Gynaecologist suspended for removing woman's ovary without her consent

SINGAPORE - A gynaecologist who appealed against his eight-month suspension by the Singapore Medical Council (SMC) on two charges of professional misconduct was rebuffed by the Court of Three Judges, which held that he should have been suspended for twice that length of time instead.

But though it ruled that the SMC Disciplinary Tribunal penalty was "on the low side", the court said the delay in prosecuting him merited the 16 months being halved, which meant the original term would stand.

The court, comprising Judges of Appeal Andrew Phang, Judith Prakash and Steven Chong, said Dr Jen Shek Wei's conduct demonstrated grave disregard for the interests of a patient, and warranted a sufficiently deterrent sentence.

In judgment grounds on Tuesday (14 Nov), the court dismissed his appeal against his conviction and sentence and affirmed the $10,000 fine imposed by the SMC. The tribunal had also censured him and ordered him to undertake in writing not to repeat such conduct.

Dr Jen, 62, who has been in practice for 28 years, had faced two charges following a woman's complaint in 2011 that he had advised her to undergo surgery to remove a pelvic mass without carrying out further evaluation and investigation of her condition when further assessment was indicated.

Furthermore, in the operation carried out on Aug 21, 2010 to remove the mass on the ovary, he had instead removed her left ovary. This he did without her informed consent, which breached SMC's Ethical Code and Ethical Guidelines. The patient, a 34-year-old finance manager, found out only later when she saw another doctor.

The SMC disciplinary tribunal, which heard the case over several days last year, convicted Dr Jen on both charges, censured him and ordered him to pay costs, in addition to the suspension and fine.

He appealed to the Court of Three Judges in July, when his lawyers led by Senior Counsel N Sreenivasan and Mr Charles Lin argued the DT's finding was unsafe and unreasonable on various grounds and added it had erred in believing her version of events.

SMC, represented by lawyers Edmund Kronenburg and Kevin Ho from Braddell Brothers, disputed their arguments.

In its 72-page judgment, the court said it was not convinced by the appeal and found, among other things, that the patient had opted to remove the mass based on Dr Jen's view that it might be malignant and needed surgery, without further evaluation.

"That was the act of serious negligence," wrote JA Phang on the court's behalf.

The Court further held the conviction on the second charge was justified since Dr Jen did not obtain her informed consent to remove her left ovary, when he knew it was incumbent on him to do so.

The court made clear the consent form alone that she had signed was "irrelevant" based on the unique facts of the case, unless it was proven that the patient understood the implications of the surgery .

It agreed Dr Jen's indifference to his patient's welfare and his lack of remorse were aggravating factors to enhance the sentence.

But a sentence discount was in order to reflect the "inordinate delay" of three years it took for the SMC to issue the notice of inquiry in July 2015. The court said this was clearly unacceptable.

The Court accepted Dr Jen's sentence should reflect the delay in prosecution but saw no reason to change the tribunal's sentence, as it was on the low side when a 16 month term would have been justified.

The court ordered the suspension to start in a month's time.