MEDICALLY REVIEWED

How Did This Happen? Doctor misdiagnosis led to teenage patient losing testicle

testicular torsion testicle doctor suspension

The Singapore Medical Council (SMC) has suspended Dr Yeo Khee Hong, a veteran doctor with 42 years of experience, for one year due to professional misconduct.

This suspension follows a misdiagnosis in 2019 that resulted in a teenage patient losing his testicle.

Incident Details

The case began on March 22, 2019, when a 15- or 16-year-old boy visited Dr Yeo, complaining of pain in his left abdomen originating from his left testicle, along with increased bowel movements and watery stools. Dr Yeo initially diagnosed the boy with abdominal colic and prescribed stomach-related medication. Five days later, the boy returned with swelling and pain in his left testicle, worsening with movement. Dr Yeo then diagnosed him with orchitis and epididymitis, prescribing antibiotics and ordering a full blood count and urine test.

Despite repeated visits, the boy’s condition deteriorated. On April 1, 2019, the boy’s father called Dr Yeo, reporting severe pain. Dr Yeo finally advised immediate hospital care, where a scrotal ultrasound revealed left testicular torsion, leading to surgery to remove the testicle.

Medical Experts’ Findings

Medical experts indicated that if the boy had been referred for urgent care promptly, he would have had a 90.4% to 97.2% chance of saving his testicle. Testicular torsion, where the spermatic cord becomes twisted, cuts off blood supply to the testicle, necessitating timely intervention to prevent irreversible damage.

Similar Incident

This incident is reminiscent of the case involving Hong Kong singer Eason Chan, who lost a testicle due to a severe groin injury sustained during a performance in 2002. Despite the physical and emotional challenges, Chan continued his career and handled the situation with characteristic humour, even joking about it during his concerts. His ability to move forward serves as a testament to resilience in the face of such personal loss.

SMC’s Decision

The SMC concluded that a competent doctor in Dr Yeo’s position would have considered testicular torsion as a possible diagnosis and referred the patient for urgent care. The standard of care dictates that all acute scrotal pain should be treated as testicular torsion until proven otherwise.

Dr Yeo pleaded guilty to professional misconduct for failing to provide appropriate care. A second charge related to not providing adequate information to the patient was considered during sentencing.

Complaint and Response

The boy’s father filed a complaint with the SMC in July 2020, alleging negligence on Dr Yeo’s part. Dr Yeo responded to the complaint and sent an apology letter to the patient and his family. The SMC’s decision highlighted that the boy’s testicle could likely have been saved with a timely referral to a specialist.

Counsel Arguments

Counsel for the SMC argued that Dr Yeo’s misconduct delayed the boy’s diagnosis and treatment. They claimed it resulted in the loss of the testicle and significant physical, emotional, and psychological distress for the boy. They also pointed out the potential fertility issues resulting from the loss.

Dr Yeo expressed deep regret over the incident. He accepted the need for penalties but argued that an urgent referral would not have guaranteed the testicle’s salvation. He acknowledged lapses in judgment but insisted he acted without malice or recklessness, always considering the patient’s well-being.

In addition to the 12-month suspension, Dr Yeo will be censured. He is also required to submit a written undertaking not to repeat the misconduct, and pay the costs of the proceedings, including the SMC’s legal fees.

Living with One Testicle

Dr Edwin Ong, Medical Director of RMDY Clinic. previously shared that the potential risks of testicular torsion, if left untreated, are significant and may include the following:

  •     Testicular damage: Without prompt medical intervention, testicular torsion can cause irreversible damage to the testicle due to the loss of blood flow. In severe cases, the testicle may become nonviable and require removal.
  •     Loss of fertility: In cases where the torsion results in the loss of one or both testicles, it can lead to a decrease in sperm production and, potentially, infertility.
  •     Chronic pain: Even if the testicle is saved, some individuals may experience chronic testicular pain following torsion.
  •     Recurrence: Without preventive measures (such as orchidopexy), testicular torsion may recur.

However, living with one testicle typically does not affect a person’s overall health significantly. The remaining testicle generally compensates for the loss. It will continue to produce sufficient testosterone and sperm for normal bodily functions and fertility. However, the psychological and emotional impact can be considerable, and regular medical check-ups are advisable to monitor the health of the remaining testicle.

Conclusion

This incident serves as a significant reminder of the critical importance of timely and accurate diagnosis in medical practice. The SMC’s decision underscores the necessity of adhering to established medical standards to prevent such unfortunate outcomes in the future.

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