BRIEF FACTS:

• The Plaintiff, Adam Bin Hamil (‘Adam’) was then a hairstylist. The Defendant, Dr Chiam Tee Kiang, (‘Dr Chiam’) was an aesthetic physician at Gorgeous Clinic (‘the Clinic’).
  
  
• On 20.5.2021, Adam met with Dr Chiam at the Clinic to enhance his nasal appearance.
  
  
• After Dr Chiam physically examined Adam, Dr Chiam advised him to remove the nose implant. This is because Dr Chiam found that there was an impending nose-tip rupture which may lead to an infection.
  
  
• Before this consultation, Adam has had 5 separate rhinoplasty procedures in Thailand.
  
  
• However, Adam refused and wanted to do an implant-trimming procedure.
  
  
• On 21.5.2021, the implant trimming procedure was conducted using an ear cartilage graft. The surgery went on for 4 hours.
  
  
• On 28.5.2021, the sutures were removed by Dr Chiam.
  
  
• On 31.5.2021, Adam communicated with the Clinic that he was experiencing swelling. The Clinic informed him that swelling after surgery was normal.
  
  
• On 4.6.2021, Adam went to meet Dr Chiam who informed him that swelling is normal and there was no sign of infection. On 22.6.2021, Adam came to the Clinic for a follow-up consultation.
  
  
• On 30.6.2021, Dr Chiam found there was minimal puss discharge from Adam’s nose. Adam was prescribed intravenous antibiotics. Dr Chiam once again advised Adam to remove his nose implant.
  
  
• On 13.7.2021, Adam came to the Clinic complaining of swelling at the nose tip but there was no pain or pus. Dr Chiam explained that if the nose implant is not removed, the infection would persist. Adam instead wanted to do another implant trimming.
  
  
• On 21.7.2021, the second implant-trimming surgical procedure was performed by Dr Chiam.
  
  
• On 28.7.2021 and 29.7.2021, Adam sent pictures to the Clinic’s WhatsApp of his nose. The Clinic informed him that they will treat it after the post-surgical swell goes down.
  
  
• Adam went to seek medical assistance from one Dr Nasir from another centre who advised him to remove the nose implant.
  
  
• On 23.12.2021, Adam eventually went through the corrective surgery.
  
  
• Adam is claiming that Dr Chiam was negligent in his treatment.

THE DECISION OF THE HIGH COURT (HC)

• Firstly, the HC looked toward Dr Chiam’s qualifications and license to determine the standard of care towards Adam. Here, Dr Chiam possessed a license under Chapter 1 of the Guidelines on Aesthetic Medical Practice.
  
  
• Dr Nazir testified that any procedure that requires a breach of skin level becomes a surgery, categorised as invasive. This kind of surgery can only be performed by someone with a license under Chapter 2 or 3.
  
  
• Therefore, the trimming of the nose implant with ear cartilage grafting performed on Adam by Dr Chiam was not within the scope of Chapter 1.
  
  
• Secondly, the HC found that the fact that Adam had persisted in nose implant trimming did not negate Dr Chiam’s breach of duty.
  
  
• This is because Dr Chiam failed to disclose the limitations of his license, preventing Adam from making an informed choice.
  
  
• Dr Chiam had also breached the medical code of ethics by proceeding with the surgery which he was not licensed for.
  
  
• Thirdly, the HC noted that medical practitioners must not perform procedures beyond their qualifications and licensing, regardless of their confidence in their ability to do so.
  
  
• Finally, the HC awarded general, special, and exemplary damages to Adam.
  
  
• Exemplary damages were awarded as a reminder and deterrence for beauty clinics nationwide to not proceed to administer or perform procedures beyond the limit allowed by their license.