SMC appeals for leniency for doctor fined $100,000

Dr Lim Lian Arn pleaded guilty to a charge of professional misconduct in June last year for failing to obtain informed consent from his patient.
Dr Lim Lian Arn pleaded guilty to a charge of professional misconduct in June last year for failing to obtain informed consent from his patient.

The Singapore Medical Council (SMC) has appealed for a more lenient sentence for an orthopaedic surgeon, after a disciplinary tribunal fined Dr Lim Lian Arn the maximum $100,000 for failing to inform a patient about the side effects of a steroid injection.

The tribunal's decision last November had led doctors to petition the Ministry of Health (MOH) to clarify its stand on taking patients' informed consent for routine procedures.

Yesterday, SMC's lawyer Chia Voon Jiet asked the Court of Three Judges to slash the fine to not more than $20,000.

In February, MOH had asked the SMC to review the appropriateness of the sentence. The ministry said: "Whilst both Dr Lim and the SMC may have accepted the sentence, the decision in this case carries with it much wider professional practice implications and also has an impact on future cases.

"This case should not be viewed as or lead to the practice of defensive medicine, which would have an adverse impact on patient and clinical safety."

The SMC said it filed the appeal after considering the sentencing guidelines for professional misconduct by doctors.

Mr Chia said the tribunal did not have the opportunity to consider the wider implications of Dr Lim's sentence during his disciplinary inquiry in June last year, and learnt of the concerns raised by doctors only after the tribunal's decision was made public in January.

He said public sentiment was that the sentence was too harsh as the injection is a common procedure.

 
 
 
 

He asked the court to review the appropriateness of the fine and reduce it accordingly.

Dr Lim had given a patient a steroid injection on her left wrist in October 2014.Later, she developed "paper-thin skin with discoloration, loss of fat and muscle tissues" in the area.

In January 2016, she filed a complaint against him for failing to advise her on the possible complications. In June last year, Dr Lim pleaded guilty to a charge of professional misconduct for failing to obtain informed consent.

The SMC sought a five-month suspension, while Dr Lim's lawyer, Mr Eric Tin, asked for the maximum $100,000 fine.

The tribunal concluded that a suspension was not warranted, as the harm caused was limited and Dr Lim's culpability was low.

Yesterday, Mr Chia said the SMC's sentencing position at the time was based on the facts of the case and sentencing precedents.

Shortly after the tribunal's decisionlast November, the court issued a landmark judgment in another case, establishing the sentencing approach for professional misconduct.

Applying the sentencing approach, a fine of not more than $20,000 would be more proportionate, said Mr Chia.

The court, comprising Chief Justice Sundaresh Menon and Judges of Appeal Andrew Phang and Judith Prakash, will give its decision at a later date.

A version of this article appeared in the print edition of The Straits Times on May 10, 2019, with the headline 'SMC appeals for leniency for doctor fined $100,000'. Print Edition | Subscribe