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2012 MarsdenLR 835
COURT OF APPEAL PUTRAJAYA
DENNIS LEE THIAN POH & ORS – Appellant
Versus
DR MICHAEL SAMY & ANOR – Respondent
[Civil Appeal No: W-02-2844-11-2011]
In cases of professional negligence, plaintiffs must clearly articulate causes of action and provide adequate proof of standard care breaches; otherwise, claims may be dismissed.
Headnote:(A) Tort of Negligence - Breach of Duty of Care - Breach of Contract - No evidence was provided to establish that the healthcare providers breached their duty, nor that the negligence claimed led to the death of the deceased - The trial court found no material risk associated with the use of Cytotec and did not err in its assessment of the facts. (Paras 8, 21, 24)
(B) Professional Negligence - The importance of precise pleadings - Clear articulation of causes of action required in professional negligence cases to allow for adequate responses and judicial consideration - The failure to provide clear pleadings may lead to misinterpretation and confusion during trial. (Paras 14, 16)
Facts of the case:
The appellants claimed negligence against the hospital and the doctor after the death of the deceased following childbirth, alleging that improper care led to excessive bleeding. They contended that the required standard of care was not met, and that there was a breach of duty in using Cytotec without proper warning. (Paras 1-6)
Findings of Court:
The court upheld the lower court’s findings, stating that the plaintiffs failed to prove negligence, and that the standard of care had not been breached. It found that the trial judge made appropriate conclusions based on the evidence presented. (Paras 27)
Issues: The main issues addressed include whether the defendants were negligent and whether proper warnings were given regarding the use of Cytotec. (Paras 8, 21)
Ratio Decidendi: The trial judge’s findings were based on the credibility of witness testimonies and the evidence presented during the trial. The court determined that there was no substantial evidence to indicate negligence by either the doctor or the hospital, affirming that it is the burden of the plaintiff to provide clear proof of their allegations. (Paras 21, 24)
Result: Appeal dismissed.
| Table of Content |
|---|
| 1. high court's conclusions on pleadings and evidence. (Para 9 , 10 , 11 , 12) |
| 2. importance of clear pleadings in negligence cases. (Para 13 , 14 , 15 , 16 , 17) |
| 3. trial judge's duty in assessing evidence. (Para 18 , 19 , 20) |
| 4. assessment of evidence in establishing standard of care. (Para 21 , 22 , 23 , 24 , 25 , 26) |
(b) The plaintiffs failed to prove their case as pleaded, that the death was caused by post partum haemorrhage in the course of induction or excessive bleeding due to a uterine tear.
(c) The plaintiffs have failed to establish that Dr Michael Samy ought to have warned the deceased of any material risk of using Cytotec.
(d) The plaintiffs have failed to establish that Gleneagles Hospital had breached the applicable standard of care for private hospitals in Malaysia.
(e) That Gleneagles Hospital is not vicariously liable for Dr Michael Samy's acts and omissions, even if he was negligent.
Our Findings
[9] It had been pleaded at para 18 of the statement of claim that:
"The deceased underwent the induction on or about 1920 hours on the 4 July 2000. In the course of the induction the deceased suffered massive post partum haemorrhage causing the deceased's demise. Alternatively, the deceased suffered excessive bleeding due to a uterine tear, which led to the deceased's demise."
[10] It was submitted that para 18 was a general paragraph and ought not have led to pedantry on the argument that the plea was defective because one could not be said suffer post partum haemorrhage in the course of an induction because 'by definition', PPH is after delivery and induction is before delivery.
[11] It was submitted:
28. This is a rather simplistic approach to the issue at hand. It is a fact that the drug Cytotec was used by Dr Michael Samy to induce/ augment labour. It is a fact that this drug causes the uterus to contract so that the birth process is accelerated. It is also a fact that the effects of this drug do not suddenly cease once birth is achieved but continue until the body breaks down the chemical in that drug. Therefore, even after the 'induction' period, the drug is still working.
29. Where is the line to be drawn between the end of labour and the beginning of the post partum era? There is no doubt Pau Yu was found to be bleeding after birth. When did this bleeding begin? It must have been a contemporaneous event with the birth, (if not before), and the induction thereof. That is only logical.
[12] Blame was then put upon the other party:
30. If the use of the phrase 'in the course of induction the deceased suffered massive PPH' resulted in any feigned confusion on the
part of the 1st defendants, then surely it was open to the 1st (and 2nd) defendants to seek clarification by asking for further and better particulars as provided for by virtue of the provisions of O 18 r 12 of the RHC 1980. The defendants had nine years to do this but did not take advantage of these provisions. Perhaps they were not as perplexed by para 18 as they had made out. This was never supposed to have been a trial by ambush.
[13] The submissions turned to the trial judge:
"31. Had the learned judge of the High court addressed her mind to the host of other particulars pleaded, inter alia, at p 13 (a to t), of the statement of claim, (TAB 2), perhaps the learned judge would have appreciated the precise allegations made against Dr Michael Samy and could quite easily have come to a completely different conclusion.
32. Unfortunately, the learned judge does not appear to have even considered the pleadings in toto as has been clearly manifested in her writeten judgment. There appears to be a complete absence of any form of scrutiny of the multitude of allegations against the defendants as particularized in the rest of the statement of claim. This alone warrants a revisit of the entire matter and an appropriate analysis of the plaintiff 's pleadings in relation to the evidence produced."
[14] That such argumen
