IMH said there were no red flags of imminent risk of suicide on Sept 6, 2017, the day before the man took his own life. - LIANHE ZAOBAO FILE
SINGAPORE (The Straits Times/Asia News Network): In a lawsuit seeking an estimated S$3.3 million in damages, the parents of a 31-year-old man who took his own life have accused two psychiatrists of being negligent in treating their son, which they say led to his suicide.
Steven Joseph Arokiasamy, 67, and Tan Kin Tee, 66, are suing Dr Nelson Lee, a psychiatrist in private practice, and the Institute of Mental Health (IMH) for the actions of its senior consultant, Dr Gomathinayagam Kandasami.
Their older son, Salvin Foster Steven, who had a long and complex psychiatric history, fell to his death from his bedroom window on Sept 7, 2017.
They alleged that Dr Lee failed to diagnose their son with schizophrenia, and that both doctors wrongfully prescribed Concerta, a drug used to treat attention deficit hyperactivity disorder (ADHD), to him at inappropriate doses.
They accused the two doctors of failing to prescribe adequate doses of anti-psychotic medication to Salvin.
They also blamed Dr Kandasami for failing to admit Salvin for observation on Sept 6, 2017 – a day before his suicide – after they took their son, who had been acting erratically in recent weeks, to see the psychiatrist.
Steven and Tan, who are separately represented by V. K. Rai and Anil Balchandani, contended that as a result of Salvin’s death, they both suffered from persistent complex bereavement disorder and could no longer work. Thus, Tan, who left her job as a school counsellor in 2019, and Steven, who left his job in the civil service in 2020, suffered a reduction in income.
The suit was heard in the High Court on Thursday. (Jan 12).The trial has been adjourned to September.
Dr Lee, who practises at The Psychological Wellness Centre, treated Salvin between November 2011 and July 2016. He diagnosed Salvin with bipolar disorder and ADHD, and prescribed Concerta from April 2012.
Steven and Tan said their son developed a dependence on the drug, but Dr Lee continued to prescribe Concerta and did not advise Salvin against taking more than the prescribed dose.
They said Salvin began showing symptoms of psychosis, such as hearing voices or believing that people were plotting against him.
In May 2015, after being charged with the assault of two police officers, Salvin was remanded at IMH and diagnosed with paranoid schizophrenia.
He was returned to Dr Lee’s care in June 2015. Steven and Tan alleged that, despite being provided with the diagnosis, Dr Lee continued to prescribe Concerta to Salvin and did nothing to prevent him from overdosing.
Dr Kandasami took over Salvin’s care in August 2016, after he was sentenced to a one-year mandatory treatment order for the assault. The couple alleged that Dr Kandasami did nothing to prevent Salvin from overdosing on Concerta and ignored his psychotic symptoms.
Dr Lee, who is represented by Jansen Aw, said his diagnosis of ADHD and bipolar disorder was reasonable in the light of the symptoms and medical history.
There was a lack of overt and persistent psychotic symptoms supporting a diagnosis of schizophrenia, he said.
Dr Lee said Mr Salvin showed improvements when he was on Concerta and, for the first time in many years, managed to get a job in a warehouse in July 2015.
IMH, which is represented by Senior Counsel Kuah Boon Theng, said Dr Kandasami’s care and treatment of Salvin was appropriate. Salvin’s response to medication was closely monitored during his mandatory treatment, and he did not show signs of psychosis, it said.
IMH said there were no red flags of imminent risk of suicide on Sept 6, 2017.
It disagreed with the couple’s assertion that Salvin’s death was caused by psychosis, noting that the coroner had found his fall to be a “deliberate act of suicide”.
“The plaintiffs are understandably devastated, and IMH empathises with them for their loss. However, the deceased’s unfortunate demise was not the result of any negligence on the part of IMH and its doctors or staff,” said Kuah in her opening statement.
