Hong Kong health care and hospitals

Paralysed Hong Kong teen’s doctors and hospital staff cleared of wrongdoing

Investigation into medical incident involving Form Four pupil, 16, ends with finding of everything being ‘done up to standard’ but her family disagrees

PUBLISHED : Monday, 30 April, 2018, 5:19pm
UPDATED : Monday, 30 April, 2018, 11:51pm

Doctors and hospital staff involved in a medical incident in which a 16-year-old Hong Kong girl was left half-paralysed have been cleared of wrongdoing as her family called the findings “hard to accept”.

The investigation into the incident at United Christian Hospital concluded that the girl had suffered a rare complication, but it failed to identify the cause.

Dr Alan So King-woon, vice-chairman of the Hospital Authority’s central coordinating committee on paediatrics, which led the investigation, said on Monday that “everything was done up to standard”.

“Doctors were doing the procedure appropriately,” he added. “Therefore, it’s not medical negligence.”

But So, who is also chief of service at Prince of Wales Hospital’s department of paediatrics, conceded the hospital doctors should have explained to the family that a complication such as what the girl suffered was possible, despite the very low risk.

Doctors were doing the procedure appropriately
Dr Alan So King-woon, Hospital Authority

The announcement offered little comfort to the family, who described themselves as “heartbroken” and concerned about the girl’s future.

“I still cannot accept [the situation] because my daughter could have been cured of myelitis, but now she is disabled with many complications,” the girl’s mother said on Monday. “She can’t eat and is unable to swallow, not even water.”

The controversy began after the Form Four girl, surnamed Chan, sought medical help at United Christian on October 31 last year for a headache, neck pain, and weakness on the right side of her body.

On November 9, she was confirmed to have acute transverse myelitis, an inflammation of her spinal cord.

After steroids did nothing to improve her condition, doctors recommended doing plasmapheresis – a procedure to replace a patient’s blood plasma with plasma from a donor or a plasma substitute – on November 16.

During the procedure, a doctor from the hospital’s paediatric intensive care unit inserted a catheter into a vein in the girl’s neck, a step necessary for the transfusion.

The girl developed shock, and blood accumulated in her chest.

She was on the same day transferred to Queen Elizabeth Hospital to treat the blood accumulation.

Doctors subsequently found the girl’s subclavian artery to be damaged.

So said there was no evidence showing the damage to the subclavian artery was caused by human error during the process of inserting the catheter into the vein.

He suspected the subclavian artery was damaged accidentally while a catheter guide wire was inserted in the vein in her neck.

“Typically, damage to the subclavian artery would affect the hand,” So said. “We do not know why in this case it caused a stroke.”

To date the girl has undergone three brain surgeries. She is still in intensive care, and the left side of her body is paralysed. She was described on Monday as in stable condition.

Her family earlier accused medical staff at United Christian of committing multiple errors, and wanted the hospital to admit its liability.

United Christian Hospital chief executive Dr Tom Kam-tim on Monday offered an apology and sympathies to the girl’s family for the hardship they had endured.

But the family disputed that claim, with the brother saying no face-to-face apology came and that “many doubts” remained.

“They haven’t explained why the artery was punctured,” he said.

“Until now the Hospital Authority won’t classify the case as a medical blunder. For us this is very hard to accept.”

Hong Kong public hospitals chief Leung Pak-yin to quit when contract ends in 2019

The brother noted the investigation report acknowledged the doctor administering the transfusion did not tell family members that a stroke was a possible complication. Nor did the doctor offer the less risky option of inserting the catheter in her thigh, he added.

“It seems [the doctor] made a judgment on what to do and informed us.”

The family planned to discuss “responsibility and compensations” with the Hospital Authority.

Democratic Party lawmaker James To Kun-sun, who has been helping the Chans, said he suggested the authority employ a part-time nurse to help the girl recover, saying such an arrangement could be made without an admission of fault.