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Hong Kong courts

Bacteria at levels ‘only seen in terminal Aids patients’: doctors await verdict over fatal beauty blunder

Dr Stephen Chow Heung-wing’s DR Group launched an unproven cancer therapy in 2012 for use on healthy patients, but the blood extraction, processing and infusion treatment saw one woman die and three fall seriously ill, including his own sister

PUBLISHED : Monday, 11 December, 2017, 3:24pm
UPDATED : Tuesday, 12 December, 2017, 12:49am

Hong Kong doctor turned businessman Stephen Chow Heung-wing had a grand plan to help China defeat cancer and improve the health of the country’s ageing population.

But just five years later he ended up a defendant in a criminal trial involving the worst beauty treatment blunder in the city’s history.

On Monday jurors retired to deliberate the fate of Chow, 63, who is accused of manslaughter after a patient in his clinic died and three others fell seriously ill.

Horrific details of a Hong Kong beauty clinic treatment gone fatally wrong

His beauty therapy empire launched an unproven cancer treatment in 2012 that the company deemed also had anti-ageing benefits for healthy people. It was based on injections thought to boost the immune system by enhancing cells in the body capable of killing their mutated, cancer-causing counterparts.

“I believe there were great prospects for this technology,” Chow said in court in September.

But his plan backfired after treating just over 40 customers.

His own sister, a lung cancer patient, and three healthy women fell seriously ill after undergoing the therapy. One died on October 10, 2012 after lethal bacteria brought multi-organ failure. Doctors said the blood poisoning Chan Yuen-lam experienced had been “most catastrophic” and likened her bacterial levels to that of “terminally ill Aids patients”. Another woman was forced to have her legs and four fingers amputated, while a third had to learn how to walk again.

The shocking cases shed light on a vast unregulated industry of beauty centres in the city that have offered everything from stem cell injections to body contouring surgery.

Search for ‘natural killer’ cells embroiled clinic in manslaughter case

In September a woman fell into a coma at a beauty parlour in Tsim Sha Tsui after receiving an adrenaline shot, leading to the arrest of two staff members for possessing and using a poison without a licence. In 2015 a dance teacher died after undergoing liposuction at a private clinic specialising in hair transplants. The tragedies prompted calls for the government to tighten regulations.

Investigations into the blunders at Chow’s clinics revealed that Chan Kwun-chung, the technician who handled the women’s blood, had never conducted bacteria tests. He cultured their blood cells outside the body for 15 days at 37 degrees Celsius and 100 per cent humidity before the blood was injected back into their bodies.

The debacle prompted prosecutors to turn what would typically be a civil matter into criminal manslaughter charges, punishable by life imprisonment, against Chow, the 32-year-old technician and Dr Mak Wan-ling, 35, who gave the injections. All have pleaded not guilty.

Closing his case, prosecutor Raymond Leung Wai-man SC asked the jury of nine: “As a member of Hong Kong society, as a patient yourself, would you want to find yourself in this position, paying HK$59,500 per shot and ending up with something like this?”

The jury will continue deliberations on Tuesday morning.

‘Almost a scientific fraud’

The 98-day trial centred on an unregulated therapy said to enhance the number and viability of cytokine-induced killer (CIK) cells in the body, a treatment currently under clinical trial.

The therapy involves extracting, processing and then reintroducing a patient’s blood. Documented side effects include fever, chills, shock, nausea, and vomiting.

But its effect on healthy people remains uncertain as its use has not been recorded in any reputable medical journal, according to prosecutors.

Hong Kong’s top microbiologist Dr Yuen Kwok-yung said the therapy should only be used on patients with late-stage cancer, and not for beautification.

To brand it as health care, Leung said, was just a guise to sell a gimmicky product for profiteering.

“It’s fake science. It’s almost scientific fraud,” he said. “They’re selling a hoax to people who are concerned about their looks. Perhaps this is a corollary of Hong Kong society becoming more affluent, and [Chow] was exploiting that.”

The prosecution case against the trio hinges on the key question of whether each of them owed a duty of care to the deceased. Madam Justice Judianna Barnes Wai-ling said that only if the jurors agreed there was a duty could they consider whether a breach of that duty was a substantial cause of the death and if that breach was “so truly, exceptionally bad and so reprehensible that it amounted to gross negligence and required criminal sanctions”.

Mak accepted she had a duty as a doctor to a patient, but Chan argued that he merely followed instructions from Chow, who for his part denied being a hands-on boss in effective control of the beauty clinic and laboratory involved.

On Monday, after four hours of deliberation, the jurors asked whether Chan’s conduct should be considered exceptionally bad if he was acting according to the instructions of his boss.

‘All my internal organs were in turmoil’

On October 3, 2012, Wong Ching-bor, then a 60-year-old primary school teacher, returned to the Hong Kong Mesotherapy Centre, owned by DR Group, in Causeway Bay for her blood infusion, thinking she would return home with improved health to take care of her two sons.

Mak told her the therapy could bring side effects like a fever and numb limbs. She connected Wong to a drip bag containing a “creamy, thick, sticky” liquid for a 30-minute infusion. But Wong began to feel cold and shivery just 15 minutes into it, and shook so violently that Mak had to pull the needle.

Hong Kong mother who died after beauty treatment felt a pain more intense than labour, court hears

“I cannot describe it. I just felt like all my internal organs were in turmoil,” Wong recalled.

In the end Wong had her legs and four fingers amputated to save her life.

“I want to be a healthy person,” she said tearfully. “But I’m now disabled and useless.”

The court heard how two other women had already begun to show signs of discomfort before Wong received her injection on the same day.

The daughter of Chan Yuen-lam, 46, recalled seeing her mother’s face turn black that night as they waited to see a private doctor who gave her flu medicine.

“It is more painful than giving birth,” Chan had told her.

She died a week later of multi-organ failure due to septicaemia caused by mycobacterium abscessus, a bacteria that was later found on two suction devices called pipettes and the centrifugal machine that handled her blood.

‘No money is no excuse’: Hong Kong court told of pressure at beauty clinic to sell treatments

Dr Raymond Liu Wai-to of Ruttonjee Hospital’s intensive care unit said the bacteria found in Chan’s blood was some of the most lethal he had ever seen, and described her case as “most catastrophic”. His assessment was echoed by Yuen, the microbiologist, who said: “I have only seen [such bacterial levels] in terminally ill Aids patients.”

A third woman, Wong Fung-kwan, 62, stayed seven months in hospital, where she had to learn how to walk again.

‘Was the DR Group really ready?’

The idea for the therapy was sparked on March 2, 2011, when technician Chan Kwun-chung emailed his boss Chow to share a speech by prominent mainland professor Dr Zhong Nanshan, who spoke of cells in the human body that could kill bad cells before they form cancer. The technician said people in China and Taiwan were secretly doing such cellular therapy for anti-ageing and health care purposes, and remarked that it could be “a good source of stable income for DR”.

From then on, the DR Group approached experts in Taiwan, Japan and mainland China while conducting research on the therapy’s efficacy and safety. An entourage of staff – including Chow, Chan and Mak – was later sent for two days of training at the General Hospital of the Guangzhou Military Command of the PLA on February 7, 2012.

There, Chow met Professor Xiao Yang, who shared his views on how the combined use of stem cells and CIK cells could help slow ageing and minimise cancer risks for the elderly, hence “alleviating the country’s medical expenses burden”, Chow said.

CIK therapy was launched within hours of their return to Hong Kong.

The DR Group recorded its first sale on February 14 and its first customer underwent blood extraction on March 28, despite Chan having yet to settle on the cell culture method, storage issues or even the number of cells to be proliferated.

Benefits of cancer treatment not documented, Hong Kong court hears

“Was the DR Group really ready to offer CIK therapy to customers?” the judge asked.

The prosecutor said: “The decision to launch was made in indecent haste. The mentality was to get ahead of the pack and earn the first batch of money from these novel treatments.

“There was no need for the urgency; no need for the treatment at all. The only need perceived by [Chow] was the need to make money quickly.”

Yuen opined that the medical doctors in charge of the CIK therapy fell far below the expected professional standard, and concluded that the tragedy could have been avoided if bacteria tests had been done.

Prosecutors also questioned whether Chan was properly qualified, and slammed Chow for failing to put in place a system of supervision and checks over the technician, who was culturing the cells according to steps in his head and without any bacteria tests.

But the two doctors in the case maintained they were kept in the dark about the absence of such tests.

Chow said he “firmly believed CIK was safe or he would not have allowed his sister to receive two infusions, including one that contaminated her bloodstream on September 29 which gave her diarrhoea 10 times a day.

‘A moneymaking monster’

In court, Chow was an eager man, taking notes and reminding the jury “to put a mental note on this date” while offering to explain unfamiliar acronyms. Sometimes the judge would stop him: “If you just ramble on, you will be here forever.”

“Yes, my lady,” he replied with a nod and a grin. “Sorry, my lady.”

Hong Kong beauty customer describes learning how to walk again after horrific treatment

At times, Chow’s testimony drew a full house. Some stood watching in the aisles while others occupied whatever space was left in the courtroom.

At the time of tragedy, the DR Group was an empire of 38 beauty and health care centres with two affiliated laboratories, employing more than 800 staff and offering more than a hundred skincare products and services to 500,000 customers a year. It was on track for a public listing. Chow called it “Project Magic”.

It was a huge moneymaking machine, or monster
Raymond Leung, prosecutor

At least 55 customers were convinced to buy CIK therapy, some of them spending half a million dollars on the product.

The court heard how the deceased Chan purchased more than HK$1 million worth of DR services in 2011 and 2012 without her husband’s knowledge. Wong Fung-kwan forked out HK$70,000 for CIK therapy from her monthly salary of HK$7,000 as a cleaner, after an unknown salesman told her that she alone would get a discount on a service worth HK$180,000.

Company staff were handsomely rewarded. Chow declared nearly HK$7 million in income on his tax return for 2012-2013. His technician Chan was earning HK$45,000 a month, while Mak was hired on a monthly salary of up to HK$72,000 plus HK$28,000 as a guaranteed bonus and an extra HK$1,000 per CIK therapy. By the time Mak left the company, she was earning close to HK$200,000 a month.

“It was a huge moneymaking machine, or monster, created by [Chow],” prosecutor Leung said.

But despite the lucrative business, Chow said he had not forgotten the Hippocratic oath he had taken in medical school.

“Customers are really smart,” he said. “They would know if you are doing it for their good. Hong Kong people are not stupid.”