SINGAPORE — A 32-year-old woman has sued her former obstetrician and gynaecologist over an injury she suffered during childbirth in 2020, alleging that his negligence had impacted her marital, social and professional life.

The woman is seeking unspecified damages from Dr Khoo Chong Kiat, who practises at CK Khoo Clinic for Women & Laparoscopy. She was working in the funeral business when she had her baby and is now a housewife. Her identity is not disclosed in this story for her privacy.

The trial opened in the High Court on Feb 4.

The woman, a first-time mother, had a healthy baby girl via vaginal birth on May 3, 2020.

Her medical negligence suit, filed in April 2023, levied a host of allegations against the doctor over his treatment of a tear in the tissue wall separating the vagina and the rectum that she suffered during childbirth.

The tear led to a rectovaginal fistula, an abnormal connection that allows bowel contents to pass through the vagina. It also caused inflammation and infection in the area.

The woman alleged that Dr Khoo did not tell her about the tear before he stitched her up in the delivery suite.

She alleged that he also did not inform her that she had the option of consulting a colorectal surgeon before he repaired the tear.

For many months after childbirth, she passed faecal matter through her vagina and period blood through her anus.

The woman also said she suffered postpartum depression and post-traumatic stress disorder, including mother-infant bonding difficulties.

She can no longer give birth naturally, and has "impaired libido and interference in her sexual life", she added.

She has also had a "change of perspective regarding children, affecting the enjoyment of children", as well as a change of personality and a change in her quality of life, she alleged.

Her lawyer, Cumara Kamalacumar, said in his opening statement that it will be shown at trial that the doctor's conduct had caused his client's injuries.

He added that the tear would not have occurred if Dr Khoo had carried out an emergency caesarean section.

But the defence lawyer, Senior Counsel Kuah Boon Theng, said the evidence will show that the medical care and treatment provided to the woman was at all times appropriate and consistent with acceptable standards of care.

The fact that the tear subsequently broke down and resulted in a fistula was not due to any negligence on the doctor's part, she said.

Kuah said Dr Khoo dealt with the tear appropriately, recognised the woman's symptoms when the repair broke down and, as a result of this, the woman was able to receive timely treatment from the appropriate specialists.

Each side is calling an obstetrics and gynaecology expert and a colorectal expert to testify for the trial.

The woman was admitted to Mount Elizabeth Novena Hospital just after midnight on May 2, 2020, to induce labour.

At about 9pm, her cervix had still barely dilated.

The woman said that after the doctor widened her cervix with his fingers, she went into labour and was transferred to the delivery suite.

At about 10pm, an anaesthesiologist administered an epidural to the woman.

At about 7.30am the next day, the woman was still dilated to only 4cm.

She told Dr Khoo via WhatsApp that her mother had encountered the same issue during her labour and had required an emergency caesarean section.

According to the woman, at around 9.20am, the doctor examined her and ordered the procedure, which she agreed to.

He disputes this, and said he only discussed the possibility of a caesarean section with her.

He said he only instructed the nurses to ask the anaesthetist to be on standby and to ensure that there was an available operating theatre.

The woman said that after a nurse left the delivery suite, Dr Khoo manually widened her cervix to 10cm.

She said that when the nurse returned, he told the nurse to cancel the emergency caesarean section and prepare the woman for vaginal delivery.

But Dr Khoo said he did not perform any act on the woman's cervix.

He left the delivery suite at around 10am, and a nurse then asked the woman to start pushing.

At about 10.30am, Dr Khoo returned to the suite, and the nurses told him that the baby was crowning.

The 3.12kg baby was delivered at about 10.35am.

According to Dr Khoo, he told the woman after delivery that there was a small tear that needed repair before he proceeded to stitch the 0.5cm "buttonhole" tear.

But the woman said she was not informed that she had sustained any injury and believed the stitching to be standard post-delivery routine.

She was discharged at about 11.30am on May 4 that year.

On the night of May 5, 2020, the woman sent a WhatsApp message to the doctor saying that she noticed some faecal discharge from her vagina. He asked her to go to his clinic the next day.

The next morning, he diagnosed the woman as having a rectovaginal fistula and referred her to a colorectal specialist.

The woman said that was the first time she was told she had suffered an injury during childbirth.

She said Dr Khoo told her that the rectovaginal fistula was caused by the baby's shoulder during the delivery. 

Her condition worsened that day.

At about 6pm, she went to the Singapore General Hospital's (SGH) accident and emergency department.

She was treated conservatively as repair of the fistula was not feasible due to inflammation and infection.

On Oct 28 the same year, the woman underwent repair surgery at SGH.

In her suit, she is claiming for, among other things, loss of future earnings and loss of earning capacity, future medical expenses, and punitive damages for Dr Khoo's "inexcusable" failure to immediately inform her of the tear and his "egregious" conduct to repair the tear without her informed consent.

This article was first published in The Straits Times. Permission required for reproduction.