- Coroner’s Court jury found that 74-year-old Yau Ming-poon died of respiratory arrest and asthma exacerbation in Tuen Mun Hospital
- But coroner says court’s verdict will not affect the chances of family members winning future civil proceedings
An elderly asthma patient died in a Hong Kong hospital of natural causes, an inquest found on Friday, despite the man's family insisting he was the victim of medical malpractice.
A Coroner's Court jury found that 74-year-old Yau Ming-poon died of respiratory arrest and asthma exacerbation in Tuen Mun Hospital on May 16, 2016.
But the five-member jury urged the Hospital Authority to upgrade its public hospitals, including the provision of different medicines for emergency use and more advanced equipment. They also recommended the authority set up additional guidelines for frontline doctors to ensure medical safety.
Yau's family members, who had asked the jury to pass a verdict of death by misadventure, broke into tears as they heard the findings.
Coroner Stephanie Tsui May-har said in her final remarks that the court's verdict would not affect the chances of family members winning future civil proceedings.
Vickie Yau, the patient's second daughter, found the outcome disappointing but said she would respect the ruling. She accused Tuen Mun Hospital of hiding the truth behind her father's death, and only revealing to the court records that supported its case.
"My father's death could have been avoided. I urge the doctors at the hospital to admit what they've done wrong," she said.
The inquest centred on three incidents that arose after Yau was admitted to the hospital's intensive care unit with breathing problems three days before his death.
Tsui directed the jury to determine whether the three events had caused injuries to the patient leading to his demise, or that his death was a result of the exacerbation of his existing ailments.
Patient not given medicine because of time needed to collect it, inquest hears
The court heard Yau was resuscitated following cardiac arrest for the first time shortly after midnight on May 14. It was later found that a flexible tube linking Yau's breathing apparatus to the respirator was disconnected.
Kenny Chan King-chung, consultant at the hospital's ICU, said Yau was not short of breath during that period as his arterial oxygen value remained above 90 per cent, meaning there was adequate oxygen in his blood.
But independent expert witness Yap Hiu-yi, an ICU consultant from Prince of Wales Hospital in Sha Tin, told the inquest it was impossible to measure oxygen saturation level in a patient's blood by measuring the pulse when the heart had stopped beating.
When Yau's blood pressure rose to life-threatening levels in the small hours of May 16, his doctor Lam Ki-wai opted to lower it with a drug named labetalol, which could adversely affect asthma patients.
But after giving him the medicine in small amounts continuously over 90 minutes, Yau developed bronchospasm " tightening in the airways " forcing the doctor to use a different medicine to stabilise the patient's condition.
Doctor connected asthma patient's breathing tube to stomach, inquest hears
In court, Lam insisted he had made the best decisions for the patient, but the two ICU consultants said it would have been better to avoid using labetalol under such circumstances given its side effects.
The same day, the patient had a second cardiac arrest, after Lam changed his breathing tube at 4am. Lam changed the breathing apparatus again 12 minutes later.
He told the court he made the first change after discovering part of the tube was broken, which heightened the risk of infection. After Yau suffered heart failure, Lam removed his breathing tube and performed cardiopulmonary resuscitation on the patient.
Yap suspected Lam had intubated the patient incorrectly at the first attempt, but she admitted that evidence before the court was not enough to support her theory.
However, she criticised Lam for not using a detector to make sure he had not placed the tube into Yau's digestive tract.
The Society for Community Organisation, which has helped Yau's family throughout the inquest, said the hospital's management could not excuse themselves from failing to supervise the performance of junior workers. It also said the hospital had not reflected on the incident, and questioned whether it had intended to cover up its mistakes.
Meanwhile, a spokesman for the hospital said it was sorry for the insufficient communication with the family. It would study the court's recommendations.
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