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Hong Kong health care and hospitals

Hong Kong doctor Wong Cheuk-yi banned for six months over death of elderly cancer patient Wang Keng-kao at Kowloon Hospital

Medical Council finds doctor guilty on two charges of professional misconduct after patient died because breathing hole in his throat was blocked by gauze

PUBLISHED : Wednesday, 09 May, 2018, 3:30pm
UPDATED : Wednesday, 09 May, 2018, 11:27pm

A Hong Kong doctor was banned from practising for six months on Wednesday over a blunder almost seven years ago that killed a 73-year-old patient whose only breathing hole was blocked by gauze.

Dr Wong Cheuk-yi’s name would be removed from the general register for doctors for six months without suspension after the Medical Council determined he was guilty of two charges of professional misconduct after a litany of medical errors caused the death of Wang Keng-kao on November 14, 2011. 

Wong, who was responsible for the care of Wang in Kowloon Hospital from October to November 2011, had faced three charges.

“I find the verdict fair and just. I am satisfied with it,” Brian Wang Ping-wan, the patient’s son, said. 

“I don’t feel the defendant had any sense of remorse.” 

Wong appeared calm when the sentence was read out and left without answering reporters’ questions.

The fatal blunder was among the most high-profile medical mistakes in the city in recent years.

Wang had undergone surgery at Queen Elizabeth Hospital in Yau Ma Tei, where a permanent tracheostomy – a surgical incision in the windpipe to aid breathing – was performed. He later suffered a stroke and was transferred to Kowloon Hospital for rehabilitation. Between June and November 2011, he was transferred several times between the two hospitals.

Doctor Wong Cheuk-yi faces disciplinary panel over death of cancer patient Wang Keng-kao in 2011

Following Wang’s death, gauze was found covering the opening in his throat – the only channel through which he could breathe – and taped down at all four edges by nurses.

On Wednesday, Wong was ruled to have failed to take proper steps to prevent the patient’s permanent tracheostoma – the opening in the windpipe – being treated or managed as a temporary tracheostomy wound. He was also found guilty of failing to alert or instruct nursing or other medical staff that the wound was a permanent tracheostoma, and not a temporary tracheostomy.

Professor Felice Lieh Mak, chairwoman of the council’s inquiry panel, said Wong’s failure to notice from reading medical records the nurses’ repeated mismanagement of the patient’s tracheostoma was “inexcusable”. 

“This demonstrated either the defendant had not read those medical records or he did not read them carefully enough,” she said, reading out the panel’s findings, and that Wong had seen the patient eight times in 10 days.

According to the findings, Wang’s medical records showed that his tracheostoma was frequently “dressed or covered by gauze” from November 2 to 14, 2011. 

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A physiotherapist had also remarked that Wang’s breathing hole was covered by gauze. But Wong failed to notice such information.

“As the case doctor of the patient, the defendant had the primary responsibility to provide proper medical care to the patient during ward rounds,” Lieh Mak said.

Given the repeated mismanagement by the nurses of Wang’s tracheostoma, Lieh Mak said, Wong “ought to have realised that there was something wrong with their professional judgment”.

She said it was incumbent on Wong to alert the nurses that the patient’s breathing hole was permanent and not temporary. “And yet, nothing was done by the defendant.”

Wong was also criticised for a lack of insight into his wrongdoings. “The defendant also failed to reflect on his wrongdoings and this indicated a lack of remorse on his part,” Lieh Mak said.

Lieh Mak later told the press the case was serious, hence the penalty. There was no suspension of the penalty as the defence did not address the doctor’s mistakes. 

However, the council found Wong not guilty of failing to take proper steps to ensure no layers of gauze and medical adhesive tape were dangerously or improperly placed over the patient’s tracheostoma. 

He had no case to answer to the second part of a charge, which accused him of failing to warn nursing staff that the term “tracheostomy” in the patient’s medical record was improper or misleading.

During mitigation, the defence counsel said Wong, who was receiving specialist training in surgery at Queen Elizabeth when the case happened, was a responsible doctor even though he had to take care of patients at both Queen Elizabeth and Kowloon hospitals. 

Wong’s counsel said: “He was extremely regretful about the loss of a patient. He was also a victim of the breakdown of the system of the Hospital Authority.” 

Queen Elizabeth Hospital would review Wong’s employment arrangement according to personnel procedures, a spokesman said. Wong is currently on leave.