Singapore Medical Council v BXR: Appeal Against Costs Order in Medical Disciplinary Proceedings
The Singapore High Court heard an appeal by the Singapore Medical Council (SMC) against a Disciplinary Tribunal's (DT) decision to award costs to Dr. BXR after he was acquitted of professional misconduct charges. The charges stemmed from a complaint by a patient regarding the use of her medical information and photographs. The High Court, comprising Andrew Phang Boon Leong JA, Steven Chong JA, and Belinda Ang Saw Ean J, dismissed the SMC's appeal, finding that the charges were not brought on grounds that reasonably appeared to be sound and that there was an inordinate delay in the prosecution. The court ordered the SMC to pay $20,000 in costs to Dr. BXR.
1. Case Overview
1.1 Court
High Court of the Republic of Singapore1.2 Outcome
Appeal Dismissed
1.3 Case Type
Regulatory
1.4 Judgment Type
Grounds of Decision
1.5 Jurisdiction
Singapore
1.6 Description
Appeal against costs order after SMC's charges against Dr. BXR were dismissed. The court upheld the decision, citing the SMC's lack of sound grounds for charges.
1.7 Decision Date
2. Parties and Outcomes
| Party Name | Role | Type | Outcome | Outcome Type | Counsels |
|---|---|---|---|---|---|
| Singapore Medical Council | Applicant | Statutory Board | Appeal Dismissed | Lost | Chia Voon Jiet, Koh Choon Min, Sim Bing Wen |
| BXR | Respondent | Individual | Costs Order Upheld | Won | Lek Siang Pheng, Melvin See Hsien Huei, Toh Cher Han |
3. Judges
| Judge Name | Title | Delivered Judgment |
|---|---|---|
| Andrew Phang Boon Leong | Judge of Appeal | Yes |
| Steven Chong | Judge of Appeal | No |
| Belinda Ang Saw Ean | Judge | No |
4. Counsels
| Counsel Name | Organization |
|---|---|
| Chia Voon Jiet | Drew & Napier LLC |
| Koh Choon Min | Drew & Napier LLC |
| Sim Bing Wen | Drew & Napier LLC |
| Lek Siang Pheng | Dentons Rodyk & Davidson LLP |
| Melvin See Hsien Huei | Dentons Rodyk & Davidson LLP |
| Toh Cher Han | Dentons Rodyk & Davidson LLP |
4. Facts
- The respondent, a plastic surgeon, treated Ms. P for enlarged parotid glands with botulinum toxin injections between 2008 and 2013.
- Ms. P filed a complaint alleging the respondent used her confidential medical information and unanonymized photos without consent.
- The respondent claimed Ms. P consented to the use of her photos and case details in medical publications and presentations.
- The SMC issued a Notice of Inquiry in 2017, approximately 2.5 years after the respondent provided his explanation.
- The Disciplinary Tribunal acquitted the respondent, finding he had obtained informed consent on August 4, 2008.
- The DT found no objective evidence to support Ms. P's claims of separate oral assurances regarding photo usage.
- The SMC's expert witness lacked authority for his opinion on the respondent's duty to inform the patient of her right to revoke consent.
5. Formal Citations
- Singapore Medical Council v BXR, Originating Summons No 14 of 2018, [2019] SGHC 205
6. Timeline
| Date | Event |
|---|---|
| Respondent began treating Ms. P with botulinum toxin injections. | |
| Respondent last treated Ms. P with botulinum toxin injections. | |
| Ms. P filed a complaint against the respondent. | |
| SMC wrote to the respondent, inviting him to provide his written explanation to the complaint. | |
| Respondent provided his written explanation to the complaint. | |
| SMC issued a Notice of Inquiry setting out the five charges against the respondent. | |
| Notice of Inquiry was amended. | |
| Hearing for the inquiry took place. | |
| Hearing for the inquiry took place. | |
| DT delivered its verdict. | |
| High Court heard the appeal. | |
| High Court dismissed the appeal. |
7. Legal Issues
- Costs in Disciplinary Proceedings
- Outcome: The court upheld the decision to award costs against the SMC, finding that the charges were not brought on grounds that reasonably appeared to be sound and that there was an inordinate delay in the prosecution.
- Category: Procedural
- Sub-Issues:
- Principles for awarding costs against regulatory bodies
- Inordinate delay in prosecution as a factor in awarding costs
- Related Cases:
- [2015] 2 SLR 1179
- Professional Misconduct
- Outcome: The respondent was acquitted of all charges of professional misconduct.
- Category: Substantive
- Sub-Issues:
- Failure to maintain clear and accurate medical records
- Failure to obtain informed consent
- Breach of patient confidentiality
8. Remedies Sought
- Costs
9. Cause of Actions
- Professional Misconduct
10. Practice Areas
- Professional Conduct
- Costs
- Medical Disciplinary Proceedings
11. Industries
- Healthcare
12. Cited Cases
| Case Name | Court | Affirmed | Citation | Jurisdiction | Significance |
|---|---|---|---|---|---|
| Ang Pek San Lawrence v Singapore Medical Council | High Court | Yes | [2015] 2 SLR 1179 | Singapore | Cited for the principle that costs typically follow the event in ordinary civil proceedings but this has to be balanced against the fact that in medical disciplinary proceedings, the SMC performs a public and regulatory function. |
| Singapore Medical Council v Dr R | Disciplinary Tribunal | Yes | [2018] SMCDT 7 | Singapore | The present appeal arises from this case, where the Disciplinary Tribunal acquitted the respondent, Dr BXR, of all the charges that were brought against him by the SMC. |
| Lam Kwok Tai Leslie v Singapore Medical Council | High Court | Yes | [2017] 5 SLR 1168 | Singapore | Cited to show that it is not unprecedented for costs to be awarded against the SMC even when the matter is referred by the Complaints Committee. |
| Ang Peng Tiam v Singapore Medical Council | High Court | Yes | [2017] 5 SLR 356 | Singapore | Cited for the principles in relation to when a sentencing discount may be given due to an inordinate delay in prosecution, and whether those principles would be equally applicable to determining when costs may be ordered against the SMC if there is a delay in the prosecution of the medical practitioner. |
| Chan Kum Hong Randy v Public Prosecutor | High Court | Yes | [2008] 2 SLR(R) 1019 | Singapore | Cited for the principle that whether or not there has been significant or inordinate delay is not measured in terms of the absolute length of time that has transpired, but must always be assessed in the context of the nature of investigations. |
| R (Perinpanathan) v City of Westminster Magistrates’ Court | City of Westminster Magistrates’ Court | Yes | [2010] 1 WLR 1508 | England and Wales | Cited for the principle that the financial prejudice necessarily involved in litigation would not normally justify an order for costs. |
13. Applicable Rules
| Rule Name |
|---|
| No applicable rules |
14. Applicable Statutes
| Statute Name | Jurisdiction |
|---|---|
| Medical Registration Act (Cap 174, 2014 Rev Ed) | Singapore |
| Supreme Court of Judicature Act (Cap 322, 2007 Rev Ed) | Singapore |
15. Key Terms and Keywords
15.1 Key Terms
- Singapore Medical Council
- Disciplinary Tribunal
- Informed Consent
- Professional Misconduct
- Costs Order
- Medical Ethics
- Regulatory Function
- Written Statement
- Vexatious Complaint
- Inordinate Delay
15.2 Keywords
- medical
- disciplinary
- costs
- SMC
- BXR
- consent
- tribunal
- appeal
16. Subjects
- Medical Disciplinary Proceedings
- Costs in Legal Proceedings
- Professional Ethics
17. Areas of Law
- Medical Law
- Civil Procedure
- Regulatory Law