'Removing breathing tube was wrong'

Anaesthetist says three steps before death of 13-year-old boy could have been improved on

PUBLISHED : Tuesday, 14 May, 2013, 12:00am
UPDATED : Tuesday, 14 May, 2013, 3:28am

An anaesthetist told an inquest yesterday that he disagreed with a decision to remove a breathing tube immediately after an eight-hour operation on a 13-year-old boy who later died. It was one of three procedures he felt could have been improved on.

Medwin Cheung Yui-ting suffered breathing difficulties soon after the tube was taken out at the end of surgery to fix a neck problem at Tuen Mun Hospital in 2011. He died 18 days later without ever having left the hospital.

Dr Simon Chan Kin-cheong, anaesthetist at the Prince of Wales Hospital and honorary assistant professor at Chinese University, testified as an expert witness. He said the breathing tube should not have been removed.

The court had earlier heard there was swelling in the boy's respiratory tract, which is common when patients have been laying face down for a long period of time. But the doctors involved have said there were no signs of swelling visible on the outside before they removed the tube.

Chan said whether to remove the breathing tube right after surgery or to keep it overnight is up to the doctors' clinical judgment. "The patient's breathing tube should not have been removed, but the problems may not have been foreseen at the time," Chan said. "If I had any suspicion of swelling in the patient, I would not have immediately removed the tube."

In the past two years, 70 per cent of the 251 patients in the Prince of Wales Hospital who underwent surgery face down were able to have their breathing tubes removed immediately.

Of the 49 cases in which the patient lay face down for over eight hours - as in Medwin's operation - 10 of them did not have the tube removed immediately as it was considered inappropriate, Chan told the court.

He said it would have been better if the surgeons had stayed behind after the operation, instead of leaving after Medwin woke up. They had to rush back after he developed breathing difficulties, the court has been told.

Thirdly, Chan said a bendresistant tube should have been used during the emergency procedures that followed.

But he said most of the procedures followed had been acceptable and stressed that his judgments were retrospective. The inquest continues before Coroner Philip Wong Wai-kuen and a jury.