Doctor suspended three months for letting bus driver continue with job despite eye problem

Dr Sanjay Srinivasan, an eye specialist at Khoo Teck Puat Hospital, let a shuttle bus driver continue work despite an eye condition.
Dr Sanjay Srinivasan, an eye specialist at Khoo Teck Puat Hospital, let a shuttle bus driver continue work despite an eye condition.PHOTO: ST FILE

SINGAPORE - A doctor has been suspended for three months after letting a shuttle bus driver continue work despite an eye condition that caused him to fall short of the standards for driving.

In doing so, Dr Sanjay Srinivasan, a doctor at Khoo Teck Puat Hospital's department of ophthalmology, was deemed to have endangered the patient, passengers and other road users.

The 45-year-old was convicted of two counts of "serious negligence" and is suspended until Oct 26, said the Singapore Medical Council on Friday (July 28).

He had allowed the patient to resume driving despite knowing that the patient did not meet the required 6/12 visual acuity standard - which is half as good as the vision of a normal person, otherwise called "driving vision".

The patient's right eye had a visual acuity of only 6/24. This goes against the Singapore Medical Association medical guidelines that require bus drivers with a Group 2 Licence to have visual acuity of at least 6/12 in each eye.

The senior resident physician at the hospital's department of ophthalmology had diagnosed the private shuttle bus driver with a mild cataract and posterior vitreous detachment in his right eye on Oct 16, 2013. He gave the driver the option of making a pair of spectacles and returning to work after a day's medical leave.

The SMC's disciplinary tribunal (DT) found that Dr Sanjay had assumed that the patient would meet the standards based on a pinhole test, rather than using the manifest refraction test that is accepted as the gold standard test. On top of that, the doctor had not made it mandatory for the patient to have spectacles made before he resumed driving.

Instead, he arranged for the patient to return for a check-up six weeks later, instead of putting him on medical leave for these six weeks.

The tribunal, which held the inquiry for the complaint from October last year to February, said it was "simply unacceptable".

The DT also found Dr Sanjay guilty of another charge which involves him failing to conduct further tests before diagnosing the patient.

The tribunal disagreed that the doctor examined the patient as thoroughly as he should have done. It also noted there was a lack of documentation of the case, as well as advice given to the patient regarding the spectacle prescription and his subsequent return to work.

There were indications that the doctor did not satisfactorily account for all the patient's signs and symptoms based on the examination, according to the tribunal.

For instance, Dr Sanjay did not re-take the driver's medical history when he realised his patient needed a Mandarin interpreter to understand the management plan and diagnosis.

The doctor had contested both charges. The DT, however, noted the public safety implications of his actions and felt it was important to send a message that careful clinical evaluation is vital.

It did, however, acknowledge that Dr Sanjay was remorseful, and had positive testimonials and references of his good character.

Besides the suspension, Dr Sanjay was censured and ordered to give a written undertaking to the SMC as well as pay for the costs of the disciplinary proceedings.