The National University Hospital (NUH) and its head neurosurgeon are being sued by the family of a woman patient who was left in a vegetative state following a brain operation, CNA reported.

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In total, the family are suing the parties for an estimated S$2.5 million over the alleged medical negligence.

Civil suit commenced

The civil suit went to trial on April 17, with lawyers, led by Abraham Vergis, representing the family asserting that the woman, 64-year-old Goh Guan Sin, had her post-operative recovery badly mishandled, Today reported.

The defendants' lawyers representing NUH and its head neurosurgeon, Yeo Tseng Tsai, have stated that an urgent decision had to be made due to her post-operation complications.

NUH is represented by Senior Counsel Kuah Boon Theng and her team from Legal Clinic LLC, while Yeo is represented by Lek Siang Pheng and his team from Dentons Rodyk & Davidson.

Woman has been in a vegetative state for about five years

Goh has been in a vegetative state for about five years.

This was after she first underwent a brain operation on June 2, 2014, to remove a large brain tumour that was compressing her brainstem, CNA further reported.

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Her operation had been performed by Yeo Tseng Tsai, both CNA and Today reported.

Subsequently, Goh began to suffer from post-operative bleeding in the brain.

In response, Yeo decided that an emergency procedure had to be done to drain the brain fluids to deal with the complication.

Family's lawyers criticises neurosurgeon's decision and attitude

A decision to write the patient off

The lawyers of Goh's family, led by lawyer Vergis, have criticised the neurosurgeon's decision and attitude, Today reported.

They alleged that Yeo and NUH had committed a "critical failure" in interpreting a post-operation CT scan of Goh, and assessing that a second major surgery would be futile due to her brainstem bleeding “substantially”, hours after her initial successful surgery.

On top of that, three neuroradiological experts have also since “negatived” the interpretations made of Goh's CT scan by Yeo and NUH, Vergis stated.

A separate MRI scan also showed that her brainstem was not bleeding substantially.

The lawyers also alleged that both parties had failed in monitoring and evaluating her condition immediately after the operation, along with surgically removing the blood clot in her brain, CNA highlighted.

The lawyers charged that this led to Goh being written off for saving.

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A "callous" attitude

Goh's family lawyers also took aim at Yeo's attitude, stating that it was "callous and cavalier", Today highlighted.

They noted that the family had registered for the brain tumour surgery, under the belief that it would be done by another surgeon, Ho Kee Hang, whom Goh had visited and was comfortable with.

It was only on the eve of the surgery that they found out that Yeo would be doing the surgery instead -- a doctor whom they had not met before.

The lawyers also highlighted that Yeo had been in Bangkok the weekend before the scheduled surgery on Monday, June 2, 2014, and that he had left Singapore for a family vacation a day after the surgery.

Vergis said with regard to how such actions reflected Yeo's "callous" attitude:

"(Yeo’s) willingness to be a fly-in and fly-out surgeon defies established clinical and surgical conventions. The fact that a teaching hospital like the NUH has not denounced and called out A/P Yeo’s conduct in this regard is troubling."

Vergis added that a responsible surgeon would owe a “solemn, non-delegable duty” to his patients before and after each surgery.

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Lawyers of neurosurgeon's and hospital assert that Yeo had properly discharged his duty

In his representation of Yeo, Lek has denied all of the allegations made by Goh's family and stated that Yeo had properly discharged his duty of care to Goh, CNA reported.

Lek's team further argued that Goh had given consent for the surgery, and that a doctor's duty of care was owed solely to the patient.

This meant that Yeo did not have a duty to obtain informed consent from the patient's family, unless a legal representative had been appointed for such a purpose.

Meanwhile, Kuah, in her representation of NUH, acknowledged that while the post-operation complication had been difficult for the plaintiff and her family, it was not the result of any negligence on the part of its staff, according to CNA.

On Goh's post-operation bleeding, Kuah's team stated:

"The brain bleed that the plaintiff developed following the first surgery is a known complication which can happen even in the best of hands, and even when all due care and precautions are taken."

They further highlighted that Goh and her family had also been adequately briefed prior to the surgery about its risks, including those of bleeding and death.

As for the draining of fluids from Goh's brain, Kuah's team stated that the decision was an urgent one the neurosurgical team had to make based on clinical information available to them at that time, under time-sensitive conditions.

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Trial to run for a month

The trial is expected to run for a month, with Justice Tan Siong Thye presiding over the case, according to CNA.

Witnesses expected to be called to the stand include doctors involved in Goh's case, neurosurgery, neuroradiology and radiology experts, and Yeo himself.

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