Jen Shek Wei v Singapore Medical Council: Appeal Against Disciplinary Tribunal's Decision on Professional Misconduct

Dr. Jen Shek Wei, a gynaecologist, appealed to the High Court against his conviction by a Disciplinary Tribunal constituted by the Singapore Medical Council for two charges of professional misconduct. The charges related to advising a patient to undergo surgery without proper evaluation and performing a left oophorectomy without obtaining informed consent. The High Court, comprising Andrew Phang Boon Leong JA, Judith Prakash JA, and Steven Chong JA, dismissed the appeal, upholding the Disciplinary Tribunal's conviction on both charges and the imposed sentence.

1. Case Overview

1.1 Court

High Court of the Republic of Singapore

1.2 Outcome

Appeal dismissed. The Disciplinary Tribunal's conviction on both charges and the sentence were upheld.

1.3 Case Type

Regulatory

1.4 Judgment Type

Grounds of Decision

1.5 Jurisdiction

Singapore

1.6 Description

Dr. Jen Shek Wei appeals against his conviction by the Disciplinary Tribunal for professional misconduct, related to advising surgery without proper evaluation and lack of informed consent.

1.7 Decision Date

12 November 2017

2. Parties and Outcomes

Party Name	Role	Type	Outcome	Outcome Type	Counsels
Singapore Medical Council	Respondent	Statutory Board	Judgment Upheld	Won	Edmund Jerome Kronenburg of Braddell Brothers LLP Kevin Ho of Braddell Brothers LLP Lynette Zheng of Braddell Brothers LLP Tan Tien Wei of Braddell Brothers LLP
JEN SHEK WEI	Applicant	Individual	Appeal Dismissed	Lost	Lim Min of Straits Law Practice LLC N Sreenivasan of Straits Law Practice LLC Charles Lin of MyintSoe & Selvaraj Tracia Lim of MyintSoe & Selvaraj

3. Judges

Judge Name	Title	Delivered Judgment
Andrew Phang Boon Leong	Judge of Appeal	Yes
Judith Prakash	Judge of Appeal	No
Steven Chong	Judge of Appeal	No

4. Counsels

Counsel Name	Organization
Edmund Jerome Kronenburg	Braddell Brothers LLP
Kevin Ho	Braddell Brothers LLP
Lynette Zheng	Braddell Brothers LLP
Tan Tien Wei	Braddell Brothers LLP
Lim Min	Straits Law Practice LLC
N Sreenivasan	Straits Law Practice LLC
Charles Lin	MyintSoe & Selvaraj
Tracia Lim	MyintSoe & Selvaraj

4. Facts

Dr. Jen advised the patient to undergo surgery to remove a pelvic mass without further evaluation.
Dr. Jen performed a left oophorectomy on the patient without obtaining informed consent.
The patient was not informed that her left ovary was removed until months later by another doctor.
The patient had consulted Dr. Jen for fertility treatment prior to the discovery of the mass.
The patient had a history of sciatica, which Dr. Jen believed heightened the risk of malignancy.
The histopathology report indicated that the masses were benign.

5. Formal Citations

Jen Shek Wei v Singapore Medical Council, Originating Summons No 3 of 2017, [2017] SGHC 294

6. Timeline

Date	Event
2010-06-07	Patient consulted Dr. Jen about conceiving a child.
2010-07-01	Dr. Jen prescribed Clomid to the patient.
2010-08-27	Patient consulted Dr. Tay for backache; MRI scan revealed a pelvic mass.
2010-08-28	Radiologic report noted a possible ovarian mass.
2010-08-30	Patient consulted Dr. Jen, who advised surgery to remove the mass.
2010-08-31	Patient underwent surgery, including a left oophorectomy, performed by Dr. Jen.
2010-09-02	Histopathology report indicated the masses were benign.
2010-09-03	Patient was discharged from Mount Alvernia Hospital.
2011-01-01	Patient assessed to be six weeks pregnant.
2011-01-19	Patient consulted Dr. Yap, who confirmed a possible miscarriage.
2011-01-20	Patient suffered a miscarriage.
2011-04-04	Patient saw Dr. Yap for bleeding during her menstrual cycle.
2011-04-19	Dr. Yap could not locate the Patient’s left ovary and informed her that it might have been removed.
2011-05-13	Dr. Yap wrote to Dr. Jen seeking clarification on the surgery.
2011-12-12	Patient filed a complaint with the Singapore Medical Council.
2012-07-17	SMC issued a Notice of Complaint to Dr. Jen.
2012-08-02	Dr. Jen sent a reply refuting the allegations.
2015-07-08	SMC issued a Notice of Inquiry setting out two charges.
2016-05-09	Disciplinary inquiry hearings began.
2016-11-01	Disciplinary inquiry hearings concluded.
2016-12-22	Disciplinary Tribunal delivered its verdict.
2017-07-25	Appeal heard by the High Court.
2017-11-13	Judgment reserved.

7. Legal Issues

Professional Misconduct
- Outcome: The court upheld the Disciplinary Tribunal's finding that Dr. Jen was guilty of professional misconduct.
- Category: Substantive
- Sub-Issues:
  - Serious negligence
  - Intentional departure from professional standards
  - Failure to obtain informed consent
  - Inadequate evaluation of patient's condition
Informed Consent
- Outcome: The court upheld the Disciplinary Tribunal's finding that Dr. Jen failed to obtain informed consent from the patient for the left oophorectomy.
- Category: Substantive
- Sub-Issues:
  - Adequacy of explanation of risks and consequences
  - Patient's understanding of the procedure
  - Documentation of consent
Standard of Care
- Outcome: The court upheld the Disciplinary Tribunal's finding that Dr. Jen failed to meet the required standard of care in evaluating the patient's condition.
- Category: Substantive
- Sub-Issues:
  - Appropriate evaluation and investigation
  - Consideration of patient's medical history
  - Use of established guidelines

8. Remedies Sought

Appeal against conviction
Reduction of sentence

9. Cause of Actions

Professional Misconduct
Breach of Ethical Guidelines

10. Practice Areas

Disciplinary Proceedings
Medical Negligence

11. Industries

Healthcare

12. Cited Cases

Case Name	Court	Affirmed	Citation	Jurisdiction	Significance
Low Cze Hong v Singapore Medical Council	High Court	Yes	[2008] 3 SLR(R) 612	Singapore	Defined the two limbs under which professional misconduct under s 53(1)(d) of the Medical Registration Act could be made out.
Ang Pek San Lawrence v Singapore Medical Council	High Court	Yes	[2015] 1 SLR 436	Singapore	Established the standard of review for appeals against decisions of a Disciplinary Tribunal.
Singapore Medical Council v Wong Him Choon	High Court	Yes	[2016] 4 SLR 1086	Singapore	Discussed the deference given to the Disciplinary Tribunal's findings and the importance of professional expertise.
Uwe Klima v Singapore Medical Council	High Court	Yes	[2015] 3 SLR 854	Singapore	Held that a Disciplinary Tribunal's failure to explain its conclusion in the face of conflicting medical evidence could render its conviction unsafe.
Yong Thiam Look Peter v Singapore Medical Council	High Court	Yes	[2017] 4 SLR 66	Singapore	Stressed that any comparison with sentencing precedents must be on the basis that the facts and circumstances as a whole are truly comparable.
Ang Peng Tiam v Singapore Medical Council	High Court	Yes	[2017] SGHC 143	Singapore	Reduced the term of suspension imposed on the doctor on account of a delay in the SMC’s prosecution of the case.
Lam Kwok Tai Leslie v Singapore Medical Council	High Court	Yes	[2017] SGHC 260	Singapore	Set aside the conviction of the doctor in question on a charge of failing to obtain a patient’s informed consent to an invasive coronary procedure.

13. Applicable Rules

Rule Name
No applicable rules

14. Applicable Statutes

Statute Name	Jurisdiction
Medical Registration Act (Cap 174)	Singapore

15. Key Terms and Keywords

15.1 Key Terms

Professional misconduct
Informed consent
Left oophorectomy
Pelvic mass
Medical Registration Act
Ethical Code and Ethical Guidelines
Serious negligence
Disciplinary Tribunal
Risk of Malignancy Index
Standard of care

15.2 Keywords

Medical negligence
Professional misconduct
Informed consent
Oophorectomy
Singapore Medical Council
Disciplinary Tribunal
Medical ethics

17. Areas of Law

Area Name	Relevance Score
Informed consent	95
Professional conduct	90
Medical Negligence	85
Medical Ethics	80
Medical Malpractice	75
Gynaecology	60
Evidence Law	50

16. Subjects

Medical Law
Professional Regulation
Disciplinary Proceedings