Harte v Tan: Medical Negligence, Varicocelectomy, and Testicular Atrophy

In Denis Matthew Harte v Dr Tan Hun Hoe and Gleneagles Hospital Ltd, the Singapore High Court addressed a medical negligence claim by Mr. Harte against Dr. Tan, a urologist, and Gleneagles Hospital. Mr. Harte alleged that Dr. Tan's recommendation and performance of a bilateral varicocelectomy resulted in testicular atrophy, rendering him infertile. The court found Dr. Tan not negligent in the surgery itself but negligent in his post-operative care, awarding damages to Mr. Harte. The claim against Gleneagles Hospital was dismissed.

1. Case Overview

1.1 Court

High Court

1.2 Outcome

Judgment for Plaintiff in part.

1.3 Case Type

Civil

1.4 Judgment Type

Judgment

1.5 Jurisdiction

Singapore

1.6 Description

Singapore High Court case involving medical negligence claim after bilateral varicocelectomy led to testicular atrophy. Judgment for Plaintiff in part.

1.7 Decision Date

2. Parties and Outcomes

Party NameRoleTypeOutcomeOutcome TypeCounsels
Gleneagles Hospital LtdDefendantCorporationClaim DismissedDismissed
Denis Matthew HartePlaintiffIndividualJudgment for Plaintiff in partPartial
Dr Tan Hun HoeDefendantIndividualJudgment against Defendant in partPartial

3. Judges

Judge NameTitleDelivered Judgment
Chan Seng OnnJudicial CommissionerYes

4. Counsels

Counsel NameOrganization
Lek Siang PhengHelen Yeo & Partners
Vivienne LimHelen Yeo & Partners
Jamie YipHelen Yeo & Partners
Wendell WongDrew & Napier
Edmund KronenburgDrew & Napier
Adrian TanDrew & Napier
Raj SingamDrew & Napier
Myint SoeMyint Soe Mohamed Yang & Selvaraj
Daniel XuMyint Soe Mohamed Yang & Selvaraj

4. Facts

  1. Mr. Harte consulted Dr. Tan for fertility problems after a previous varicocelectomy in New York.
  2. Dr. Tan recommended a bilateral varicocelectomy, which he performed at Gleneagles Hospital.
  3. Mr. Harte fell in the hospital toilet after the surgery.
  4. Mr. Harte experienced significant swelling and pain after the surgery.
  5. Dr. Tan did not examine Mr. Harte until four days after the surgery, despite complaints of pain and swelling.
  6. Mr. Harte's condition worsened, leading to testicular atrophy and infertility.
  7. A scrotal ultrasound scan revealed a haematoma.

5. Formal Citations

  1. Denis Matthew Harte v Dr Tan Hun Hoe and Another, Suit 1691/1999, [2000] SGHC 248

6. Timeline

DateEvent
Mr. and Mrs. Harte married.
Mr. and Mrs. Harte started trying for a child.
Mrs. Harte consulted Dr. James Jones, a gynaecologist.
Seminal test on Mr. Harte revealed a total sperm count of 98 million.
Dr. Dubin wrote to Dr. Jones regarding Mr. Harte's condition.
Dr. Dubin performed the left varicocelectomy surgery.
Mr. and Mrs. Harte arrived in Singapore.
Mr. Harte consulted Dr. Tan Hun Hoe.
Seminal test results from Sheng Yu Laboratory.
Dr. Tan wrote to Dr. Winnie Wun.
Mr. and Mrs. Harte saw Dr. Tan again and handed him medical documents.
Dr. Koay Lok Hin performed the scrotal ultrasound scan.
Dr. Tan wrote to Dr. Wun informing her of Mr. Harte’s CDUS results.
Mr. Harte checked into Gleneagles Hospital for his operation.
Dr. Tan performed the bilateral varicocelectomy.
Mr. Harte fell in the toilet after the surgery.
Mr. Harte was discharged from the hospital.
Mr. Harte found that both his testes had swollen considerably.
Mr. Harte called Dr. Tan’s clinic again.
Mr. Harte had a consultation with Dr. Tan after the surgery.
Mr. and Mrs. Harte went to see Dr. Tan.
Mr. Harte had another consultation with Dr. Tan.
Dr. Tan ordered a seminal analysis at the plaintiff’s request.
Second seminal analysis showed no more sperm production.
Mr. Harte went for another CDUS scan of his testes.
Mr. Harte saw Dr. Tan again.
Mr. Harte saw Dr. Tan again.
Dr. Tan noted that the ‘haematoma occurred 2 –3 days post operation, initially very gradual.’
Mrs. Harte called Dr. Tan to find out the reasons for the disastrous seminal test results.
Dr. Tan broke the news that it was very unlikely that he would ever father his own child.
Mrs. Harte queried Dr. Tan again.
Dr. Tan’s reply to the Singapore Medical Council.
Mr. Harte consulted Dr. Dubin again for bilateral testicular biopsies.
Dr. Jimmy Beng prescribed testosterone supplement tablets.
Decision Date

7. Legal Issues

  1. Medical Negligence
    • Outcome: The court found Dr. Tan negligent in his post-operative care of Mr. Harte but not in the surgery itself.
    • Category: Substantive
    • Sub-Issues:
      • Breach of duty of care
      • Causation
      • Standard of care
      • Post-operative care
    • Related Cases:
      • [1985] 2 WLR 480
      • [1998] A.C.232
      • [1984] 1 WLR 634
      • [1957] 1 WLR 582
  2. Vicarious Liability
    • Outcome: The court found that Gleneagles Hospital was not vicariously liable for Dr. Tan's actions.
    • Category: Substantive
  3. Causation
    • Outcome: The court determined that the fall in the toilet was a significant cause of the testicular atrophy.
    • Category: Substantive

8. Remedies Sought

  1. Monetary Damages

9. Cause of Actions

  • Medical Negligence

10. Practice Areas

  • Medical Malpractice
  • Commercial Litigation

11. Industries

  • Healthcare

12. Cited Cases

Case NameCourtAffirmedCitationJurisdictionSignificance
Sidaway v Board of Governors of the Bethlem Royal Hospital and Maudsley Hospital and OthersHouse of LordsYes[1985] 2 WLR 480England and WalesApplied the Bolam test to the giving of medical advice, specifically regarding non-disclosure of risks.
Bolitho v. City and Hackney H.A. (H.L.(E.))N/AYes[1998] A.C.232N/AClarified the ambit of the Bolam test, stating that the court is not bound to hold a doctor escapes liability just because medical experts support their conduct.
Maynard v West Midlands Regional Health AuthorityN/AYes[1984] 1 WLR 634N/AAddressed the difficulties of proving negligence in fully considered decisions of consultants and emphasized that a judge's preference for one body of professional opinion over another is insufficient to establish negligence.
Bolam v Friern Hospital Management CommitteeN/AYes[1957] 1 WLR 582N/AEstablished the Bolam test for assessing reasonable skill and care in medical treatment.
White House v JordanN/AYes[1981] 1 All ER 267N/AApproved the Bolam test.
Sidaway v Board of Governors of the Bethlem Royal HospitalN/AYes[1985] 1 All ER 643N/AApproved the Bolam test.
Hucks v ColeN/AYes(1968) 112 Sol Jo 483N/AEstablished the standard of proof required for matters of professional negligence against a medical man.
Hornal v Neubergger Products LtdN/AYes[1957] 1 QB 247N/AStates that in proportion as the charge is grave, so ought the proof to be clear.
Roe v Minister of HealthN/AYes[1954] 2 QB 66N/AIllustrates that things do sometimes go amiss in surgical operations or medical treatment.
Cutler v Vauxhall Motors LtdN/AYes[1970] 2 All ER 56N/AStates that the plaintiff is not allowed to claim any expense that would have been incurred regardless of the tort of negligence committed against him.
Napier v HunterN/AYes[1993] 2 WLR 42N/AStates that insurers have an equitable interest in money received by the insured.
Re Miller, Gibb & CoN/AYes[1957] 1 WLR 703N/AStates that if the insured who has received the money goes bankrupt, the insurers can recover the money in priority to the claims of other unsecured creditors.

13. Applicable Rules

Rule Name
No applicable rules

14. Applicable Statutes

Statute NameJurisdiction
No applicable statutes

15. Key Terms and Keywords

15.1 Key Terms

  • Varicocelectomy
  • Testicular Atrophy
  • Medical Negligence
  • Scrotal Haematoma
  • Infertility
  • Post-operative Care
  • Duty of Care
  • Causation
  • Bolam Test
  • Syncope
  • TESE
  • ICSI

15.2 Keywords

  • Medical Negligence
  • Varicocelectomy
  • Testicular Atrophy
  • Infertility
  • Singapore
  • High Court
  • Personal Injury
  • Surgery
  • Urology

17. Areas of Law

Area NameRelevance Score
Medical Negligence95
Medical Malpractice90
Breach of Duty of Care60
Infertility60
Personal Injury50
Measure of Damages40
Urology30
Contract Law20

16. Subjects

  • Medical Law
  • Negligence
  • Surgery
  • Urology
  • Fertility Treatment