Hong Kong leukaemia patient dies five days after missing critical blood test

Hospital did not book electrician Lin Sui-man’s appointment for May 7, 2014 despite doctor’s instructions, coroner’s court hears

PUBLISHED : Wednesday, 05 April, 2017, 3:58pm
UPDATED : Wednesday, 05 April, 2017, 10:41pm

An electrician suffering from acute leukaemia died five days after he missed a critical blood test, as the hospital had left out his appointment slip despite the doctor’s instructions.

The coroner’s court heard that Lin Sui-man, 46, was supposed to return to Princess Margaret Hospital on May 7 and 9, 2014 for follow-up tests to monitor his declining blood platelet level as it dropped from 79 on May 2 to 15 on May 5 following chemotherapy.

But he returned to the hospital only in the small hours of May 9 because he felt dizzy. By then, his blood platelet level had dropped to 1, and he was found to be suffering from a brain hemorrhage.

Lin died after three days of intensive care.

The hospital later apologised in a letter dated June 10 the same year, acknowledging that only one appointment was arranged due to communication problems, and admitted that it would have been more satisfactory if Lin had been given a blood test and brain scan as soon as possible.

The patient’s wife Huang Huizhan demanded on Wednesday that the hospital explain why the appointment slip was left out and why her husband was given a blood test only after he passed out.

“Your hospital is negligent, [you] did not care for every patient,” she said.

Medical officer-in-charge Dr Kwok Chi-hang explained that on May 5, he had marked the appointment dates in a written and a computerised record that was then printed out for the nurse or clerk to make arrangements.

He later admitted that the Hospital Authority did not have an alert system to notify patients who failed to show up.

But he said the hospital had since reviewed procedures and introduced an additional round of checks by a senior nurse, who would see if the doctors’ instructions had been complied with.

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Lin was diagnosed with acute myeloid leukaemia on March 17, 2014 after reporting lumps in his limbs. But his condition soon stabilised after he received palliative and consolidation chemotherapy.

By April 24, he was discharged from hospital on condition that he return for follow-up appointments.

Kwok explained that Lin’s leukaemia was a fatal one, with only 30 to 40 per cent of patients surviving more than five years from diagnosis.

He agreed that a low platelet level was a common side effect in treatment as it tended to drop rapidly after consolidation chemotherapy and would rise again only when the bone marrow recovered.

“So I scheduled the appointments,” the doctor continued.

The normal blood platelet level ranges from 150 to 450. But Kwok said the risk of hemorrhage was deemed high only if it dropped below 10.

The six-day inquest continues before coroner Ada Yim Shun-yee and a five-member jury.