Woman sues Singapore General Hospital claiming womb removal surgery affected kidney

SINGAPORE: A woman who underwent surgery to remove her womb and related parts in her reproductive system at Singapore General Hospital (SGH) is suing the hospital and a surgeon who performed the procedure, alleging negligence.

Madam Faith Gao, who is also known as Faith Ang, alleges that the surgery obstructed a tube that connects her kidneys to the bladder and left one of her kidneys functioning at only 6 per cent.

However, lawyers for the hospital and the surgeon, Professor Tan Hak Koon, called the suit "entirely ill-conceived and fuelled by sub-standard advice", maintaining that the surgery was performed appropriately and the obstruction was not caused by Prof Tan.

The trial opened in the High Court on Tuesday (Jun 25), with Mr David Gan from DG Law representing Mdm Gao and a team of lawyers from Legal Clinic, led by Senior Counsel Kuah Boon Theng, defending SGH and Prof Tan.

WHAT HAPPENED

According to opening statements from both Mdm Gao and the defendants' lawyers, the 54-year-old woman had been considering going under the knife for some time. The operation involved the removal of her uterus, ovaries and fallopian tubes. 

This was because she had severe endometriosis, a disease where tissue similar to the lining of the uterus grows outside the uterus, and her condition did not respond to conservative treatment.

Mdm Gao was infertile and underwent two prior surgeries in 2000 and 2011, her lawyer, Mr Gan, said in his opening statement.

She consulted Prof Tan around November 2018 for a second opinion while receiving treatment at the National University Hospital.

She decided to go to SGH for the procedure - known as a total abdominal hysterectomy, bilateral salpingo-oophorectomy and adhesiolysis.

It took place at SGH on Jan 4, 2019, under three surgeons. Prof Tan, a senior consultant obstetrician and gynaecologist, was the first surgeon.

Both sides agreed in their opening statements that the surgery was uneventful and successful.

Mdm Gao was discharged three days later, and the defendants' lawyers claim that Mdm Gao told Prof Tan in her final consultation that she was happy with the surgery.

However, Mdm Gao developed intermittent abdominal pain around June 2019. She sought medical attention in December 2019 at another hospital, the defendants' lawyers said.

A computed tomography (CT) scan purportedly showed swelling of the left kidney and left ureter, which is a tube connecting the kidney to the bladder. This was likely due to an obstruction of the left ureter, with urine build-up.

Senior Counsel Kuah said that not relieving the obstruction promptly would have allowed the pressure to continue building up, with adverse consequences to kidney function.

"However, for reasons that are unclear to the defendants, it was not until February 2020 that the plaintiff finally underwent surgery to excise the left ureteric obstruction or stricture," said Ms Kuah and her team.

Mdm Gao has two witnesses for her case - Dr Lewis Liew, who performed general surgery on Mdm Gao, and Dr Gong Ing San, an "expert on surgery".

According to Mdm Gao's lawyer Mr Gan, the two witnesses think Mdm Gao's claim "has merit".

Dr Liew, a urologist, concluded that the renal impairment was due to the surgery with Prof Tan, said Mr Gan. 

Mr Gan said his client would argue that the duty of care provided to her was "inadequate", and that reasonable care was not exercised, leading to her injury.

HOSPITAL, SURGEON'S RESPONSE; COUNTERCLAIM

Lawyers for the defendants said in their opening statement the defendants were not only not negligent, but that the delay in appropriate treatment for the ureter was "something that needs to be answered by Dr Liew as it was the cause of the damage to the plaintiff's left kidney".

They added that Dr Liew had "made no effort to find out details of how the surgery was actually performed" before making his "baseless and irresponsible statement" that the surgery had likely caused her injury.

"Had he done so, he would have discovered that the surgery was uneventful and there were no operative procedures carried out in the vicinity of the ureters," said the lawyers.

They alleged that while Dr Liew later "backtracked" and issued a clarification report saying he had been only "speculating", the damage had been done.

"The plaintiff had been misled into thinking that she was a victim of negligence, and would go on to commence this action against the defendants," said the lawyers for SGH and Prof Tan.

They said Mdm Gao treated Dr Liew as an expert, and that Dr Gong was trained as a general surgeon but it is unclear if he still actively performs surgeries today.

"He is certainly not an O&G specialist, and is not qualified to offer an expert opinion on a total abdominal hysterectomy bilateral salpingo-oophorectomy and adhesiolysis," said the defendants' lawyers.

SGH had filed a counterclaim against Mdm Gao for S$9,449 (US$6,986) in hospital bills that were left outstanding.

Mdm Gao's defence was that the bills should be claimed from her medical insurers, but her insurer has rejected the claim, with the hospital's lawyers saying Mdm Gao remains liable for her own medical bills.

The trial continues before Justice Choo Han Teck.