KKH chemo blunder: Son of victim described pharmacists responsible for error as “idiots”
November 18th, 2009 | 
Author: Written by our Correspondent
Mr Ng Chun Kiat, son of KKH medication error victim Madam Ng L.K lambasted the two pharmacists responsible for the mistake as being “idiots” on his blog, started a few days ago to create “public awareness” for the incident!
Mr Ng took issue with the fact that the two pharmacists had yet to aplogize to his mother in person:
“To date, not a single one of the two idiots has personally apologize to my mum. En-route to hospital with my dad, I was told that the culprits, however, did visit Mdm Ng Poh Hung(the other victim) and apologize for the blunder. Two cases of overdosage (drug that was supposed to be administered over 3-4 days was induced within 3-4 hours), two different type of drugs (Mdm Ng’s drug was much more potent, as explained)”, he wrote.
Mrs Ng was given an overdose of the chemotherapy drug doxorubicin over a few hours instead of days. The pharmacists had used the wrong infusion pump to deliver the toxic medicine.
Upon discovery of the error by the family, the pharmacist told them that Mrs Ng’s drug was “not as potent” as Madam Poh’s and it was “OK” for her to go home.
It was only during the inquiry conducted 5 days later that Mr Ng was told by the hospital that pharmacists have no right to send patients home. The decision has to be made by a medical doctor.
Mr Ng was visibly peeved at the apparent cavalier attitude that the hospital staff had taken towards his mother:
“One thing I couldn’t stand is that over the past week, the words “serious” and “it’s ok” have been used loosely!!!
She told us it’s ok and that the side effects will be similar to undergoing the treatment over 3 days. I’m like “Hello, this is a negligence by the hospital, right? No way am I going to accept that a drug that was suppose to be taken over 3 days is the same as taking it over 3 hours!”
He poured scorn over reports carried by the mainstream media that KKH had spent time “counselling” the two pharmacists:
“Rather than to assure or cure the victims, we were told that the hospital was looking into the matter, found out the mistake was the negligence of 2 pharmacist, and spent time counselling them when they broke down upon knowing their mistake?
Counselling the pharmacists was much more important?!?! We all found it hard to swallow honestly.”
He was also unhappy with the inquiry conducted by KKH on 12 November 2009 which left more questions than answers for the family:
“Dr Soh, my mum’s chemo doctor, kept throwing medical statistics and facts at us (I HAVE THIS RECORDED), saying that the international guide for the administration of doxorubicin is acceptable even within 6 minutes, but has higher risks on the heart, which was why she prescribed it to be infused over 3 days. But she kept insisting “it is okay to have it administered over 6 minutes.”
WHAT DO YOU MEAN BY IT’S OKAY WHEN YOU’VE CLEARLY MENTIONED THERE’S HIGHER RISK?!?!
It made me lose my cool and I argued with her by saying that if it is okay, then I suggest that you have all your patients to complete their sessions over 6 minutes rather than over days as that would rule out any chances of any blunder by anyone.”
According to the Washington Manual of Medical Therapeutics, cardiomyopathy (or failure of heart muscles to work as a pump) occurs in 2 per cent of patients who receive a cumulative lifetime dose of 550mg/m2.
The incidence increases dramatically at higher cumulative doses. If the dose approaches 450 – 550 mg/m2, serial radionuclide ventriculography should be performed.
KKH only “offered” full waiver of Madam Ng’s current stay in hospital and her 4th chemotherapy treatment.
Due to the cardio-toxic effects of doxorubicin, Madam Ng may require to be on long-term follow-up with a cardiologist. KKH did not mention if it will pay for her future medical expenses as such.
In fact, KKH had refused to accept any responsibility should Mrs Ng suffered from complications of heart failure in the future:
“The hospital claimed that in case of heart failure in future, they will perform post-mortem op to see if it was caused by the drug (which they said can be done by slicing up the heart). Cases of failure due to dietary reasons, blood clots etc will not deem the hospital responsible. WTH?!?!?!”, wrote Mr Ng on his blog.
The Temasek Review advises Mr Ng and his family to seek a second opinion from a cardiologist in the private sector to ascertain if Mrs Ng does require long-term cardiology follow-up.
Heart failure is a chronic debilitating disease and it is almost impossible to prove that it is caused by doxorubicin unless a post-mortem is done on the heart tissue of the deceased.
Medication errors like this are not uncommon in Singapore’s much vaunted public healthcare system where junior doctors and nurses often work for long hours without adequate rest.
The KKH drug blunder would have gone unnoticed had not Mr Ng’s aunt contacted her friend in the Straits Times who in turn requested an interview with KKH authorities.
Even then, the state media has gone on a PR overdrive to exonerate the hospital from blame and to play down the severity of the mistake.
Minister of Health Khaw Boon Wan had refused to apologize for the blunder, blaming it instead on the manufacturer of the pump for making the two pumps too “similar” in appearance which raised the question whether the two pharmacists have received the training needed to operate the pumps.
According to Mr Ng, KKH had even gone to the extent of removing the newspapers carrying the report on 12 November 2009 from its premises:
“On the day the article wrote by Ms Salma Khalik was published on the Straits Times on the 12th Nov 2009, why was it that the hospital, which has the papers on their stands on a daily basis not have one on the 12th? Even 7-eleven store in KKH did not put out any for purchase.”
MOH and KKH should give a detailed explanation to Mr Ng’s family and the public on what happened exactly without holding back any information.
The two pharmacists must not be made scapegoats for the error. Surely there are flaws within the system itself which contributed to the blunder in the first place.
The public deserves no less a complete disclosure by MOH. After all, Mr Khaw Boon Wan is the highest paid health minister in the world and was once praised by Senior Minister Goh Chok Tong as the “best” health minister Singapore ever has.
Read Mr Ng’s blog here
Related articles:
>> Interview with Mr Ng Chun Kiat
>> Son of KKH victim of medication error disputes reports in state media
>> KKH medication error: Khaw dismissed worker fatigue as cause
>> Was medication error at KKH caused by fatigue?
>> KKH CEO Prof Ivy Ng yet to apologize for drug blunder
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Tags: KKH chemotherapy error, KKH drug blunder, KKH medication blunder, Ng Chun Kiat
14 Responses to “KKH chemo blunder: Son of victim described pharmacists responsible for error as “idiots””
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Hi All,
It seems nowsadays doctors have great IQ, but disappointing EQ.
Is it due to the amount of patients that they see everyday? So many that they tend to treat them just as numbers, not human beings anymore?
We can boast to have the latest and most sophisticated medical hardware but sadly from my observations, our medical personnel is very lacking in heart where.
Patients are treated as digits and not human in Singapore unless you are rich or somebody.
Sad! So Sad! Very Sad!
@Jim
well,ummm,wt’s dat? productivity….cheaper better,faster,faster,faster…
yes,indeed,depends on who you are really,but most of us will
fall under the category of prodcution units sooner or later,
one way or another?
KKH will never admit any wrongdoing to do so would be to invite a lawsuit and future liability.
Poorly differentiated medication is not a new problem, Dennis Quaid’s daughter(s?) almost died recently due to an massive overdose of blood thinner, they sued the manufacturer in the end.
That happened at Cedars-Sinai, so this happens to the best in the business too.
Still is deplorable that the authorities seem more concerned with deflecting blame and extricating themselves from responsibility rather than trying to make things right or implementing procedures to ensure something like this doesnt happen again.
The “Jim” above is an imposter Jim
Looks like someone has taken oo-opted the pen name Jim to pretend he is the one who has been making very relevant and pertinent questions regarding government practices, and “malpractices” as well.
The “candour” in the comments of this new “Jim” is definitely not the same. So , who is the imposter. TR knows very well. An ISD operative.
Beware all who read this post.
The real “Jim” never ever touched on problems afecting individuals. He is more concerned about things at the macro level, the problems facing society at large. Therefore, I do not believe this “Jim” is the same Jim that we are familiar with. He could have been blocked out by TR because his views are very substantive and cogent, but is threatens the “whiteness” of the PAP regime with his disclosures of so many events which the public did not know.
KKH had even gone to the extent of removing the newspapers carrying the report on 12 November 2009 from its premises:
掩耳盗铃
Doctors and pharmacists nowadays are only concerned about making money, more money and digging money for their patients. Gone are the days where doctors are there to help the common peoople. Now they are gold-diggers. This happens when the selection criteria for NUS medicine students is so dubious that those admitted are either rich, politicians’ kids or come from a long line of doctors.
every life is important . i am sicken by the way all the hospital managenment are behaving ,including the admin staff. they are care givers and not any one that can dictate terms and misuse the power given to them by the hospitals. of course they can call in the police if we are ever rude to them . this is stated very clearly on the notice board of every governmental offices.
just another example of the powers saving their faces and lying low for a while…what’s with this stupid fascination with saving face….sometimes have to just lay bare everything for public criticism when wrong is done…people will feel better….isn’t that the mantra in the retail sector….listen to customers first and not talk or jsutify too much….
This is what will mostly likely happen…..they probably will apologize to the families involved and maybe even compensate by way of free followup treatment…..but on the condition that compensation terms are not to be revealed….doesn’t this sound so familiar, what with all the out of court settlements….so that the general public remains dumb and stupid
Hmmmm, and finally whichever PR angency they employed….useless I must say, probably advised the client to say the usual standard PR statements….and that is why we hate PR so much…PR is just a nice term for people who practise the art of sweeping dirt under the carpet and damage control professionals…in fact i think SQ did a shade better with their PR by coming out to apologize after the SQ006 fiasco
KKSHite on Thu, 19th Nov 2009 1:13 pm
Doctors and pharmacists nowadays are only concerned about making money, more money and digging money for their patients. Gone are the days where doctors are there to help the common peoople. Now they are gold-diggers. This happens when the selection criteria for NUS medicine students is so dubious that those admitted are either rich, politicians’ kids or come from a long line of doctors.
sorry for the spam, i posted my last comment prematurely.
KKSHite on Thu, 19th Nov 2009 1:13 pm said:
Doctors and pharmacists nowadays are only concerned about making money, more money and digging money for their patients. Gone are the days where doctors are there to help the common peoople. Now they are gold-diggers. This happens when the selection criteria for NUS medicine students is so dubious that those admitted are either rich, politicians’ kids or come from a long line of doctors.
this is not true. there are students in NUS medicine who are rich, politicians’ kids and/or come from a long line of doctors but they in no way make up the whole body of medical students. also, medical education is heavily subsidised and every student, regardless of social/financial background, has to serve a 5-6 year bond (depending on nationality) in the public health sector.
let me guess the pharmacists are cheap “foreign talent” from china or india?
Those very high quality one in TR on the 70 yr old lady who plunged to her death due to grave fanancial problems.
It IS indeed a shame. That a significant number of postings here are Presumptious, Assuming, Clueless and so Careless in their Blames and Accusations of the Medical Profession here as a whole.
The Medical Staff, local and foreign in TTSH where my aunt was warded before she past away… WAS CERTAINLY… UNProfessional… Or even Deliberately So as some of the comments posted here suggested. Far from it!
A. But first on Health Minister Khaw’s blame on that pump manufacturer. Indeed he must have been told by KKH. But that beckoned the SIMPLE Question as to why niether did…
1. Mr. Khaw mention about KKH OR him asking KKH to IMMEDIATELY MARK those 2 DIFFERENTLY RATED Pump Units with Permanent Paint for IDENTIFICANTION???
2. And ALSO… Why is it that KKH’s “Medical Safety” Department Unit DID NOT have this done and the manufacturer informed to date???
3. Thus… Why did Mr. Khaw who WAS NOT there when it happen… ABLE TO Dismiss it as NOT due to Staff Fatigue from work overload??? Clearly, he couldn’t have known then except informed by KKH Supervisory/Senior Staff!… Sounds more like a TACTICAL response by Mr. Khaw to protect KKH or not?!!!
B. Secondly, about medical staff in hospitals. Depending on ward type Class and illness(es) in any ward… The Stress Level and it’s Occurance Frequencies DO differ. And certain old folks DO add to their Stress due partly to their Lower Thresholds of Pain & Etc Tolerance. Lack of knowledge and understanding about their medical conditions, cause of their illness(es) and it’s changes Plus EFFECTS of Medications ARe also contributing factors!…
My aunt was well-cared for in TTSH. no doubt about that. But I witnessed all the stress in her wards – BOTH patients and staff! And due in part to education and lack of “Strret-wise” working experience… I noted and gingerly communicated with doctors and physiotherapists that…
1. It is NOT a good idea to explain 100% truth to all patients… Especially those old and ignorant of their conditions and who also Clamour About wanting to go home before they are medically fit to. As the doctors can unwittingly cause their patients to PESTER their NURSES about discharging them. Why?… And the cause…
2. I told them never to explain to such patients like my aunt about this and that they have to do… BECAUSE they won’t, don’t or even refuse to except any sane medical reasoning for needing to be ward for some more days!!!…
3. That said… I told them never to say that tomorrow is a Saturday, there’ll be no physio and following day is a Sunday… So we’ll see you (Patient) on Monday! It’s A WHAMMY to a Die-Hard patient who insist endlessly to go home home!
DOTORS and Dear FLORENCE NIGHTGALE NURSES out there!!!… Please take careful note here… That…
Sometimes more IS less… And less IS MORE!!! God Bless You All!!!