The picture that emerges is that of total mayhem and confusion. Nobody seemed to know what to do," he said.
Dr Foo said he spent about 45 minutes trying to raise the oxygen saturation level and to diagnose the cause of the drop before the ambulance was called.
Justice Choo said there was no reason why he could not have called an ambulance while simultaneously diagnosing the problem.
"The fact that it took him 45 to 50 minutes to realise that he could not figure out what was going on compels me to infer that Dr Foo was not adequately trained for such surgeries," said the judge.
In the suit, Madam Yeong's family said they lost a substantial source of financial support as a result of her death.
At the time of her death, Madam Yeong's income of more than $420,000 a year as head of regional market development at Roche Diagnostics Asia Pacific, was three times that of her husband's.
The family said she paid for a large portion of the family's expenses, including the educational expenses of her two sons, who were 13 and 17 when she died, and also supported her parents.
Justice Choo awarded $1.7 million for the dependency claims of Madam Yeong's family members.
This included $1.4 million for her husband Seto Wei Ming, about $97,000 for her elder son, about $122,000 for her younger son, and $94,000 for her elderly parents.
Justice Choo also awarded $3.8 million for loss of inheritance, based on Madam Yeong's projected income and stock options, which is the wealth she would have accumulated had she not died.
He awarded about $31,000 for estate claims, which included funeral expenses, medical expenses incurred at the clinic and general damages for pain and suffering.
Second botched liposuction death
The death of Madam Mandy Yeong due to pulmonary fat embolism was the second fatality in Singapore arising from a negligent liposuction procedure.
In December 2009, Mr Franklin Heng, chief executive of YTL Starhill Global Reit Management, died after he was given too much anaesthesia during a liposuction procedure.
Mr Heng, who was 44 at the time, suffocated when his airway collapsed because of the heavy sedation.
Estate trustees sued the two doctors and the clinic responsible on behalf of his family. In May 2015, his family was awarded $5.3 million by Justice Choo Han Teck.
The sum included $3.88 million to make up for the loss of inheritance his dependants suffered. In September 2016, the Court of Appeal reduced the payout from $5.3 million to $3.2 million.
In November 2018, a Court of Three Judges ordered one doctor, Wong Meng Hang, to be struck off the register, and the other, Zhu Xiu Chun, to be suspended for 18 months. The court also called for the duo to be investigated for possible criminal offences.
In January this year, Wong was charged with causing Mr Heng's death through a rash act, while Zhu was charged with abetting him.