Close
18 Mar 2024
A cancer specialist has been reprimanded after a tribunal found he failed to obtain informed consent from a patient and kept inadequate clinical records.
Content advice: Some readers may find this article distressing. If you are experiencing distress and are a medical practitioner, please visit drs4drs. Anyone can contact Lifeline on 13 11 14 for confidential help.
The Medical Board of Australia (the Board) referred Dr Jason Jit-Sun Tan to the State Administrative Tribunal of Western Australia (the tribunal) for allegations involving complex issues within the sub-specialty of gynaecological oncology and his care of six patients at St John of God Hospital in Subiaco.
After investigations into complaints began, in April 2018, Dr Tan gave an undertaking to the Board that prevented him from undertaking any gynaecological oncology procedures, or having to perform them under supervision, for periods which ended before the tribunal hearing.
One of the patients who made a notification about Dr Tan died before she could give evidence at the October 2022 tribunal hearing, and the majority of the Board’s allegations could not be substantiated.
Dr Tan disagreed with the Board’s contention that his conduct fell below the acceptable standard. He also argued that the number of his alleged failings were small relative to the number of patients he had treated, that he specialised in difficult and complex cases, and that professional judgement varies from conservative to aggressive in the complex area of gynaecological oncology.
After examining the records and circumstances surrounding the treatment of the six patients, the tribunal found that Dr Tan engaged in unsatisfactory professional performance due to poor record-keeping and failing to obtain properly informed consent for surgery from one patient.
In relation to poor recording-keeping, the tribunal found Dr Tan’s notes were unduly brief, did not properly describe the operative findings and procedures performed, and did not properly describe the extent and location of residual disease, and that he:
In one case, the tribunal found Dr Tan failed to have any adequate discussions with a patient or her next of kin about treatment options apart from surgery before gaining consent from her next of kin.
‘Given the clinical condition of Patient C and particularly in light of her limited life expectancy, it was especially important that those discussions occur before consent was obtained,’ the tribunal found.
The tribunal accepted that there are two somewhat different approaches to the management of complex gynaecological oncology cases and that neither is deficient or improper such to amount to conduct falling below the standard expected.
The Board submitted that Dr Tan be reprimanded and have conditions placed on his registration requiring him to undertake education, while the specialist stated he should have either no penalty or a ‘caution at most’.
The tribunal dismissed Dr Tan’s application for costs and instead ordered he pay $20,000 of the Board’s costs, determining his conduct warranted a penalty. It also found there was no risk of Dr Tan repeating his poor conduct, so further education was not required.
‘Having carefully considered the parties' submissions, we consider that the imposition of a reprimand constitutes an appropriate and sufficient penalty in all of the circumstances of this case,’ the tribunal found.
The tribunal’s decision is published on the eCourts portal of Western Australia.