At least 3 patients had urgent treatments delayed by doctor who put them through needless tests

A cardiologist in private practice used to pay two ambulance services a commission for bringing him patients.

He would then run the patients through a battery of scans, many of which were not necessary, in order to inflate their bills.

As a result of these tests, three patients were delayed from receiving the urgent treatments they needed, according to a report by a committee, which was posted on the Singapore Medical Council (SMC) website last Friday.

An Interim Orders Committee (IOC) was set up to see if precautions needed to be put in place in the case of Dr Wong Siong Sung before a final decision is made by the disciplinary tribunal.

SMC’s disciplinary inquiries usually take years to complete.

The “Decision of the IOC” said that Dr Wong used to pay between 10 per cent and 20 per cent of what he billed patients to the Singapore Ambulance Association (SAA) and the Singapore Emergency Ambulance Services (SEAS) for bringing the patients to him.

Having received a complaint, the Ministry of Health (MOH) carried out an audit on Aug 6, 2020, which found that Dr Wong had done unnecessary tests and scans on five patients brought by the ambulance services to his facilities.

As a result, three of them were delayed from getting the urgent treatments they needed. One of these patients died.

Dr Wong is the medical director of Healthy Heart Specialist Centre (HHSC) and Somerset Imaging Centre (SIC).

The committee said one patient had fallen at home and hurt his head. An SAA ambulance took him to HHSC and SIC at around 10.40am where he had computed tomography (CT) scans of his brain, cervical spine, thorax, and pelvis. He was also given an electrocardiogram test.

During the CT scan, the patient’s condition deteriorated. He vomited and had difficulty breathing. He was sent to a hospital at around 1.50pm. He died three days later. His death was caused by a stroke.

Two MOH experts in emergency care told the IOC that the patient was “a priority one case” who needed urgent medical attention. He should have been taken straight to a hospital emergency department.

Instead, “140 minutes elapsed from the time that P1 (the patient) was conveyed from his home to HHSC and SIC, to the time that he was conveyed to hospital”.

One of the experts said the delay of more than two hours had a negative impact, but that it would require a neurosurgeon’s expert opinion on whether the outcome might have been different.

The second patient also fell and had a fracture at the top of her left leg. Following an X-ray that showed the fracture, Dr Wong wanted to do a CT scan and a magnetic resonance imaging (MRI) scan despite the woman being disoriented, restless and confused upon arrival.

Her family objected and called 995 to have her moved to a hospital. On arrival at the hospital, she was assessed to be suffering from hyponatremia, or low blood sodium.

The experts said she needed immediate medical attention and should have been directly transferred to an acute hospital. The trip to SIC was unnecessary, and the multiple transfers added to her pain and suffering.

Dr Wong was called to the home of the third patient, who had abdominal pain and low oxygen saturation. The patient was taken by SEAS to HHSC and SIC, where he remained from 1.15pm to 5.45pm.  

The IOC said Dr Wong ordered CT scans of his thorax, brain, abdomen and pelvis, and MRI scans of his heart and prostate “instead of prioritising immediate resuscitation or stabilisation”.

In August 2021, MOH filed a complaint with the SMC against Dr Wong.

Among other things, MOH had obtained a police report made by a radiographer formerly employed by HHSC/SIC, and tip-offs and complaints made by a former marketing staff member of the companies, a patient and the Corrupt Practices Investigation Bureau (CPIB).

An earlier statement by the SMC listed the six conditions imposed by the IOC under which Dr Wong is allowed to continue practising for 18 months or till the disciplinary inquiry is completed. They include not paying ambulance services for referring patients to his place of work or making house calls.

The IOC said such interim restrictions are needed, as “while only SAA and SEAS were the ambulance operators identified in the MOH’s audit, there is a risk that Dr Wong may have financial arrangements with other ambulance services and/or operators”.

Timeline of events

Aug 6, 2020: The Ministry of Health (MOH) carries out an audit of Healthy Heart Specialist Centre (HHSC) and Somerset Imaging Centre (SIC) after receiving a complaint.

Oct 13, 2020: The Corrupt Practices Investigation Bureau (CPIB) does not take further action against Dr Wong, HHSC and SIC as it agreed with MOH that the matter falls under the purview of the Singapore Medical Council (SMC).

Aug 3, 2021: MOH files a complaint against Dr Wong with the SMC.

Oct 25, 2022: SMC’s Complaints Committee requests an Interim Orders Committee (IOC) be convened.

Jan 20, 2023: IOC sends a notice of inquiry to Dr Wong. At the time, the case had yet to be referred to a Disciplinary Tribunal.

May 23, 2023: Interim orders take effect for 18 months or till disciplinary hearing is completed.