High Court dismisses man's $800k negligence suit against TTSH over mum's death

The man alleged in his lawsuit that the doctors were negligent in not diagnosing his mother correctly. ST PHOTO: KUA CHEE SIONG

SINGAPORE - A man who sued Tan Tock Seng Hospital (TTSH) and three doctors in the High Court, seeking $800,000 for the death of his 74-year-old mother, has lost his case.

Justice Choo Han Teck said the allegations against the defendants were "woefully short of evidence, and have been methodically refuted by not just the treating doctors and nurses, but also the defendants' expert witnesses".

Madam Tan Yaw Lan, who had multiple ailments, including diabetes, hypertension, chronic heart disease and chronic kidney disease, was admitted to TTSH on April 20, 2018, after she had gone to the emergency department with a fever.

Her heart stopped while she was in the shower, assisted by a nursing intern, on the fourth day of her stay.

She died three weeks later, on May 13, 2018, without regaining consciousness.

Her son, Mr Chia Soo Kiang, 47, a public servant with the National Library Board, alleged in his lawsuit that the doctors were negligent in not diagnosing Madam Tan correctly.

Mr Chia contended that his mother had suffered from an acute heart attack which was not picked up at the emergency department and on her admission. He said she should have been referred to a cardiologist.

Mr Chia also alleged that TTSH was negligent in taking Madam Tan for a shower against her family's instructions and in being too slow in its efforts to resuscitate her after she collapsed.

He also criticised the defendants for withholding medications in the first two days, namely aspirin, furosemide and losartan, that Madam Tan had been taking for her existing ailments.

The defendants and their experts maintained that Madam Tan had been correctly diagnosed as having sepsis, an infection, from an unknown source.

In his judgment, Justice Choo accepted the evidence of the defendants' expert, Dr Yeo Khung Keong from the National Heart Centre, that a heart attack would not have been the only possible cause of Madam Tan's death.

Dr Yeo said Madam Tan's entire clinical history, electrocardiograms (ECGs) and various laboratory results did not lead to a clinical finding that she had had an acute heart attack.

He said another possible cause for cardiac arrest would be a blood clot in the lung.

However, there was no definitive answer in Madam Tan's case, as her family declined to have an autopsy performed, said the judge.

Justice Choo said the TTSH doctors were right to focus on treating the sepsis. Madam Tan showed signs of recovery, and by April 23, was able to sit, have her breakfast, chat with the nurses and walk unassisted to the shower room.

"It is important to understand that a cardiac arrest is unpredictable, and that Madam Tan's collapse, had it been caused by a heart attack... could have occurred at any time, anywhere - even in an ICU or HDU," he said, referring to an intensive care unit or high dependency unit.

Mr Chia, who was represented by lawyer Clarence Lun, had relied on the expert evidence of Dr Eric Chong, a cardiologist in private practice.

Justice Choo said Dr Chong's evidence that Madam Tan had an acute heart attack was "perplexing" as she did not show signs of chest pain or shortness of breath and there were no significant changes in her ECG readings.

Justice Choo said the medications were stopped to avert acute complications, and could have been reinstated should the situation change.

The judge said there was no basis for the claim that TTSH was negligent in allowing a medically untrained person to handle Madam Tan, as assisting a patient with a shower does not require any specialised skills.

As for the alleged slow response, Mr Chia had contended that Madam Tan should not have been moved back to her bed before resuscitation efforts commenced.

The judge said it made better sense to move Madam Tan back to her bed, which was next to the shower room and connected to resuscitation equipment, rather than resuscitate her on the wet floor of the shower room.

"Mr Lun produced no evidence, only an assumption on his part, that the brief period that Madam Tan was in coma and suffered brain and spinal injuries was the result of the acts of the defendants. The law requires evidence, not assumptions," said the judge.

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