Tan Hun Hoe v Harte Denis Mathew: Negligence, Damages, and Costs in Post-Operative Care

In Tan Hun Hoe v Harte Denis Mathew, the Court of Appeal of Singapore heard appeals from both Dr. Tan Hun Hoe, a urologist, and Mr. Harte Denis Mathew, a patient, regarding a High Court decision. The High Court found Dr. Tan 60% liable for Mr. Harte's testicular atrophy due to post-operative negligence following a bilateral varicocelectomy. Mr. Harte appealed for enhanced damages, while Dr. Tan appealed the cost order. The Court of Appeal allowed Mr. Harte's appeal in part, increasing the damages awarded, and dismissed Dr. Tan's appeal on costs.

1. Case Overview

1.1 Court

Court of Appeal

1.2 Outcome

Appeal of Mr. Harte allowed in part; appeal of Dr. Tan dismissed.

1.3 Case Type

Civil

1.4 Judgment Type

Grounds of Decision

1.5 Jurisdiction

Singapore

1.6 Description

The Court of Appeal addressed appeals concerning a urologist's negligence in post-operative care, damages for testicular atrophy, and cost allocation. The court enhanced the damages awarded to the patient.

1.7 Decision Date

12 October 2001

2. Parties and Outcomes

Party Name	Role	Type	Outcome	Outcome Type	Counsels
Gleneagles Hospital	Defendant	Corporation	Claim Dismissed	Dismissed
Tan Hun Hoe	Appellant, Respondent	Individual	Appeal Dismissed	Lost	Myint Soe of Myintsoe Mohamed Yang & Selvaraj Mohamed Abdullah of Myintsoe Mohamed Yang & Selvaraj
Harte Denis Mathew	Respondent, Appellant	Individual	Appeal Allowed in Part	Partial	Edmund Kronenburg of Drew & Napier Tan Siu-Lin of Drew & Napier Raj Singam of Drew & Napier

3. Judges

Judge Name	Title	Delivered Judgment
Chao Hick Tin	Justice of Appeal	Yes
L P Thean	Justice of Appeal	No
Yong Pung How	Chief Justice	No

4. Counsels

Counsel Name	Organization
Myint Soe	Myintsoe Mohamed Yang & Selvaraj
Mohamed Abdullah	Myintsoe Mohamed Yang & Selvaraj
Edmund Kronenburg	Drew & Napier
Tan Siu-Lin	Drew & Napier
Raj Singam	Drew & Napier

4. Facts

Mr. Harte underwent a bilateral varicocelectomy performed by Dr. Tan.
Mr. Harte fainted and fell in the toilet after the surgery.
Mr. Harte experienced swelling and pain in his scrotum the next day.
Dr. Tan did not immediately examine Mr. Harte after being informed of the swelling and pain.
Dr. Tan diagnosed a scrotal haematoma on May 2, 1997.
Seminal analysis revealed a dramatic reduction in sperm quantity and quality.
Dr. Tan informed the Hartes that Mr. Harte was unlikely to father a child.
The court found Dr. Tan negligent in his post-operative care.
The court apportioned liability for the atrophy 60% to Dr. Tan and 40% to Mr. Harte.

5. Formal Citations

Tan Hun Hoe v Harte Denis Mathew, CA 170/2000 ,171/2000, [2001] SGCA 68

6. Timeline

Date	Event
1989-01-01	Mr. Harte married Mrs. Michelle Lynn Harte.
1996-04-01	Mrs. Harte consulted a gynaecologist, Dr. James Jones.
1996-06-01	Dr. Dubin performed a left varicocelectomy on Mr. Harte.
1996-08-01	Mr. Harte was seconded to Singapore as a trading manager.
1997-04-01	Mr. Harte consulted Dr. Tan.
1997-04-28	Dr. Tan performed a bilateral varicocelectomy on Mr. Harte.
1997-04-28	Mr. Harte fainted and fell in the toilet after the surgery.
1997-04-29	Mr. Harte called Dr. Tan's office to report swelling and pain.
1997-04-30	Mr. Harte tried to contact Dr. Tan without success.
1997-05-02	Mr. Harte consulted Dr. Tan, who diagnosed a scrotal haematoma.
1997-05-09	Dr. Tan examined Mr. Harte's scrotum with ultrasound.
1997-05-26	Dr. Tan prescribed Povinorum to Mr. Harte.
1997-08-29	Seminal analysis revealed a dramatic reduction in sperm quantity and quality.
1997-09-05	Second seminal analysis showed no sperm.
1997-10-09	Dr. Tan explained that Mr. Harte's testes were not functioning properly.
1997-10-11	Dr. Tan informed the Hartes that Mr. Harte was unlikely to father a child.
2000-05-16	Dr. Tan made an offer to settle for $300,000.
2000-01-01	Mr. Harte underwent a failed TESE-ICSI attempt in October.
2001-10-13	Court of Appeal decision.

7. Legal Issues

Negligence in Post-Operative Care
- Outcome: The court found Dr. Tan negligent in his post-operative care of Mr. Harte.
- Category: Substantive
- Sub-Issues:
  - Failure to promptly examine patient after reported complications
  - Failure to conduct necessary investigations (ultrasound)
  - Failure to inform patient of potential risks
Assessment of Damages for Personal Injuries
- Outcome: The court enhanced the general damages awarded and adjusted the amounts for future medical expenses.
- Category: Substantive
- Sub-Issues:
  - Quantum of general damages for pain and suffering and loss of amenities
  - Quantum of special damages for medical expenses
  - Loss of future earnings
  - Cost of future medical treatment (fertility treatment, hormone replacement therapy)
  - Discounting damages due to contributory negligence
- Related Cases:
  - [1987] AC 750
  - [1987] 2 All ER 909
Causation in Negligence Claims
- Outcome: The court found that both Dr. Tan's negligence and Mr. Harte's fall contributed to the atrophy, apportioning liability 60-40.
- Category: Substantive
- Sub-Issues:
  - Establishing a causal link between the defendant's negligence and the plaintiff's injuries
  - Apportionment of liability where there are multiple causes of the injury
- Related Cases:
  - [1987] AC 750
  - [1987] 2 All ER 909
Costs in Civil Proceedings
- Outcome: The court dismissed Dr. Tan's appeal on costs, finding no reason to interfere with the High Court's order.
- Category: Procedural
- Sub-Issues:
  - Awarding costs to the successful party
  - Effect of an offer to settle on cost orders
  - Discretion of the court in awarding costs

8. Remedies Sought

Monetary Damages

9. Cause of Actions

Negligence

10. Practice Areas

Personal Injury
Medical Malpractice
Civil Litigation

11. Industries

Healthcare

12. Cited Cases

Case Name	Court	Affirmed	Citation	Jurisdiction	Significance
Hotson v East Berkshire Area Health Authority	House of Lords	Yes	[1987] AC 750	England and Wales	Cited regarding causation in personal injury claims and the burden of proof for establishing the extent of disability.
Hotson v East Berkshire Area Health Authority	House of Lords	Yes	[1987] 2 All ER 909	England and Wales	Cited regarding causation in personal injury claims and the burden of proof for establishing the extent of disability.
Low Swee Tong v Liew Machinery	High Court	Yes	[1993] 3 SLR 89	Singapore	Cited as a reference point for the quantum of damages awarded for impotence.
Lai Wee Lian v Singapore Bus Service (1978)	High Court	Yes	[1984-1985] SLR 10	Singapore	Cited as a reference point for the quantum of damages awarded for pain and suffering and loss of amenities.
Lai Wee Lian v Singapore Bus Service (1978)	High Court	Yes	[1984] 1 MLJ 325	Singapore	Cited as a reference point for the quantum of damages awarded for pain and suffering and loss of amenities.
The World Beauty	Not specified	Yes	[1970] P 144	Not specified	Cited regarding the principle that additional loss or damage resulting from reasonable mitigating steps is recoverable.
The World Beauty	Not specified	Yes	[1969] 3 All ER 158	Not specified	Cited regarding the principle that additional loss or damage resulting from reasonable mitigating steps is recoverable.
Chan Pui Ki v Leung On	Not specified	Yes	[1996] 2 HKLR 401	Hong Kong	Cited regarding the approach of making a general upward revision of awards to reflect current social and economic conditions.
Heil v Rankin	English Court of Appeal	Yes	[2000] 3 All ER 138	England and Wales	Cited regarding the approach of making a general upward revision of awards to reflect current social and economic conditions.
Ariffin bin Omar v Goh Beng Kee	Not specified	Yes	Ariffin bin Omar v Goh Beng Kee	Singapore	Cited as precedent.
Ng Hock Chye v Singapore Shuttle Bus	Not specified	Yes	Ng Hock Chye v Singapore Shuttle Bus	Singapore	Cited as precedent.
Yeap Boon Onn v Neo Hui Nee	Not specified	Yes	Yeap Boon Onn v Neo Hui Nee	Singapore	Cited as precedent.

13. Applicable Rules

Rule Name
No applicable rules

14. Applicable Statutes

Statute Name	Jurisdiction
No applicable statutes

15. Key Terms and Keywords

15.1 Key Terms

Bilateral varicocelectomy
Testicular atrophy
Scrotal haematoma
Post-operative negligence
TESE
ICSI
Hormone replacement therapy
Causation
Contributory negligence

15.2 Keywords

negligence
damages
costs
post-operative care
testicular atrophy
fertility treatment
medical malpractice

17. Areas of Law

Area Name	Relevance Score
Negligence	95
Personal Injury	90
Damages	85
Fertility treatment	80
Post-operative care	75
Civil Practice	70
Medical Malpractice	65
Costs	60
Appellate Practice	50
Urology	30

16. Subjects

Medical Malpractice
Personal Injury
Civil Procedure
Damages