SINGAPORE: The prosecution has called for between 1½ and two years’ jail for a doctor who performed a negligent act that led to a patient’s death after an aesthetic treatment in 2019.
Court documents stated that Chan Bingyi, 37, intravenously administered ethylenediaminetetraacetic acid (EDTA) to property agent Lau Li Ting, 31, on March 8 that year, when there was no need to do so.
EDTA should be used only if there are specific indications of certain conditions, such as heavy metal poisoning or elevated calcium levels, and must be administered only by clinicians trained in its use, the court heard.
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.
On April 21, Deputy Public Prosecutor Thaddeus Tan noted that Lau was the one who had asked Chan to perform a “chelation” treatment, involving the use of EDTA to bind to metallic ions and extract them from the body.
Stressing that Chan knew EDTA could cause complications, the DPP told the court that the doctor was “not a common vendor where the customer was always right”.
The prosecutor also said that Chan had shown a disregard for Lau’s safety.
Defence lawyer Adrian Wee from Lighthouse Law, however, urged the court to sentence his client to between six and eight months’ jail.
He added: “This was not a case in which (Lau) had been a complete novice who had been introduced to EDTA chelation therapy by Dr Chan.
“There was evidence that (she) had undergone EDTA chelation therapy previously without incident... Dr Chan had himself performed over a hundred EDTA chelation therapies without incident.”
Wee also said that Chan had acted without malice, and there was no evidence of any systemic disregard for patient safety.
He added that the doctor had taken “appropriate and diligent steps” when he discovered that Lau had a seizure.
“This included attempts at resuscitation, calling for an ambulance, and attending at the hospital on multiple occasions,” said Wee.
Chan will be sentenced on May 14.
Following a trial, Senior District Judge Ong Hian Sun convicted Chan in January of committing a negligent act that led to Lau’s death.
In earlier proceedings, the prosecution told the court that Chan had administered the “dangerous substance” to her at “too high a concentration and too quickly”, at a clinic called Revival Medical & Aesthetics Centre in Bras Basah Road.
Before the tragedy, Lau went to the clinic at Esplanade Xchange shopping mall on March 8, 2019, for aesthetic reasons.
According to Chan, Lau wanted to reduce fine lines on her forehead.
DPPs Tan and Jiang Ke Yue stated in court documents that Chan, who attended to her, agreed to perform a “chelation” treatment, and EDTA was administered intravenously.
They added: “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.
Following the tragedy, Chan told the Ministry of Health (MOH) that he had 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. Lau was... talking about her plan for the day.
“(After) about five minutes of talking, 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 Straits Times/ANN
