SINGAPORE — The daughter of a woman left in a vegetative state after brain surgery has questioned the accuracy of multiple doctors’ observations regarding her mother’s condition leading up to the procedure.
In court on Thursday (18 April), 43-year-old Chiam Yu Zhu disputed the assessment that her mother, 69-year-old Goh Guan Sin, was “awake and alert” in the few weeks leading up to the operation.
Chiam is representing Goh in a suit against the National University Hospital (NUH) and Dr Yeo Tseng Tsai, the hospital’s senior consultant and head of neurosurgery, for alleged medical negligence.
Goh’s condition had deteriorated due to complications after a surgery on 2 June 2014 to remove a cystic brain tumour. The housewife fell into a vegetative state after a second surgery on the same day.
According to court documents, Goh’s outstanding bills for care provided at NUH amounted to $512,116.98 as of 18 January. In April, the hospital administration authorised four Medishield Life deductions in relation to Goh’s bills.
Advised to clear fluids in brain
Under cross examination by Dr Yeo’s lawyer, Toh Cher Han, Chiam testified that her mother’s cystic brain tumour was first detected after her sister brought her mother to medical examination due to an injury sustained from a fall. What they discovered instead was a “dark spot” in Goh’s head.
The family, which comprises six children including Chiam, next consulted neurosurgeon Timothy Lee at Gleneagles Hospital, who diagnosed the tumour as being benign.
He noted, however, that the accumulation of fluid in Goh’s brain due to the tumour was the more urgent problem. Lee’s advice was to have the fluid removed before treating the tumour, which was the size of a ping pong ball.
Seeking a second opinion, the family next consulted Dr Ho Kee Hang, a neurosurgeon and visiting senior consultant at NUH on 15 May 2014. By then, Goh was experiencing drowsiness and headaches.
According to Teo, however, Dr Ho stated in his notes that Goh was not suffering from drowsiness and was “otherwise very well”. “Dr Ho actually told (Goh’s) family that she is very well, would you agree that your recollection that she very drowsy on 15 May was wrong?” the lawyer asked Chiam, who disagreed.
Dr Ho had also noted that Goh had no problems with her bladder control, a point that Chiam disagreed with. Emphasising that her mother had not been well, Chiam said Goh could not “control (her) walking and urine” and was already wearing diapers by the time she had met Dr Ho.
Chiam also alleged that Dr Ho’s notes were inaccurate and that she could not see what he had been typing during the consultation session.
Third neurosurgeon consulted
According to Chiam, Goh’s conditioned worsened after that session with the latter often feeling dizzy and restless. The family decided to approach a third neurosurgeon, Dr James Khoo of Mount Elizabeth Hospital, to treat her symptoms and Goh was prescribed diamox on 23 May 2014.
By that point, Goh was often bed bound, said Chiam, who added that her mother was “very active, very independent” woman who often went to the market on her own.
Toh pointed out that Dr Khoo had also made no mention of drowsiness and incontinence, prompting Chiam to respond that she did tell the doctor of Goh’s symptoms.
As part of her consultation with NUH, Goh visited another NUH neurosurgeon on 29 May 2014 when Chiam told the doctor that her mother was unwell. However, that doctor’s notes again stated that Goh was well with no headaches.
“I don’t understand why (Goh’s symptoms) were not documented… I will definitely tell the doctor my mother’s condition,” said Chiam.
The family eventually decided to have Goh’s surgery conducted at NUH. While Dr Ho had initially been scheduled to lead the operation, Dr Yeo was brought in to replace the former.
Chiam claims that her family was informed of the swop only the day before Goh’s surgery while the hospital’s lawyers say the family were notified much earlier than that.
Mum’s condition on day of surgery disputed
Goh’s condition a day before her surgery, after being admitted to NUH, was also called into question by the defendant’s lawyer.
Toh pointed out that the medical notes for Goh indicated that her “general condition” was “good”. “The truth was that (Goh) was alert and conscious and (her) condition was good on 29 May 2014,” said the lawyer.
Chiam, however, told the court that her mother had been unwell on the day of the admission and had to be wheeled into the hospital due to her legs feeling weak. She also vomited that day, said Chiam.
When asked if her recollection of Goh being unwell and not alert before her surgery was wrong, Chiam stood by her observations.
“I put it to you that Madam Goh did not exhibit drowsiness before period of surgery from 15 May 2014 to 2 June 2014,” said Toh, prompting Chiam voice her disagreement.
The trial continues next Tuesday.