MOOT QUESTION

MOOT QUESTION (ENGLISH)

IN THE COURT OF APPEAL, MALAYSIA

AT PUTRAJAYA

[APPELLATE JURISDICTION]

MOOT NO.      OF 2013

BETWEEN

DR. ERIK ANAKIN LAU & ANO                                                                        …APPELLANTS

AND

LUNA RAIM KARIN (A MINOR)

(THROUGH ELISABETH ZIRYAB, HER MOTHER

AND LITIGATION REPRESENTATIVE)                                             …RESPONDENT

Background of the case

The Respondent a minor suing through her Mother and Litigation Representative, (the Plaintiff) had sued the Appellants (the Defendants) for medical negligence resulting in her blindness. The first Defendant is Dr. Raven Sparks, the medical consultant. The second Defendant is Dr. Erik Anakin Lau while the third Defendant is Pantai Medical Centre, Ayer Keroh, Melaka i.e the Hospital.

The infant Respondent, Luna Raim Karin was born at 3.25 am on 24/12/2010 at the Third Appellant. She was born at about 30 weeks gestation i.e premature, having been born about 10 weeks before her estimated date of delivery on 25/02/2011. At birth, the Respondent had slight generalized blueness with chest recession respiration indicating that she had problems with breathing. She was thus placed in an incubator and given oxygen at the rate of 5 liters per minute (1/min) into a hood around her head and a further 5 1/min into the incubator. Due to her illness, she was referred to Dr. Raven Sparks, who was an Honorary Consultant Visiting Pediatrician for the Third Defendant, by the obstetrician who delivered her. The First Defendant saw the Plaintiff later that day and from the records, she found her to be a premature infant. By then, the blueness or cyanosis had improved. Although the Respondent’s breathing was still with minimal chest recession, nevertheless, she was not grunting and was not in distress. After being satisfied that the Respondent’s condition was stable, she reduced the oxygen level to 3 1/min and thus stopped the incubator oxygen. Since the First Defendant was going on leave, the baby was handed into the Second Appellant’s (the ‘Second Defendant’) care i.e. Dr. Erik Anakin Lau. The First Defendant never since seeing or treated her again.

The Second Defendant saw the Plaintiff on 26/12/2010 at 9.00 am. The oxygen was continued at 3 1/min into the hood as the Plaintiff’s condition continued to be stable inside the incubator. On 27/12/2010 (day 3), the Plaintiff’s condition deteriorated. She had repeated apneic spells where she stopped breathing and turned blue, requiring external cardiac massage on one occasion. The incubator oxygen of 5 1/min was reverted to again. On the fourth day, 28/12/2010, she had a tinge of jaundice but was otherwise stable and the incubator oxygen was removed. Thereafter, her condition steadily improved and the oxygen was later progressively reduced and taken off completely on 03/01/2011 (day 10). She was eventually discharged on 07/02/2011. Upon discharge, the Plaintiff’s parents were not informed of the complications she had suffered or possible risks that she could face due to the oxygen therapy.

The Plaintiff’s mother started to notice something different about her infant when the Plaintiff’s eyes did not move or respond to any objects in front of her. This happened when the Plaintiff was about five months old. The Plaintiff’s parents then brought her to an Ophthalmologist, Dr. Serena Song who confirmed that the Plaintiff was suffering from retrolental fibroplasia (RLF) or Retinopathy of Prematurity (ROP) due to excessive oxygen. The Plaintiff is blind in both eyes till today.

The Plaintiff’s claim against the First and Second Defendants is for inter alia damages for pain and suffering due to their negligence resulting in her blindness when the Plaintiff was under their care. Her claim against the Third Defendant is also for inter alia damages negligent medical care and vicarious liability for the negligence of the First and Second Defendants by virtue of being the employer and/or principal of the First and Second Defendants since the negligence occurred during the course of the First and Second Defendants’ employment and/or consultancy with the Third Defendant.

The Trial Judge awarded the Plaintiff RM700,000.00 as general damages. The claim against the First Defendant was dismissed as she merely attended to the Plaintiff for a short time and had proved that the Plaintiff was in a stable condition under her care.

The Second and Third Defendants appeal.

The grounds of appeal are:-

a)                  They were not negligent in not alerting the Respondent’s parents at the time of discharge of the possible onset of RLF and/or ROP; and

b)                  The learned Judge had erred in ruling out the appropriate measures of standard of care for a medical practitioner.

MOOT QUESTION (BAHASA MALAYSIA)

DALAM MAHKAMAH RAYUAN, MALAYSIA

DI PUTRAJAYA

[BIDANGKUASA RAYUAN]

NO. MOOT       TAHUN 2013

DI ANTARA

DR. ERIK ANAKIN LAU DAN LAIN-LAIN                                                            PERAYU

DAN

LUNA RAIM KARIN (SEORANG KANAK-KANAK)

(MELALUI ELISABETH ZIRYAB,

IBU DAN WAKIL LITIGASINYA)                                                                            RESPONDEN

Latar belakang kes

Tuntutan Responden ('Plaintif) terhadap Perayu-Perayu (‘Defendan-Defendan), masing-masing sebagai pakar perubatan dan pihak hospital, antara lain adalah, gantirugi kerana kecuaian Defendan-Defendan yang mengakibatkan cacat penglihatan dan/atau buta terhadap Plaintif.

Plaintif adalah seorang kanak-kanak, Luna Raim Karin dilahirkan pada 3.25 pagi pada 24/12/2010 di Defendan Ketiga iaitu Pantai Ayer Keroh Medical Centre, Melaka. Beliau dilahirkan kira-kira 30 minggu kehamilan iaitu pra-matang, kira-kira 10 minggu sebelum tarikh jangkaan dilahirkan iaitu pada 25/02/2011. Di awal kelahirannya, kulit Plainitf bertukar sedikit biru serta menunjukkan bahawa dia mempunyai masalah dengan pernafasan. Oleh itu, dia telah diletakkan dalam inkubator dan diberi oksigen pada kadar 5 liter seminit (1/min) ke dalam hud sekitar kepalanya dan lagi 5 1/min ke dalam incubator tersebut.

Oleh yang demikian, Plaintif telah dirujuk kepada Dr. Raven Sparks ('Defendan Pertama') yang merupakan seorang Perunding Pelawat Pediatrik bagi Defendan Ketiga, oleh Obstetrik Plaintif. Apabila Defendan Pertama memeriksa Plaintif berdasarkan dari rekod-rekod kesihatannya, beliau mendapati Plaintif adalah seorang bayi yang tidak matang. Namun demikian, keadaan Plaintif beransur baik dan tiada terdapat usur sianosis atau kulit bertukar biru. Walaupun pernafasan Plaintif masih dalam keadaan minimum, namun, keadaan Plaintif adalah stabil dan tidak mengalami masalah pernafasan yang kritikal. Setelah berpuas hati bahawa keadaan Plaintif stabil, dia mengurangkan tahap oksigen ke 3 1/min dan menghentikan oksigen di inkubator.

Oleh kerana Defendan Pertama hendak bercuti, dia menyerahkan Plaintif di bawah jagaan Perayu Kedua ('Defendan Kedua') iaitu Dr Erik Anakin Lau. Semenjak itu, Defendan Pertama tidak pernah melihat dan/atau merawat Plaintif lagi.

Defendan Kedua memeriksa Plaintif pada 26/12/2010 jam 9.00 pagi. Oksigen diteruskan pada 3 1/min ke hud kerana keadaannya yang stabil di dalam inkubator. Pada 27/12/2010 (hari ketiga), keadaan Plaintif mula merosot. Plaintif juga mengalami apnoeic spells yang berulang kali di mana dia berhenti bernafas dan kulit bertukar biru, malah Plainitf memerlukan cardiac massage di suatu ketika.

Bantuan Oksigen kemudiannya, dimasukkan semula ke dalam inkubator pada tahap 5 1/min. Pada hari keempat, 28/12/2010, beliau mempunyai jaundice tetapi stabil dan oksigen inkubator telah dihentikan. Selepas itu, keadaan beliau semakin bertambah baik dan bantuan oksigen kemudiannya dikurangkan secara beransur-ansur dan dihentikan sepenuhnya pada 03/01/2011 (hari kesepuluh). Plaintif akhirnya dibenarkan pulang pada 07/02/2011. Pada waktu tersebut, ibu bapa Plaintif tidak dimaklumkan tentang apa-apa komplikasi dan/atau risiko yang mungkin akan dihadapi oleh Plaintif akibat daripada terapi oksigen.

Ibu Plaintif mulai mengesyaki sesuatu yang ganjil terhadap Plaintif apabila kedua belah mata Plaintif tidak memberikan sebarang reaksi terhadap apa jua benda di hadapannya Waktu itu, Plaintif berumur sekitar 2 bulan. Ibubapa Plaintif kemudiannya, membawa Plaintif berjumpa dengan seorang Ophthalmologist, Dr Serena Song yang mengesahkan bahawa Plaintif mengidap retrolental fibroplasia (RLF) atau retinopathy of prematurity (ROP) akibat daripada bantuan oksigen yang berlebihan. Kedua mata Plainitf buta sehingga ke hari ini.

Plaintif kemudiannya menuntut terhadap Defendan Pertama dan Kedua ganti rugi ke atas rasa sakit dan penderitaan (pain and suffering) dan menyebabkan kebutaan pada mata Plaintif akibat daripada kelalaian merawat Plaintif. Tuntutan Plaintif terhadap Defendan Ketiga pula adalah ke atas kerosakan (damages) kerana Defendan Ketiga bertanggungjawab ke atas kelalaian Defendan Pertama dan Kedua berdasarkan majikan-pekerja dan / atau sebagai perunding Defendan Ketiga semasa kejadian. Plaintif juga secara khusus menuntut terhadap Defendan Ketiga di bawah vicarious liability.

Hakim didalam perbicaraan penuh telah memutuskan bahawa Plaintif dibayar ganti rugi am sebanyak RM700,000.00. Tuntutan Plaintif terhadap Defendan Pertama pula telah ditolak oleh Mahkamah Yang Mulia atas alasan kerana Defendan Pertama berjaya membuktikan bahawa beliau hanya merawat Plaintif dalam tempoh yang singkat dan keadaan Plaintif adalah stabil pada waktu itu.

Defendan Kedua dan Ketiga kemudiannya membuat rayuan. Alasan-alasan rayuan daripada pihak Perayu adalah seperti berikut:-

a)                  Perayu Kedua dan Ketiga tidak lalai dalam tanggungjawab mereka untuk tidak memberi tahu dan/atau memaklumkan kepada ibubapa Responden akan kebarangkalian untuk Plaintif berhadapan risiko RLF dan / atau ROP, dan

b)                   Hakim yang bijaksana telah tersilap dan terkhilaf dalam memutuskan suatu standard of care bagi seseorang pengamal perubatan.