Medical Malpractice Nightmare in Malaysia

This can easily happen to anyone. Many others have come out with similar horror stories, since original publication,

A 35-year-old Malaysian businessman named Nur Muhammad Tajrid Zahalan is charging that he was left permanently disabled in a Kuala Lumpur hospital in 2015 in what can only be described as a medical malpractice nightmare of negligence, unnecessary surgery, false expense charges and insurance claims and other misuses.

A three-year investigation by the Malaysian Medical Council into the affair, which took place at Prince Court Medical Center in Kuala Lumpur, cross-examined 12 doctors and referred charges against four physicians including the neurosurgeon at the center of the matter, Ramesh Kumar, who has been charged with “infamous conduct in a professional respect,” also termed “gross professional misconduct.”

The others are orthopedic surgeon Deepak Singh, neurologist Hamidon Basri and surgeon Tikfu Gee. Tikfu Gee’s case has been referred directly to the Malaysian Medical Council for disciplinary hearing. Despite the charges, all four doctors are said to be still practicing at Prince Court. Ramesh Kumar and Tikfu Gee also practice at other private hospitals in Kuala Lumpur and Kumar practices and teaches at a university hospital in Cheras, a Kuala Lumpur suburb. Hamidon Basri is an academic at a public university in Serdang.

Tikfu Gee, ended his association with a public university, University Putra Malaysia (UPM), shortly after the revelations of the accusations against him in the MMC. UPM have confirmed that he did not follow their ethics protocols in the conduct of clinical trials whilst he was associated with them.

He has been suspended from conducting clinical trials in public facilities by the Ministry of Health but has recently joined the private sector at Sunway Medical Centre. He is registered by the National Medical Research Register (NMRR) in Malaysia as continuing to conduct clinical trials at Sunway University outside of the reach of the public research ethics authorities.

However, given the laxity of Malaysia’s disciplinary procedure against medical offenders, only one doctor has been struck off the medical registry since 2005, raising questions whether authorities will take more stringent action against those named in the complaints.

Geoffrey Williams, a business partner and associate of Tajrid, filed a police complaint over the episode in a Kuala Lumpur police station on November 19 over the botched surgery, which occurred in July of 2015 at the Prince Court facility. Williams alleged that Ramesh and possibly others had submitted a false statutory declaration to a Malaysian Medical Council investigation committee, and that “deliberately presenting false or misleading information to a statutory investigation committee with the intention to deceive the committee that proper consent was obtained when it was not is also a crime. I also believe that the people mentioned above may be working together to practice this deception and that this may also be a crime.”

Tajrid entered the hospital on July 17, 2015, complaining of back pain and other minor symptoms, according to a charge sheet prepared for the Malaysian Medical Council on Aug. 5, 2019. He alleges that Kumar examined him and recommended that he be admitted immediately for a magnetic resonance imaging exam.

After the MRI, Kumar allegedly told Tajrid he had suffered a slipped disc which required immediate surgery, although he was never shown the MRI results or any other diagnostic information. When he asked about alternative treatment, Kumar allegedly told him there was no alternative to surgery, that the surgery would cost less than RM10,000 (US$2,403) and that there would be no serious risk. He resisted Tajrid’s entreaties for a second opinion.

A six-hour operation left Tajrid with a 12-14 cm scar on his side and severe, unremitting pain. He had to be wheeled out of the hospital six days later. It was later discovered that the neurosurgeon had removed a large section of his rib on his left side without his consent, causing severe nerve damage. Subsequently, according to the complaint, although Tajrid spent several days in the hospital in severe pain, Ramesh didn’t attend to his complaints and later allegedly refused to treat him because his insurance cover was no longer sufficient.

That sent Tajrid off on a grim journey of pain, additional treatment and rising medical costs. He would also uncover allegations of insurance fraud, including RM2,375 for surgery claimed by Deepak in the first operation and RM2,985 for surgery for the second, although Deepak later acknowledged that he had had nothing to do with either operation beyond helping to put the patient into a more comfortable position for the surgery and that his presence in the operating room was on a “good will” basis.

The case of overcharging by Prince Court Medical Centre is under investigation by the Ministry of Health. In another case in May 2020 Prince Court was fined RM200,000 for profiteering during the pandemic.

Finally, in December of that year, Tajrid sought a second opinion from a surgeon in another hospital who said his ailment could have been managed conservatively before the need to resort to surgery. Two other physicians also confirmed that conservative treatment rather than surgery would have been appropriate. Tajrid, now a quadriplegic, was left with permanent nerve damage and disabilities “that severely diminished his quality of life” according to the complaint filed with the Malaysian Medical Council.

“Ramesh Kumar and Deepak Singh have made two false insurance claims to pay Deepak Singh for surgery on Tajrid and have taken the money from the insurance company – Prudential Assurance Malaysia Berhad,” Williams said in an email to Asia Sentinel, “when Deepak Singh has now admitted under a sworn Statutory Declaration dated 9 October 2019 that he did not do any surgery.”

Deepak Singh stated in the statutory inquiry hearing the charges of malpractice against him that Kumar had made the insurance claims using his name and credentials without his knowledge or consent.

The claims of insurance fraud have been reported to Prudential Assurance Malaysia and one of their managers Dr Ashish can be heard in an audio recording of a meeting to discuss the case stating that it is not their standard practice to volunteer help to the police in cases of insurance fraud.

The medical society has ordered Kumar to answer the charges or to face an inquiry by the full Medical Council. If found guilty the neurosurgeon could lose his position on the Malaysian Medical Register and possibly face criminal charges. Prince Court Medical officials could also face imprisonment for three months, a fine of up to RM10,000 or both.

A list of questions about the investigation of this case was sent to Dr Noor Hisham Abdullah, as president of the MMC. Dr Noor Hisham has not replied.

Originally published in the Asia Sentinel, 21st November 2019