I am pleased to present the annual report.

This year saw a negotiated court settlement in a medico-legal case involving a brain damaged child for RM3.25 million. This excluded legal fees and court costs. The last bench mark for a negotiated court settlement was RM2.5 million in year 2005. Court awards are now in the millions ringgit bracket. MDM Bhd foresee increasing medico-legal suits and corresponding increases in court awards.

There is an increasing frequency in incident reporting in high risk categories, but the highest is in Obstetrics and Gynaecology, especially in gynaecologists doing therapeutic laparoscopic surgery. Incidents reported include perforated gut, damaged ureter, lacerated urinary bladder and perforated major vessels. We do not see these incidents in abdominal surgeons performing therapeutic laparoscopic surgery. Are the gynaecologists involved taking greater risks or practising beyond the limits of their competence?

For year 2009, MDM Bhd will maintain the current subscription rate except for Obstetrics & Gynaecology which will have two categories. Obstetrics & Gynaecology with therapeutic laparoscopic surgery will have an annual subscription of RM27,020.00. Obstetrics & Gynaecology without therapeutic laparoscopic surgery will have an annual subscription of RM21,420.00. It will be difficult for MDM Bhd to maintain the current subscription rates in view of the trend in increasing court awards and negotiated settlements.

Members are also advised to immediately inform MDM of any medical mishap. You can be assured of prompt response and assistance. MDM’s early advice can help you defuse a potential adverse event. But members after contacting and receiving advice MUST also inform MDM of the outcome of such events. This will enable us to track whether any of these will eventually result in a legal suit.

Members are reminded not to directly contact MDM’s panel of advocates and solicitors when you have a medical mishap or an adverse event. The advocate and solicitor will not be able to advise you most of the time as the case requires clinical judgement and assessment. Members MUST contact MDM first whether it is an incident report, receiving a writ of summons, a letter of demand or notice to attend a Preliminary Investigation Committee hearing of the Malaysian Medical Council. Your informing MDM first will not preclude your choice of the advocate and solicitor on our panel.

The Malaysian Government and the private hospitals are actively promoting medical tourism. There is a definite and gradual increase in such patients being treated in the country. Such patients travel to Malaysia to seek specialized care which is not available in their country or it is cheaper here. MDM members have been cautioned in the past on the potential medico-legal complications that may arise. This was posted on our website, www.mdm.org.my on 10th Feb 2006.

MDM reemphasizes that members will be eligible for assistance regardless of the origin of the patient if the suit is filed in Malaysia.

Members will not be assisted if such foreign patient decides to pursue legal action in their home country.

This also applies to foreigners living in Malaysia.

Enclosed is a jurisdiction agreement for your information. It is advised that such medical tourist signs this agreement before commencement of treatment. With this agreement the patient is made aware of the situation.

Conversely an MDM member may wish to learn skills and techniques in another country. Your MDM membership covers only for practice done in Malaysia. Such members will have to subscribe for medical indemnity from a defence organisation or insurance company in that country where they will be practicing. You may approach MDM for such assistance.

The Private Healthcare Facilities and Services Act 1998 (PHFS Act 1998) and Regulations & Order 2006 have been enforced for 1½ years now. Many members are still not conversant with the Act & Regulations.

Members who are acting as Person-in-Charge, or as the Licence Holder of a medical centre, beware, for the responsibilities are heavy. When a License Holder or person-in-charge commits an offence he shall be liable upon conviction to a fine or imprisonment or both.

Happy New Year.

Tan Sri Dato Abu Bakar Suleiman
Chairman
Medical Defence Malaysia Berhad

Governing Law and Jurisdiction Agreement