A doctor who misinformed a patient that his cancer markers were "normal" has been censured and ordered to pay a fine of SGD10,000 by the Singapore Medical Council (SMC) on 5 June.

The patient was later diagnosed by another doctor to be suffering from colorectal cancer and had to undergo surgery and chemotherapy.

In the grounds of decision released by the Disciplinary Tribunal in April, the SMC said Dr Fernandes Mark Lee, 43, pleaded guilty to one charge of failing to provide medical services of the quality that was reasonable to expect of him.

He was also ordered to give a written undertaking to the SMC stating that he will not engage in similar conduct, and to foot the costs and expenses of the proceedings, including the costs of the SMC solicitors.

Patient loses opportunity for follow-up action due to overlook of cancer marker levels


Dr Fernandes who has a decade's experience had been practicing at Asia HealthParners at Lucky Plaza as a gasteroenterologist when the patient underwent a health screening on 9 February 2012.

A few days after the screening, the patient was told over the phone that his medical results were good and a review with a doctor was unnecessary for any follow-up treatment or management.

The report, which the patient also received in the mail, stated that his cancer markers were "normal" when they were in fact considered to be high, was prepared and signed off by Dr Fernandes.

According to the SMC, the patient's Carcino-Embryonic Antigen (CEA) was 16.5ng/ml, which was an "abnormal" result and outside the normal range of 0 to 5ng/ml.

“As a result of Dr Fernandes’ oversight and the lack of a detailed, in-person review of the results with the patient – the patient lost the opportunity to take earlier appropriate follow-up action,” said the SMC. “In fact, the patient saw a specialist only about 20 months later.”

Doctor not suspended due to several mitigating factors


The patient was diagnosed with colorectal cancer and had to undergo surgery and six months of chemotherapy, and subsequently made a complaint to the SMC on 18 June 2014.

A disciplinary tribunal held an inquiry on 24 March 2017.

In a written explanation to the SMC's complaints committee, Dr Fernandes admitted the overlook of the CEA readings, which the disciplinary tribunal concluded as a "serious violation" which could damage public trust and confidence in the medical profession.

However, it decided not to suspend Dr Fernandes due to several mitigating factors such as his plea of guilt, his unblemished record, goof character references and the measures he took to improve his practice. MIMS

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Sources:
http://www.channelnewsasia.com/news/singapore/doctor-fined-after-failing-to-inform-patient-of-abnormal-cancer-8913336
http://www.straitstimes.com/singapore/health/doctor-who-told-patient-health-screening-results-were-normal-when-they-were-not