Hong Kong health care and hospitals

Hong Kong teenager left partially paralysed after suspected medical blunder

Family of 15-year-old girl accuse United Christian Hospital of neglect after she was left unable to move the left side of her body following a blood plasma exchange procedure

PUBLISHED : Saturday, 17 March, 2018, 11:04pm
UPDATED : Sunday, 18 March, 2018, 1:10pm

A 15-year-old girl was left half paralysed after a suspected medical blunder in United Christian Hospital, when an artery was wrongly pierced in a medical procedure which was meant to treat an inflammation in her spinal cord. 

In a press conference on Saturday, family members of the Form Four girl, accused medical staff at the Kwun Tong hospital of committing multiple errors when treating the girl’s condition, known as acute transverse myelitis. They hoped the hospital would admit its liability. 

“The left side of my sister’s body can’t move. Doctors said her chance of recovery was slim,” said the girl’s elder brother, surnamed Chan, adding that his sister’s eyesight and ability to swallow was affected too. 

“My daughter hoped to study in university and become a nurse,” the girl’s mother said, in tears. “But now she might lose self-care skills in the future and suffer lots of pain in her life.” 

The girl first sought medical help from the hospital on October 31 last year after suffering from a headache, neck pain and weakness on the right side of her body. On November 9, she was confirmed to be suffering from acute transverse myelitis, an inflammation of her spinal cord. 

If the doctor did not place the catheter in the wrong place, there would not be any problem
Brother of 15-year-old girl

While the girl’s condition did not improve after taking a high dosage of steroids for five days, she was suggested to receive a procedure named plasmapheresis, a process to replace affected plasma with good plasma or a plasma substitute. 

The girl received the procedure on November 16. While a doctor from the hospital’s paediatric intensive care unit inserted a catheter into a vein of the girl’s neck, a step necessary for the plasma exchange procedure, the girl developed shock and blood accumulated in her chest. 

“On the day when the incident happened, doctors from United Christian Hospital told us that there was only bleeding from [my sister’s] vein and there was no problem with her artery,” said Chan. 

He said doctors gave the assurance after conducting an X-ray check on his sister. 

The girl was transferred to Queen Elizabeth Hospital on the same day for treatment of the accumulation of blood in her chest, as United Christian did not have specialists in cardiothoracic surgery.  

Medical blunder linked to patient overload in Hong Kong public health care sector, doctors say

It was then the family was told by Queen Elizabeth doctors that the girl’s artery was damaged during the process of inserting the catheter into the vein. They also confirmed the girl, who was unconscious at that time, suffered an ischemic stroke in a large area of her right brain. This specific type of stroke happens when the blood supply to brain is obstructed. 

“A doctor said over the past period of more than 20 years, she had never seen such a serious consequence [of a catheter insertion procedure], in which a stroke happened in large area of right brain,” said Chan. 

The girl underwent three brain surgeries, which involved removing some of her right brain tissue, to reduce pressure inside her skull. Because of the stroke and brain surgeries, the girl’s eyesight and ability to swallow was affected and left side of her body was paralysed. 

The girl, who now remains in Queen Elizabeth’s intensive care unit, could not stand or sit. 

Chan said United Christian should be held responsible for every mistake. 

“If the doctor did not place the catheter in the wrong place, there would not be any problem,” said Chan. “Even if the catheter was wrongly placed, if doctors responsible for X-ray imaging did not misjudge, the result would not be that bad. The medical team should also have discovered earlier that she had signs of a stroke. 

“We hope the hospital will admit the liabilities they have to take,” said Chan. 

Lawmaker James To Kun-sun, who has been assisting the family, said the family has already lodged complaint to the hospital. 

Medical blunders at Hong Kong hospitals point to overstretched public health care system

“We feel that United Christian Hospital is negligent,” said To. “[The hospital] should apologise.” 

A spokesman for the Hospital Authority said doctors from United Christian Hospital had explained to the girl’s family members that plasmapheresis was a high-risk medical procedure as it required placing a catheter in a patient’s central vein. It would possibly involve risks, such as damage to arteries and blood accumulation in the chest. The procedure was done with the family’s consent.

The spokesman said the girl’s condition had been stable since December. She is receiving rehabilitation treatment, such as chest physiotherapy, limb movement training and speech therapy in Queen Elizabeth. 

“United Christian Hospital is very concerned and feels upset about the incident,” the spokesman said, adding the hospital has offered condolences to the girl and her family. 

The hospital has also invited third-party experts to review the medical procedures performed on the girl and is awaiting the report. After they have received the report, they would explain the content to the family.

Lawrence Wong Ka-sing, an honorary professor in neurology at Chinese University, said it was “rare” and “serious” to see a stroke caused by a plasma exchange process. 

But he said as the arteries and veins were close to each other, it would be possible to place a catheter in the wrong place.