The Evolving Medico-Legal Landscape: Notable Medical Negligence Cases from 2024

By Jeremy Balang, Jason Lim and Dhanya Nair

Article source from: https://mahwengkwai.com/medico-legal-landscape-malaysia-medical-negligence-cases-2024/

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The medico-legal landscape continues to evolve, and 2024 has been no exception. This year witnessed a series of landmark judgments that have not only tested the boundaries of medical practice and legal accountability but have also set new precedents for healthcare professionals, institutions, and patients alike.

In this article, we examine some of the most notable medico-legal cases of 2024, exploring their stories, outcomes, implications, and the lessons they offer for the future of healthcare and legal practice.

Siow Ching Yee – Hospital Liable for its Consultants

In a landmark decision (see Siow Ching Yee (suing through his wife and litigation representative, Chau Wai Kin) v Columbia Asia Sdn Bhd [2024) 3 MLJ 66), the Federal Court on 23.2.2024 held that private hospitals owe a statutory non-delegable duty of care to their patients. This decision establishes that private hospitals can be held liable for the negligence of their specialist consultants, even if they are independent contractors.

In this case, the patient Mr Siow Ching Yee suffered severe brain injuries and permanent disabilities due to an anaesthetic accident at Columbia Asia Hospital, Puchong. Mr Siow, then aged 36, presented with post-operative bleeding following a tonsillectomy at another hospital. While at Columbia Asia’s Emergency Department, he collapsed and experienced a delay in receiving intubation and resuscitation, leading to a hypoxic event that left him in a vegetative state.

The Federal Court also increased the award of damages for, amongst others, brain injuries or damage and the consequent permanent physical and mental disabilities suffered by Mr Siow, resulting in a total award of approximately RM4.5 million, for which the hospital was held jointly liable.

Thaqif Asyraf – A New Record in Damages

On 25.9.2024, the Court of Appeal ordered the Government of Malaysia (“the Government”) to pay RM9.45 million in damages and costs to Thaqif Asyraf Khairol Nizam, a 10-year-old boy who suffered, amongst others, irreversible brain injuries at birth following negligent treatment at the Penang Hospital, increasing the High Court’s award of damages of RM7.6 million (see Thaqif Asyraf bin Khairol Nizam (suing through his mother and litigation representative, Syazwani binti Drani v Government of Malaysia & Ors [2023] 1 LNS 2261), following the Government’s admission on liability.

The sum is the highest award to date in a medical negligence claim, surpassing the sum of RM8.6 million awarded earlier in the year by the Court of Appeal in another case, also involving a Government hospital (more is said below).

On 25.10.2014, the patient Thaqif’s mother was admitted to Hospital Pulau Pinang at 37 weeks of gestation and was noted to have amongst others, gestational hypertension, gestational diabetes, obesity, and irregular uterine contractions. Two days later, a decision was made to induce labour on 30.10.2024.

Following the induction, cardiotocography monitoring of the mother’s contractions and the fetus’s heartbeat revealed, amongst others, signs of fetal distress. Unfortunately, the nurses misinterpreted these signs as the baby being “asleep”, which resulted in a delay in calling a senior doctor. A junior doctor later reviewed the tracing and classified it as “pathological”, indicating an emergency that required delivery within 30 minutes. However, the actual delivery was postponed by 48 minutes, leading to prolonged fetal distress.

Thaqif was born with cyanosis, meconium-stained amniotic fluid, and had aspirated meconium, resulting in severe complications. Immediately after birth, Thaqif needed intubation and spent nine days on a ventilator in the Neonatal Intensive Care Unit (“NICU”). He faced multiple complications, such as meconium aspiration syndrome, metabolic acidosis, pulmonary hypertension, seizures, and persistent hypoglycemia.

Thaqif was discharged home on 14.11.2014. However, his parents were not informed about the brain injuries he sustained or the complications that would ensue. It wasn’t until six months later that doctors at a Government health clinic informed the parents of his abnormal and delayed growth.

Of the RM9.45 million award, a substantial portion went to Thaqif’s future needs and treatment.

Lim Yoke Har – A Record Tied in Aggravated Damages

On 27.8.2024, the High Court awarded the sum of approximately RM4.2 million in damages (see Prince Court Medical Centre Sdn Bhd v Lim Yoke Har (suing through his son and litigation representative, Goh Seng Cha) & Ors and another suit [2024] MLJU 2699) to Madam Lim Yoke Har, a 75-year-old patient who was left in a vegetative state after falling from her hospital bed at Prince Court Medical Centre (“Prince Court”) sometime in 2018. The cause of her fall was later found to be a mechanical failure on the cot side of her hospital bed.

Significantly, the High Court in that case awarded the sum of RM1 million as aggravated damages, matching the previous award by the Federal Court in Dr Hari Krishnan & Anor v Megat Noor Ishak bin Megat Ibrahim & Anor and Another Appeal [2018] 3 MLJ 281.

In its grounds of judgment, the High Court states as follows regarding its award of aggravated damages:-

1. that when Madam Lim’s family sought explanations from Prince Court, Prince Court attempted to blame Madam Lim by falsely claiming that they were not informed of her prior fall, despite documentary evidence proving otherwise;
2. that during the Court proceedings, Prince Court did not come clean but continued to pervert the course of justice;
3. that there was deliberate non-disclosure of material evidence by Prince Court, including incident reports prepared by the on-duty nurse and the internal nursing review conducted into the fall. Even after the Court mandated the release of the incident reports and the internal review, there was a conscious failure to provide the complete documents;
4. that there was also suppression by Prince Court of evidence and knowledge of the cause of the fall which resulted in Madam Lim suing her physician and nurse, and which had caused unnecessary stress and attack on their reputations as professionals;
5. that Prince Court had failed to report the fall to the Ministry of Health within 24 hours or immediately thereafter pursuant to the Ministry of Health’s Director General Directive No.1 of 2010 thereby avoiding a statutory inquiry into the fall; and
6. that it was common knowledge that the cot sides of the beds at Prince Court suffered mechanical failures, and that the outdated beds at Prince Court should have been inspected and replaced promptly to prevent any unfortunate incidents;
7. that unfortunately, it took the tragic fall involving Madam Lim for Prince Court to take action and replace all the old beds with new ones, exemplifying the adage of being penny wise but pound foolish

Prince Court has since filed an appeal to the Court of Appeal on both liability and quantum.

Nur Adeena – the 2nd Highest Award

On 27.3.2024, the Court of Appeal in Civil Appeal No. W-01(NCvC)(W)-227-04/2023 increased the damages by the High Court to RM8.6 million to Nur Adeena binti Mohd Syahmir, a minor who suffered, amongst others, tetraplegia (paralysis from the neck down) caused by, amongst others, a spinal cord injury due to medical negligence following the delivery events at birth at Hospital Selayang.

In 2020, Adeena filed suit against the Government and its tortfeasor defendants at Hospital Selayang. The Government admitted liability two years later, and following a trial on quantum, the High Court awarded damages in the sum of RM5.6 million (see Nur Adeena bt Mohd Syahmir v the Government of Malaysia & Ors [2023] MLJU 1400).

The Government subsequently appealed to the Court of Appeal on the High Court’s decision on quantum, and the Court of Appeal in increasing the sum awarded stated, amongst others, that the approximately RM 3 million increase was, amongst others, to allow Adeena’s home and transport to be suited to her needs, and that the High Court’s decision to limit damages at RM5.6 million was not supported by evidence provided by experts from the government.

In addition to the above, the Courts have also delivered their judgments in other medical negligence claims. Some examples of recent cases are set out below, in chronological (ascending) order.

Adam bin Hamil v Dr Chiam Tee Kiang

On 15.11.2024, the High Court in Kuala Lumpur allowed the plaintiff’s claim against an aesthetic physician and awarded the sum of approximately RM421,770 in damages and costs (see WA-23NCvC-26-03/2022 / [2024] MLJU 3311).

The plaintiff, a 34-year-old hairstylist, sought treatment from the defendant with a view to aesthetic enhancement. He later underwent a trimming procedure using ear cartilage by the defendant in 2021. Post-operatively, the patient developed various complications requiring him to undergo further treatment, including surgical reconstruction and laser treatment to remedy his condition.

The High Court in allowing the plaintiff’s claim held, amongst others, as follows regarding liability:-

1. that the defendant had failed to disclose his limitations, namely the procedures that he was licensed to undertake and not undertake;
2. that the surgical procedures carried out by the defendant on the plaintiff were not within the scope of works of which the defendant was licensed for; and
3. that the defendant’s failure to disclose the limitations of his qualifications to the plaintiff undermined the Plaintiff’s ability to make an informed choice about his treatment.

The High Court awarded, amongst others, the following damages:-

1. RM150,000 as general damages for pain and suffering and loss of amenities of life, taking into account, amongst others, that any reconstructive surgery would not fully revert the plaintiff’s nose shape back to its original condition;
2. RM68,239.55 as special damages for the plaintiff’s subsequent reconstructive surgeries and treatments;
3. RM100,000 as exemplary damages which the High Court held was to serve as a deterrent, especially considering the rapid increase of beauty clinics across the country offering aesthetic surgeries and the need for caution to be exercised to ensure they do not carry out procedures that exceed the limits specified in their licenses; and
4. RM23,530.45 for future medical expenses including for any laser treatments for the removal of the plaintiff’s scars.

Airis Nurhana binti Alfian (an infant suing by her father and litigation representative Alfian bin Zainudin) v Darul Aiman Sdn Bhd & Anor

On 3.10.2024, the Court of Appeal reversed the High Court’s dismissal of a medical negligence claim brought by an infant who suffered, amongst others, a brachial plexus injury following treatment at a private hospital, and awarded approximately RM750,000 in damages and costs (see B-02(NCVC)(W)-2095–11/2022 / [2024] 6 MLJ 552).

The patient Airis was an infant born via vacuum-assisted delivery in 2013 at Putra Medical Centre. She was delivered by a medical officer in the obstetrics and gynaecology department. The patient alleged in her suit that the brachial plexus injury was caused by, amongst others, shoulder dystocia and excessive traction during the delivery, which was denied by the defendants. The defendants also claimed, amongst others, that the vacuum extraction was undertaken appropriately and was necessary due to alleged poor maternal effort.

The High Court initially dismissed the patient’s claim with costs. The Court of Appeal, in overturning the High Court’s decision, held, amongst others, as follows regarding liability:-

1. that the High Court had not properly evaluated the evidence including the expert evidence and was plainly wrong in finding, amongst others, that there was maternal exhaustion warranting the vacuum delivery; and
2. that going by such evidence, the injury suffered by the patient was caused or materially contributed to by, amongst others, excessive traction applied by the said medical officer whilst undertaking the delivery.

Jayshree L. C. Doshi (suing as the executor of the estate of Vinayak Pradhan) v The Government of Malaysia & Ors

On 5.9.2024, the High Court in Kuala Lumpur allowed a claim in negligence against, amongst others, the Government brought by the estate of the late Vinayak Pradhan, a former consultant of Messrs Skrine in Kuala Lumpur and one of the most senior members of the Bar at the time of his passing. The High Court also awarded, amongst others, approximately RM1,580,000 in damages and costs (see WA-21NCvC-126-12/2020).

The deceased, aged 72 at the material time, underwent, amongst others, a radiofrequency ablation (“RFA”) procedure by an interventional radiologist at the National Cancer Institute, Putrajaya (“NCI”). However, post-operatively, the deceased suffered various complications and endured significant pain requiring, amongst others, various medical procedures in Singapore. The deceased unfortunately succumbed to his injuries sometime later.

The High Court in allowing the claim had made, amongst others, the following findings on liability:-

1. that the radiologist who undertook the surgery had failed to advise the deceased regarding the RFA procedure, including its risks, benefits and consequences;
2. that the radiologist was not qualified to effectively undertake the RFA procedure; and
3. that the radiologist had failed to provide appropriate treatment to the deceased post-operatively; and
4. that the Government was vicariously liable for the negligence of the radiologist practising at NCI.

The High Court’s decision is pending appeal on quantum to the Court of Appeal.

Nurul Iman Binti Abu Mansor v Gleneagles Hospital Kuala Lumpur Sdn Bhd & Anor

On 23.9.2024, the High Court in Kuala Lumpur awarded the sum of approximately RM1.1 million in damages to Nurul Iman, a 17-year-old student who suffered, amongst others, permanent right median nerve damage following a negligently performed carpal tunnel release surgery by a consultant orthopaedic surgeon at Gleneagles Hospital (see WA-22NCvC-457-08/2022). Despite undergoing corrective surgeries, the plaintiff continues to experience significant impairment in her dominant hand.

In this case, the High Court had made, amongst others, the following findings:-

1. that the Plaintiff’s median nerve had been negligently cut during the operation;
2. that there was a delay in identifying the cut injury and providing corrective treatment; and
3. that the risks of the procedure were not properly explained to the plaintiff, breaching the duty to obtain informed consent.

Usamah Ariffin bin Abdillah (suing through his father and litigation representative, Abdillah bin Ariffin) & Ors v. The Government of Malaysia & Ors

On 19.8.2024, the High Court in Ipoh awarded damages of approximately RM3.1 million to a patient who suffered, amongst others, an amputation of his right leg above the knee following negligent treatment at Hospital Raja Permaisuri Bainun in Ipoh (“HRPB”) (see: AA-21NCVC-33-12/2021 / [2024] MLJU 2609).

In this case, the patient had received treatment at HRPB following a motor-vehicle accident. However, as a result of, amongst others, various delays in diagnosing and treating his condition, the patient suffered, amongst others, severe vascular complications, requiring him to undergo amputation later.

Following the filing of the suit, the Government admitted liability, and the Court then determined the damages and costs to be awarded.

The Court awarded the following damages:-

1. RM2,687,625 as special damages to cover amongst others, essential cots including high-quality prostheses, necessary replacements, long-term maintenance, physical therapy, allowances for future inflation and loss of earnings;
2. RM150,000 as general damages to compensate the Plaintiffs for the pain and suffering endured, the loss of amenities, the significant diminution of life and the adverse effects on the prospects of marriage resulting from the Defendants’ negligence; and
3. RM200,000 as aggravated damages to account for amongst others a clear failure on the part of the Defendants to provide medical advice which significantly worsened the the 1st Plaintiff’s condition and the suppression of medical records by the Defendants which has led to unnecessary costs and delays in pursuing pre-action discovery.

Conclusion
The landmark cases of 2024 underscore the dynamic interplay between medical practice and legal accountability, reflecting the judiciary’s evolving stance on issues such as non-delegable duty of care, informed consent, and the adequacy of care in both public and private healthcare settings. These rulings not only set important precedents but also serve as reminders of the far-reaching implications of medical negligence on patients’ lives.

The heightened scrutiny of professional standards and institutional responsibilities emphasizes the need for healthcare providers to prioritize patient safety, ensure transparency, and adhere to the highest ethical and professional standards. As the medico-legal landscape continues to evolve, these decisions pave the way for greater justice for patients and reinforce the shared responsibility of fostering trust and excellence in healthcare.

Note: This article does not constitute legal advice to any specific case. The facts and circumstances of each and every case will differ and therefore will require specific legal advice. Feel free to contact us for complimentary legal consultation.