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Following is a question by the Hon Emily Lau and a written reply by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, in the Legislative Council today (May 28):
Question :
It has been reported that a five-year-old boy, suspected of being infected with the Severe Acute Respiratory Syndrome ("SARS"), was admitted to Queen Mary Hospital ("QMH") on April 3. During the whole period of his stay in hospital, he was treated as a SARS patient. The boy died afterwards and the cause of his death as stated in the death certificate was "atypical pneumonia (Severe Acute Respiratory Syndrome) and immunodeficiency". Subsequently, a staff member of QMH informed the boy's family that he had not died of SARS and sought their consent to delete from the boy's death certificate the reference to SARS. Meanwhile, the Department of Health has not counted this case as a fatality of SARS. In this connection, will the Executive Authorities inform this Council:
(a) of the exact cause of the boy's death;
(b) of the justifications for QMH's requesting to alter the cause of death of the boy, and whether this practice is unusual; and
(c) whether they have assessed if the Department of Health's not counting this case as a fatality of SARS was an deliberate act to cover up the position of the disease?
Reply :
(a) The patient in question died of atypical pneumonia and not of confirmed SARS.
(b) SARS is a new disease. At this stage, its diagnosis is still based on a host of clinical, epidemiological and exclusion criteria rather than a specific diagnostic test. It is recognised by the World Health Organisation that as SARS is currently a diagnosis of exclusion, the status of a reported case may change over time.
In the course of treatment, the patient was diagnosed by his attending physicians to be a probable case of SARS. SARS was therefore recorded as the cause of death on his death certificate. Para-mortem investigations conducted subsequently to learn more about the exact cause of death of the deceased however revealed that the result of lung biopsy, by both culture and electron microscopy, was negative for the SARS coronavirus. The patient's lung histology was also not supportive of a diagnosis of SARS. That apart, the patient could not be linked epidemiologically to any confirmed SARS cases. This piece of new information suggested that it was highly unlikely that SARS was the cause of death of the patient. The clinicians have therefore initiated a review of the reported status of the patient and concluded that he was not a probable case of SARS and should be denotified as such.
Normally the Hospital Authority (HA) would not seek an amendment to the death certificate. This is because the cause of death as recorded on the death certificate should be that determined by the attending physicians at the time of death. In this case, HA sought an amendment to the death certificate because it was the wish of the patient's parents to do so.
(c) Upon receipt of HA's notification of the said case as a SARS case, the Department of Health (DH) included the case in the list of patients suffering from SARS. Subsequently, HA informed DH that laboratory results for SARS for the said patient were negative and that on the basis of a review of the case, the Queen Mary Hospital (QMH) advised denotification of the patient as a probable case of SARS. Based on HA's advice, DH would remove the patient from the SARS patients list and the death of the boy was not recorded in the list on death of SARS patients.
End/Wednesday, May 28, 2003
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