Neo Ah Luan v Public Prosecutor: Illegal Dermal Filler Injections & Medical Registration Act Violation

In Neo Ah Luan v Public Prosecutor, the High Court of Singapore heard an appeal by Neo Ah Luan against her sentence for violating the Medical Registration Act by administering dermal filler injections without authorization. The Chief Justice, Sundaresh Menon, delivered the judgment, finding that the charges were justified and establishing a sentencing framework for offenses under the MRA. The court allowed the appeal in part, reducing the sentence to six weeks' imprisonment per charge, to run concurrently.

1. Case Overview

1.1 Court

High Court of the Republic of Singapore

1.2 Outcome

Appeal allowed in part.

1.3 Case Type

Criminal

1.4 Judgment Type

Judgment

1.5 Jurisdiction

Singapore

1.6 Description

Neo Ah Luan, a freelance beauty service provider, was convicted for unauthorized dermal filler injections. The court established a sentencing framework for MRA offenses.

1.7 Decision Date

2 September 2018

2. Parties and Outcomes

Party Name	Role	Type	Outcome	Outcome Type	Counsels
Neo Ah Luan	Appellant	Individual	Appeal allowed in part	Partial	Peter Cuthbert Low, Priscilla Chia Wen Qi
Public Prosecutor	Respondent	Government Agency	Appeal partially successful	Partial	Peggy Pao-Keerthi Pei Yu, Teo Lu Jia

3. Judges

Judge Name	Title	Delivered Judgment
Sundaresh Menon	Chief Justice	Yes

4. Counsels

Counsel Name	Organization
Peter Cuthbert Low	Peter Low & Choo LLC
Priscilla Chia Wen Qi	Peter Low & Choo LLC
Peggy Pao-Keerthi Pei Yu	Attorney-General’s Chambers
Teo Lu Jia	Attorney-General’s Chambers

4. Facts

Appellant, Neo Ah Luan, provided freelance beauty services, including dermal filler injections, from her home.
Appellant was not a registered medical practitioner and did not possess a valid practicing certificate.
Appellant administered injections of 'Cross Linked Sodium Hyaluronate' fillers to clients.
The Health Sciences Authority (HSA) raided the appellant's home and seized various exhibits, including syringes containing Promoitalia Skinfill products.
Promoitalia Skinfill products were not registered with the HSA as medical devices under the Health Products Act.
The appellant had been trained in how to administer the products by Italian doctors in Hong Kong in 2010.
The appellant charged her customers between $250 and $500 for each set of injections.

5. Formal Citations

Neo Ah Luan v Public Prosecutor, Magistrate’s Appeal No 9307 of 2017, [2018] SGHC 188
Public Prosecutor v Neo Ah Luan, , [2018] SGDC 36

6. Timeline

Date	Event
2012-01-01	Appellant started providing home-based beauty services.
2013-03-13	Ms. Guan Na's last visit to the appellant.
2014-01-01	Appellant injected Ms. Huang Jindi with Skinfill Carbonium Mini.
2014-02-24	HSA and Ministry of Health raided the appellant’s home.
2018-04-23	Hearing adjourned for parties to address the issue of whether the offences were made out.
2018-05-11	Matter restored before the court.
2018-09-03	Judgment reserved.

7. Legal Issues

Interpretation of 'practise as a medical practitioner' under the Medical Registration Act
- Outcome: The court held that 'practise as a medical practitioner' includes doing acts which should only be done by a qualified medical practitioner, regardless of whether the person holds themselves out as such.
- Category: Substantive
- Sub-Issues:
  - Scope of prohibited activities
  - Requirement of holding oneself out as a medical practitioner
Sentencing for offences under the Medical Registration Act
- Outcome: The court established a sentencing framework considering the level of harm and culpability, and held that lack of professional liability insurance should not be an aggravating factor.
- Category: Procedural
- Sub-Issues:
  - Consideration of potential harm
  - Assessment of offender's culpability
  - Relevance of lack of professional liability insurance

8. Remedies Sought

Appeal against the custodial sentences imposed by the District Judge

9. Cause of Actions

Violation of Section 13(1) of the Medical Registration Act
Practising medicine as an unauthorised person

10. Practice Areas

Criminal Appeals
Sentencing
Regulatory Offences

11. Industries

Healthcare
Beauty

12. Cited Cases

Case Name	Court	Affirmed	Citation	Jurisdiction	Significance
Tan Cheng Bock v Attorney-General	Court of Appeal	Yes	[2017] 2 SLR 850	Singapore	Cited for the principle of purposive interpretation under s 9A of the Interpretation Act.
Attorney-General v Ting Choon Meng and another appeal	Court of Appeal	Yes	[2017] 1 SLR 373	Singapore	Cited for the three-step process of purposive interpretation.
Public Prosecutor v Lam Leng Hung and others	Unknown	Yes	[2018] 1 SLR 659	Singapore	Cited regarding the use of rules of statutory construction as an aid.
JD Ltd v Comptroller of Income Tax	Unknown	Yes	[2006] 1 SLR 484	Singapore	Cited for the principle that Parliament shuns tautology.
Public Prosecutor v Kulandaivelu Padmanaban	District Court	Yes	[2010] SGDC 407	Singapore	Compared to the present case regarding the severity of the sentence for unauthorized medical practice.
Public Prosecutor v GS Engineering & Construction Corp	Unknown	Yes	[2017] 3 SLR 682	Singapore	Cited for the principle of considering potential harm in sentencing.
Public Prosecutor v Koh Thiam Huat	Unknown	Yes	[2017] 3 SLR 1099	Singapore	Cited for the principle of considering potential harm in sentencing for offences affecting public health and safety.
Logachev Vladislav v Public Prosecutor	High Court	Yes	[2018] SGHC 12	Singapore	Cited for the principle that offences perpetrated over a sustained period of time would generally be more aggravated than a one-off offence.
Public Prosecutor v Fernando Payagala Waduge Malitha Kumar	Unknown	Yes	[2007] 2 SLR(R) 334	Singapore	Cited for the principle that the duration of offending indicates how determined the offending conduct is.
Public Prosecutor v Raveen Balakrishnan	High Court	Yes	[2018] SGHC 148	Singapore	Cited for the principle that the sentencing court should be careful not to double-count any factors which may already have been taken into account in assessing the level of culpability.
Ng Kean Meng Terence v Public Prosecutor	Unknown	Yes	[2017] 2 SLR 449	Singapore	Cited for the totality principle.
Public Prosecutor v Law Aik Meng	Unknown	Yes	[2007] 2 SLR(R) 814	Singapore	Cited for the principle that entering Singapore for the purpose of carrying out illegal activities is a particularly aggravating factor.
Yap Ah Lai v Public Prosecutor	Unknown	Yes	[2014] 3 SLR 180	Singapore	Cited for the principle that the law generally does not treat factors which are inherent in an offence as aggravating.
Pittis Stavros v Public Prosecutor	Unknown	Yes	[2015] 3 SLR 181	Singapore	Cited for the principle that the law generally does not treat factors which are inherent in an offence as aggravating.

13. Applicable Rules

Rule Name
No applicable rules

14. Applicable Statutes

Statute Name	Jurisdiction
Medical Registration Act (Cap 174, 2014 Rev Ed) s 17(1)(e)	Singapore
Medical Registration Act (Cap 174, 2014 Rev Ed) s 13	Singapore
Health Products Act (Cap 122D, 2008 Rev Ed) s 15(1)	Singapore
Criminal Procedure Code (Cap 68, 2012 Rev Ed) ss 390(3) and 390(4)	Singapore
Criminal Procedure Code (Cap 68, 2012 Rev Ed) s 390(6)	Singapore
Medical Registration Act s 2A	Singapore
Interpretation Act (Cap 1, 2002 Rev Ed) s 9A	Singapore

15. Key Terms and Keywords

15.1 Key Terms

Dermal filler injections
Medical Registration Act
Unauthorised person
Health Sciences Authority
Promoitalia Skinfill
Sentencing framework
Potential harm
Culpability
Purposive interpretation
Medical practitioner

15.2 Keywords

Medical Registration Act
Dermal Fillers
Unauthorized Practice
Sentencing
Criminal Law

16. Subjects

Criminal Law
Medical Law
Sentencing
Statutory Interpretation

17. Areas of Law

Criminal Law
Criminal Procedure and Sentencing
Medical Law
Statutory Interpretation