Docs guilty in tragic liver patient's case

Top News | Wallis Wang 24 Sep 2021

The punishments of two public hospital doctors guilty of professional misconduct over the death of a mother following a transplant have been suspended for up to three years.

Tang Kwai-sze, a 43-year-old mother of two, died after two surgeries in which she received part of a liver from the same unrelated donor in 2017.

The two United Christian Hospital doctors - Lam Chi-kwan and Chan Siu-kim - pleaded guilty to professional misconduct before the Medical Council yesterday.

The inquiry panel suspended Lam's license for five months, but the punishment was suspended for three years. Chan's license was suspended for three months, but the penalty was suspended for 18 months.

Both remain in practice - Lam at UCH and Chan in a Tsim Sha Tsui clinic.

The council heard that Tang was found to be a carrier of the hepatitis B virus in 2008. But the two doctors did not notice that a positive test result for the hepatitis B virus was listed in Tang's medical record.

In January 2017, she consulted the public hospital in Kwun Tong for her kidney inflammatory condition, when Lam prescribed Tang a high dosage of steroids - which can induce hepatitis - without anti-hepatitis B viral drugs as a counter-medication.

Tang went back to the hospital in February 2017, with Chan treating her and prescribing a lower dosage of steroids due to her improved kidney condition. But he also failed to prescribe anti-hepatitis drugs.

In April, Tang suffered from acute liver failure and had to receive a liver transplant, but passed away after two surgeries from a living donor.

Tang's daughter Michelle could not donate because she was not yet 18 years old at that time.

Lam told the council earlier that he was distracted by other matters when prescribing medications to Tang and admitted misconduct. He agreed that distractions and being busy were not reasonable excuses.

Chan said he noticed Tang did not take antiviral drugs during her follow-up visit and assumed that Lam had asked Tang to take the drugs but the patient just refused to do so.

Because of this he did not ask about the drugs. He admitted that his assumption was inappropriate.

The prosecution concluded that Tang suffered from hepatitis B due to the two doctors' lack of vigilance.

As professional specialists, Lam and Chan should have been fully aware of the need to prescribe antiviral drugs to Tang, the prosecution said, citing an expert's report.

Although the two had arranged follow-up visits and liver function tests for Tang, it was unacceptable that they did not prescribe antiviral drugs, the prosecution stressed.

The prosecution also said doctors are responsible to explain the side effects of medications to patients according to the Code of Professional Conduct, but Lam and Chan failed to do so.

In mitigation, Lam said he was sorry for his negligence and stressed he would not commit the same mistake again. He cried as he apologized to Tang's family and begged for their forgiveness.

Chan said he was sorry for his mistake which led to Tang's death and that he had failed his patient as a doctor.

The two doctors bowed to Tang's daughter as they read their mitigation letters.

Tang's case attracted a lot of attention after Michelle was rejected from donating her liver in April 2017 because she was three months away from turning 18 at the time.

The case triggered discussions on lowering the legal age for organ donation.

Eventually, 26-year-old office clerk Momo Cheng Hoi-yan, who is not related to the family, donated two-thirds of her liver to Tang.

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October 2021

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