A diabetic man is now missing part of his testicles due to gangrene — which could have been detected and treated earlier if a doctor actually did his job.
Dr. Mohd Syamsul Alam Ismail, a Malaysian doctor practicing in Johor, has since been suspended for two-and-a-half years on top of a $40,000 fine. The Singapore Medical Council (SMC) disciplinary tribunal had initially imposed a suspension of three months, but the duration was increased by 10 times yesterday by Court of Three Judges following a successful appeal to lengthen it.
Dr. Syamsul was found guilty of failing to provide adequate clinical evaluation of a patient when he worked as the company doctor at the medical center of a marine and shipping company here in 2013. The patient had been having a fever for five consecutive days and went to the doctor to check on a painful lump on his right buttock area as well.
“The Complainant thought the lump was a normal abscess but the lump had grown drastically in size and was causing him immense pain,” noted SMC. “It made a crackling sound when pressed and he could not even sit due to the pain.”
Even after the patient told Dr. Syamsul that he was diabetic and he had not been taking his meds, the doctor said that it was unnecessary to conduct a physical examination on the lump. Instead, he simply gave him three days of medical leave and prescribed him some antibiotics.
It proved to be a huge mistake. The next day, the patient’s lump started to spread to his testicles and his groin area, causing those parts of his body to well up as well. He immediately went to the hospital and was diagnosed with Fournier’s gangrene, a particularly worrisome type of infection that attacks the genital area. He required hospitalization for more than a month.
The infection required multiple surgical interventions, which included partial removal of his scrotum. In his complaint to SMC in November 2014, he blames Dr. Syamsul for his inability to have sex for the rest of his life due to the pain.
SMC found that Dr. Syamsul failed to make the appropriate diagnosis that the patient had gangrene and that he had also failed to immediately refer the patient to the emergency department of a hospital. According to the expert opinion of a general surgeon enquired by the SMC, the doctor should have had a high index of suspicion when it came to dealing with a poorly controlled diabetic patient.
On Dr. Syamsul’s part, he refused to take part in the disciplinary inquiry against him and ghosted SMC’s attempts to contact him.
“So far as we can tell, he is no longer practicing in Singapore,” said Chief Justice Menon, who presided over the case.
