SINGAPORE: A doctor has been convicted of performing a negligent act that led to a patient’s death after an aesthetic treatment in 2019.
Court documents stated that Chan Bingyi intravenously administered ethylenediaminetetraacetic acid (EDTA) to property agent Lau Li Ting, 31, when there was not a need to do so.
The court heard that EDTA should be used only for specific indications, such as heavy metal poisoning or elevated calcium levels, and must be administered only by clinicians trained in its use.
The prosecution said that Chan, 37, administered the “dangerous substance” to Lau at “too high a concentration and too quickly”, at a clinic called Revival Medical & Aesthetics Centre in Bras Basah Road on March 8, 2019.
They added that Lau, who had no underlying medical conditions, developed EDTA toxicity, which led to cardiac arrest, and she died in Singapore General Hospital (SGH) five days later.
Following a trial, Senior District Judge Ong Hian Sun convicted Chan on Jan 9 of committing a negligent act that led to her death.
His mitigation and sentencing will take place in March.
The Singapore Medical Council’s database shows that he is still registered as a medical practitioner.
In their submissions, deputy public prosecutors Jiang Ke Yue and Thaddeus Tan stated that on March 8, 2019, Lau went to the clinic at Esplanade Xchange shopping mall for aesthetic reasons.
According to Chan, she wanted to reduce fine lines on her forehead.
He added: “For her dried skin on both sides of her face, I recommended a skin booster. For her pores, I recommended her to go for the laser treatment.”
The DPPs added that Chan, who attended to her, agreed to perform a “chelation” treatment, and EDTA was administered intravenously.
The prosecutors told Judge Ong: “Chelation treatment involves the use of EDTA to bind to metallic ions and extract them from the body.
“Disodium EDTA, which the accused used in this case, binds preferentially to calcium – a mechanism that makes it inherently dangerous. This is because ionic calcium plays a critical role in essential bodily functions, including neurotransmission and neuromuscular function.”
They also said that when EDTA depletes calcium levels, patients can suffer heart failure and impaired muscle function.
The prosecutors told the court that Chan had earlier admitted to administering EDTA to Lau.
They added that he also provided a detailed account of the incident to the Ministry of Health (MOH) 10 days after the incident involving her.
Among other things, he told MOH that she wanted to improve her fine lines on her forehead, and he recommended a treatment involving botulinum toxin.
The doctor had said: “Ms Lau then asked me whether I provided a treatment called ‘chelation’, which she had previously undergone with (another doctor). This treatment is to remove ‘various metals, including heavy metal’, from the body.
“I told her that she was not suitable to undergo this ‘chelation’ treatment, but she insisted, as she had undergone this treatment... and she was happy with the outcome.”
Chan told MOH that he agreed to provide the chelation treatment to her after a consultation that lasted about 15 minutes.
He told the ministry that Lau then went to a procedure room and sat on a treatment bed, where a staff member helped Chan set up drip lines for saline to be administered intravenously to Lau.
Chan said he left the room to draw 12.5cc of sodium bicarbonate and 12.5cc of “disodium ethyl-diamine-tetra-acetic” acid in a syringe.
He told MOH that he returned to the procedure room and “slowly pumped in” both substances into a bag of saline connected to Lau.
He said: “I was monitoring the drip rate and speed to time it for at least an hour’s duration and, at the same time, monitoring side effects like burn sensation and nausea. Ms Lau was... talking about her plan for the day.
“(After) about five minutes of talking, Ms Lau suddenly stopped talking. I tried to speak to her, but there was no response. I checked on her and realised that she was having a seizure.”
Chan told the ministry that he placed her in a “safe position” to make sure that she did not injure herself and allowed the seizure to “self-abort”.
He said that her seizure stopped about a minute or two later, and he told his staff to bring in a resuscitation kit.
He also said that he immediately switched off the drips when Lau was having her seizure.
The Singapore Civil Defence Force was alerted. Officers who went to the clinic found that Lau was not breathing, with no detectable pulse, the court heard.
The DPPs said she was in a critical condition when she arrived at SGH’s Department of Emergency Medicine.
They told the court that she died of EDTA toxicity on March 13, 2019.
The prosecutors told Judge Ong that Chan later recanted his admission of administering EDTA to Lau, claiming the treatment had not commenced when she collapsed.
He alleged that his admission was unreliable due to his “poor mental state” and “misunderstanding of the question” on what happened at the clinic when he met her on March 8, 2019, the court heard.
The prosecutors said: “It is baffling that a well-educated doctor with a degree and multiple graduate diplomas would claim to misunderstand this question.
“The prosecution has adduced clear evidence demonstrating that the accused administered EDTA to the deceased, causing her death. This evidence is corroborated by objective medical and physical facts.”
The doctor is represented by lawyers Adrian Wee and Lynette Chang from Lighthouse Law.
During the trial, a defence witness, Professor Johan Duflou, said that “400g of yellowish pill residue” was found in Lau’s stomach during autopsy, but the substance was not sent for analysis.
He argued that this residue must have come from substances she had consumed before she collapsed, and stated that he could not exclude the possibility of her collapse being caused by these substances.
In their submissions, the DPPs said: “Prof Duflou posited that these substances could have come from slimming products, which possibly had adverse effects on the deceased’s body.
“We disagree with Prof Duflou. There is no evidence that the deceased was consuming such slimming products prior to her collapse.”
Chan still has three other pending charges under the Health Products Act.
Among other things, he was charged in 2022 with possessing expired injection ampoules of adrenaline and a heartburn relief drug at Revival Medical & Aesthetics Centre in March 2019.
These charges will be dealt with at a later date. - The Straits Times/ANN
