Daughter praised as mom's death ruled misadventure

A five-member jury yesterday determined that a victim of a drug prescription blunder seven years ago died of misadventure due to the omission of a prescription drug.

The jury of two men and three women deliberated for nearly seven hours and decided by a majority verdict of four to one that Tang Kwai-sze, 44, had her hepatitis B virus activated as she took high dosages of steroids without antiviral drugs as a counter-medication.

Coroner Monica Chow Wai-choo praised Tang's daughter, Michelle Wu, for "being strong" as she showed up every day during the 13-day inquest.

"I hope the inquest can help you find a positive way to fill the void left by your mother's death," she said.

Chow said Wu had intended to donate her liver to her mother and that Tang would have been proud to have such a brave and selfless daughter.

"I believe your mother must be proud of your love, even though she didn't have the chance to tell you that in person."

The court heard that Tang had been a hepatitis B carrier since 2008.

However, two United Christian Hospital doctors failed to prescribe anti-hepatitis B viral drugs to her during kidney treatment between August 2016 and February 2017. Tang suffered from acute liver failure and passed away in 2017 despite a liver transplant.

The jury offered five suggestions to the Hospital Authority, saying patients taking a high dosage of steroids for less than seven days should still be classified as high-risk and be prescribed antiviral drugs.

Even if hepatitis B carriers are asymptomatic, the authority should still consider offering them subsidies for checkups in the private sector and providing relevant information, the jury said.

The jurors said doctors should ensure clear documentation for easy understanding by other doctors. Laboratories should provide reasons if they cancel medical tests for a patient.

While thanking the jury for carefully reviewing the evidence, Chow explained that UCH and the authority have implemented a series of new guidelines after the blunder to prevent similar incidents from happening.

For example, when doctors prescribe high dosages of steroids without prescribing antiviral drugs, the clinical management system will issue a warning.

If doctors decide not to prescribe antiviral drugs, they must provide an explanation when bypassing the warning, as well as consult a pharmacist.

The authority has revised its drug formulary to provide subsidies for high-risk hepatitis B patients undergoing immunotherapy to purchase antiviral drugs at standard prices.

A UCH spokesman said in a statement that it acknowledges and respects the verdict, and will thoroughly study the ruling and follow up with the suggestions given by the coroner's court.

adelyn.lau@singtaonewscorp.com