Tong Seok May Joanne v Yau Hok Man Gordon: Medical Negligence, Anaesthesia, Informed Consent, Neck Injury
In Tong Seok May Joanne v Yau Hok Man Gordon, the High Court of Singapore heard a medical negligence claim by Tong Seok May Joanne against Dr. Yau Hok Man Gordon, an anaesthetist, arising from a lower segment caesarean section (LSCS) surgery in 2006. Tong alleged negligence in obtaining informed consent, neck manipulation during anaesthesia, and post-surgery care, claiming damages of $3 million for a cervical spine injury. The court, presided over by Andrew Ang J, dismissed the claim, finding no breach of duty of care by Dr. Yau and a lack of causation between his actions and Tong's alleged injury. The court found that the plaintiff failed to prove that the defendant had conducted the intubation process in a manner which is not accepted as proper by a responsible body of medical men.
1. Case Overview
1.1 Court
High Court1.2 Outcome
Plaintiff's claim dismissed with costs.
1.3 Case Type
Civil
1.4 Judgment Type
Grounds of Decision
1.5 Jurisdiction
Singapore
1.6 Description
Medical negligence claim against anaesthetist for neck injury during caesarean section. Claim dismissed due to lack of proof of negligence and causation.
1.7 Decision Date
2. Parties and Outcomes
| Party Name | Role | Type | Outcome | Outcome Type | Counsels |
|---|---|---|---|---|---|
| Tong Seok May Joanne | Plaintiff | Individual | Claim Dismissed | Lost | Melanie Ho, Chang Man Phing, Yuwen Teo-Mcdonnell |
| Yau Hok Man Gordon | Defendant | Individual | Judgment for Defendant | Won | Lek Siang Pheng, Mar Seow Hwei, Lim Xiu Zhen |
3. Judges
| Judge Name | Title | Delivered Judgment |
|---|---|---|
| Andrew Ang | Judge | Yes |
4. Counsels
| Counsel Name | Organization |
|---|---|
| Melanie Ho | Wong Partnership LLP |
| Chang Man Phing | Wong Partnership LLP |
| Yuwen Teo-Mcdonnell | Wong Partnership LLP |
| Lek Siang Pheng | Rodyk & Davidson LLP |
| Mar Seow Hwei | Rodyk & Davidson LLP |
| Lim Xiu Zhen | Rodyk & Davidson LLP |
4. Facts
- Plaintiff underwent LSCS with general anaesthesia on October 26, 2006.
- Plaintiff claimed to have suffered a neck injury due to the defendant's negligence.
- Plaintiff alleged negligence in obtaining informed consent, neck manipulation, and post-operative care.
- Plaintiff sought $3 million in damages for physical, emotional, and psychological harm.
- Defendant denied negligence and claimed the plaintiff's condition was due to natural wear and tear.
- Plaintiff consulted multiple doctors over several years before initiating legal proceedings.
- Plaintiff's husband is a general practitioner with anaesthetic experience.
5. Formal Citations
- Tong Seok May Joanne v Yau Hok Man Gordon, Suit No 885 of 2009, [2012] SGHC 252
6. Timeline
| Date | Event |
|---|---|
| Plaintiff admitted to Gleneagles Hospital due to vaginal bleeding and abdominal cramps. | |
| Plaintiff undergoes LSCS surgery with general anaesthesia. | |
| Plaintiff discharged from Gleneagles Hospital. | |
| Plaintiff's husband contacts defendant regarding plaintiff's neck pain. | |
| Plaintiff consults Dr. Chang regarding neck and upper back pain. | |
| Plaintiff has follow-up consultation with Dr. Tham. | |
| Plaintiff obtains referral for physiotherapy from Dr. Chang. | |
| Plaintiff consults Dr. Chang again, complaining of persistent neck pain. | |
| Plaintiff undergoes MRI scan. | |
| Plaintiff brings MRI scan to Dr. Chang. | |
| Plaintiff starts physiotherapy. | |
| Plaintiff undergoes Needle Electromyography test. | |
| Plaintiff consults Dr. Lim. | |
| Plaintiff consults Dr. Tay. | |
| Plaintiff takes MRI scan. | |
| Assoc Prof Lo carries out neurophysiological tests on the plaintiff. | |
| Plaintiff consults Dr. Furneaux in New Zealand. | |
| Plaintiff consults Dr. Chong. | |
| Plaintiff consults Dr. Goh K J in Kuala Lumpur. | |
| Plaintiff returns to see Assoc Prof Lo. | |
| Plaintiff consults Dr. Pillay. | |
| Plaintiff has flexion-extension MRI done in Kuala Lumpur. | |
| Plaintiff sees Dr. Yue. | |
| Plaintiff obtains an aqua-physiotherapy evaluation. | |
| Plaintiff sees Dr. Winslow, a psychiatrist. | |
| Plaintiff consults Dr. Chang again. | |
| Dr. Winslow diagnoses the plaintiff with post traumatic stress disorder and a major depressive disorder. | |
| Plaintiff stumbles down the stairs. | |
| Plaintiff consults Dr. Pillay again. | |
| Plaintiff goes for her fourth MRI. | |
| Plaintiff signs up for aqua-physiotherapy. | |
| Plaintiff falls again and injures her foot. | |
| Plaintiff consults Dr. Ho, a pain specialist. | |
| Plaintiff consults Dr. Lee, a pain specialist. | |
| Plaintiff consults Dr. Chua, a pain specialist. | |
| Judgment reserved. |
7. Legal Issues
- Medical Negligence
- Outcome: The court found no breach of duty of care by the defendant and a lack of causation between his actions and the plaintiff's alleged injury.
- Category: Substantive
- Sub-Issues:
- Breach of Duty of Care
- Causation
- Informed Consent
- Informed Consent
- Outcome: The court found that the defendant had obtained informed consent from the plaintiff for the general anaesthesia procedure.
- Category: Substantive
- Sub-Issues:
- Disclosure of Risks
- Alternatives to Treatment
- Joint Responsibility
- Causation
- Outcome: The court found a lack of causation between the defendant's actions and the plaintiff's alleged injury.
- Category: Substantive
- Sub-Issues:
- Direct Causation
- Indirect Causation
- Eggshell Skull Rule
- Res Ipsa Loquitur
- Outcome: The court found that the principle of res ipsa loquitur did not apply in this case.
- Category: Procedural
8. Remedies Sought
- Monetary Damages
9. Cause of Actions
- Medical Negligence
- Breach of Duty of Care
10. Practice Areas
- Medical Malpractice Litigation
- Civil Litigation
11. Industries
- Healthcare
12. Cited Cases
| Case Name | Court | Affirmed | Citation | Jurisdiction | Significance |
|---|---|---|---|---|---|
| Khoo James v Gunapathy d/o Muniandy | Court of Appeal | Yes | [2002] 1 SLR(R) 1024 | Singapore | Established the applicable law on medical negligence in Singapore, adopting the Bolam test as supplemented by Bolitho. |
| Bolam v Friern Hospital Management Committee | High Court | Yes | [1957] 1 WLR 582 | England and Wales | Established the Bolam test for medical negligence, which states that a doctor is not negligent if they acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art. |
| Bolitho v City and Hackney Health Authority | House of Lords | Yes | [1998] AC 232 | England and Wales | Clarified the Bolam test, stating that the practice accepted as proper by a responsible body of medical men must have a logical basis. |
| Sidaway v Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and others | House of Lords | No | [1985] AC 871 | England and Wales | Discussed the application of the Bolam test to the giving of medical advice, with Lord Scarman objecting to its application. |
| Pearce v United Bristol Healthcare NHS Trust | Court of Appeal | No | [1999] PIQR P53 | England and Wales | Argued for a 'reasonable patient' test in cases where a plaintiff alleges deprivation of the opportunity to make a proper decision about treatment. |
| Chester v Afshar | House of Lords | No | [2005] 1 AC 134 | England and Wales | Addressed the issue of causation in medical negligence cases, particularly regarding the duty to warn patients of risks. |
| Rogers v Whitaker | High Court of Australia | No | (1992) 175 CLR 479 | Australia | Advocated for the 'reasonable patient' test. |
| Rosenberg v Percival | High Court of Australia | No | (2001) 205 CLR 434 | Australia | Advocated for the 'reasonable patient' test. |
| Reibl v Hughes | Supreme Court of Canada | No | (1980) 114 DLR (3d) 1 | Canada | Advocated for the 'reasonable patient' test. |
| Foo Fio Na v Dr Soo Fook Mun and Anor | Federal Court | No | [2007] 1 MLJ 593 | Malaysia | Advocated for the 'reasonable patient' test. |
| D’Conceicao Jeanie Doris (Administratrix of the estate of Milakov Steven, deceased) v Tong Ming Chuan | High Court | Yes | [2011] SGHC 193 | Singapore | Summarized the Court of Appeal’s interpretation of Sidaway in Gunapathy and rejected the proposition that the English cases of Pearce and Chester supported an extension or repudiation of the Bolam test. |
| Surender Singh s/o Jagdish Singh and another (administrators of the estate of Narindar Kaur d/o Sarwan Singh, deceased) v Li Man Kay | High Court | Yes | [2010] 1 SLR 428 | Singapore | Reiterated that the Singapore High Court is bound by the Court of Appeal in Gunapathy. |
| Birch v University College London Hospital NHS Foundation Trust | High Court | No | (2008) 104 BMLR 168 | England and Wales | Discussed the duty to inform a patient of the risks associated with a procedure, including the comparative risks of alternative procedures. |
| Lloyde v West Midlands Gas Board | Court of Appeal | Yes | [1971] 1 WLR 749 | England and Wales | Explained that res ipsa loquitur is a common sense approach to assessing evidence, not limited by technical rules. |
| Teng Ah Kow v Ho Sek Chiu | High Court | Yes | [1993] 3 SLR(R) 43 | Singapore | Stated that res ipsa loquitur may not be used to subvert the ordinary rules of proof. |
| Scott v The London and St Katherine Docks Company | Court of Exchequer | Yes | (1865) 3 H&C 596 | England and Wales | Established the conditions for the application of res ipsa loquitur. |
| Zweite MS “Philippa Schulte” Shipping GmbH & Co KG v PSA Corporation Ltd | High Court | Yes | [2012] SGHC 135 | Singapore | Reiterated the conditions for the application of res ipsa loquitur. |
| Tesa Tape Asia Pacific Pte Ltd v Wing Seng Logistics Pte Ltd | High Court | Yes | [2006] 3 SLR(R) 116 | Singapore | Stated that res ipsa loquitur is inapplicable where there is evidence on causation. |
| Mahon v Osborne | Court of Appeal | No | [1939] 2 KB 14 | England and Wales | Discussed the application of res ipsa loquitur in a case where a cotton swab was left in a patient's body after surgery. |
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
- General Anaesthesia
- Lower Segment Caesarean Section
- Anterior Longitudinal Ligament
- Cervical Spondylosis
- Intubation
- Cricoid Pressure
- Pre-oxygenation
- Informed Consent
- Medical Negligence
- Res Ipsa Loquitur
15.2 Keywords
- Medical Negligence
- Anaesthesia
- Informed Consent
- Neck Injury
- Caesarean Section
- Singapore
- High Court
16. Subjects
- Medical Law
- Negligence
- Civil Litigation
- Healthcare
17. Areas of Law
- Medical Negligence
- Anaesthesiology
- Tort Law
- Civil Procedure