An anesthetist working in the island-state of Singapore has been suspended after he was found to have left one of his patients in the middle of an operation to take a phone call. As reported by Singaporean newspaper The Straits Times, the 64-year-old patient had been undergoing surgery at Gleneagles Hospital over a fracture that was caused by bone marrow cancer back in September 1st, 2016.
SG anesthetist leaves patient during operation to take phone calls
Owing to his advanced age as well as other preexisting factors such as obesity, cancer and prior heart issues, the deceased was “considered a high anaesthetic risk patient” by the Singapore Medical Council’s disciplinary tribunal. At the time of the procedure, he suffered from a complication known as a pulmonary embolism, where a blood clot had suddenly blocked oxygen to his lungs.
This eventually caused his oxygen readings to fall under 90% during surgery, and into the 80s and 70s range. For reference, the normal blood oxygen level range is between 96% to 99%. Even in light of this, the amount of oxygen administered to the patient was not increased.
A letter addressed to the implicated anesthetist, Dr Islam Md Towfique, from the hospital’s parent firm Parkway Pantai Ltd stated that increasing oxygen delivery should be among the first few actions taken by an anesthetist when the patient’s SpO2 level begins to dip.
“…and yet for almost 50 minutes, with the SpO2 either un-recordable or in an unacceptable range, this remedial action was not taken.” they said.
Patient would later pass away a day later after surgery
While doctors were able to resuscitate the patient, he would eventually pass away the very next day. The tribunal points out that while the patient’s chances of surviving the embolism were very low, but it was only further exacerbated by Dr Islam’s delay in recognising the patient’s weakening vital signs and subsequent lateness in administering further action.
Dr Islam defended himself by claiming that it was common practice for anesthetists to leave the operating theater for short periods of time.
“I was with the patient and did apply my expertise to keep the Haemodynamics but I forgot to increase the oxygen to 100 per cent.” the veteran doctor said.
However, an expert from the Singapore Medical Council’s disciplinary tribunal points out that things can go wrong in the blink of an eye, and that an anesthetist should not leave their patient in the operating theater at any juncture.
Anesthetist had been taking calls from other patients regarding when they can visit for treatment
CCTV footage obtained from the hospital corridor indicated that Dr Islam had left the operating theater multiple times, with one instance going on for as long as 9 minutes. This was corroborated by the by the surgeon carrying out the operation. Dr Islam’s calls were from both local and overseas patients who wanted to know when they could visit him for their treatments.
The anesthetist argued that the damage caused by his conduct was minimal, as the chances of the patient surviving the blockage was low to begin with, but was immediately rebuffed by the tribunal who said that such an argument would imply that doctors are able to take less care with a patient if they knew that their chances of survival were slim.
Dr Islam has since been suspended for 30 months, a reduction from the previous 36 months that he was initially sentenced to, owing to his past record of taking calls during other surgeries.