Patients 'not for experimenting'

Any doctor who supervised a procedure on a patient when he did not have the skill or experience to do so was essentially experimenting on that patient, the Court of Appeal said yesterday.

The court rejected an appeal by Lam Kui-chun, who in February was found guilty of professional misconduct after a Medical Council inquiry into claims he had overseen a procedure on a cancer patient for which he was not qualified.

The council decided to remove Dr Lam from the medical register for six months after it found he performed radio frequency ablation (RFA) on a man with liver cancer in 2001 - a procedure that led to the man's death.

The former legislator was also found guilty of convincing the man that he had the requisite experience to conduct RFA treatment.

Dr Lam's patient died after the probe used in the procedure came too close to his gall bladder and colon, causing 'thermal induced necrosis'.

While the actual ablation was performed by a radiologist untrained in the method, the council found that it was Dr Lam who had overall control of the procedure.

Dr Lam did not dispute that fact, but appealed on the basis that the council's finding - that he did not have adequate training in the procedure - was wrong and that the council did not indicate what training in particular he should have had.

The Court of Appeal found the council was right to conclude Dr Lam's various conference visits and attendances at workshops, as well as solo experimenting on a pig's liver, did not constitute sufficient training.

'[Dr Lam], albeit with his undoubted experience as a physician, was not in a position to undertake RFA procedures [and] it was not sufficient for him to enlist the assistance of a radiologist,' the court said.

'The co-operation of two persons who have different skills which are not complete for the procedure in question cannot constitute the accumulation of the necessary skill.'

In reply to a suggestion that medical science could not advance without doctors occasionally going beyond their experience, the court, to a limited extent, agreed, noting that was not the issue in Dr Lam's case.

'Whatever is undertaken has to involve steps which are within the practitioner's competence. Patients are to be treated, not to be experimented on.'

The court ordered Dr Lam to pay the costs of the hearing.