Dr Eric Gan v SMC: Negligence in Post-operative Care After ERCP Procedure

Dr. Eric Gan Keng Seng appealed to the High Court of Singapore against the Disciplinary Committee (DC) of the Singapore Medical Council's (SMC) decision finding him guilty of professional misconduct. The charge stemmed from the post-operative care of Mr. Toh Hock Ken (the Patient) following an unsuccessful endoscopic retrograde cholangiopancreatogram (ERCP) procedure. The DC acquitted Dr. Gan on the first charge but convicted him on the second charge for wilful neglect of his duties and gross mismanagement of the post-operative treatment of the Patient, who later died from septicaemia. The High Court dismissed the appeal, upholding the DC's decision.

1. Case Overview

1.1 Court

High Court

1.2 Outcome

Appeal Dismissed

1.3 Case Type

Civil

1.4 Judgment Type

Grounds of Decision

1.5 Jurisdiction

Singapore

1.6 Description

Dr. Gan appeals a guilty verdict for professional misconduct due to negligent post-operative care following an ERCP, leading to a patient's death. The High Court dismissed the appeal.

1.7 Decision Date

2. Parties and Outcomes

Party NameRoleTypeOutcomeOutcome TypeCounsels
Singapore Medical CouncilRespondentStatutory BoardDecision UpheldWon
Dr Eric Gan Keng SengAppellantIndividualAppeal DismissedLost

3. Judges

Judge NameTitleDelivered Judgment
Chao Hick TinJustice of the Court of AppealYes
Andrew Phang Boon LeongJustice of the Court of AppealNo
Steven ChongJudgeNo

4. Counsels

Counsel NameOrganization
Ho Pei Shien MelanieWongPartnership LLP
Tan Chee MengWongPartnership LLP
Chang Man PhingWongPartnership LLP
Emily SuWongPartnership LLP
Cavinder BullDrew & Napier LLC
Charles Lin Ming KhinDonaldson & Burkinshaw
Harleen KaurDrew & Napier LLC

4. Facts

  1. Dr. Gan performed an ERCP with Pre-cut Technique on the Patient on 6 December 2005.
  2. The Pre-cut Technique was unsuccessful in cannulating the bile duct.
  3. Post-surgery, the Patient suffered bilious vomiting and epigastric tenderness.
  4. Dr. Gan did not personally assess the Patient on the night of 6 December 2005.
  5. A CT scan, performed later, revealed a retroduodenal perforation.
  6. The Patient passed away on 22 January 2006 from septicaemia due to intra-abdominal sepsis.
  7. The Disciplinary Committee found Dr. Gan guilty of wilful neglect and gross mismanagement.

5. Formal Citations

  1. Dr Eric Gan Keng Seng v Singapore Medical Council, Originating Summons No 144 of 2010, [2010] SGHC 325

6. Timeline

DateEvent
Patient admitted to Alexandra Hospital with severe abdominal pain.
Patient discharged from Alexandra Hospital.
Follow-up outpatient appointment; Dr. Gan advises ERCP.
Dr. Gan performs ERCP on the Patient at Alexandra Hospital; Pre-cut Technique attempted unsuccessfully.
Patient experiences bilious vomiting and epigastric tenderness.
Dr. Gan visits the Patient at the ward.
CT scan ordered.
Emergency exploratory laparotomy performed by Dr. Gan.
Patient passed away from septicaemia due to intra-abdominal sepsis.
Mdm Neo Guat Dee lodged a complaint against Dr Gan with the SMC.
Notice of Inquiry issued, proffering two charges against Dr Gan.
Disciplinary Committee hearing begins.
Disciplinary Committee hearing continues.
Disciplinary Committee finds Dr. Gan guilty of professional misconduct.
High Court dismisses Dr. Gan's appeal.

7. Legal Issues

  1. Professional Misconduct
    • Outcome: The court found that Dr. Gan's actions constituted professional misconduct under the Medical Registration Act.
    • Category: Substantive
    • Sub-Issues:
      • Wilful neglect of duties
      • Gross mismanagement of post-operative treatment
  2. Scope of Charge in Disciplinary Proceedings
    • Outcome: The court held that the Disciplinary Committee did not go beyond the scope of the charge, as Dr. Gan's entire conduct was put in issue.
    • Category: Procedural
    • Sub-Issues:
      • Sufficiency of particulars in the charge
      • Whether the Disciplinary Committee went beyond the scope of the charge
  3. Standard of Care for Medical Professionals
    • Outcome: The court found that Dr. Gan failed to meet the required standard of care by not personally assessing the patient and ordering a timely CT scan.
    • Category: Substantive
    • Sub-Issues:
      • Duty to personally assess patient
      • Delegation of care to junior doctors
      • Timeliness of diagnostic tests

8. Remedies Sought

  1. Appeal against Disciplinary Committee's decision

9. Cause of Actions

  • Professional Misconduct
  • Medical Negligence

10. Practice Areas

  • Healthcare Law
  • Medical Negligence
  • Appeals

11. Industries

  • Healthcare

12. Cited Cases

Case NameCourtAffirmedCitationJurisdictionSignificance
Low Cze Hong v Singapore Medical CouncilHigh CourtYes[2008] 3 SLR(R) 612SingaporeCited regarding the court's role in appeals against Disciplinary Committee decisions and the deference given to the Committee's findings unless unsafe, unreasonable, or contrary to evidence.
Gobinathan Devathasan v Singapore Medical CouncilHigh CourtYes[2010] 2 SLR 926SingaporeCited regarding the court's role in appeals against Disciplinary Committee decisions and the circumstances under which the court will interfere with the Committee's findings.
Lim Teng Ee Joyce v Singapore Medical CouncilUnknownYes[2005] 3 SLR(R) 709SingaporeCited to support the principle that a party is only required to respond to the charge and nothing more.
Ho Paul v Singapore Medical CouncilUnknownYes[2008] 2 SLR(R) 780SingaporeCited to support the principle that a party is only required to respond to the charge and nothing more.
Law Society of Singapore v Ahmad Khalis bin Abdul GhaniHigh CourtYes[2006] 4 SLR(R) 308SingaporeCited regarding the argument that a charge was vague and unclear.
Chew Seow Leng v PPCourt of AppealYes[2005] SGCA 11SingaporeCited to support the holding that there was no question that the respondent was misled or prejudiced by the allegedly faulty charges.

13. Applicable Rules

Rule Name
No applicable rules

14. Applicable Statutes

Statute NameJurisdiction
Medical Registration Act (Cap 174)Singapore
Medical Registration Act (Cap 174), section 45(1)(d)Singapore

15. Key Terms and Keywords

15.1 Key Terms

  • ERCP
  • Pre-cut Technique
  • Professional Misconduct
  • Post-operative Care
  • Duodenal Perforation
  • Wilful Neglect
  • Gross Mismanagement
  • Standard of Care
  • CT Scan
  • Septicaemia

15.2 Keywords

  • Medical Negligence
  • Professional Misconduct
  • ERCP
  • Post-operative Care
  • Singapore Medical Council
  • Disciplinary Committee
  • Appeal
  • Medical Law

17. Areas of Law

Area NameRelevance Score
Medical Negligence90
Medical Malpractice90
Disciplinary Proceedings (Medical)80
Medical Registration Act80
Disciplinary Proceedings70
Professional conduct70
Breach of Duty of Care60
Patient Confidentiality50

16. Subjects

  • Medical Law
  • Healthcare
  • Professional Responsibility
  • Disciplinary Proceedings