Ang Yong Guan found guilty of professional misconduct by appeal court

SINGAPORE: Prominent psychiatrist Dr Ang Yong Guan has been found guilty of professional misconduct by the Court of Three Judges for departing from established guidelines in prescribing medications to a former patient.

This decision overturns the previous ruling by the disciplinary tribunal.

The case, dating back to 2012, revolves around a series of prescriptions provided by Dr Ang to his patient Quek Kiat Siong, who passed away from multiple organ failure shortly after the last prescription was issued.

The final prescription, which included a daily dosage of 60mg of the antidepressant mirtazapine, was deemed by Dr Ang himself to be at the “edge of the killing range.”

The Singapore Medical Council (SMC) brought three disciplinary charges against Dr Ang following a complaint lodged by the patient’s sister.

The tribunal initially acquitted Dr Ang of professional misconduct but found him guilty of failing to provide services of the expected quality.

However, the Court of Three Judges ruled differently, asserting that Dr Ang’s deviations from prescribing guidelines amounted to misconduct because he failed to adequately justify these decisions.

Notably, the prescriptions included concurrent use of multiple benzodiazepines and opioid painkillers, as well as excessive dosages of mirtazapine and zolpidem.

Dr Ang had treated Mr Quek for various conditions, including insomnia, depression, and anxiety. The patient’s death in 2012 was attributed to mixed drug intoxication.

The court’s judgment emphasized the responsibility of doctors to justify any departure from established medical standards, particularly when significant risks are involved.

While Dr Ang was able to justify some departures from guidelines, his prescription of mirtazapine and zolpidem in excess of recommended dosages was deemed unjustifiable.

The court will determine appropriate sanctions against Dr Ang, which could range from suspension to removal from the medical register, in accordance with the Medical Registration Act.

Dr Ang, also the assistant secretary-general of the Progress Singapore Party, contested the Marymount single-member constituency in the 2020 general election and lost the seat with a narrow margin of just over five per cent of the vote.