"Liposuction death" inquest opens

[youallhumsup]

"Liposuction death" inquest opens
Posted: 17 October 2011 1926 hrs

SINGAPORE: The liposuction procedure conducted on Franklin Heng, who headed property firm YTL Pacific Star, was not performed in a manner that was acceptable in ensuring patient safety.

Mr Heng died following the procedure.

Dr Vincent Yeow, who heads the Plastic, Reconstructive and Aesthetic Surgery Department at KK Women's and Children's Hospital, gave the expert opinion at an inquest into Mr Heng's death.

Mr Heng, who was 44, underwent the procedure at Reves Clinic on 30 December 2009.

It was performed by Dr Jim Wong, a general practitioner.

The inquest heard that Mr Heng suffered multiple penetrating wounds to his intestines and stomach following the procedure.

Senior Investigation Officer Acting Inspector Lim Chee Peng told the court the damage to the intestines could have caused Mr Heng to go into shock before he died later that day.

Dr Yeow said he felt that a perforation of the bowel can be attributed to "extremely poor technique and inexperience".

He added it was "highly likely" that Mr Heng was deeply sedated almost to the point of general anaesthesia with inadequate monitoring.

A total of 17 witnesses will be giving their testimonies during the inquest, which will be held until 4 November.

The hearing continues.

- CNA/wk

 

[youallhumsup]

I did not cause liposuction death, says doctor
She says her monitoring of patient during procedure was adequate

Published on Oct 20, 2011​

Dr Wong (above) found Mr Heng pale and unresponsive when he returned to the procedure room after a toilet break. -- ST PHOTOS: WONG KWAI CHOW

By Selina Lum

A doctor monitoring a liposuction carried out on property management firm boss Franklin Heng said she did not cause his death and cannot be held responsible for his collapse after she left the procedure room.

Dr Zhu Xiu Chun, 48, also known as Dr Myint Myint Kyi, said her monitoring was adequate and that the dosage of propofol - a sedative used in the procedure - was adjusted according to the patient's response.

She conceded, however, that it was unsatisfactory that changes in dosage had not been recorded, according to practice guidelines for safe sedation.

She also agreed with a suggestion by the lawyer for Mr Heng's family that it would have been better to record the patient's vital signs - pulse rate, blood pressure, oxygen saturation - every five minutes, instead of 15 as in this case.

Read the full story in Thursday's edition of The Straits Times.

Dr Zhu says that the patient's vital signs were within an acceptable range during the procedure. -- ST PHOTOS: WONG KWAI CHOW

 

[youallhumsup]

Doctor in fatal liposuction under fire for toilet break
By Alvina Soh | Posted: 24 October 2011 2006 hrs

SINGAPORE: A doctor, who was handling a liposuction procedure which led to a patient's death, came under fire on Monday for going for a five-minute toilet break without waiting for his patient to wake up from sedation.

44-year-old Franklin Heng, who was the CEO of YTL Pacific Star, underwent the procedure at Reves Clinic on 30 December 2009, and later suffered multiple penetrating wounds to his intestines and stomach.

He was rushed by ambulance to Tan Tock Seng Hospital but was pronounced dead on the same day.

The inquest heard that 35-year-old Dr Jim Wong completed the procedure at about 3.45pm, and continued observing Mr Heng until he had to leave for the loo at 4.05pm. The general practitioner maintained that he had assessed Mr Heng and that Mr Heng's condition was stable before he left for the toilet.

Dr Wong added that his absence only took a few minutes, and that he had never left Mr Heng alone after his return from the loo.

However, Mr Heng's family lawyer, Ms Kuah Boon Theng, said that Dr Wong "should not have left Mr Heng to go outside the clinic when he had undertaken the task of observing Mr Heng before he had awakened fully."

Upon his return from the toilet, Dr Wong said that he detected a slight increase in Mr Heng's blood pressure but attributed it to the waking process and the attached possibility of anxiety.

Dr Wong said that he was not "unduly concerned" as he was not "expecting sudden complications at that time". He added that he knew that Mr Heng did not have a history of hypertension.

Ms Kuah Boon Theng also took Dr Wong to task over his lack of compliance with guidelines in administering Propofol, a sedative used in the procedure. Dr Wong said that he used Propofol to achieve light to moderate sedation.

However, Ms Kuah cited the American Society of Anesthesiologists, whose guidelines stated that patients receiving Propofol should receive care consistent with that required for deep sedation. Ms Kuah said that Dr Wong also failed to satisfy the guidelines which included electrocardiographic (ECG) monitoring and monitoring of exhaled carbon dioxide.

Dr Wong also said he was unable to recall clearly the events on that ill-fated day, as he was in a "state of shock".

A total of 17 witnesses will be giving their testimonies during the inquest, which will be held until November 4. The hearing continues.

-CNA/ac

 

[youallhumsup]

Liposuction death: Forensic consultant agrees with autopsy findings
By Alvina Soh | Posted: 04 November 2011 2200 hrs

SINGAPORE: A forensic consultant has agreed with autopsy findings that a property management firm boss died from multiple punctures to his intestines following a liposuction procedure.

Dr Wee Keng Poh, a senior consultant forensic pathologist at the Health Sciences Authority (HSA), said this at an inquest into the death of 44-year-old Mr Franklin Heng, the CEO of YTL Pacific Star.

Dr Wee said that the damage to Mr Heng's intestines was likely caused by the liposuction cannula, which is a hollow steel tube used to draw fats out.

He said that this could have pierced Mr Heng's gut, and that resulted in him going into shock and subsequent death.

Dr Wee added that it was unlikely that the puncture wounds could have healed itself.

He testified that there was no evidence of multi-organ failure, or other diseases which could have contributed to Mr Heng's death.

The trial will continue next week.

-CNA/ac

 

[youallhumsup]

Liposuction death inquest enters last day
Posted: 08 November 2011 2000 hrs

SINGAPORE: An expert witness said during an inquest into the death of a property management firm CEO that Franklin Heng was so heavily sedated he could not adequately maintain his own airway.

This could have resulted in cardiac arrest and death, said anaesthesia and pain management consultant Boey Wah Keong.

Dr Boey was testifying on the last day of the inquest into the death of Mr Heng.

Mr Heng, the CEO of YTL Pacific Star, was undergoing a liposuction procedure at Reves Clinic on 30 December 2009 when he was later rushed by ambulance to Tan Tock Seng Hospital but was pronounced dead on the same day.

The inquest had heard that 35-year-old Jim Wong, the doctor who was handling Mr Heng's liposuction, had administered Propofol, a sedative, to achieve moderate sedation.

However, Dr Boey, who has a private practice in Gleneagles Hospital, said Mr Heng was under a deep level of sedation instead.

He said Mr Heng did not fully recover from the anaesthesia and was unable to maintain his airway on his own.

This could have led to airway obstruction and asphyxiation, resulting in cardiac arrest.

Dr Boey also noted Propofol is a potent anaesthetic drug where there is a narrow difference between an effective and toxic dose.

He said "Propofol could be your best friend or your worst enemy".

In an autopsy, Mr Heng was found to have multiple penetrating wounds to his intestines and stomach.

Dr Boey said the deep sedation may have masked the pain when Mr Heng's abdominal wall was penetrated.

He added the VASER liposuction was "not a very painful procedure" and that the deep sedation was probably unnecessary.

Dr Boey also said the monitoring of Mr Heng was inadequate during and after surgery.

State Coroner Victor Yeo will make known his findings on 4 January next year.

- CNA/wk

 

[General Veers]

"Liposuction death" findings unveiled
By Alvina Soh | Posted: 04 January 2012 1736 hrs

SINGAPORE: The State Coroner has ruled that property management firm boss Franklin Heng died from asphyxia due to airway obstruction following a liposuction procedure.

Mr Victor Yeo described the procedure, which was handled by 35-year-old Dr Jim Wong, as "perplexing, cumbersome and unsatisfactory".

He agreed with anaesthesia and pain management consultant Boey Wah Keong's previous testimony on several points.

Dr Boey was one of 17 witnesses, including six medical experts, who testified during the inquest, which started in October last year.

Forty-four-year-old Mr Heng, the former CEO of YTL Pacific Star REIT Management, underwent the procedure at Reves Clinic on 30 December 2009.

He suffered multiple penetrating wounds to his intestines and stomach, and was rushed by ambulance to Tan Tock Seng Hospital but was pronounced dead on the same day.

The inquest had heard Dr Wong had administered Propofol, a sedative, to achieve moderate sedation.

However, Dr Boey, who has a private practice at Gleneagles Hospital, had earlier said Mr Heng was under a deep level of sedation.

Mr Yeo agreed with this, adding Mr Heng was in "deep sedation almost to the point of general anaesthesia".

He also said both Dr Wong and Dr Zhu Xiu Chun, who assisted him in the procedure, failed to recognise the state of their patient.

The court also heard Mr Heng suffered multiple punctures to his intestines which was "inadvertently caused" by the probes and cannula, which is a hollow steel tube used to draw fats out.

Dr Wong told reporters after the hearing he was "deeply sorry" and sent his condolences to Mr Heng's family who were present in court on Wednesday.

A pre-trial conference will also be held later this month.

A civil suit is expected to take place in March this year.

- CNA/wk

 

[General Veers]

Liposuction death: Clinic renamed Yume Aesthetic and Medical Clinic

Published on Jan 5, 2012

Dr Jim Wong Meng Hang (left) and Dr Zhu Xiu Chun (right), also known as Dr Myint Myint Kyi, at the court on 28 Oct 2011. It seemed like business as usual on Wednesday at the clinic where Mr Franklin Heng underwent liposuction shortly before he died. Now called Yume Aesthetic and Medical Clinic, the private practice is owned and run by Dr Jim Wong and Dr Zhu Xiu Chun. -- ST PHOTO: LAU FOOK KONG

By Elizabeth Soh

It seemed like business as usual on Wednesday at the clinic where Mr Franklin Heng underwent liposuction shortly before he died.

Now called Yume Aesthetic and Medical Clinic, the private practice is owned and run by Dr Jim Wong and Dr Zhu Xiu Chun.

These are the same two doctors who were involved in the 2009 operation to remove fat from Mr Heng's back. Then it was called Reves Clinic.

On Wednesday, State Coroner Victor Yeo found that the 44-year-old property firm chief executive was sedated so heavily that he later suffocated.

Read the full story in Thursday's edition of The Straits Times.
​

 

[General Veers]

Doctors gave liposuction patient too much sedative: Coroner
Heavily sedated man eventually died from effects of asphyxia

Published on Jan 5, 2012

State Coroner Victor Yeo's 63-page findings cast doubt on the credibility of Dr Jim Wong as well as that of Dr Zhu Xiu Chun (above) - also known as Dr Myint Myint Kyi - who played a supporting role in the operation that resulted in the death of property management firm boss Franklin Heng. -- ST PHOTOS: WONG KWAI CHOW

By Selina Lum

Liposuction patient Franklin Heng suffocated after doctors gave him too much sedative during the operation, a coroner found on Wednesday.

The property management firm boss was meant to have been conscious during the procedure to remove fat from his back and abdomen.

But in fact, he was given such a big dose of propofol - the controversial sedative that killed singer Michael Jackson - that the effect was almost like a general anaesthetic.

BACKGROUND STORY

State Coroner Victor Yeo on Dr Wong and Dr Zhu​

• On why neither Dr Wong nor Dr Zhu detected that Mr Heng was repeatedly inflicted with injuries

'In my view, this was probably a case where the dose of propofol was increased whenever the patient was responding to painful stimulation. Not only did this mask the patient's response to the perforations during the procedure, but it had also resulted in the patient drifting into a state of sedation that was deeper than the intended 'light' to 'moderate' sedation, without the two doctors realising it.'

• On the doctors' claim that the dose of propofol was adjusted throughout the procedure and that a total of 60ml was given

'Having seen and heard the testimonies of both witnesses, I do come to the view that the doctors' evidence on the titration of the propofol and the total amount of propofol administered to the patient was obviously tailored and an afterthought.'

• On the inconsistencies between Dr Wong's account in court and what he had earlier told the police about the sedation given to Mr Heng, and Dr Zhu's role

'It was evident that Dr Wong had not given any meaningful thought or shown any serious appreciation to the sedation that was given to the patient, at least not until after the police started to focus the investigations on the role of propofol and the anaesthetic complication as a possible cause of death.
Therefore, I have serious reservations about accepting the evidence of Dr Wong and Dr Zhu, especially with regard to the monitoring of the patient during the procedure, and treated their evidence with caution.'

• On Dr Wong's nurse, Ms Hong Jieying, who often paused while answering straightforward questions and claimed not to remember important facts

'Having carefully observed Ms Hong's demeanour in court... I do form the impression that Ms Hong was less than forthcoming in her testimony for reasons best known to her.'

• On Dr Zhu's memory

'I was incredulous that she could recall the sequence of titration as well as the level of propofol titrated during the entire procedure, when no contemporaneous record was ever made of the number of times the propofol was adjusted and the level titrated.'

He was so heavily sedated, he was unable to protest when Dr Jim Wong, 36, accidentally punctured his intestines 13 times.

Read the full story in Thursday's edition of The Straits Times.