Another doctor in trouble

[Atrecord]

1 hour ago, Wind30 said:

I think Singapore is pretty good in a lot of aspects but the cost or quality of medical care is not as good as our neighbouring countries like Taiwan Australia.

government is not focusing enough in cutting the medical costs.

It is sad when your residents need to go overseas todo dental work....

i am not poor but I have experienced if I want to see a specialist in public hospital got to wait for months. Private is Insanely expensive even for me.

https://www.channelnewsasia.com/news/singapore/dental-treatment-cost-johor-bahru-bangkok-singaporeans-11913880

I haven't read much on this topic, but like to cite one case here.

Last Dec I went to NZ, and met an old neighbour who moved there about 5-6 yr ago. He said his daughter, who just graduated, needed to extract wisdom tooth, and she was going to come back SG the next month to do so. He said it was very expensive to do so there... 😓

[Atrecord]

50 minutes ago, Lala81 said:

Blood transfusion for post tkr older or frail folks is common. Some surgeons may even do it almost routinely. 

I used to check the blood when I was a house officer. 

There would be a tube leading to a bag, of the 'bleeding blood' coming out of the wrapped-up wound. Honestly see liao quite scary 😅. That would continue for i think maybe a day after the op. Then the transfusion could be done at the same time...

Doc also need to check? i tot it's the nurses who will monitor and replace the bag when it's full.

[Lala81]

45 minutes ago, Atrecord said:

There would be a tube leading to a bag, of the 'bleeding blood' coming out of the wrapped-up wound. Honestly see liao quite scary 😅. That would continue for i think maybe a day after the op. Then the transfusion could be done at the same time...

Doc also need to check? i tot it's the nurses who will monitor and replace the bag when it's full.

Blood transfusion need to check patient identity, blood type. Nurse check, doctor also check. 

Think what you meant is a drain? Though i don't think most TKRs have drain sites if i recall.

[Atrecord]

8 minutes ago, Lala81 said:

Blood transfusion need to check patient identity, blood type. Nurse check, doctor also check. 

Think what you meant is a drain? Though i don't think most TKRs have drain sites if i recall.

Arrh... ok, yes, good to have counter checks for the blood. v impt.

Yes, the pack of blood given is not scary. I meant the blood flowing out from the wound - so it's called a drain - is the one that was worrying. It wasn't so much as disgusting, but i got worried about when would it stop... 😓

No drain normally meh? I clearly remembered my mother had, the same day after the op...

[Lala81]

1 minute ago, Atrecord said:

Arrh... ok, yes, good to have counter checks for the blood. v impt.

Yes, the pack of blood given is not scary. I meant the blood flowing out from the wound - so it's called a drain - is the one that was worrying. It wasn't so much as disgusting, but i got worried about when would it stop... 😓

No drain normally meh? I clearly remembered my mother had, the same day after the op...

Hmm maybe there is. My memories from 14 years ago. I only see the patients after they are discharged from hospital

[Atrecord]

34 minutes ago, Lala81 said:

Hmm maybe there is. My memories from 14 years ago. I only see the patients after they are discharged from hospital

oh... then i can confirm there is. My mum did the ops 3 yr ago. I just dunno was it normal, or was her case more jialat... She was already 79 at that time.

But for one leg, 3 of the 4 patients in the room were TKR patients, all had ops maybe same day or one day apart. The other 2 were likely in their 50s. And my mother recovered fastest.

[Lala81]

38 minutes ago, Atrecord said:

oh... then i can confirm there is. My mum did the ops 3 yr ago. I just dunno was it normal, or was her case more jialat... She was already 79 at that time.

But for one leg, 3 of the 4 patients in the room were TKR patients, all had ops maybe same day or one day apart. The other 2 were likely in their 50s. And my mother recovered fastest.

Depends on patient.

But also surgical technique is important. Some people are just better surgeons than their peers. Just like saying these group of players are premier league standard. But even within premier league standard, got significant difference in skill. The good surgeons are really quite obsessed with improving every facet of their surgery.

Time under tourniquet, blood loss, small alignment differences all matter.

 

Edited September 20, 2019 by Lala81

[Etnt]

1 hour ago, Atrecord said:

oh... then i can confirm there is. My mum did the ops 3 yr ago. I just dunno was it normal, or was her case more jialat... She was already 79 at that time.

But for one leg, 3 of the 4 patients in the room were TKR patients, all had ops maybe same day or one day apart. The other 2 were likely in their 50s. And my mother recovered fastest.

i had drains from laminectomy and nephrectomy, think it's common for larger wounds?

[Lala81]

6 minutes ago, Etnt said:

i had drains from laminectomy and nephrectomy, think it's common for larger wounds?

 yeah drains are quite commonly placed after certain surgeries. 

[Philipkee]

3 hours ago, Atrecord said:

Apart from long waiting time, govt hosps or RHs also have resource constraints. TTSH for example, prob has the most load of all hosps. occupancy rate likely hovers around100% 99% of the time. I remember many years ago, TTSH actually leased ward space from KKH (which is maybe 5 min away) as KKH was bo business (birth rate declined, remember?) for a while.

And for the subsidised wards, i suspect nursing care could be quite stretched, as even for the private wards, also sometimes it takes a long time for nurses to respond to calls for assistance.

KK is the default for child birth, but I know in the past, TMC was very popular as they sold it as different from other hospitals, in that normally, people (esp. older gen) used to shun hospitals as in the olden days, go hosp almost always meant got problems, and often mean bad news and even bad outcomes (or never come out... 😓)... So while all other hospitals have got A&E, where unfortunately, loss of life is not unheard of, meaning there can be 'sad' scenes, TMC sold the story that it's a place of life, so only had 'happy' scenes. But i think the reputation was tarnished somewhat when the IVF blunder came out...

Oh, almost all the gynaes who set up clinics in TMC, were experienced ones who had handled countless deliveries over the years. And because it's a dedicated woman and children hosp, most if not all the staff there are also very well trained.

Eh I dunno how to edit your post so I quote everything.  I am only replying to the first paragraph.  A hospital is RARELY IF EVER 99%  100% full.

In very simple terms, there are three kinds of beds in a hospital.

Occupied beds - beds where there are physically patients on them 

Booked beds - beds that have NO patients on them but they are reserved for patients who are post surgery the next day.  

Example.  On Monday night, three beds are empty.  They are booked for patients going for elective surgery on Tuesday morning because after surgery they need to be admitted.  If these beds are given to fresh admissions it means that the next day post surgery they have to wait in the OT for a bed to be available.

Why is this important?  Sometimes these beds will be released at  night because either surgery is cancelled, postponed or there is so much pressure for the beds and they release one bed for one very ill patient.  I always hear when I work night shift in the ED when i tell family of patients maybe a bed will be available later.  They always retort

"Who is going to be discharged at night?"

So yea it happens. Of cos there are night discharges (rare). 

And of cos if @RadX does his job there are people who die and the bed becomes vacant - but if I say this I think I am gonna be shot by everyone.

Lastly, physically empty beds that have no bookings.  When you read the news they always say maybe 80-90% occupancy in the hospital so no beds for patients....  so where is the 10-20% empty beds?  In a thousand bedder hospital that is over 100 empty beds.  Well, they are in ICU, empty wards like labour wards, or burns ICU which tend to be empty if there is no disaster and such.  Just in case some of you are thinking like in the post I quoted (its 99% full.  So why cant I get admitted since there is still 1%?).  Or they are A+ beds.  Usually B2 - C class gets filled up.  Every hospital have their own policies regarding upgrading a patient for free (B2 patients warded in B1) which brings back to my point how come a bed can be available suddenly at 3 am in the morning when there are supposedly no discharges.

Ok.  Off topic liao.  Heheh

Edited September 20, 2019 by Philipkee

[Vratenza]

14 hours ago, RogerNg_185295 said:

The salary gap i read online between private and public hospital doctors is very huge.  That's why a lot of doctors jump ship. 

Of course.

Because the masters think only their skills and competency needs to be tagged to the top income basket of professionals.

The rest of the professionals are just mediocre and do not deserve to be paid to be in public service. 

[Voodooman]

5 hours ago, Atrecord said:

Apart from long waiting time, govt hosps or RHs also have resource constraints. TTSH for example, prob has the most load of all hosps. occupancy rate likely hovers around100% 99% of the time. I remember many years ago, TTSH actually leased ward space from KKH (which is maybe 5 min away) as KKH was bo business (birth rate declined, remember?) for a while.

And for the subsidised wards, i suspect nursing care could be quite stretched, as even for the private wards, also sometimes it takes a long time for nurses to respond to calls for assistance.

KK is the default for child birth, but I know in the past, TMC was very popular as they sold it as different from other hospitals, in that normally, people (esp. older gen) used to shun hospitals as in the olden days, go hosp almost always meant got problems, and often mean bad news and even bad outcomes (or never come out... 😓)... So while all other hospitals have got A&E, where unfortunately, loss of life is not unheard of, meaning there can be 'sad' scenes, TMC sold the story that it's a place of life, so only had 'happy' scenes. But i think the reputation was tarnished somewhat when the IVF blunder came out...

Oh, almost all the gynaes who set up clinics in TMC, were experienced ones who had handled countless deliveries over the years. And because it's a dedicated woman and children hosp, most if not all the staff there are also very well trained.

Yes. TMC or KK for child birth. My first child was born at Gleneagles, second in KK.  The doctor were equally experienced and competent but the KK nurses really impressed me.  They know exactly when to do and when to activate the doctor. 

Wifey recently did a joint ops in SGH with a senior doctor recommended by a friend, all the patients in the ward were there for some form of joint or bone surgery, the post surgery care is pretty good.  My faith in govt hospital has been restored. 

I heard the bed crunch issue has been largely alleviated with the opening of a few new hospitals.

Edited September 20, 2019 by Voodooman

[Etnt]

6 hours ago, Atrecord said:

And for the subsidised wards, i suspect nursing care could be quite stretched, as even for the private wards, also sometimes it takes a long time for nurses to respond to calls for assistance.

I was in B2 of 2 different wards, I find the response from the nurses reasonable.

If anything, they were faster than the nurses responding to my parents warded at Mt E on other occasions.

Edited September 20, 2019 by Etnt

[Windwaver]

https://www.theonlinecitizen.com/2021/03/12/from-recovering-well-post-op-to-dying-from-pneumonia-just-three-days-later-tragic-death-of-sgh-patient/

From recovering well post-op to dying from pneumonia just three days later – Tragic death of SGH patient

by kathleen

 12/03/2021

in Current Affairs

When her mother was due to undergo surgery, one woman was counting on Singapore’s world-class healthcare system to handle everything properly. However, the frustrating medical journey ended up tragically as her mother died just a few days after a surgery that purportedly went well.

Within less than 10 days after being admitted for a medical review, Ms Esther Lim had to grapple with her mother’s death following a pneumonia infection—though without the usual symptoms of fever or cough—just 24 hours prior to that fateful moment.

Ms Lim’s mother was due for a medical review at Singapore General Hospital (SGH) on 24 October 2019 for a thoracic spine cord compression diagnosed in August. Since then, a doctor in the general had noted that her mother’s weak legs was due to ageing, said Ms Lim.

At the time, she was told that there was no urgency for any operation. Instead, her mother could go for rehabilitation or physical therapy instead, and only consider an operation in three to six months.

This review was actually brought forward to September instead after the elder Mdm Hay’s condition deteriorated following a fall at home, according to Ms Lim. Though the SGH said in its letter in response to Ms Lim’s later complaint that the review was brought forward on request of the family due to Mdm Hay’s weakening condition.

The letter also outline Mdm Hay’s underlying medical conditions such as high blood pressure, high blood cholesterol, diabetes, chronic kidney disease, subdural haematoma and meningioma.

So on 10 September, Mdm Hay was admitted into SGH for her second MRI scan—the first done in August 2019—in preparation for a procedure which was scheduled for 12 September. A young doctor, Dr Ang, had informed the family that urgent operations were needed.

As required, Mdm Hay fasted before the procedure. Unfortunately, a nurse had mistakenly administered the wrong medication, meaning that the operation had to be pushed back for the next 48 hours, “as advised”, claims Ms Lim.

What SGH said in their defence

According to Ms Lim’s account, the operation was then rescheduled for 8am in the morning of 13 September – decidedly well within the 48 hour period since the last time Mdm Hay took her medication. But there were clearly problems even then as the operation kept being postponed to make way for more “urgent” cases, said Ms Lim, adding that her mother had to fast the entire time.

Finally, she was given some food at 1pm on 13 September, and the nurse informed the family that the time of the operation remained unconfirmed.

What SGH said in their defence

Ms Lim noted that the family was left hanging right up until 8pm that day and Mdm Hay was eventually wheeled into an operating theatre at 10.30pm.

But rather than getting the operation immediately as she expected, Mdm Hay had to wait another two hours before the operation began. She was in the operating room alone the whole time and told her family that she was “terrified and nervous” about the operation.

SGH confirmed in its letter that the operation eventually happened at 12.40am on 14 September, adding that it was completed “uneventfully” at 5am when she was then placed in the High Dependency Unit (HDU).

When she went to visit her mother the next day, Ms Lim said was told by the doctor in charge of the case that the operation was very successful with 8 screws having been inserted. This was different to the initial 4 screws they were told it would be, she recounted.

What SGH said in their defence

Now, post-surgery, Ms Lim recalled that the doctor said Mdm Hay could be transferred to a normal ward the next day. However, Mdm Hay insisted on remaining in the High Dependency ward until she was fully recovered as she was still in so much pain from the surgery.

At this point, Ms Lim noted several concerning observations about how the hospital and nurses cared for her recovering mother.

First was that her mother was given brown rice for a meal even though she was supposed to be on a soft food diet. After voicing this out, the nurse then brought in porridge instead.

The other concern was how rough the nurses were when changing Mdm Hay’s clothes. Ms Lim recalled her mother telling her that they kept rubbing against her operation wounds, and that the pain was so terrible that she refused to change clothes. The nurses ignored her, however, and kept changing her clothes despite protests.

To this, SGH simply said that “Mdm Hay did not report pain when the nursing team changed her clothes and carried out bed sponging.”

Ms Lim had also observed a nurse coming to take blood but was unsuccessful, which caused her mother a lot of pain.

The next day, Ms Lim visited her mother again and tried to feed her some soup. But at this point, Mdm Hay said she had no appetite. She did manage some spoonful of porridge for lunch. The nurse had also checked Mdm Hay’s temperature and said that there was no fever, which was a good sign, said Ms Lim.

At this point, the doctor had once again tried to convince Mdm Hay to move to a regular ward. She still refused, said Ms Lim.

Here, SGH recounts in its letter a series of bowel related issues that Mdm Hay was apparently experiencing, including constipation for which she was prescribed laxatives.

Just two days after her operation—which was successful and she seemed to be recovering well—the family was informed by SGH that Mdm Hay’s oxygen levels had fallen drastically by half, said Ms Lim.

Ms Lim rushed over to the hospital that morning around 8am to see her mother. However, she found that her mother wasn’t in the ward. The neighbouring patient in the ward told her that many people attended to Mdm Hay around midnight.

After asking the nurses, Ms Lim was informed that her mother was taken to an urgent CT scan. She was also transferred to a different ward. Ms Lim made her way there.

SGH noted in its letter that Mdm Hay’s oxygen level had dropped “suddenly” around 12.27am on 16 September. She was given oxygen supplements. The hospital said there were also crackling sounds in Mdm Hay’s lungs and that her abdomen was distended.

She was referred to the Surgical ICU team and the General Surgery team for these conditions. The letter notes, “By then, Mdm Hay did not have signs and symptoms such as fever to suggest severe systemic infection but was possibly aspiration in the lungs.”

Ultimately, the hospital performed several more tests and procedures to deal with these issues including a plan to order an abdominal x-ray, carry out chest physiotherapy, chest, abdomen and pelvic CT scans, and more.

Ms Lim then recalled seeing her mother when she woke up, noting that Mdm Hay was thirsty and requested water but the nurse refused, only allowing dips of water onto the lips. She had to settle for offering her mother a soaked piece of cotton, she said.

On the morning of 16 September, SGH said that Mdm Hay had developed a fever and was subsequently referred to the infectious diseases specialist who, after some tests, diagnosed her with pneumonia and prescribed a broad spectrum of antibiotics.

Ms Lim says that the family was informed around 3.30pm by the doctor that Mdm Hay had contracted pneumonia and would need antibiotics, as well as further observation over the next 24 to 48 hours.

Ms Lim recalled that there were also several “procedures” conducted from then till about 5pm, thought she wasn’t allowed in the room while those were carried out.

A colon specialist was also assigned to brief the family – her job was to confirm if the Mdm Hay had an infection in her colon, as an operation would be required if it was. An endoscopy later confirmed that there was no infection.

Mdm Hay was then sent to the ICU for 24 hours of monitoring.

Things took a fatal turn the next day on 17 September when the family was informed that Mdm Hay’s condition had deteriorated. They then put her on new antibiotics.

According to SGH, Mdm Hay “remained very ill with septic shock” and that her condition continued to deteriorate, as she also started suffering from hypoxaemia “despite ventilation and maximum treatment”.

On this day, Ms Lim had visited her mother again in the morning and was shocked to find her mother lying face down on the bed, her face completely buried and unsupported. The hospital, in its letter, described this as a “prone position” in order to improve oxygenation.

When asked about this, the nurse on duty told Ms Lim that Mdm Hay was on 100 percent oxygen and not breathing on her own. Unsatisfied by that answer, Ms Lim requested for her mother’s head to be supported and tilted to a more comfortable position.

SGH explained this positioning as “part of the usual treatment for patients with severe hypoxaemia” and that their nurses were “extremely familiar” with the technique. Noting the family’s concern over the sight, SGH added that a headrest pillow was initially used to support Mdm Hay’s head but that was later swapped out for rolled towel “for better positioning”.

The hospital also noted that the nurses repositioned Mdm Hay’s head and limbs every two hours to relief pressure and that Mdm Hay’s head was not in direct contact with the bed, reassuring the family that “appropriate measures were taken to minimise harm to Mdm Hay when she was nursed in a prone position.”

At this point of questioning Mdm Hay’s positioning, Ms Lim said that the nurse asked her to leave and told her that ICU visiting hours would be at 12 noon. This, of course, was inaccurate. Ms Lim later learned that there was no time restriction on visiting hours at the ICU, only that it was limited to two persons at a time. Ms Lim was there alone at the time, so she later wondered why she was chased out of the room.

At the time, Ms Lim decided to stick around. About an hour later around 8.30am, Ms Lim snuck back into the ICU but was told that she had to wait outside because some procedures were being done.

At 10.30AM when she was finally able to go back into the room, she saw that a sponge cushion had been placed to prop up her mother’s face from the bed.

Ms Lim recalled that the nurse then said that the doctor wanted to meet the family for a briefing around 4pm. The family insisted on an earlier meeting given Mdm Hay’s critical condition, so they met at 2PM, instead.

To this, SGH said the primary team doctor had requested for a meeting anytime before 4pm. It added, “Mdm Hay’s clinical deterioration was rapid and may have overtaken any anticipated arrangements by the team who were arranging the family meeting”.

“We apologise if this have led to any misunderstanding,” it added.

At the meeting, Ms Lim said the doctor told the family that the Mdm Hay would not make it and had little time to live due to a “too fast” virus infection.

Mdm Hay died that day around 3pm.

Complaint to SGH

Following this harrowing  chain of events and highly stressful few days, Ms Lim wrote in an official complaint to SGH on 30 September 2019. SGH replied with a letter on 29 November 2019 explaining its version of evens – which we’ve recounted above in tandem with Ms Lim’s recollection.

Not satisfied, Ms Lim followed up with more questions and clarifications,  requesting further clarifications on the procedures that were done and the rapid deteriorating of Mdm Hay’s condition even after the doctor said she was recovering well. She also disputed the hospital’s claim that the nurses has acted professionally. Ms Lim had threatened legal action against the hospital.

This follow up prompted a meeting between the hospital and the family scheduled for 30 January 2020. However, Ms Lim recounted that the meeting was later cancelled but she was not informed until she called the hospital to find out the venue and time.

A meeting was eventually held on 29 November 2020, though without any conclusion, says Ms Lim, adding that it was “mainly for SGH to close their file.”

TOC reached out to SGH for their comments on the matter.

The hospital said: “We had arranged a family meeting with the medical team in Nov 2020 as the family has further concerns despite our detailed written explanation dated 29 Nov 2019.

“Out of respect to the family, we are unable to share details of the meeting.”

Ms Lim told TOC that she recalled SGH saying during the meeting that Mdm Hay’s cause of death was certified by a coroner to be “pneumonia” and that they were puzzled as well as to why her condition deteriorated so fast after being transferred to the ICU.

As to the question of how the nurses cared for Ms Lim—such as laying her face down on the bed with nothing to prop her head up, and a nurse saying that ICU visiting hours only started at 12 noon—SGH apparently said that their nurses were very professional and followed SGH guidelines.

They explained, as they did in their letter, that the patients were turned every hour and that the nurses ensured that patients were places in the most comfortable position.

About the ICU visiting hours, SGH just said that it could have been a “miscommunication”.

Overcome with anger, Ms Lim said she walked out of the meeting halfway through, unable to listen anymore to SGH’s rationalisation of the events.

On the issue of expediting the request a medical report, Ms Lim said that this took a long time as well since the hospital requested not only for all Mdm Hay’s children to submit their birth certificates and NRIC, but also for the dead certificate of Ms Lim’s father who had passed away 37 years ago.

Eventually, the medical report was received on 9 December 2020, more than two month after it was requested.

As described by Ms Lim, the two paged report was drafted by the young doctor who operated on her mother and advised the family that she was “well” enough to be discharged.

TOC reached out to SGH for further comments on Ms Lim’s detailing of the family meeting but have yet to receive a response.

[Watwheels]

That's unusual. With her age and pre-existing condition the doctor still went ahead with the surgery wor. Most likely family insisted. 

Quote

The letter also outline Mdm Hay’s underlying medical conditions such as high blood pressure, high blood cholesterol, diabetes, chronic kidney disease, subdural haematoma and meningioma.

I gave up reading. A great wall of text. Is it a pelvic surgery?

Cannot lah. Given the old age and pre-existing conditions whatever you do...do not opt for surgery. Their body cannot take it.

 

[Wind30]

On 9/19/2019 at 2:56 PM, Lala81 said:

The final details will be out when the SMC releases it's final verdict on whether there was misconduct.

 

Is the smc report out? Cant find anything...

Someone died. Coroner said it was doctor fault. Mt E filed a complaint with SMC vs the doctor. 

1.5 years and nothing from SMC... sigh... 

I hope it is me who cannot find the report, not that they take 2 years to close something... like zero accountability whatsoever.

 

Edited March 12, 2021 by Wind30

[Windwaver]

https://www.todayonline.com/singapore/2-doctors-appeal-suspension-medical-practice-sex-patient-1960341

2 doctors appeal against disciplinary action over alleged attempted sex with patient

Dr Julian Ong Kian Peng (left), who ran Julian Ong Endoscopy & Surgery at Mount Elizabeth Novena Specialist Centre, and Dr Chan Herng Nieng (right) who runs his own private practice at Capital Mindhealth Clinic.

• Two doctors, Chan Herng Nieng and Julian Ong Kian Peng, were close friends and boasted about their sexual exploits with married women
• A disciplinary tribunal found that they engaged in professional misconduct
• Dr Ong had introduced a female patient to Dr Chan, allegedly so that Dr Chan may try to have sex with her
• Both men are now appealing against their convictions and suspensions from medical practice
• The Singapore Medical Council is also appealing for longer lengths of suspension for them

SINGAPORE — Two doctors, convicted of professional misconduct by a medical watchdog's tribunal after they were accused of trying to sexually exploit a patient, went to court on Wednesday (Aug 3) in a bid to clear their names or, failing that, receive shorter periods of suspension from medical practice.

In a counter-appeal, the Singapore Medical Council (SMC) is asking the court to impose tougher penalties on psychiatrist Chan Herng Nieng and colorectal surgeon Julian Ong Kian Peng.

The Court of Three Judges, which is the highest disciplinary body that deals with doctors’ misconduct, reserved their judgement until a date yet to be fixed.

The two senior doctors have been embroiled in a string of legal disputes over the past few years after Dr Chan began dating a married woman.

In 2018, the woman, Ms Serene Tiong Sze Yin, found explicit WhatsApp text messages that the two close friends exchanged about their sexual exploits with other married women.

READ ALSO

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After she filed a complaint with SMC, the council launched an investigation into both doctors’ conduct and brought the disciplinary charges against them.

Its disciplinary tribunal convicted them of engaging in improper conduct that brought disrepute to the profession. The charges stated that Dr Ong colluded with Dr Chan to introduce a female patient to him so that Dr Chan could attempt to have sex with her.

The tribunal suspended Dr Ong and Dr Chan for eight months and five months respectively.

Both men are now appealing against their disciplinary convictions and sentences. At the same time, the council is appealing for longer sentences of at least four more months’ suspension for both men.

'FEEL FREE TO PLAY YOUR GAME'

The disciplinary case revolves around a WhatsApp exchange where Dr Ong had shared the contact number of a female patient — a property agent identified only as Ms K — with Dr Chan.

During Wednesday’s hearing, the three judges — Chief Justice Sundaresh Menon, as well as Judges of Appeal Andrew Phang and Tay Yong Kwang — repeatedly urged both men’s lawyers to explain what their reasonable interpretation of the WhatsApp messages was.

The court was shown screenshots that Ms Tiong had submitted to the council, which went like this:

• Dr Chan to Dr Ong: “Can ask her for drinks instead?”
• Dr Ong then responded with Ms K’s contact and said: “Feel free to play your game.” He also replied “sure” to Dr Chan’s earlier question about drinks
• Dr Chan: “Me? Out of the blue ask her?”
• Dr Ong then responded with a crude sexual suggestion that Chief Justice Menon described as distasteful and offensive, before Dr Ong added: “She’s expecting you (regarding) the property.”
• Dr Chan replied: “I can’t decide to go (through) the property route.”

Dr Ong’s lawyer, Senior Counsel N Sreenivasan, argued that both men were talking about a property deal all along and it had nothing to do with trying to have sex with Ms K. At the time, Dr Chan was thinking of buying property for investment purposes.

Chief Justice Menon told Mr Sreenivasan: “That theory, that hypothesis you put forward, that this was an innocent act, passing on a contact of a property agent friend — that has got to be consistent with the entirety of the WhatsApp exchange. How do you make that good?

“(If this was an) innocent introduction of a property agent, why are you thinking of asking her for drinks, playing a game, plotting how to get it across because it’s out of the blue? Why is there a message of an overtly sexual tenor there?”

Chief Justice Menon added: “Why are they discussing the seeming awkwardness of doing this through a property route? How can you say your contention is a reasonable interpretation?”

PHILANDERING

Another of Mr Sreenivasan’s arguments was that the disciplinary tribunal should not have relied on Dr Chan’s and Dr Ong’s earlier conversations about their sexual escapades to support its finding that they were trying to exploit Ms K.

However, Chief Justice Menon pointed out that this should be a relevant factor in contexualising their WhatsApp messages.

Mr Sreenivasan then gave a hypothetical scenario where a lawyer, such as himself, was a philanderer and had a similar conversation with a friend.

"Then someone says I have an improper relationship with a client. Just because I’m a philanderer doesn’t mean I have an improper relationship with a client,” he added.

This led to Justice Phang quipping, to laughter from the parties and the public gallery: “So you’re saying there are honourable philanderers around?”

Chief Justice Menon later said: “To be fair, I don’t think you’re making that point… for the record, you’re not a philanderer.”

Dr Chan’s lawyer, Senior Counsel Lee Eng Beng, put forth similar evidence that his client had been deciding between investing in property or buying securities.

The lawyer explained that the message, “Feel free to play your game”, referred to Dr Chan’s habit of "lowballing", or giving very low offers, to drive up prices. Dr Chan had also told the tribunal that he did not know why Dr Ong sent the explicit suggestion and he did not reply to it.

The judges told the court that this explicit message was the “elephant in the room” and that the defence teams cannot ignore it.

PUBLIC INTEREST CONSIDERATIONS

SMC, represented by Mr Chia Voon Jiet from law firm Drew & Napier, argued that the two doctors had colluded to treat Ms K as an object of sexual gratification.

“There is no doubt that the conduct by two eminent doctors would distress and disturb the public, and I submit that it will lead to the undermining of the medical profession here,” Mr Chia said.

Both were specialists of more than 20 years’ standing and their lack of antecedents would be outweighed by public interest considerations, Mr Chia added.

In asking for longer periods of suspension, he argued that the disciplinary tribunal did not take into account the extent of premeditation and planning involved, and that the doctors’ actions also “involved deception and trickery”.

On a separate point, Mr Chia said that he is not arguing for the court to draw an adverse inference against the doctors in the act of Dr Ong deleting all of his WhatsApp messages with Dr Chan.

Dr Ong testified during the tribunal hearing that he wanted to get rid of evidence so that his wife did not know what was going on, and never considered SMC getting involved. His stance remains that there was no professional misconduct.

Following Ms Tiong’s complaint to SMC, Dr Ong sued her for defamation but lost.

He then lodged an appeal with the High Court, whereupon a judge found that both men did not collude to take sexual advantage of Ms Tiong, but said that they could have come together to target Ms K.

Last month, another High Court judge dismissed Ms Tiong’s negligence lawsuit against Dr Chan. She had sued the psychiatrist for allegedly getting her hooked on Xanax pills to manage her anxiety.

Both judges at the time chided the doctors for their blatant treatment of women as sex objects, with one saying that there was “no true winner” in the long-running saga.

[Watwheels]

I better be serious with my Whatsapp text messages. Some day might end up in court for ppl to see.

Or delete whatever texts that might seem offensive.