SGH neurosurgery chief under investigation after failing to report patient's death: ‘My heart overruled my brain’

SINGAPORE: In early 2024, the head of neurosurgery at the Singapore General Hospital (SGH) began operating on a 75-year-old woman. Complications during the procedure compelled him to stop, and the woman died six days later. Out of compassion for the family, Jai Prashanth Rao, the department head of SGH’s National Neuroscience Institute, did not report his patient’s death to the coroner. However, the case is now under investigation.

According to reporting from CNA, he testified on Wednesday (Oct 14) that he had erroneously thought that only deaths that had taken place within 24 hours of surgery were required to be reported to the coroner.

While he had informed the family that he would have preferred to report his patient’s death, due to the desire to prevent further distress and give them closure, he did not do so.

The backstory

Dr Rao operated on Madam Tan Suan Lin on Jan 3, 2024. She had been diagnosed wth a large brain tumour the year before, and he had advised her that an operation was necessary to remove it.

However, due to excessive bleeding during the procedure, Dr Rao was forced to end the surgery.

Mdm Tan was transferred to SGH’s intensive care unit and passed away on Jan 9.

Her doctor had told Mdm Tan's husband and daughter about the complications during surgery and that her chances of survival were poor, adding that an autopsy may be needed after she passed.

Her family, especially her daughter, told Dr Rao repeatedly that she did not want this, desiring for her mother to retain "dignity in death.”

Because Dr Rao, who told the court that “probably my heart overruled my brain”, did not report Mdm Tan’s death to the coroner, no autopsy was performed.

While her death certificate indicated that the elderly woman had died due to the brain tumour, according to a forensic pathologist from the Health Sciences Authority, Mdm Tan may have died from bleeding complications during her operation.

When the National Neuroscience Institute conducted an internal review, her case was identified and flagged to the coroner in February 2025. In the following month, a police report was filed because the death had not been reported.

Under the Coroners Act, an individual who is aware of a reportable death, including one that occurred directly or indirectly from medical treatment, should report this death as soon as it is reasonably practicable.

If they do not do so without reasonable excuse, they could be sentenced to a jail term of one month, a fine of as much as S$1,500, or both.

An independent expert witness told the court, “The death should have been reported because that is in our training and experience from the time we started this speciality… However, the academic knowledge of it sometimes can be marred by emotions."

The findings on Dr Rao’s case will be given by State Coroner Adam Nakhoda at a later date. /TISG

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