A specialist in obstetrics and gynecology, Dr. Chen Yun Hian Christopher, has been suspended for 12 months due to negligence linked to a surgery he performed in 2013. This surgery resulted in a patient suffering a miscarriage after experiencing a uterine rupture. The Singapore Medical Council (SMC) Disciplinary Tribunal publicly announced its decision on September 24, outlining the details of the case against Dr. Chen.
The patient, referred to only as Ms. C, approached Dr. Chen seeking his expertise to enhance her chances of fertility. Upon examination, he diagnosed her with adenomyosis and polycystic ovary syndrome—conditions known to hinder fertility. Following his assessment, Dr. Chen recommended surgical intervention as a means to improve her prospects for conception, leading to a surgical procedure in March 2013. This procedure involved a thorough examination of the uterine cavity, removal of lesions, and cauterization of endometriosis, which is a condition where tissue similar to the lining of the uterus grows outside the uterus.
After the surgery, Ms. C continued to have follow-up appointments with Dr. Chen to manage her heavy menstrual cycles and optimize her chances of ovulation and pregnancy. In August 2014, she discovered she was pregnant. However, in October of the same year, tragedy struck as Ms. C suffered a uterine rupture during her early second trimester, leading to a miscarriage.
In May 2016, Ms. C filed a complaint with the SMC, alleging that Dr. Chen’s surgical techniques were responsible for her uterine rupture during her pregnancy. She contended that he had failed to inform her adequately about the risks and consequences of the surgery, including the potential need for a cesarean section.
The SMC's decision noted that a competent surgeon would have made a smaller incision along the uterine wall to preserve healthy tissue. Additionally, the closure of any resulting defect should have been done without tension using absorbable sutures. Dr. Chen admitted during the proceedings that he did not meet the expected standard of care during the surgery. His actions placed Ms. C at an increased risk for complications, including future uterine ruptures.
A responsible and competent doctor would have ensured that any incision made along the uterine wall was small enough to avoid removing healthy tissue.
Singapore Medical Council Disciplinary Tribunal
The SMC initially recommended a suspension lasting between 24 to 30 months for Dr. Chen, while also noting a 50% discount due to delays in the prosecution of the case. However, Dr. Chen's defense team argued for a much shorter suspension of no more than 10 months. They argued that Dr. Chen genuinely believed he was acting in the best interest of his patient and recognized, in hindsight, that he could have taken a more conservative approach by excising less myometrial tissue.
Additionally, Dr. Chen's lawyers presented evidence of his declining health, including a diagnosis of an abnormal heart rhythm in 2015 and a subsequent stroke that further diminished his ability to practice. They argued that the stress resulting from the disciplinary proceedings had taken a toll on his health and well-being, leading to his withdrawal from surgical practice since being cleared for clinical duties.
I should have been more conservative by excising less myometrial tissue.
Dr. Chen Yun Hian Christopher
Ultimately, the disciplinary tribunal found Dr. Chen's surgical methods to be inadequate and inappropriate, directly causing irreparable harm to Ms. C. The tribunal did not find much merit in his defense, highlighting that this case did not involve any form of personal gain or breach of trust.
Despite acknowledging the significant delay in the prosecution of the case—deemed exceptionally long—the tribunal imposed a 12-month suspension. Along with the suspension, Dr. Chen will face a formal censure and must provide a written undertaking to the SMC, promising to avoid similar misconduct in the future. Furthermore, he is required to bear the costs related to the proceedings, which underscores the seriousness of the tribunal’s findings and the responsibility of medical practitioners to adhere to the highest standards of care in their practices.
Reference:
1. Lam, L. (2024, September 25). Gynaecologist suspended after patient suffers miscarriage from uterine rupture following surgery. CNA. https://www.channelnewsasia.com/singapore/gynaecologist-suspended-after-patient-suffers-miscarriage-uterine-rupture-following-surgery-4633941
(Input from various sources)
(Rehash/Yash Kamble/MSM)
