Prosecutors were appealing for a stiffer sentence for a “defiant” doctor, who continued to sell codeine-laced cough syrup even—despite under investigation for doing so. Between January 2014 and June 2015, Dr Tan Gek Young, who runs Meridian Polyclinic and Surgery in Bedok North, sold approximately 57 bottles of the standard 90ml cough mixture preparation a day—raking in a total of SGD600,000.

It was reported that he sold more than 2,300 litres of cough mixture during that period, one of the highest quantities of such illegal sales.

Tan paid an average of SGD39 for a gallon, which he sold for more than SGD1,000. He has been sentenced to two years’ jail and a SGD130,000 fine at the beginning of this year.

Deputy Public Prosecutor Tan Wen Hsien sought at least three years’ jail and a SGD145,000 fine for Tan, as an example to medical professionals who may think of selling cough mixture at huge mark-ups.

She urged the court to lay down a sentencing framework for all doctors and pharmacists who are convicted of illicit sales of cough mixture.

Doctor appeals for lighter sentence

While Tan was being investigated, it was found that he continued selling cough mixture at an even higher quantity—selling it by the gallon instead of usual 90ml bottles. Therefore, DPP Tan argued that his original sentence was inadequate.

To support her argument, she said the number of cases investigated by the authorities reached a high 67 in 2015, compared with between 43 and 61 in the previous three years. Up till November last year, the number stood at 53.

Tan’s lawyer, Mr Amogh Chakravarti argued that the prosecutor’s statistics were irrelevant as not all investigations led to a guaranteed conviction.

Backing his argument, he showed evidence that of the 417 cases investigated by the Health Sciences Authority between 2009 and 2014, only 47 cases led to prosecution.

Additionally, he appealed that Tan’s sentence was too harsh, compared to pharmacist Woo Tat Meng, who was only jailed eight months and three weeks for selling 2,452 litres of cough syrup.

Illicit sale of codeine cough mixture fast becoming a ‘prevalent problem’

Judge of Appeal Chao Hick Tin rejected both appeals.

Judge Chao first addressed DPP Tan’s request for a sentencing framework by saying that there were insufficient precedents at the moment—making it difficult for the court to formulate detailed sentencing guidelines.

He cited how all six previous similar cases were prosecuted under different criminal provisions in the Poisons Act and Medicines Act.

However, Judge Chao agreed with DPP Tan on how the illicit sale of codeine cough mixture has become a “prevalent problem” in the country.

He added that deterrence should be the primary sentencing consideration. In his written judgment, Judge Chao also raised several issues with the sentencing range proposed by the district judge, which would increase in proportion to the quantity of codeine cough mixture involved.

He however, said it would not be “wise to lay down sentencing bands tied to the quantity of codeine cough mixture supplied, as suggested by the district judge and prosecution.”

“Whether a transaction was for resale would depend both on the quantity involved and the way the transaction was carried out,” he remarked.

He listed aggravating factors that may be relevant for sentencing, such as the offender’s role, whether the offences took place during investigations, and the amount of profit made. Illustrating an example, he pointed out that an offender who sold codeine cough mixture to buyers – who in turn resold them to individual abusers – is more culpable than one who sold them only to individual abusers. MIMS

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