'Syed Alman Zain aware of risk when opting for general anaesthetic'

A former dental surgery assistant at Imperial Dental Specialist Centre Sdn Bhd, Noor Azima Mohd Nuwi, 26, said Syed Alman Zain went to the clinic on May 26 last year because his wisdom tooth was aching.

She said an orthopantomogram was conducted on Syed Alman Zain to determine the cause of the pain and the result of the x-ray found that the tooth had to be extracted.

"From the x-ray itu, Dr Arlena Phillips Lee (who conducted the surgery on Syed Alman Zain) told him that the wisdom tooth had to be extracted. Otherwise, it would affect other teeth and he would be in more pain," she said during examination-in-chief by deputy public prosecutor Nadia Zulkefli in the trial in which the clinic is facing nine counts relating to Syed Alman Zain's death.

Noor Azima, who is the 10th prosecution witness, was responsible for assisting the doctor in the surgery room, including in preparing the necessary equipment for the surgery.

Noor Azima also told the court that the deputy prime minister's son-in-law did ask on the procedures involved in for his tooth to be extracted and was told that he had an option to either be given an injection of the anaesthetic on the gum or surgery by general anaesthetic, whereby he would be unconscious throughout the surgey.

She said for both procedures, the patient would be required to take a pain killer tablet of either 'arcoxia' or 'ponstan' as well as 'augmentin', which is an antibiotic.

"Dr Arlena explained that of the surgery is done using general anaesthetic, the clinic will call an anaesthetist from Kuala Lumpur Hospital (HKL) and Dr Arlena also said that if it is general anaesthetic, there is a risk of the patient taking some time to regain consciousness.

"After hearing the explanation, the patient (Syed Alman Zain) opted to have the surgery done using general anaesthetic," she said.

Following which, she said, Syed Alman Zain then made an appointment for the surgery to be done on June 4, 2016, but for reason unknown, carried forward to June 1, 2016.

Noor Azima, who is now with Klinik Pergigian Dentistree at Sunway Nexis, said Syed Alman Zain came for the appointment on June 1 at 5.30pm.

She said besides Dr Arlena, there was another doctor, an anaesthetist known as Dr Ting (Dr Ting Teck Chin) in the surgery room with Syed Alman Zain.

Questioned by Nadia whether she knew Dr Ting and how did she know that Dr Ting was the specialist anaesthetic for Syed Alman Zain, Noor Azima said she had seen Dr Ting conducting the procedure (anaesthetic) on patients.

"I also used to ask my colleagues and they told me that Dr Ting is an anaesthetist from HKL and normally the one to conduct the anaesthesia at Imperial was Dr Ting," she said.

On Aug 12 last year, the company represented by company director Datin Dr Wong Yen Ling claimed trial to nine charges in connection with Syed Alman Zain's death.

Dr Wong, as licence holder, was charged with, among others, failing to ensure that Dr Ting Teck Chin, who administered anaesthesia to Syed Alman Zain, had the qualification to do so.

The clinic is also accused of failing to ensure that the individuals it engaged to perform orthopantomogram, anaesthesia and IV sedation on Syed Alman Zain had the necessary qualifications.

It is also accused of failing to put in place, life-saving measures by not providing oxygen as a basic emergency care service as well as failing to submit to University Malaya Medical Centre, a copy of all of Syed Alman Zain's medical records when he was transferred there.

The clinic is also charged with failing to keep and maintain a staff register record, adhere to medicine labelling regulations and take adequate measures to protect its professional healthcare and environment staff from biological hazards.

The offences were allegedly committed at the dental specialist centre located at Lot 62 & 64, Jalan Telawi, Bangsar Baru, Kuala Lumpur.

Seven of the charges are under Section 31(4), 39(2), 40(4) and 117(2)(b)(i) of the Private Healthcare Facilities and Services Act 1998, which provides for a fine of between RM30,000 and RM300,000, upon conviction.

The other two charges are under Regulation 49(7) and 245(6) of the Private Healthcare Facilities and Services (Private Hospitals and Other Private Healthcare Facilities) Regulations 2006, which carry a fine of up to RM10,000 or three months imprisonment or both, on conviction.

Lawyer P. Sreekant represented Dr Wong on behalf of the dental centre.