Two docs face manslaughter over blunder

Jane Cheung

Two doctors have been charged with manslaughter over an alleged blunder that caused the death of a mother after a liver transplant six years ago.

Chan Siu-kim, 45, and Lam Chi-kwan, 50, are believed to be the first doctors in public service on such a charge that involves alleged human error and negligence in the death of Tang Kwai-sze, 44.

Hong Kong Patients' Voices chairman Alex Lam Chi-yau, a lay member of the Medical Council, said he was shocked to hear police had charged the pair.

It is alleged Chan and Lam, working at United Christian Hospital in Kwun Tong in early 2017, failed to prescribe chronic kidney patient Tang - a hepatitis B carrier - an antiviral drug to counteract the side effects of high-dosage steroids, triggering acute liver failure.

Tang eventually underwent two surgeries by a team of top liver experts including now Secretary for Health Lo Chung-mau to receive part of a liver from an unrelated female donor - Momo Cheng Hoi-yan, then 26 - in Queen Mary Hospital.

Tang's eldest daughter Michelle was unable to donate as she was still three months away from turning 18. Tang died in August that year.

Internal medicine specialist Lam, who studied in Auckland, is still employed by the Hospital Authority, while kidney specialist Chan, who graduated from the University of Hong Kong, has moved to private practice. A Hospital Authority spokesman said yesterday that Lam has been suspended from clinical duties.

A review committee was established after the incident to prevent similar events from occurring again.

"The clinical medical management system has been improved to remind doctors when they prescribe immuno-suppressive medication to hepatitis B patients," the spokesman said.

The Coroner's Court is to hold an inquest on Tang's death from February 27.

The Medical Association said it is highly concerned about the prosecution, "in particular doctors' criminal responsibilities when treating patients."

Police announced just after midnight on Wednesday that the two doctors were arrested on Monday and each charged with one count of manslaughter. They will appear in an Eastern Magistrates' court next Monday.

Police said the action was made "subsequent to investigation and legal advice," but it did not explain why the arrests came six years after Tang's death.

"Between January and February 2017, the 44-year-old woman received medical treatment from the two men in a hospital in Kwun Tong, resulting in acute liver failure," police said.

"She was then transferred to a hospital in Western District for further treatment with multiple surgeries undertaken. She was subsequently certified dead on August 26, 2017."

Alex Lam of the patients' group was surprised by the arrests. He said: "From what I remember no public hospital doctors have been criminally charged with manslaughter over a medical blunder or negligence. I hope the legal procedure can do the deceased justice."

But he is worried the prosecution will lead to more pressure on doctors and lead them to conservative treatment.

"Doctors need to see a lot of patients within a very short time," Lam said. "Maybe dozens every day, and each patient may have over a thousand pages of medical records.

"It's very difficult to completely understand their medical history in just one or even two to three consultations."

He said public doctors may switch to private practice for higher pay and to avoid risks.

"The Hospital Authority should look into ways to strike a balance between patient rights and preventing medical blunders," he said.

In September 2021 Chan and Lam pleaded guilty to professional misconduct at a Medical Council hearing. Lam admitted he was distracted when Tang consulted him for kidney disease in January 2017, and he did not prescribe her anti-hepatitis B viral drugs together with steroids.

During a follow-up consultation the next month, the council heard, Chan noticed the patient was not taking antiviral drugs. He assumed she rejected the prescription.

Lam was sentenced to five months of deregistration, suspended for 36 months, and Chan to three months, suspended for 18 months.

jane.cheung@singtaonewscorp.com