By MELISSA PANG

ONE woman has died and two oth-ers fell ill after taking traditionalherbal drugs from Indonesia andMalaysia.

Now, the Health Sciences Au-thority (HSA) has warned anyonetaking a drug named Flutulang tostop immediately, and alertedthose using two other drugs thatthey could be at risk from takingthem.

The advice comes after thewoman in her 70s died last monthafter suffering a serious adversereaction to an ingredient found inFlutulang.

This same ingredient had previ-ously caused her a serious skinrash in 2006.

Not knowing that the herbalremedy contained the ingredient,she started taking Flutulang in Au-gust.

Her son had bought it inIndonesia for her muscle ache.

The Malay woman developed asimilar rash on her neck andthighs, which progressed to toxicepidermal necrolysis – a life-threatening skin reaction charac-terised by widespread blisteringor peeling of the skin due to sepa-ration of the skin’s top layer fromits lower layers.

Another undisclosed ingredientfound in Flutulang is chlorphe-niramine, a type of antihistamine.Unsupervised use of the drug cancause side effects such as drowsi-ness, confusion and urinary reten-tion.

The HSA also warned againsttwo other adulterated health prod-ucts that each caused adverse ef-fects in a woman in her 50s and aman in his 70s.

Kapsul Gaut (Asam Urat) andTrue ProLife Vegrow were market-ed as traditional herbal remedies,but contained undeclared West-ern drugs.

Kapsul Gaut (Asam Urat) con-

tains a potent steroid called dex-amethasone. Those who stop tak-ing steroids suddenly are at risk ofsteroid withdrawal symptoms.

A Malay woman in her 50s hadbeen taking Kapsul Gaut (AsamUrat), bought in Malaysia, for hergout problem.

When she stopped taking it af-ter four months, she experiencedweakness, aches and pains, diar-rhoea and vomiting.

The woman, who has since re-covered, was treated with a taper-ing course of steroids to wean heroff her dependence on the drugs.

Because of the possibility ofsuch withdrawal symptoms, theHSA is advising those on KapsulGaut (Asam Urat) to see a doctorstraightaway.

In the third case, a Malay manin his 70s developed giddiness,headache, backache and shortnessof breath after taking True ProLifeVegrow for three days.

The product contained a chemi-cal similar to sildenafil, the malesexual enhancement drug.

The man recovered after a doc-tor advised him to stop taking thedrug.

An HSA spokesman said it hadreceived 46 adverse drug reactionreports associated with adulterat-ed products from January lastyear to last month. These prod-ucts were labelled as traditionalherbal medicine. Two people died.

She added that traditional medi-cine is not subject to pre-marketlicensing controls before beingsold here. Local traditional medi-cine dealers are fully responsiblefor the safety and quality of theproducts that they import, sell ormanufacture.

Dr Bernard Thong Yu Hor,head of Tan Tock Seng Hospital’srheumatology, allergy and immu-nology department, said sideeffects may not be limited to skinrashes, but could involve theorgans too.

melpang@sph.com.sg

By SALMA KHALIKHEALTH CORRESPONDENT

IN AN unprecedented move, theCourt of Appeal has asked the Sin-gapore Medical Council (SMC) torelook a case before the court, inthe light of a judgment given lastmonth in a similar case.

In the current case, aestheticdoctor Georgia Lee is appealingagainst paying the full cost of anSMC disciplinary committee hear-ing, which found her guilty ofthree of six charges of practisingnon-evidence-based aestheticprocedures.

Her appeal follows that of aes-thetic doctor Low Chai Ling, whohad also been found guilty by thecouncil of providing similar treat-ments.

Last month, the Court ofAppeal threw out the case againstDr Low, who appealed againstthe verdict itself.

On Tuesday, Senior CounselTan Chee Meng for the SMC andMs Kuah Boon Theng for Dr Leemet Judge of Appeal V. K. Rajahin chambers. Counsel will appearbefore the court again on Oct 22after consulting their clients.

Veteran lawyer Myint Soe,who represented Dr Low and hasbeen dealing with medical litiga-tion here for more than 30 years,told The Straits Times that theappeal court’s action in askingthe SMC to review a case is high-ly unusual.

“In my experience, it hasn’thappened before. This is anextraordinary situation,” he said.

Last December, the SMCfound both doctors guilty of pro-fessional misconduct.

They were fined the maximum$10,000, censured and asked togive an undertaking not to repeat

the offence.Dr Low, found guilty of five of

seven charges, was told to pay80 per cent of the cost of theSMC hearing, while Dr Lee wasordered to pay the full cost.

Last month, the Court ofAppeal, comprising Justice Rajahas well as Chief Justice Chan SekKeong and Judge of AppealAndrew Phang, threw out thecase against Dr Low.

The judges accepted that thefive procedures Dr Low wasfound guilty of – mesotherapy,mesoglow, stem cell extract facialtherapy, sonophoresis and carbox-ytherapy – had plainly not metthe standards of evidence-basedmedicine (EBM), which meansthey had not been proventhrough large-scale clinical trials.

They also said the SMC disci-plinary committee had been rightin rejecting Dr Low’s argumentthat a medical treatment was“generally accepted” if widelypractised by a large number ofdoctors.

“The assessment of whetheror not a particular medical treat-ment is generally accepted mustbe scientific rather than empiri-cal. Illegitimate or unethical prac-tices are not legitimised merelybecause large numbers of doctorsengage in them,” said JusticeRajah in the court’s written judg-ment.

However, he found it “puz-zling” that the SMC took a differ-ent approach from that of itsexpert witness, by “flatly con-demning any treatment thatfailed to meet the exactingrequirements of EBM”.

He also said it was not possi-ble to find Dr Low guilty of proce-dures performed in 2007, beforeguidelines were spelt out in 2008.

And he found the SMC unjust forsingling out doctors to prosecutewhen many were offering similartreatments.

The court also criticised theSMC for apparently not knowingwhat exactly it was prosecutingDr Low for.

This is because in the midst ofthe disciplinary hearing, Dr Lowwas told that she was being prose-cuted because, unlike other doc-tors, she had not stopped provid-

ing the treatments upon receivinga letter from the Ministry ofHealth.

Justice Rajah pointed out thather seemingly wilful behaviourwas not the subject of the prose-cution, and he described the disci-plinary hearing as “legally embar-rassing”.

Asked what its next stepswould be, the SMC told TheStraits Times this week: “SMCrespectfully notes the issues

raised in the Court of Appeal’sjudgment and will need time tocarefully study the issues whichhave been put forth, before com-menting further.”

The complainant in both caseswas the Ministry of Health.

When asked why it had singledout Dr Low and Dr Lee, a minis-try spokesman told The StraitsTimes: “Where appropriate,MOH may refer to the SMC infor-mation that has come to its atten-tion about possible professionalmisconduct by doctors, and thismay lead to the SMC taking pro-fessional disciplinary action.”

He said the same happenswhen a complaint is lodged by amember of the public.

He added that the ministry’sinterest lay in protecting the safe-ty and health of the public andensuring that all doctors and reg-istered health-care practitionersmaintain high professional stand-ards at all times.

salma@sph.com.sgwww.facebook.com/ST.Salma

Flutulang is packaged as a sachet of five different tablets. A woman in her 70sdied last month after taking it. PHOTO: HEALTH SCIENCES AUTHORITY

ACTING ON INFORMATION

Where appropriate,MOH may refer to theSMC information thathas come to its attentionabout possibleprofessional misconductby doctors, and this maylead to the SMC takingprofessional disciplinaryaction.– Spokesman for the Ministry ofHealth, the complainant in bothcases, one against Dr Low ChaiLing and the other, Dr Georgia Lee

By YASMINE YAHYA

FOUR journalists from SingaporePress Holdings (SPH) have won fi-nancial journalist awards fortheir work over the past year.

Ms Emilyn Yap, a correspond-ent at The Business Times (BT),was named Financial Journalistof the Year at the annual Securi-ties Investors Association of Sin-gapore (Sias) Investors ChoiceAwards last night at Raffles City.

Her BT colleague, Ms GraceLeong, won the Financial Storyof the Year prize for breaking thenews about a group of retailinvestors suing investment bankMorgan Stanley over a failedfinancial product known as Pinna-

cle Notes.Straits Times journalist Jonath-

an Kwok was named PromisingJournalist of the Year.

Mr Kwok, 28, has written on awide range of corporate news forthe Money desk in the past year,most recently, on the twists andturns of Heineken’s buyout ofAsia Pacific Breweries from Fras-er & Neave.

“I’m thankful to have been giv-en the chance to cover some ofthe most exciting stories in thecorporate scene,” he said.

“It’s a huge honour to receivethis award from Sias. I’ll contin-ue to put my best foot forward inmy work.”

Senior Business Times corre-

spondent Sivanithy Rathanan-than received an award for out-standing commentaries.

SPH itself received the MostTransparent Company Awardamong firms in the “services” cat-egory.

SPH chief executive AlanChan said: “SPH is guided by thetenets of best practices in corpo-rate governance and transparen-cy in our engagement with inves-tors.

“By adhering to a high stand-ard, we help our investors gain agood understanding of our com-pany’s operations and strategiesand in the process, earn theirtrust and support.”

yasminey@sph.com.sg

Two others fall ill after consumingtraditional remedies; HSA issues alert

Dr Georgia Lee is appealing against paying the full cost of an SMC disciplinaryhearing, which found her guilty of professional misconduct. TNP FILE PHOTO

From left: Mr Sivanithy Rathananthanand Ms Grace Leong from TheBusiness Times, Mr Jonathan Kwokfrom The Straits Times and Ms EmilynYap from The Business Times.

ST PHOTO: CHEW SENG KIM

Unusual move after court threw outsimilar case against another doctor

SPH journalists bag awards

Woman dies aftertaking herbal drug

Court tells SMC to relookcase against aesthetic doctor

KEEPING STANDARDS HIGH

SPH is guided by the tenets ofbest practices in corporategovernance and transparency inour engagement with investors.By adhering to a high standard,we help our investors gain agood understanding of ourcompany’s operations andstrategies and in the process,earn their trust and support.

– SPH chief executive Alan Chan, onreceiving the Most TransparentCompany Award among firms in the“services” category

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