20 February 2019
After much delay, the United Christian Hospital finally admitted that its doctors committed a blunder that resulted in the patient's acute liver failure. Photo: RTHK
After much delay, the United Christian Hospital finally admitted that its doctors committed a blunder that resulted in the patient's acute liver failure. Photo: RTHK

No excuse for sloppiness in treating patients

Tang Kwai-sze, the 43-year-old mother who underwent two liver transplants at the United Christian Hospital recently, has remained in critical condition.

Many are simply puzzled why Tang, who was first diagnosed with a mild IgA nephropathy (a kind of kidney condition) when she first sought treatment at the outpatient department of the UC Hospital in July 2016, would suddenly deteriorate in health and end up with acute liver failure last month.

According to her daughter, Tang had been taking her medication religiously according to the doctor’s instructions until she suddenly fell very ill and was rushed to the hospital on April 1.

What went wrong?

It wasn’t until this week that the mystery was finally solved: Dr. Chui Tak-yi, director of the UC Hospital, held a press conference on Tuesday admitting that Tang’s acute liver failure was a result of her doctor’s negligence and, as he put it, “a lack of communication between medical staff and her family”.

Dr. Chui’s explanation: After Tang had been diagnosed with IgA nephropathy last year, her doctor prescribed her a steroid known as Prednisolone, a commonly prescribed drug for treating such kidney disease.

The drug has a side-effect: it could temporarily undermine the immune system, making the person taking it more susceptible to infections.

This was where the tragedy began: the medical staff at the UC Hospital had failed to take note of the fact that Tang is Hepatitis B positive, and therefore didn’t prescribe her the anti-viral drug Entecavir as a precautionary measure along with the steroid in order to suppress the Hepatitis B virus that had remained latent in her body.

As a result, the Hepatitis B virus in Tang’s liver suddenly became active again since her weakened immune system could no longer curb it due to the side-effect of the steroid, and this led to her acute liver failure.

Suffice it to say that if the doctors at the UC Hospital had taken note of the fact that Tang is a Hepatitis B carrier and prescribed her anti-viral drugs accordingly, she probably would not have suddenly come down with acute liver failure and would have no need for liver transplantation.

To make things worse, Tang’s family members were notified by the UC Hospital staff of the possible link between Tang’s liver failure and their failure to take note of her being Hepatitis B positive only after they had repeatedly demanded to know why her situation had not improved after everything had been done.

This has aroused public suspicion that the hospital staff could have been trying to cover up their negligence.

Anyway, what is done is done. As Tang’s daughter has put it, a hundred apologies would not give her back a healthy mother, whose life is still hanging by a thread because of a medical blunder that is totally avoidable.

Tang’s case is not an isolated one. According to the Society for Community Organization (SCO), a similar case took place eight years ago, in which a kidney disease patient who was also Hepatitis B positive eventually died of liver failure because he wasn’t prescribed anti-viral drugs along with the medication for his kidney condition.

Apparently, the SCO said, the Hospital Authority didn’t take that lesson seriously.

This got us into thinking: would Tang’s case also have gone under the public radar like the one that took place eight years ago had it not been for the massive media coverage of her story?

In recent years the number of medical accidents in public hospitals has been growing at an alarming rate, so much so it has already taken an irreversible toll on public confidence in our health care system.

The public health care sector may be plagued by staff shortage and low morale, but there is absolutely no excuse for any sloppiness or negligence when it comes to treating patients, because what is at stake here is people’s lives.

As such, we strongly urge the Hospital Authority to look into the matter thoroughly and adopt all necessary remedial measures to prevent the same tragedy from happening again.

In the meantime, we also call on political parties in the Legislative Council to set aside their differences and grudges against one another in order to pass as soon as possible the Medical Registration (Amendment) Bill, under which the Medical Council of Hong Kong will undergo structural reforms so that it can investigate public complaints about medical mishaps more efficiently.

This article appeared in the Hong Kong Economic Journal on May 10

Translation by Alan Lee

[Chinese version 中文版]

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