Dr Ho Tze Woon was suspended for 3 months by the Court of Three Judges on 7 August, after he had performed CPR on a patient suffering an asthma attack without positioning him to a lying position – the patient later died about 1 week later, according to Channel NewsAsia.
The Unexpected Crisis
The incident unfolded at the Central 24-Hr Clinic in Yishun on January 14, 2017, with a patient arriving at the clinic complaining of breathlessness.
Dr. Ho, who was on duty as a stand-in doctor, quickly diagnosed the patient with an asthma attack. In response, a clinic assistant was instructed to administer a nebuliser treatment, a common approach to delivering medication to the lungs.
The patient, seated in a chair, received the treatment, but the situation took a dire turn as he suddenly went into cardiac arrest and lost consciousness.
Amid the chaos of the situation, Dr. Ho took immediate action, attempting to resuscitate the patient while he remained seated.
This unorthodox approach to CPR, though performed with the best of intentions, would later become the focal point of the controversy surrounding the incident.
Despite Dr. Ho’s efforts and the subsequent transport of the patient to a hospital, the outcome was devastating. The patient succumbed to his condition and passed away a week later.
Professional Standards and Accountability
In the aftermath of the incident, Dr. Ho faced charges under the Medical Registration Act for failing to meet the expected professional standards of care. Central to the charges was the assertion that Dr. Ho neglected to reposition the patient to a lying position before initiating CPR.
This failure to adhere to established protocols brought into question the doctor’s competence and training.
A disciplinary tribunal under the Singapore Medical Council (SMC) found Dr. Ho guilty of the charges and handed down a nine-month suspension.
However, Dr. Ho appealed the decision, arguing that the punishment was excessive and that his actions were reasonable given the chaotic circumstances of the clinic’s treatment room.
Weighing the Arguments
During the appeal, Dr. Ho’s defense lawyer contended that the small and chaotic treatment room, coupled with Dr. Ho’s lack of training in patient transfer, influenced his decision to perform CPR in a seated position. The defense emphasized that Dr. Ho’s actions were based on his experience and assessment of the situation.
While Dr. Ho’s defense presented a compelling argument, the prosecution countered with expert opinions that questioned the effectiveness of the CPR administered in a seated position.
The prosecution highlighted Dr. Ho’s training in CPR and his prior experience in dealing with cardiac arrest cases. Furthermore, the presence of clinic assistants who could have assisted in repositioning the patient was a point of contention.
The Verdict and Implications
In the end, the Court of Three Judges, comprising Justice Steven Chong, Justices Judith Prakash, and Tay Yong Kwang, decided to reduce Dr. Ho’s suspension from nine months to three months.
The judges acknowledged the challenges of performing CPR in a tense situation but underscored the importance of adhering to established medical practices.