Teaching not the reason to operate on teen, US don says

It was in the patient’s interest to fix misaligned neck bones, HK-born overseas surgeon says

PUBLISHED : Thursday, 28 March, 2013, 12:00am
UPDATED : Thursday, 28 March, 2013, 4:50am

A professor invited from the United States to perform neck surgery said it was not for the purpose of teaching that he decided to operate on a teenager who later died, the Coroner's Court heard yesterday.

Professor Dachling Pang was testifying over the death of Medwin Cheung Yui-ting, 13, who died two weeks after the surgery at Tuen Mun Hospital in 2011.

Pang, chief of the Regional Centre for Paediatric Neurosurgery at Kaiser Permanente hospitals in Northern California and paediatric neurosurgery don at the University of California, Davis, was invited to Hong Kong at the time to take part in a training programme run by the Hospital Authority. Medwin was one of the four cases selected for it.

In court yesterday, Pang said it was in the teen's interest to fix two misaligned neck bones.

"I have been doing it for 13 years in Hong Kong," he said. "I was born here, grew up as a child here and I want to contribute to Hong Kong." Pang said he did not prolong operation procedures for teaching purposes.

The surgery, held on August 4, 2011, ended in about eight hours, before Medwin's condition started deteriorating. Pang worked with Dr Wong Sui-to, then a neurosurgeon at the hospital.

On completion of their work, they checked that he was awake, could move his limbs and respond to their instructions, and had no swelling in the face. They handed the case to a junior doctor and left, but were called back about 15 minutes later as Medwin developed breathing problems.

They had to adjust a halo ring on Medwin's head that might have affected the airway, but "the airway problem was very much the domain of anaesthetists", Pang told the court.

He disagreed with an orthopaedic and traumatology specialist's report, commissioned by the Cheungs, which said the surgery was unnecessary in an asymptomatic case such as Medwin's. The patient had displayed symptoms such as weak hand muscles and scans showed bone misalignment. Pang said he decided to go ahead only after meeting the teenager in person and checking his records.

He denied having told Medwin's mother the surgery bore "zero risk", contrary to her testimony on Monday. "I have tremendous experience in this area but I would not have said that."

Meanwhile, Wong clarified the testimony he made on Tuesday, saying the surgery was not a preventive operation.

He also said when they were called back, he began performing emergency tracheotomy to provide air for the patient. He had never done it before, he admitted. "No matter how experienced a doctor is, the surgery is difficult. It was difficult for me," he said.

Pang also said he had little experience in emergency tracheostomy as it was usually done by general or ear, nose, throat surgeons. A general surgeon later arrived and finished the procedure.

The inquest continues before Coroner Philip Wong Wai-kuen and the jury.





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