Doctors should report surgery injuries to protect patients, coroner says
Recommendation is to protect patients from infection through blood contact, coroner says in judgment on HIV-positive doctor's death
The Hospital Authority should make it compulsory for doctors to report any injuries they suffer during surgery, to protect patients from infection through blood contact, the Coroner's Court has urged.
The recommendation came as Coroner Philip Wong Wai-kuen found yesterday that HIV-infected Dr Wong Ho-hing died by suicide in January last year.
Although the surgeon at the Pamela Youde Nethersole Eastern Hospital in Chai Wan carried out operations till the day before his death, none of his patients were found to be infected by the virus, the court heard.
Dominic Tsang Ngai-chong, the authority's chief infection control officer, testified earlier that medical staff were encouraged to report any possible risk of infection during procedures. There was no punishment if they did not come forward.
The coroner said this was inadequate. "The present system is voluntary … It is not enough in protecting patients' interests," Wong said. "It should be compulsory that they report it."
Tsang said that the advice was reasonable, depending on how the rule was enforced.
An authority spokesman said it would look into the issue. Staff were often reminded to report to their superiors injuries sustained in surgery, he said.
Dr Tang Chung-ngai, chief of service at the hospital's surgery department, agreed with the advice. "It is not just to protect patients but also to protect doctors as transmission is two-way," he said.
Although the authority did not know the doctor was an HIV carrier before his death, Wong said its follow-up work after discovering it was ideal.
The authority contacted 143 patients who had been operated on by the doctor in recent years, and all, except 12 who declined testing, were found to be HIV-negative. It also set up a hotline for other patients in doubt and arranged tests for them.
HIV could be transmitted through blood contact when doctors hurt themselves in surgery, and this would put patients at risk, Wong said.
He agreed that reporting HIV infection should not be compulsory because of the need to protect doctors' privacy, but said more measures were needed to protect patients.
The court ruled that the 34-year-old doctor's death was caused by injuries and not his HIV infection, although there were signs of his health deteriorating before his death.
His body was found outside his Wan Chai residential block on January 12 last year. Closed-circuit television footage showed him jumping from his balcony on the 39th floor.