A doctor who specializes in obstetrics and gynecology has been given a 12-month suspension for care related to a 2013 patient who afterwards miscarried after her uterus ruptured.
According to the grounds of a decision by the Singapore Medical Council ( SMC) Disciplinary Tribunal published on Tuesday ( Sep 24 ), Dr. Chen Yun Hian Christopher had performed a procedure on a patient known only as Ms C. He saw him increase her chances of fecundity.
Dr. Chen made an “excessively broad” incision along the patient’s uterus wall, cutting off” an excessive amount” of healthy tissue, and failing to layer-close the deeper fault by applying” right a needles” and applying” straight a needles” to the deeper fault.
The 84-year-old senior physician admitted guilt to one count of skilled wrongdoing that amount to serious negligence.
He acknowledged that he had not followed the standard of care that was expected of him when he performed a technique on the patient. Another fact that needs to be considered was that he allegedly did not give the patient enough information to assent to the operation.
WHAT HAPPENED
Dr. Chen has been a licensed health practitioner since 1965 and a professional since 1998.
He was working at the Christopher Chen Center for Reproductive Medicine, then known as the Advanced Centre for Reproductive Medicine- Fertility Clinic at the time of the crime.
Ms C and her father consulted Dr. Chen for guidance in January 2013 to increase her chances of getting pregnant.
Dr. Chen identified polycystic ovaries and disease, which can lead to physiological inequities and irregular periods.
He suggested that the person have a treatment to increase her chances of getting pregnant, and it did. The procedure took place in March 2013.
In order to treat a condition in which tissue similar to the lining of the uterus grows outside the uterus, it involved an examination of the uterine chamber, the removal of abnormalities, and” cauterization of endometriosis,” where muscle is removed by burning.
Following the surgery, Ms. C saw Dr. Chen for follow-up consultations to maintain her long menstruation and to have ultrasonic scans to determine ovulation dates more accurately to improve her pregnancy chances.
Around August 2014, Ms C realised she had conceived normally. She stayed with Dr. Chen until October 2014.
Around Oct 20, 2014, she suffered a uterus rupture and miscarried. She was in her first next week.
The SMC just received a problem from Ms C in May 2016. She claimed that Dr. Chen had not been informed of the risks and consequences of the procedure, including whether she would need to have her child undergo a cesarean section.
THE Investigation
A “responsible and capable doctor” carrying out the operation would have prevented the removal of healthy tissue from any incisions along the vaginal wall to the underlying module, according to the arguments in the case.
This was done to keep the good layers intact and prevent stress from closing the uterus wall defect.
Additionally, the vaginal walls fault could have been fixed by applying “absorbable stitches” layer by layer.  ,
Dr. Chen acknowledged that he had deviated from this common and that his actions had put his person at greater risk of ovarian rupture and pregnancy.
In consequence, the patient has both the above problems and a higher chance of developing uterine rupture in upcoming uterus issues. This was honestly” a near effect” of Dr Chen’s misconduct, the view stated.
Dr. Chen was a very experienced and top doctor with close to 50 years of experience as a medical professional and 15 years of experience as a professional at the time of the operation, according to the SMC, who requested a suspension of between 24 and 30 times.
SMC claimed that Dr. Chen, who requested extension of his explanation, should receive a 50 % discount for” some delay in prosecution.”
SMC claimed that the event involved “niche health concerns” and that time was needed to find professionals who were willing to serve as authorities for SMC in explaining the wait of about six years and seven months since the notice of problem in November 2016.
Many of the medical professionals contacted by SMC declined to participate on the grounds of a conflict of interest, which was “apparently due to the rank and majesty” of Dr. Chen. Ultimately, SMC engaged an specialist based abroad.
Dr Chen’s doctors from Allen &, Gledhill asked for not more than 10 times ‘ expulsion, saying Dr Chen had believed that he was acting in the victim’s best interest.
He later came to terms with the fact that he” may have excised less myometrial cells” and that he had” should have been more conventional” by layering the vaginal wall defect.
Dr. Chen argued that using the purse-string thread would gain Ms. C. by reducing the amount of medical blood loss, scarring, and facilitating faster recovery after removing an appropriate amount of tissue.
According to Dr. Chen’s attorneys, he had no harmful intentions toward the sufferer and was not motivated by an desire to profit financially or for any other reason.
They added that Dr. Chen, who is now 84, has been having trouble with his health ever since being diagnosed with an irregular heart rhythm in 2015. His lawyers claim that he has a device to control his hypertension, and that his hypotension has reached high observations as a result of the stress of the disciplinary proceedings.
They claimed that Dr. Chen, who had a stroke in 2015, has been in agony and grief as a result of the protracted lapse of time.
He was unable to maintain an active clinical process after receiving the problem see in 2016 because he was so stressed and anxious. In order to get over his patients, different doctors were hired to take over the doctor until the center no longer bore his name.
According to the attorneys, Dr. Chen did not attempt to return to medical practice after being assessed as fit to perform medical duties following his stroke, which would have reduced the likelihood of reoffending.
THE TRIBUNAL’S Selection
The administrative panel found that Dr. Chen had performed the procedure in a way that was “lacking in many ways”. The method he closed the vaginal wall defect was “entirely improper” and caused irreversible harm to the patient.
Given the extent of the deviation from the accepted methods, the court “very much weight” the claim that Dr. Chen had sincere belief that his use of purse-string sutures would benefit the individual.
However, the court determined that this event “did not require a misuse of trust and confidence for personal private gain.”  ,
It found there was an excessive delay in the prosecution, claiming that it was “exceptionally long” yet if SMC had trouble getting professional opinion without” logical reasons to explain the delay.”
Dr. Chen will also be subject to criticism and be required to promise in writing to the SMC that he will not participate in the wrongdoing or any other related conduct in the future in addition to the 12-month suspension.
He will also have to pay the costs and charges of the proceedings, including the costs of SMC’s lawyer.