SINGAPORE: A experienced physician has been suspended for a year by the Singapore Medical Council ( SMC) for specialized misconduct, after a mistake in 2019 resulted in a young individual losing his testicles.
Dr. Yeo Khee Hong, who has practiced medicine in his native tongue for about 42 years, initially diagnosed the teen with abdominal complication, which he afterwards discovered caused him to have testicles that were swollen and inflamed, and prescribed him antibiotics and stomach-related medicine.
However, the boy’s situation worsened despite repeated visits to Dr Yeo, until he had to have surgery to remove his testicles. His actual situation was testicular bending, a condition in which the umbilical cord that controls blood flow to the testicle twists and obstructs body flow.
According to the reasons for the case’s decision, which was made on Monday ( May 27 ), the boy had an estimated 90.4 % to 90.2 % chance of recovering his testis if he had been referred for urgent care in time.
THE Event
Dr. Yeo admitted guilt to one count of skilled misconduct for allegedly failing to manage his person with due care and care.
Sentencing was taken into account when considering a second command of failing to provide the individual with sufficient details.
The child was 15 or 16 when he consulted Dr Yeo at his clinic on Mar 22, 2019.
He claimed that his remaining stomach was experiencing problems that began in his left testis.
He even had increased bowel movements, with watery stools.
Dr. Yeo examined the boy, and he discovered that neither his remaining testis nor his abdomen had any unusual mass or torsion.
He gave the boy stomach-related medication after he identified his chest pain.
Five days later, the teenager reported that he had swelling and pain in his left gonads, which he claimed felt worse while sat or walking.
Dr. Yeo examined the child, and discovered that his remaining testis was delicate and enlarged.
He identified the child with cystitis and epididymitis, which is swelling and inflammation in the remaining testis. He gave the boy antibiotics, and he also requested that he have his diagnosis verified by conducting a complete blood count and urine test.
But, before arriving at his treatment, Dr Yeo did not consider the possibility of continuous genital bending.
He disregarded this and concluded that cystitis and orchitis were more likely.  ,
Before excluding testicular torsion, Dr. Yeo even did not refer the child to a doctor or the hospital’s accident and emergency department.
The teen’s mother received a notification of the results of the blood exam the following morning, stating that an illness was most likely to be the cause of the swelling. He requested that the youngster keep the medications he had prescribed.
The boy’s state did not improve. On April 1, 2019, his father called Dr. Yeo to complain that his brother was in excruciating pain.
Dr. Yeo requested urgent treatment for the boy because he was in such critical situation and should be taken to an accident and emergency department.
A chest ultrasound revealed left genital bending, which the boy went to the hospital.  ,
He had his left testis removed, and he was taken to a medical unit.
CASE COMES TO SMC
The SMC was informed that a “reasonable and skilled doctor” in Dr. Yeo’s place would have taken into account the possibility of continuous testicular bending at the discussion on March 27, 2019, and would not have dissuaded it from the differential treatment without first referring the person to a professional or an accident &, emergency department of a hospital.
Until proven otherwise, the applicable standard of care treats all acute scrotal pain as testicular torsion.
Around July 2020, the boy’s father complained to the SMC, alleging that Dr. Yeo was careless in his son’s removal of the left testicle and failed to properly diagnose and reduce the risk of testicular torsion.
Dr. Yeo responded to the SMC’s complaint in response and later wrote an apology letter to the patient and his family.
If Dr. Yeo had referred the patient to a specialist or the hospital’s accident &, emergency department during the consultation on March 27, 2019, the patient’s likely early testicular salvage rate would have been an estimated 90.4 % to 90.2 %, according to the decision’s justification.
According to Mr. Chia Voon Jiet, Mr. Chia Voon Jiet, Ms. Lee I-Lin and Ms. Chin Dan Ting from Drew &, Napier, Dr. Yeo’s misconduct delayed the patient’s diagnosis and treatment, leaving him with a slim chance of salvaging his left testis.
The loss caused the boy both physical and psychological distress.  ,
The potential harm to the boy also includes fertility issues from losing a testis, said SMC’s lawyers.
Dr Yeo, who was represented by Mr Christopher Chong and Ms Sharon Liu from Dentons Rodyk &, Davidson, said he was “deeply saddened” by the patient’s plight.
He accepted that he should be disciplined for not referring the boy to an accident and emergency department on March 27, 2019.
He claimed, however, that a quick referral would not have ensured the survival of the testis.
The SMC’s attorney claimed that Dr. Yeo had acted improperly and that his treatment of the patient was insufficient for the purpose.
The lawyers claimed that Dr. Yeo was content to treat the patient with antibiotics, conduct laboratory tests, and “make the decision to refer only if the pain and swelling persisted in a few days and depending on the full blood count test results” despite the patient’s clinical presentation and age suggesting that he may have had testicular torsion.
In response, Dr. Yeo responded that despite his physical examination of the patient, he had considered the possibility of testicular torsion. However, his preferred preliminary diagnosis was orchitis and epididymitis.
Dr. Yeo called Dr. Yeo’s decision to not warn the boy about the possibility of testicular torsion” a wrong judgment call,” but he also claimed it was “out of good intention because he did not want to cause the patient an unnecessary amount of distress.”
He acknowledged errors on his part but said he was thinking about the boy’s well-being and best interests without making any suggestion that he was acting inadvertently or maliciously.
On top of the 12- month suspension, Dr Yeo will also be censured. He will have to give the SMC a written promise that he will refrain from doing the same thing or engaging in any other similar behavior, and he will have to cover the costs and costs of the proceedings, including the expenses caused by SMC’s attorneys.