A court recently sentenced a female doctor 10 months in prison and ordered to arrest her immediately after the verdict for causing a patient’s death by administering a colon cleanser without knowing the patient had a bowel blockage.

The medical community expressed shock over the ruling, saying the patient’s death occurred unintentionally despite the doctor’s best effort to save the patient’s life.

Doctors argued that such a strong punishment on the inevitable mishap would hurt patients’ trust in clinicians, and physicians will leave the field if the law does not protect their clinical judgment.

Physicians are campaigning to submit a petition to persuade the court to release her on bail, and the Korean Medical Association is staging rallies to protest the arrest.

Doctor sentenced to 10 months in prison, another doctor, 2-year probation

On Sept. 10, the Seoul Central District Court sentenced then clinical assistant professor to 10 months in prison and ordered to arrest her immediately after the ruling on charges of negligence in duty. Another doctor, then a trainee physician who was also indicted, received two years of probation on 10-month imprisonment.

On June 24, 2016, an 82-year-old male patient underwent abdominal X-ray and CT scans at a hospital where the clinical assistant professor and the trainee doctor worked. The results of the medical exams indicated the patient might have had an “ascending colon tumor invading the ileocecal valve,” “paralytic bowel obstruction,” and “expansion of the small intestine due to the obstruction of the ileocecal valve.”

The clinical assistant professor, who was the attending doctor for the patient, decided to perform a colonoscopy to check for colon cancer. On the morning of June 26, the trainee doctor examined the patients, received the attending doctor’s approval, and administered the colon cleanser in the evening and the next morning.

However, the patient had multiple organ failure within a day and died eventually.

Physicians should be careful in administering a bowel cleansing agent to the elderly and the weak. If the cleanser is administered to a patient with bowel blockage, the intestinal pressure will rise, resulting in fatal side effects such as ruptured bowel.

The attending doctor appealed at the court that she did not cause any error in administering the colon cleanser, but the court refused to accept the doctor’s claim and sentenced her to imprisonment.

The court said the sentence was lighter than expected because it considered that the doctor did not have a criminal record.

However, the doctor’s error was not light, and the consequence that led to the patient’s death was grave, the court said.

“The doctor claimed that she tried to offer compensation for damage, but the bereaved family refused to agree on it. But in light of the proceedings of the lawsuit, her effort cannot be taken as a matter of consideration or equivalent to the compensation for damage,” the court said.

Doctors stage rally in front of detention center to protest arrest

The jail-term sentence and the arrest of the doctor met with the medical community’s backlash.

The KMA, a group of some 130,000 doctors, strongly condemned the court’s judgment and held an all-night, one-person demonstration in front of the Seoul Detention Center on Sept. 14.

At the rally, KMA President Choi Dae-zip said despite the various controversies over the doctor's medical treatment, the medical community was furious that the court ordered the arrest because of the “risk of fleeing.”

No one among the 130,000 doctors can accept this decision, he said.

Choi went on to say that medical practices based on good faith are not usually subject to criminal penalties.

“Medical communities in advanced countries have already built consensus on this. But in Korea, it has not been introduced yet, and these outdated events continue to occur,” he said.

He vowed to do everything he could to help the doctor get acquitted and released.

“The KMA does not accept this wrong ruling and will make every effort to get the doctor acquitted and released. I want her to know that numerous doctors are willing to 'support her until the end,'” he said.

Doctors to submit petition to court to release her on bail

Then trainee physician, who was indicted together with the arrested clinical assistant professor, was reportedly encouraging other doctors to submit a petition to the court to release the doctor on bail.

According to the defendant doctor, the medical lawsuit has been ongoing since he worked as a trainee doctor at the hospital in Gangnam, southern Seoul, in 2016.

He explained that the medical staff administered the bowel cleansing agent to the 82-year-old male patient who seemed to have a cerebral infarction caused by cancer.

The doctors suspected intestinal obstruction and colon cancer on CT scans.

However, the patient continued to have diarrhea, which would not occur in bowel blockage. The doctors administered the colon cleanser, but the patient had bowel perforation and eventually died due to disseminated intravascular coagulation (DIC).

There is still plenty of controversies over the doctor’s treatment, and the sentence has not been confirmed yet, the then-trainee physician said.

Also, the arrested doctor has been working as a university professor for a long time, giving no risk of escaping, he added.

“It is extremely harsh to arrest the doctor and prevent her from continuing her daily life,” he said.

The then-trainee physician said he would apply for bail of the doctor and a petition to the court. An increasing number of colleague doctors are joining the petition.

Roh Hwan-kyu, former president of the KMA, posted the petition letter on his Facebook page.

“The process in which a doctor makes a diagnosis, decides a treatment, and execute treatment is a process where the doctor finds the best way to save the patient’s life,” Roh wrote.

Suppose a doctor faces a stern criminal punishment just because a consequential error occurred in the process. In that case, the doctor will not use the best treatment to save the patient but rather choose the minimal and defensive treatment, he added.