Patient moaned in surgery, court told

PUBLISHED : Wednesday, 22 February, 2006, 12:00am
UPDATED : Wednesday, 22 February, 2006, 12:00am

A plastic surgeon did not stop an operation to remove fat from the abdomen of his elderly patient even though she had started moaning, a coroner was told yesterday.

Piano teacher Lam King-fong, 70, was moaning and kept turning her head from side to side when surgeon Franklin Li Wang-pong was injecting her with anaesthetic on August 28, 2003, according to registered nurse Yip Wai-kuen, who assisted in the operation.

'[After injecting two syringes] Dr Li asked her whether she was in pain; she did not respond but kept moaning,' Ms Yip said.

After Dr Li injected four more syringes, he withdrew the injection tube and inserted a suction tube about 3mm in diameter to continue the operation, she said.

'Dr Li made the movement [of moving the suction tube inside the body to loosen the fat] tens of times ... But after five or six minutes, Dr Li spotted her breathing was very weak.'

The nurse said the patient might not have been in pain even though she was moaning and moving her head. 'Some patients who make the same gestures only try to let out [their feelings] and they may not actually be in pain,' she said.

But Lam's husband, Chiu Cheuk-ming, disagreed. He accused the medical workers of ignoring signs of pain to continue the operation. 'The gestures showed she was in pain at the time and the doctor should have stopped the operation,' Mr Chiu said.

Lam passed out shortly after the start of the liposuction at Dr Li's Tsim Sha Tsui clinic. Dr Li and nurse Tang Lai-sheung carried out cardiopulmonary and mouth-to-mouth resuscitation at the scene, the coroner heard earlier.

Private cardiologist Cyrus Chow Tak-hau, whose clinic is in the same building, joined the resuscitation attempt, but failed to revive the patient. Lam died on the way to hospital in an ambulance.

Dr Chow told the coroner yesterday that Lam had no pulse and her pupils had dilated when he arrived at Dr Li's clinic. 'There was no spontaneous breathing ... It implies that the patient had cardiac arrest,' Dr Chow said.

The cardiologist, who has practised since 1991, said it was 'very unusual' for him to carry out resuscitation in a private clinic. He said the chance of reviving the patient was slim in view of the clinic setting, where the resuscitation was carried out by a plastic surgeon and a nurse.

'The chance [of successful resuscitation] depends on the speed and efficiency of resuscitation and the cause of cardiac arrest, whether it is reversible,' he said. 'For example, it would be easy if the cardiac arrest was caused by the obstruction of a foreign body but the chance would be small if it is caused by a massive heart attack.'

Based on Lam's medical report, Dr Chow said her left ventricle was thicker than normal, which indicated she had a heart problem.

The hearing will continue before coroner Peter White today.