Hong Kong health care and hospitals

Surgeon who left Hong Kong transplant patient open for three hours had special contract because of doctor shortage

Rare arrangement given to Dr Kelvin Ng because of serious lack of skilled doctors

PUBLISHED : Thursday, 26 October, 2017, 10:03pm
UPDATED : Friday, 27 October, 2017, 1:22am

A Hong Kong surgeon who left a liver transplant patient with an open wound for three hours to attend to another patient, has a special part-time contract because of a severe manpower crunch, the Post has learned.

The rare arrangement is given to Dr Kelvin Ng Kwok-chai because of a serious lack of skilled doctors capable of handling complex operations at Queen Mary Hospital, the only public hospital in the city that performs transplants.

Surgeon leaves patient mid-operation with abdomen open to do surgery at another hospital

It was understood that Ng, a private doctor employed as a part-time associate professor by the hospital’s partnering school, the University of Hong Kong (HKU), is now out of town and the hospital could not get hold of him.

“None of this would have happened if we had enough manpower and did not require a part-timer,” Professor Lo Chung-mau, chief of HKU’s liver transplant division, said.

“Part-time doctors are not normally on call for emergencies. In this case, Dr Ng was put in a very embarrassing situation, because he also felt responsible for his private patient who was waiting for him with a planned surgery.”

Under normal circumstances, a part-time contract would specify a doctor’s working hours.

The patient was said to be in a stable condition after the transplant, while the hospital confirmed it has received a compliant from a member of staff and was investigating.

Patients’ Rights Association spokesman Tim Pang Hung-cheong urged the hospitals to give clearer guidelines to non full-time staff to ensure they would concentrate fully on treating patients.

“The three-hour wait is entirely unacceptable as it has exposed the patient to risk,” Pang said.

A senior anaesthesiologist, who refused to be named, said three hours with an open wound could increase the risk of blood loss or infection, but was unlikely to cause any long-term effect if it was done under supervision.

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Lo said a liver transplant surgery could be put on hold for up to six hours, but this case was “unsatisfactory” because it was to wait for a surgeon.

Only seven doctors in the hospital are skillful enough to perform a liver transplant individually, which requires at least 17 years of medical training, Lo said, and the others were all engaged or on leave an organ became available in Prince of Wales Hospital, Sha Tin on October 13.

Ng partnered with Dr Tiffany Wong Cho-lam, the patient’s chief surgeon, who cancelled her holiday, after they heard the organ had been harvested at noon. They had opened the abdomen of the recipient in Queen Mary at around 3.30pm.

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But as they were waiting for the organ to arrive, Ng suddenly left the operation room and rushed to perform the other surgery in a private hospital, promising to return at 5pm.

Five minutes after he left, the liver arrived but Wong decided to wait for Ng due to the complexity of the procedure, leaving the patient unconscious on the operation table with the supervision of nurses and anaesthesiologist.

Ng returned at 6.30pm and finished the transplant at 10pm.

Lo said it was difficult to blame Ng for leaving to treat his own patient, saying that Wong should have come up with other solutions instead of waiting for him.

Lo added it was disappointing to see the trend for young surgeons leaving for the more lucrative private sector after they received enough training.

The understaffed public hospitals have a shortage of around 250 doctors.