(SINGAPORE) The aesthetics doctor accused of botching a patient's nose job has laid the blame squarely at his patient's feet; Amal Dass says the damage suffered by make-up artist Sng Hock Guan was the result of the numerous procedures Mr Sng had undergone before and his refusal to heed Dr Dass's post-operative advice.
In his defence filed in response to Mr Sng's suit, Dr Dass - represented by Mak Wei Munn of Allen & Gledhill - denies the various claims made by Mr Sng that he had caused him excruciating pain during surgery and caused his nose to become infected and eventually collapse.
Dr Dass also denied Mr Sng's claim that he was not qualified to carry out the rhinoplasty (nose job). Mr Sng, represented by Wendell Wong of Drew & Napier, had said that he had relied on Dr Dass's representations that he was a qualified plastic surgeon and found out only later that the doctor was not registered on the Singapore Medical Council's (SMC) Register of Specialists as a specialist in plastic surgery. Dr Dass replied in his defence that he agreed that 'he had never implied, advertised and/or held out that he was a specialist in plastic surgery, or that he otherwise had a degree, qualification or experience in plastic surgery', nor had he represented that he was on the SMC register. But, he added that he is 'skilled, qualified and competent to advise on and perform rhinoplasties' and that he had 'complied with all relevant laws and regulations in place at the relevant time, in or around February 2008'.
Singapore's official national body of plastic surgeons has written to The Business Times to say that Dr Dass is not a qualified plastic surgeon. Dr Vincent Yeow, president of the Singapore Association of Plastic Surgeons, had said: 'His (Dr Dass's) qualifications do not allow him to be considered an accredited surgeon in Singapore.'
The Guidelines on Aesthetic Practices were updated by the SMC and the Aesthetic Practice Oversight Committee in October 2008 to state that cosmetic doctors are not allowed to carry out invasive procedures such as rhinoplasties.
Dr Dass also said in his defence that he explained all the risks and possible complications of the procedure to Mr Sng and that his patient understood the risks.
He denied Mr Sng's claim that he was not properly sedated during the operation and was therefore in 'excruciating pain'. Dr Dass said Mr Sng was 'placed under sedation as was the usual practice at established centres' and was closely monitored throughout the entire procedure.
In response to Mr Sng's claim that a 15cm strip of gauze had been left in his nose cavity after the operation, Dr Dass said 'it is routine to use a vestibular dressing to soak up post-operative bleeding and to prevent backflow of blood and provide comfort to patients and this was communicated to (Mr Sng)'. He added that this gauze would have been removed during the post-op consultation (which took place about five days later).
Dr Leslie Kuek, one of Singapore's leading plastic surgeons, had said in an expert testimony provided in Mr Sng's claim that placing gauze following such operations is 'highly unusual' and should never be left inside nasal passages for more than 48 hours.
Dr Dass also claims, in his defence, that he had noted the presence of infection in Mr Sng's nose during his post-op consultation and that he had advised his patient to remove the implant (the nose implant Dr Dass had inserted during the operation) and to commence intravenous antibiotics, and that Mr Sng had refused to remove the implant. Dr Dass said he again advised his patient to remove the implant during the second consultation, but that Mr Sng again refused.
Dr Dass concluded that 'the alleged damages and/or loss suffered by the plaintiff (Mr Sng) were caused and/or contributed by the plaintiff's previous rhinoplasties prior to the procedure (performed by Dr Dass) and/or the complications arising from his previous rhinoplasties and/or the plaintiff's failure to heed (Dr Dass's clinic's) post-procedure advice'.
Mr Sng is claiming damages for pain, suffering and mental distress, as well as for what he had to spend to repair his nose - estimated at $80,000. He is also asking for aggravated and punitive damages, in the area of $250,000.