Doctor fined $30,000 after patient who was not immediately referred to specialist loses most of sight in eye

A doctor has been fined $30,000 after failing to refer a patient who had a corneal ulcer to a specialist "in a timely manner".
A doctor has been fined $30,000 after failing to refer a patient who had a corneal ulcer to a specialist "in a timely manner".PHOTO: ST FILE

SINGAPORE - A doctor has been fined $30,000 after failing to refer a patient who had a corneal ulcer to a specialist "in a timely manner".

The patient later underwent surgery and permanently lost most of her sight in her left eye.

Dr Sim Kwang Soon, 53, was, at the time, working as a general practitioner at Alliance Clinic & Surgery in Block 652, Jalan Tenaga, off Bedok Reservoir Road.

On June 16, 2010, he diagnosed a patient as suffering from a corneal ulcer in her left eye, but did not refer her to an eye specialist immediately.

Instead, he said that the corneal ulcer was small and would not affect her vision. He advised her to return to him if her condition did not improve, after which he would refer her to a specialist.

One day after her consultation with Dr Sim, the patient saw another general practitioner, who referred her to a hospital's accident and emergency department. She was hospitalised for more than two weeks, and later underwent a corneal transplant and cataract operation.

The patient subsequently filed a complaint with the Singapore Medical Council (SMC) on May 28, 2013.

The SMC convened a disciplinary tribunal to conduct an inquiry on March 24 and Sept 9 of last year, and on Jan 13 and Aug 18 of this year.

In its grounds of decision issued to the media on Tuesday (Sept 26), the disciplinary tribunal said: "Dr Sim's failure to refer the patient to a specialist in a timely manner caused a further aggravation of the ulcer, and ultimately, after a therapeutic corneal transplant, the patient suffered permanent disability in her left eye, with a decreased rate of functionality of only 20 per cent post-surgery."

Dr Sim pleaded guilty to failing to refer the patient to a specialist in a timely manner, and was found guilty by the tribunal.

However, he was not suspended from practising.

Said the disciplinary tribunal: "There was insufficient evidence to show that the harm caused to the patient was due to Dr Sim's failure to refer her to a specialist (in a timely manner)... The (tribunal) also considered and gave full credit to Dr Sim for pleading guilty at an early stage, for his long good standing in the medical profession, and the good testimonials tendered on his behalf."

The tribunal was also satisfied that Dr Sim did not show a propensity to reoffend, since there was no evidence of him being dishonest in the current case, and no further complaints of possible misconduct had been made since the date of the offence.

Aside from the $30,000 fine, the tribunal ruled that Dr Sim should be censured, provide a written statement that he will not engage in any similar conduct in the future, and pay SMC for the solicitors and other costs related to these proceedings.