Juwariyah binti Sal Hamid @ Ahmad v Dato' Dr Shahrudin bin Mohd Dun

Case Significance

Illustrates the application of the Bolam standard of care in a surgical-negligence claim, where expert evidence that the treatment met accepted practice defeated the patient’s claim.

This High Court decision at Shah Alam determines, after a full trial, a patient’s claim in medical negligence against a consultant general surgeon who had treated her at a private specialist centre. The plaintiff, who had suffered recurrent abdominal pain, was diagnosed with gallstone disease and underwent a laparoscopic cholecystectomy, and her complaint was that in the course of her subsequent management the defendant surgeon had failed to perform a cholangiogram after removing a biliary stent, and had not carried out regular follow-ups such as liver function tests and abdominal ultrasounds. Her case was that, had a cholangiogram or proper follow-up been done, a biliary stricture would have been diagnosed sooner and treated by less invasive endoscopic procedures rather than the riskier open surgery she ultimately underwent. The Court assessed the claim against the established standard of care for medical professionals, applying the Bolam test as explained in Zulhasnimar bt Hassan Basri v Dr Kuppu Velumani, asking whether the surgeon’s management fell below the standard of a reasonably competent practitioner in the field. It gave weight to the defence expert, a surgeon of extensive experience in general and hepatobiliary surgery, whose opinion was that the defendant had acted as a competent general surgeon at every stage, that all investigations, procedures and operations accorded with what was expected of a surgical specialist, and that the biliary stricture, which manifested as obstructive jaundice roughly three years after the second operation, could not be ascribed to any wrongdoing or neglect on the surgeon’s part. The Court noted that the surgeon had the training, qualifications and experience to perform the operations he carried out and had done so to the professional standards demanded of a consultant in the field, and it found no basis to conclude that the overall management had breached the standard of care. Concluding that the defendant’s conduct met the accepted standards of medical practice, the Court, per Hazizah Kassim JC, dismissed the claim on the balance of probabilities with costs of RM35,000. The judgment illustrates the application of the Bolam standard in a surgical-negligence claim.