SINGAPORE (ANN/THE STRAITS TIMES) – A physician with over 40 years of experience based in Singapore, has been suspended from medical practice for one year following an incident where a critical misdiagnosis resulted in a teenage patient losing his left testicle. The event transpired in 2019 at a clinic located in Bukit Batok.
The teenage patient, who was between 15 and 16 years old at the time, initially consulted
Dr Yeo Khee Hong on March 22, 2019, for pain originating from his left testis and radiating towards his abdomen.
The doctor diagnosed the patient with abdominal colic. When the patient returned five days later with swelling and heightened pain in the left testicle, Dr Yeo examined him and diagnosed an infection and inflammation of the testicle, for which he prescribed antibiotics.
Subsequently, it was determined that the patient was actually suffering from testicular torsion, a condition in which the spermatic cord becomes twisted, cutting off the blood supply to the testicle. This misdiagnosis unfortunately led to the loss of the patient’s left testicle.
The teenager went to a hospital’s emergency department on April 1, 2019, on Dr Yeo’s advice after his father called the doctor to say he was in severe pain. That was 10 days after he first consulted Dr Yeo.
According to the grounds of decision by the Singapore Medical Council (SMC) disciplinary tribunal, released on May 27, the boy was discovered to have a tender and swollen left testis with swelling caused by too much fluid trapped in the tissues and inflammation of the skin in the area. The hospital was not named.
He had to undergo surgery to remove his left testicle, after doctors found he suffered left testicular torsion resulting in a non-viable left testis, which means it was not capable of functioning or living.
The disciplinary tribunal said the teenager had a 90.4 to 97.2 per cent chance of salvaging his testis if Dr Yeo had referred him to the emergency room or to a specialist during the first consultation.
The father of the patient had written to the SMC around July 30, 2020, complaining about Dr Yeo’s negligence that he said resulted in the removal of his son’s left testicle.
According to a statement outlining facts mutually accepted by Dr Yeo and the SMC before the hearing, based on the patient’s history of left testicular pain, his profile and age, and Dr Yeo’s physical examination, the patient was already at risk of testicular torsion on March 27, 2019.
The statement said “a reasonable and competent doctor” would not have excluded testicular torsion as a differential diagnosis – one of several possible conditions based on the symptoms – without referring the patient to the emergency department of a hospital or to a specialist first.
Doctors should always consider acute scrotal pain as possibly being testicular torsion until they can rule it out, and Dr Yeo’s failing to act as “a reasonable and competent doctor” was in breach of the applicable standard of care, the SMC said.
Dr Yeo pleaded guilty to failing to provide competent and appropriate care and to exercise due care in the management of his patient. A second charge of failing to provide adequate information to the patient was taken into consideration for sentencing.
Dr Yeo said his failure to inform the boy was “a wrong judgment call”, but said it was “out of good intention as he did not want to cause undue alarm to the patient”. He said he accepted the lapses on his part.
The SMC said Dr Yeo caused a delay to the boy’s diagnosis and treatment, losing him a significant chance of salvaging his left testicle.
The council also considered the boy’s pain from the time he sought help to the day he had his testicle removed, the emotional and psychological distress he suffered from the loss, the potential harm to his fertility, and the effects of the case on public confidence in doctors.
On top of the 12-month suspension, Dr Yeo was censured and had to submit a written undertaking to the SMC that he would not engage in the conduct again or any similar conduct.
Dr Yeo was also ordered to pay the costs and expenses of the proceedings, including the cost of the SMC’s lawyers.
