Taipei says doctor didn't review case

The fiasco involving the transfer of a critically injured four-year-old girl from Taipei to Taichung for urgent brain surgery last Tuesday took an unexpected turn yesterday, as Taipei Deputy Mayor Yeh Chin-chuan (葉金川) announced that the neurosurgeon, Lin Chih-nan (林致男), had been absent and made up the case report without viewing the patient's CT scan.

"During the critical time, from 2:05am to 4:27am on Tuesday morning, Lin did not come to the hospital's Intensive Care Unit [ICU]. Nor did he check the girl's brain CT scan on the computer as he said," Yeh said.

Yeh led an ad hoc task force to probe the cause of the much-criticized delay in treatment of the girl.

At midnight on Jan. 10, the critically injured girl, surnamed Chiu, was taken to Taipei Municipal Jen Ai Hospital (台北市立仁愛醫院) after being beaten by her father. The hospital turned her away, saying there weren't enough beds. She was subsequently turned away from several other hospitals in Taipei, and was finally transferred to Taichung for brain surgery.

"Lin is one of the doctors who should take the blame. He made up the case report and did not at first tell the truth to the investigation team," said Chin Fu-chung (金溥聰), another deputy mayor.

Prior to yesterday, Lin had told city officials that he had been in Taipei Municipal Jen Ai Hospital's ICU on the third floor. According to Lin's previous testimony, he had been too busy taking care of patients in the ICU on the third floor to come down to the emergency room on the ground floor and personally check the girl.

After the chief of the emergency room Lin Bin-chou (李彬洲) called Lin and reported Chiu's condition, Lin insisted on referring the comatose girl to other hospitals in Taipei on the grounds that no empty bed was available at that time.

However, the city's investigation task force yesterday said that Lin had not been telling the truth.

"At about 11 o'clock last night, I ask Lin if he had lied to me. He admitted it. And he fell down in a faint," said Hsiao Sheng-huang (蕭勝煌), the hospital's chief of neurosurgery, who again offered his apology to the public.

According to Yeh, Lin already acknowledged that he had not seen the patient's CT scan before submitting the case report. Another neurosurgeon, Liu Chi-hwa (劉奇樺), who was on call that night was also involved, Yeh said.

The city government will mete out penalties for the doctors today, and prosecutors also plan to probe staff negligence.

"Lin's act certainly violates medical ethics. According to Article 25 of the Doctor's Law (醫師法), the government can deal out administrative punitive measures, like canceling his license," said Hsueh Jui-yuan (薛瑞元), chief of the Department of Health's Medical Affairs Bureau.

Yet city officials said that the punishment could amount to criminal responsibility.

"It depends on the patient's condition and the prosecutors' judgment. The heaviest penalty could be accidental homicide (過失致死)," said Chen Ching-hsiou (陳清秀), chairperson of the law and regulation commission of Taipei City Government.

Yeh also said that Taipei Mayor Ma Ying-jeou (馬英九) expressed disappointment when he learned the news yesterday morning.

"The mayor said that our medical ethics and doctor training are evidently in desperate need of improvement," he said.

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