The family of a teenage girl half-paralysed following surgery in Hong Kong have challenged a hospital review that claimed there was no medical negligence, after conducting their own research.
John Chan – whose younger sister Amy Chan, 16, sought help at United Christian in Kwun Tong on October 31 last year – on Wednesday contested several aspects of the findings, released in late April.
“The Hospital Authority was insincere and we have had to find out many facts for ourselves. This is the responsibility of the expert, but he did not explain clearly,” Chan, 24, said.
“The report did not respond to some key questions we had and some of the findings were different from the information we found.”
Dr Alan So King-woon, vice-chairman of the authority’s central coordinating committee in paediatrics and the expert who was commissioned by United Christian to review the case, concluded “everything was done up to standard” and there was no negligence. The case was put down to “very rare complications”.
Amy Chan went to the hospital suffering with a headache, neck pains and weakness on the right side of her body. On November 9, she was diagnosed with acute transverse myelitis, an inflammation of her spinal cord.
When treatment did not bring significant improvement, doctors suggested plasmapheresis, a procedure to remove and replace the blood plasma.
During the surgery, which took place on November 16, a doctor inserted a catheter into a neck vein, a necessary step for the procedure. During insertion, there was bleeding around Chan’s major intrathoracic vessels, causing her blood pressure to drop and blood to accumulate in her chest.
She was on the same day transferred to Queen Elizabeth Hospital where doctors found her right subclavian artery, which supplies blood to the arm, was damaged and she had suffered from an acute ischemic stroke.
John Chan said his sister, who was still in Queen Elizabeth Hospital’s intensive care unit, could now talk and eat though the left side of her body remained paralysed. She was also learning to stand and walk with the help of physiotherapy.
Chan said he had found at least five medical articles that said stroke could be caused by an injury to the subclavian artery following the insertion of a central venous catheter. Yet, So in the report claimed such a condition had not been noted in any medical literature.
Also, the doctor involved in surgery removed the catheter immediately after realising it might have been placed improperly and So’s report stated management of the injury had been “appropriate”.
However, Chan cited medical literature that said removing a misplaced catheter without any prior check could increase the risks of stroke and hematoma, or blood collecting outside a vessel.
Amy Chan was injected with a litre of saline solution for her low blood pressure, but her brother cited a British expert who wrote that such an act on a patient suffering from bleeding could be fatal.
Patients’ rights advocate Tim Pang Hung-cheong, who was assisting the Chans, said they had also consulted a private surgeon with close to 40 years’ experience, who said there were problems with the case, including the handling of the vascular injury.
Democratic Party lawmaker James To Kun-sun, who was also helping the family, said they would contact the hospital and hoped to meet So in person to have their questions addressed.
A spokesman for United Christian Hospital said they would continue to follow up the case and provided necessary help to the girl and her family. The hospital apologised for the unforeseeable and unfortunate complications and also for the pain and suffering experienced by the girl and her family.
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