Bangkok: Doctor of British woman who died in surgery clinic unlicensed

[Emster23]

Don't want to sound like I am defending doctor, but death during surgery is more widespread than we would like to admit (or know). Just got stats from USA: 2,211 died during surgery due to anesthesia between 1999 and 2005 or about 64 per 100,000 surgeries, and that is with a certified anesthesiologist. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697561/

That said if doctor was doing operation and anesthesiology at same time... too many balls in the air.

Did local police or medical board know about his practicing outside his licensing? If so, they should be on trial also imho.

[Strangebrew]

In the US that would be manslaughter pure and simple not to mention multi million dollar lawsuit loss of title Plus 7 to 10 years in prison. But Thailand 60 day vacation few leo's time to pay bribes, Get several ladyboys to say you did job on them had an add a dick to me done. Oh forgot customary I'm sorry merit making trip to temple plus blame on Farang.

[wilcopops]

In the US that would be manslaughter pure and simple not to mention multi million dollar lawsuit loss of title Plus 7 to 10 years in prison. But Thailand 60 day vacation few leo's time to pay bribes, Get several ladyboys to say you did job on them had an add a dick to me done. Oh forgot customary I'm sorry merit making trip to temple plus blame on Farang.

...or become a monk?

[Traveling Sailor]

closed for 60 days after the owner, an unlicenced doctor operated there ilegally, should be closed permanently and be forced to pay out heaps but then the hi-so would lose too much money and face, that would simply be too much for a thai, after all, it was only another "farang"(sarcasm), Yet people wonder why this sort of sh*t keeps happening, simple answer, profits are more important than people

Looks as though you missed the part where it said he's being charged with criminal negligence in the girls death.

Being charged means nothing. TIT. Seajae is right. This guy will probably not see any jail time or pay any fine.

[ParadiseLost]

Many doctors in Thailand, are licensed through the hospital they work in!

The same ones who can now bypass pharmacists when prescribing some seriously heavy duty meds?

Or was that change thrown out - I recall some loud protests?

I noticed that this was tightened up somewhat after the '06 coup. Valium etc became more difficult to acquire "under the counter", or in less places.

This is still ongoing:

"In a statement, the network claimed the legislation would damage the country's pharmaceutical system and harm people, as it would let health professions use registered medicines in mixing their own formulas without asking for FDA approval or revealing the recipe."

Thai pharmacists up in arms against draft bill

Edited October 28, 2014 by ParadiseLost

[richusa]

closed for 60 days after the owner, an unlicenced doctor operated there ilegally, should be closed permanently and be forced to pay out heaps but then the hi-so would lose too much money and face, that would simply be too much for a thai, after all, it was only another "farang"(sarcasm), Yet people wonder why this sort of sh*t keeps happening, simple answer, profits are more important than people

Looks as though you missed the part where it said he's being charged with criminal negligence in the girls death.

Community work because it was a foreigner.

[KonKorat]

The Brits are having a bad run in Thailand at the moment.lets hope he is charged with the criminal offences they are charging him with, and the hospital gets shut down.R.I.P young lady.

[Maestro]

Removed a nonsensical post and the replies to it, and a troll post.

[Time Traveller]

"She died under anaesthesia after the doctor successfully removed the implants". --

That does not sound like they were successfully removed, unless you conclude that they were successful in removing them from a corpse.

This story also leaves out the important information. Did the doctor fake a Surgery license or did the British woman just not care?

Many times I've seen stupid tourists come to Thailand for medical procedures and they have no idea who is cutting them open or even if they are qualified....And they don't even realize malpractice insurance is virtually non-existent in Thailand.

....The medical tourism industry in Thailand is a joke.

Edited October 28, 2014 by Time Traveller

[TPI]

closed for 60 days after the owner, an unlicenced doctor operated there ilegally, should be closed permanently and be forced to pay out heaps but then the hi-so would lose too much money and face, that would simply be too much for a thai, after all, it was only another "farang"(sarcasm), Yet people wonder why this sort of sh*t keeps happening, simple answer, profits are more important than people

Looks as though you missed the part where it said he's being charged with criminal negligence in the girls death.

The Nation writes he has been charged, but I'd eat up my best hat when the BiBs would already have closed their investigation that fast (don't forget it's about a Doctor here, someone high up in the Thai ...preying order list, with a lot of connexions), or they botched it (as it seems to 'sometimes' happen). Wait and see until the file (wonder what will be in there...) goes to the public attorney, whenever, then follow what happens, when we are ever told, and whether it ever comes in front of a criminal court, what the verdict will be, and the first, later second appeal, when you're not too old to live long enough to witness it, never in jail, a slap on the wrist, some ridiculous fine, and probably never take his MD license away. Even when you murder your wife, chop her into bits, flush those through the toilet, you are and remain a MD, a highly respected person in the LoS and treated as such!

Never did find out whether they kept him out of jail to look after his 2 kids or not......"but he's a doctor, you can't put him in jail with criminals!"

[ericjt]

OK, Just to clear a point up...unlicensed doesn't necessarily mean unqualified. After you have gained a medical or care related qualification, you then have to pay for a very expensive license which is simply a license to practise. No where in the article does it say he was 'unqualified' to carry out this procedure.

This is not a statement of his innocence or guilt, but legally he should have had a license to practise. There is always a risk with anaesthetics.

Problem with all these cases we read about on here is we hardly ever get any follow up !!

Shame for the young lady and her family but it says a lot about modern society when plastic surgery is so important, The number of thais i know who have loaned money or paid on credit card to have those ridiculous nose jobs is unbelievable. Sad.

On stories like this where real people have died, lets try to have a little decorum and less of the chest beating rhetoric. Thank you

At the risk of taking an unpopular position, the facts we have say the patient died from the anesthesia, not the liposuction procedure. "Unlicensed" does not mean "unqualified", and Dr. S was NOT unlicensed. He WAS licensed as an MD. He just hadn't done one more residency -- a surgical residency, apparently.

Dr. S. might have performed the liposuction procedure perfectly, but a bad reaction to the anesthesia might have still killed his patient. Any doctor will tell you that there is a small but definite risk of death or complications every time a patient is put to sleep using general anesthesia.

So I think the question we need to ask is, "Was the anesthesiologist (gas passer) qualified and properly licensed, and, did he/she do anything wrong?" If he/she was licensed and didn't do anything wrong, then maybe punishing the doctor for what is basically a technical licensing violation is unfair.

If the anesthesiologist wasn't licensed (or if the doc himself was doing the gas passing), and, if the anesthesiologist deviated from the established standard of care, then maybe the anesthesiologist should be punished.

But if nobody did anything negligent, and if nobody deviated from good medical practices, then this death might not have had anything to do with whether Dr. S had one more license, or did one more residency. If that turns out to be the case, how heavy handed do we want to be about punishing him, when he might not have done anything medically wrong?

Last thought: In the future, I think relatively simple procedures like liposuction will be done by PAs (physician assistants) or nurses under the overall supervision of an MD. Liposuction using today's liposuction equipment can be learned, AFAIK, in about a week. Maybe a month or two if you want to give a PA some time to work with an experienced provider. But lipo is still not a difficult or complicated thing to do -- certainly nothing like traditional surgery.

Traditional surgery does require a high skill level, so, IMO, a long residency is appropriate. But that's not the case here. Requiring a surgical residency to do liposuction is like requiring the use of a sledge hammer to kill an ant.

Let's all take a deep breath, and see how this situation plays out.

Edited October 28, 2014 by ericjt

[ParadiseLost]

OK, Just to clear a point up...unlicensed doesn't necessarily mean unqualified. After you have gained a medical or care related qualification, you then have to pay for a very expensive license which is simply a license to practise. No where in the article does it say he was 'unqualified' to carry out this procedure.

This is not a statement of his innocence or guilt, but legally he should have had a license to practise. There is always a risk with anaesthetics.

Problem with all these cases we read about on here is we hardly ever get any follow up !!

Shame for the young lady and her family but it says a lot about modern society when plastic surgery is so important, The number of thais i know who have loaned money or paid on credit card to have those ridiculous nose jobs is unbelievable. Sad.

On stories like this where real people have died, lets try to have a little decorum and less of the chest beating rhetoric. Thank you

At the risk of taking an unpopular position, the facts we have say the patient died from the anesthesia, not the liposuction procedure. "Unlicensed" does not mean "unqualified", and Dr. S was NOT unlicensed. He WAS licensed as an MD. He just hadn't done one more residency -- a surgical residency, apparently.

So Dr. S. might have performed the liposuction procedure perfectly, but a bad reaction to the anesthesia might have still killed his patient. Any doctor will tell you that there is a small but definite risk of death or complications every time a patient is put to sleep using general anesthesia.

So I think the question we need to ask is, "Was the anesthesiologist (gas passer) qualified and properly licensed, and, did he/she do anything wrong?" If he/she was licensed and didn't do anything wrong, then maybe punishing the doctor for what is basically a technical licensing violation is unfair.

If the anesthesiologist wasn't licensed (or if the doc himself was doing the gas passing), and, if the anesthesiologist deviated from the established standard of care, then OK, maybe the anesthesiologist should be punished.

But if nobody did anything negligent, and if nobody deviated from good medical practices, then this death might not have had anything to do with whether the doc had one more license, or did one more residency. If that turns out to be the case, how heavy handed do we want to be about punishing Dr. S. -- who might not have done anything medically wrong?

Last thought: In the future, I think relatively simple procedures like liposuction will be done by PAs (physician assistants) or nurses under the overall supervision of an MD. Liposuction using today's liposuction equipment can be learned, AFAIK, in about a week. Maybe a month or two if you want to give a PA some time to work with an experienced provider. But lipo is still not a difficult or complicated thing to do -- certainly nothing like traditional surgery.

Traditional surgery does require a high skill level, so, IMO, a long residency is appropriate. But that's not the case here. Requiring a surgical residency to do liposuction is like requiring the use of a sledge hammer to kill an ant.

Let's all take a deep breath, and see how this situation plays out.

This was not liposuction, but rather removal of botched implants from her buttocks...

In my opinion, it was ultimately her own vanity that killed her...

[ericjt]

Thanks for the clarification. Guess I thought it was lipo after watching the video embedded in one of the comments.

If the procedure involved cutting and removing implants, then maybe some of my previous comment was off base. To the extent the procedure called for skills closer to traditional surgery, I guess I should modify or retract parts of my comment. I'll leave it up to the readers to decide which parts have value and which don't.

Thanks again --

[Searat7]

I was a patient in this clinic last month and received general anesthesia. The anesthesiologist was a young woman who didn't say much and I suspect she might be a "Nurse Anesthesiologist" who is not a doctor but I can't be sure about this. This is legal I believe.

If this clinic re-opens in 60 days I think they will need to hire a licensed surgeon as Dr. Sompob is a solo practitioner from my observations and many of the procedures done there are surgical. The doctor had many certificates/diplomas hanging on the walls and glass cases in his clinic and his website (which has disappeared) indicated he was board certified in the USA which convinced me to use his services.

I actually liked the doctor and his nurses even though I had some complications which never should have occurred. This week I will visit a major Bangkok hospital to be checked out.

One fallout from this incident will be that patients will be reluctant to undergo general anesthesia outside of a hospital....I know that I for one will never take this risk again.

[ericjt]

Good post, Seara7.

I'm not defending Dr. S. I don't know him and have never been a patient. I'm just saying I think there's more to the story than was covered in The Nation's article.

And I think your comment adds some good facts.

[4u2mad]

As the boys in blue are already here, could they not "observe" the case with some pressure from our hi-so's of course?

[4u2mad]

The obvious question would be....

How come there is no enforcement/checks for licenses on these types of businesses?

Seems much too much time is spent checking licenses at farang bars and businesses, (not to mention on the checks for a license to drive on the road) but nobody cares about checking something that would be a life or death situation, and cause such extreme loss of face, such as letting untrained doctors perform surgery.

Somebody needs to start spot checking these slaughter houses.

It seems there is little enforcement of licensing laws as well as lax licensing standards for all types of activities in Thailand. However, anyone who has been here for any length of time should know that. Poor Brit tourist probably had no clue to be careful of unscrupulous medical treatment. Vanity and ignorance, a pitiful closure to anyone's life.

Can't believe you would feel justified in posting that, SL. She was a TOURIST fer Christs sake! Have you no sympathy? Would you check to see if a doctor had a surgeons certificate in your home country?

As for him being too busy, being handcuffed and put in the cells is not OTT is it? As I read it he is nothing more than an unlicensed butcher and should be struck off

[drgoon]

Bangkok the medical hub

Don't forget the Ebola vaccine...

[Thai at Heart]

I was a patient in this clinic last month and received general anesthesia. The anesthesiologist was a young woman who didn't say much and I suspect she might be a "Nurse Anesthesiologist" who is not a doctor but I can't be sure about this. This is legal I believe.

If this clinic re-opens in 60 days I think they will need to hire a licensed surgeon as Dr. Sompob is a solo practitioner from my observations and many of the procedures done there are surgical. The doctor had many certificates/diplomas hanging on the walls and glass cases in his clinic and his website (which has disappeared) indicated he was board certified in the USA which convinced me to use his services.

I actually liked the doctor and his nurses even though I had some complications which never should have occurred. This week I will visit a major Bangkok hospital to be checked out.

One fallout from this incident will be that patients will be reluctant to undergo general anesthesia outside of a hospital....I know that I for one will never take this risk again.

Might be legal in Thailand, but that is probably extemely unlikely.

GA is a serious business.

[larsjohnsson]

Many doctors in Thailand, are licensed through the hospital they work in!

But this guy was the owner of the clinic!!

So he licensed himself??

All about making a quick buck, patients merely considered an " inconvenience"!!

And his punishment will be?? Yes you guessed it: Nothing!!

Why would you think something so bizarre? He's obviously licenced by the medical authorities.

Interesting how you seem to have some advance information on his guilt, or otherwise, and the punishment also

The story is about an unlicensed doctor. And you tell us he is licensed by the authorities !!!!!

[Searat7]

Bangkok the medical hub

Don't forget the Ebola vaccine...

I just spoke to a doctor anesthesiologist in Bangkok and he said use of a nurse anesthesiologist would depend on the procedure and anesthesia used...if minor procedure with light anesthetic then nurse anesthesiologist could work under supervision of the doctor but I think doctor would have to be a licensed surgeon and not a GP for this to apply.

[wilcopops]

I was a patient in this clinic last month and received general anesthesia. The anesthesiologist was a young woman who didn't say much and I suspect she might be a "Nurse Anesthesiologist" who is not a doctor but I can't be sure about this. This is legal I believe.

If this clinic re-opens in 60 days I think they will need to hire a licensed surgeon as Dr. Sompob is a solo practitioner from my observations and many of the procedures done there are surgical. The doctor had many certificates/diplomas hanging on the walls and glass cases in his clinic and his website (which has disappeared) indicated he was board certified in the USA which convinced me to use his services.

I actually liked the doctor and his nurses even though I had some complications which never should have occurred. This week I will visit a major Bangkok hospital to be checked out.

One fallout from this incident will be that patients will be reluctant to undergo general anesthesia outside of a hospital....I know that I for one will never take this risk again.

This post underlines something I've been saying about healthcare in Thailand for years.

"I actually liked the doctor and his nurses even though I had some complications which never should have occurred"

​Patients are ofte so grateful to "get out alive" or with a "result" that they actually have no idea of what is being done and whether the procedure is the most appropriate one for their condition.

​the doctors and nurses seem "so nice" it is almost inconceivable that one would apportion any blame on them in the event of consequences.

let be give you an exaggerated example - if you went into a hospital or clinic with a very painful sceptic big toe and the doctor removed half of the toe but you left knowing that the pain would =never return, you might be grateful....when all that was really needed was a course of antibiotics.

both procedures acheie the same result - a toe that doesn't hurt....but it is obvious which one is most appropriate.

In reality the distinction between appropriate and inappropriate procu=edures is far less ov=bvious and certainly not available to the average patient.

​couple this with poorly trained, or unscrupulous doctors and you have a recipe for disaster.

I've asumed all along that the victim in this case was administered a GA.....whether or not this is standard procedure i can't tell.....what does surprise me is that they were neither in a hospital nor with access to ICU.....

"The doctor had many certificates/diplomas hanging on the walls and glass cases in his clinic and his website (which has disappeared) indicated he was board certified in the USA which convinced me to use his services."

this is a classic situation.

​How many doctors in tUS or Europe do you see with walls covered with certificates??? - you seldom see any from Europe, because they can't be got.

If you want to practice any medicine in the US, you have to train in the US - it is VERY hard to get a practice there. However there are PLENTY of hospitals and Universities that offer "observational" courses in various areas of medicine.....these are not part of training to be a doctor in the US they are often designed solely so that a doc from outside tha=e States can get an idea of what is going on at the cutting edge......Ofo course by the time that Doc has returned home all it says to his patients is "TRAINED IN AMERICA"

[smileydude]

The title is rather misleading. According to what I read in the Bangkok Post the owner of the clinic is a plastic surgeon who is licensed and the one who originally performed surgery on the British patient. He subsequently then allowed this doctor who is a GP to remove the prosthetics.

In theory an anethesiologist should be present when administering any kind of sedative/anethesia prior to a surgical procedure.

I think the violations in this case are:

1. A certified anesthesiologist was not present when the sedative was administered.

2. A GP was allowed to perform a surgical procedure that he was not trained and certified to do so.

3. The clinic did not have the appropriate life-saving equipment present in its facilities.

These violations are widely known to occur on a regular basis at most clinic-based surgeries and only come to attention when something goes wrong.

Its about time the Medical Council got serious about it.

[Munger]

The obvious question would be....

How come there is no enforcement/checks for licenses on these types of businesses?

Seems much too much time is spent checking licenses at farang bars and businesses, (not to mention on the checks for a license to drive on the road) but nobody cares about checking something that would be a life or death situation, and cause such extreme loss of face, such as letting untrained doctors perform surgery.

Somebody needs to start spot checking these slaughter houses.

It seems there is little enforcement of licensing laws as well as lax licensing standards for all types of activities in Thailand. However, anyone who has been here for any length of time should know that. Poor Brit tourist probably had no clue to be careful of unscrupulous medical treatment. Vanity and ignorance, a pitiful closure to anyone's life.

Can't believe you would feel justified in posting that, SL. She was a TOURIST fer Christs sake! Have you no sympathy? Would you check to see if a doctor had a surgeons certificate in your home country?

As for him being too busy, being handcuffed and put in the cells is not OTT is it? As I read it he is nothing more than an unlicensed butcher and should be struck off

YUP, only on this forum would the Thai apologists blame the dead victim, and say "IGNORANCE"

[wilcopops]

The title is rather misleading. According to what I read in the Bangkok Post the owner of the clinic is a plastic surgeon who is licensed and the one who originally performed surgery on the British patient. He subsequently then allowed this doctor who is a GP to remove the prosthetics.

In theory an anethesiologist should be present when administering any kind of sedative/anethesia prior to a surgical procedure.

I think the violations in this case are:

1. A certified anesthesiologist was not present when the sedative was administered.

2. A GP was allowed to perform a surgical procedure that he was not trained and certified to do so.

3. The clinic did not have the appropriate life-saving equipment present in its facilities.

These violations are widely known to occur on a regular basis at most clinic-based surgeries and only come to attention when something goes wrong.

Its about time the Medical Council got serious about it.

with virtually no comeback, why would they care?

[ParadiseLost]

The obvious question would be....

How come there is no enforcement/checks for licenses on these types of businesses?

Seems much too much time is spent checking licenses at farang bars and businesses, (not to mention on the checks for a license to drive on the road) but nobody cares about checking something that would be a life or death situation, and cause such extreme loss of face, such as letting untrained doctors perform surgery.

Somebody needs to start spot checking these slaughter houses.

It seems there is little enforcement of licensing laws as well as lax licensing standards for all types of activities in Thailand. However, anyone who has been here for any length of time should know that. Poor Brit tourist probably had no clue to be careful of unscrupulous medical treatment. Vanity and ignorance, a pitiful closure to anyone's life.

Can't believe you would feel justified in posting that, SL. She was a TOURIST fer Christs sake! Have you no sympathy? Would you check to see if a doctor had a surgeons certificate in your home country?

As for him being too busy, being handcuffed and put in the cells is not OTT is it? As I read it he is nothing more than an unlicensed butcher and should be struck off

YUP, only on this forum would the Thai apologists blame the dead victim, and say "IGNORANCE"

Definitely does not take a Thai apologist to spot ignorance and vanity as the main contributing factors here - unless you think buttock implants are somehow a medical necessity?

Nobody is saying 'serves her right', but she chose to have the surgery. Hard to feel pity; the best anyone can hope for is that other ignorant, vain people will think twice before having ridiculous surgical procedures...

Edited October 30, 2014 by ParadiseLost

[jaidam]

Interesting and damning article in today's Daily Mail about this case. If anybody was wondering what happened to the doctor, well he's back at work at his clinic.