Court quashes suspension of surgeon over medical records

A general surgeon who appealed against a three-month suspension for professional misconduct had the charge against him quashed by the Court of Three Judges.

"There was no basis for the charge to have been brought in the first place," said Chief Justice Sundaresh Menon in ex tempore judgment grounds last week.

The court, which included Judge of Appeal Andrew Phang and Justice Woo Bih Li, ruled that the "relevant threshold was not crossed" based on the evidence and facts, and set aside both the conviction and the sentence.

Dr Edward Foo Chee Boon pleaded guilty to a charge of failing to keep clear and accurate medical records before a disciplinary tribunal (DT) in 2018. It was one of three charges that the Singapore Medical Council brought against him.

Dr Foo did not appeal against the other two charges which related to his failure in exercising due care in managing a patient in 2012. He was convicted on both charges and suspended for a total of 18 months.

But the tribunal held that he should get a 50 per cent discount given the "inordinate delay" in prosecuting him. This effectively means that he will be suspended for nine months. The DT's report was released on Monday.

Dr Foo appealed to the Court of Three Judges against the sentence on the first charge, arguing that a $15,000 fine in lieu of the three-month suspension would suffice.

The patient at the centre of the case was diagnosed in 2012 with rectal cancer by Dr Foo who discussed various treatment options with her.

Two procedures were subsequently performed by Dr Foo and a co-surgeon on Jan 31, 2012, but the patient later developed complications and died on Feb 4, 2012.

The cause of death was acute suppurative pericarditis with myocarditis - a rare heart infection unrelated to the procedure.

Dr Foo, who has been in practice since 1983, was charged with inadequate documentation by the DT, but the Court of Three Judges, after reading submissions by both parties during the appeal, ruled Dr Foo's conviction as unsafe based on the facts and evidence.


"It did not seem to us that any inadequacy in Dr Foo's documentation rose to the level of professional misconduct," said the court.

The court, among other things, found that there was a fair amount of documentation of the discussion between Dr Foo and the patient in January 2012.

The court found that in relation to his failure to record the patient's consent, the co-surgeon had in fact documented this at a time when Dr Foo was abroad and there was some urgency, given the patient's condition.

The co-surgeon had informed him that the admission procedures had been completed. Her consent was a "sufficiently informed one" in the circumstances, the court said.

Dr Foo's lawyer Gan Guo Wei and the SMC's counsel Philip Fong then revised their positions, agreeing that the inadequate documentation was limited to a fairly narrow category of information.

Both parties concurred that there was no evidence the failure of documentation showed a persistent failure on the part of Dr Foo, or that there was actual or potential harm arising from this particular breach.

"Dr Foo's conduct in this respect could not be said to be due to an indifference to the patient's welfare," said the court.

The court further noted that Dr Foo was found liable on two other charges of professional misconduct in relation to the patient's management. "As neither party has appealed against the DT's decision in respect of those charges, nothing in this judgment displaces those convictions and sentences and we make no comment on them," wrote CJ Menon.

In relation to the two charges referred, the DT had in December 2018 ordered that Dr Foo be suspended, censured and gives a written undertaking to the SMC that he would not engage in the conduct complained of or any similar conduct.

A version of this article appeared in the print edition of The Straits Times on February 06, 2020, with the headline 'Court quashes suspension of surgeon over medical records'. Subscribe