Negligence in medical contexts requires demonstrable evidence linking alleged harm to specific acts of healthcare providers.

Introduction

[1] This is an appeal against the decision of the learned judge of the High Court of Malaya in Kota Bahru, in allowing the respondent's claim against the appellants in a medical negligence suit.

[2] For ease of reference, the respondent will be referred to as the plaintiff and the appellants, the defendants.

Salient Facts

[3] On 5 April 2004, the plaintiff's then seven-year-old daughter (the deceased), sought treatment at the Kota Bahru Hospital. On 7 April 2004, she was transferred to the Hospital Raja Perempuan Zainab II (HRPZII) where she was diagnosed with chronic rheumatic heart disease with severe mitral regurgitation and began to receive treatment for that condition.

[4] Between the period of 7 April 2004 and 27 October 2004, the deceased was admitted to the HRPZII and Hospital Gua Musang (HGM) on several occasions for complaints related to her medical condition and was given various treatments in the paediatric ward of the hospitals.

[5] On 27 October 2004, the deceased was discharged from HGM after her condition was found to be stabilised.

[6] On 16 June 2009, after an absence of five years, the deceased was readmitted to the HGM for her fever and coughing which had lasted for a month. The deceased was diagnosed as having bronchopneumonia and was given due treatment and a TB test conducted on her turned out to be negative.

[7] The deceased was discharged from the HGM on 24 June 2009. However, on 15 July 2009, the deceased again sought treatment at the HGM for her fever which lasted for two weeks and upon examination, she was found to be suffering from dehydration, oral thrush, low white blood cells and heart murmur and an x-ray examination showed enlargement of the heart. A repeat TB test conducted on her was again found to be negative. The deceased was again given the necessary treatment for her conditions.

[8] On 23 July 2009, the deceased was transferred from the HGM to the HRPZII for further treatment after her condition failed to improve.

[9] At the HRPZII, the deceased was found to be suffering from oral thrush, although all her organs and vital signs were found to be normal. An x-ray test on the deceased found patchy opacities in the left lung and she was treated with intravenous antibiotic.

[10] On 26 July 2009, the deceased experienced headache and vomiting continuously and on 28 July 2009, she complained of blurred vision and vertigo. On 3 August 2009, the deceased underwent a CT scan of her brain and was found to have "hypodense lesion" in the cerebellum which indicated ischemia, demyelination or cerebellitis.

[11] Due to her prolonged illness and oral candidiasis, the doctors at the HRPZII decided to conduct immunisation tests on the deceased for HIV Elisa, which were carried out on 28 July 2009 and 18 August 2009. Both test results indicated she was positive for the Human Immunodeficiency Virus (HIV) where CD4 was 8 (2%) and CD8 was 143 (40%).

[12] Similar HIV tests were conducted on the plaintiff and his wife on 23 August 3009 and the results turned out to be HIV non-reactive.

[13] On 25 August 2009, the deceased person's condition deteriorated further where she experienced extreme headache and went into a coma shortly after. The deceased passed away on 26 August 2009 at the HRPZII and the cause of death on her death certificate was stated as "brain abscess (with underlying HIV infection and severe immunosuppression)".

[14] It was not disputed that during her treatment at the HGM and HRPZII, the deceased received blood transfusions on five occasions, ie 12 May 2004, 24 June 2004, 19 June 2009, 25 J