How Do Medical Negligence Claims Work in Malaysia? | Bagaimana Tuntutan Kecuaian Perubatan Berjalan di Malaysia

By Muhammad Faiz bin Hasan, Advocate & Solicitor

Short answer: a medical negligence claim in Malaysia is a civil claim in the tort of negligence against a doctor, a hospital or both. You must prove four things: the doctor or hospital owed you a duty of care, they breached the standard of care expected of them, the breach caused your injury, and you suffered loss as a result. The claim is usually built on your medical records and the opinion of an independent medical expert, and it must be filed within the limitation period, which is shorter where a government hospital is involved.

The standard of care: what the courts apply

The Federal Court settled the test in Zulhasnimar bt Hasan Basri & Anor v Dr Kuppu Velumani P & Ors [2017] 5 MLJ 438:

• Diagnosis and treatment are judged by the Bolam test, as qualified by Bolitho. A doctor is not negligent if he acted in accordance with a practice accepted as proper by a responsible body of medical opinion, provided that opinion is capable of withstanding logical analysis.
• The duty to advise on risks is judged by the test in Rogers v Whitaker, adopted by the Federal Court in Foo Fio Na v Dr Soo Fook Mun & Anor [2007] 1 MLJ 593. A doctor must warn the patient of material risks, being risks to which a reasonable person in the patient's position would be likely to attach significance. Here the court, not medical opinion, decides whether the warning was adequate.

This position was affirmed by the Federal Court in Dr Hari Krishnan & Anor v Megat Noor Ishak bin Megat Ibrahim & Anor and another appeal [2018] 3 MLJ 281, which also recognised that aggravated damages may be awarded in appropriate cases.

Who can be sued?

• The doctor personally, for his own negligence.
• A private hospital, which is vicariously liable for the negligence of its employees. Whether it is also liable for an independent consultant depends on the facts; the Federal Court considered the doctrine of non-delegable duty in Dr Kok Choong Seng & Anor v Soo Cheng Lin [2017] 10 CLJ 529.
• The Government, where the treatment was at a government hospital or clinic. Such claims are brought under the Government Proceedings Act 1956, and a shorter limitation period applies.

How a claim works, step by step

1. Request your medical report and full records. These include case notes, nursing notes, test results, imaging and consent forms.
2. Obtain an independent expert opinion. A specialist in the same field reviews the records and gives a view on breach and causation. Without supportive expert evidence, most claims cannot succeed.
3. Apply for pre-action discovery if the records are withheld. Under Order 24 rule 7A of the Rules of Court 2012, the court may order the hospital to disclose documents before a suit is filed.
4. Send a letter of demand setting out the claim and inviting settlement.
5. File the suit in the Sessions Court where the claim does not exceed RM1 million, or in the High Court where it does.
6. Case management and trial, where expert witnesses for both sides give evidence and are cross-examined.

Time limits

• Six years from the date of the negligent act or injury against a private doctor or hospital, under section 6(1)(a) of the Limitation Act 1953. The extended period for latent damage in section 6A does not apply to claims for personal injury.
• 36 months against the Government or a public authority, under section 2(a) of the Public Authorities Protection Act 1948.
• Three years from the date of death for a dependency claim, under section 7(5) of the Civil Law Act 1956.

Because obtaining records and an expert report takes time, it is prudent to seek advice early rather than near the end of the limitation period.

What compensation can be claimed?

• General damages for pain, suffering and loss of amenities.
• Special damages, including past medical expenses, transport and care costs.
• Loss of earnings and loss of future earnings, assessed under section 28A of the Civil Law Act 1956.
• Future medical treatment and care, where proved by evidence.
• In a fatal case, dependency claims under section 7 of the Civil Law Act 1956, including bereavement damages of RM30,000 for the spouse, children or parents.
• Aggravated damages in appropriate cases.

Complaint or claim?

A complaint to the Malaysian Medical Council or the Ministry of Health concerns professional conduct and discipline. It does not award compensation. Compensation is obtained through a civil claim, by settlement or court judgment.

Read more in Malay: Apa Itu Kecuaian Perubatan? If you need advice on a possible medical negligence claim, you may contact our office or read about our medical negligence practice. FAAIZ Law acts for patients and families across Malaysia from our offices in Puchong, Durian Tunggal and Sungai Petani.

This article is general information on Malaysian law and is not legal advice on any particular case.

oleh Muhammad Faiz bin Hasan, Peguambela & Peguamcara

Jawapan ringkas: tuntutan kecuaian perubatan di Malaysia ialah tuntutan sivil di bawah tort kecuaian terhadap doktor, hospital atau kedua-duanya. Anda perlu membuktikan empat perkara: doktor atau hospital itu mempunyai kewajipan berjaga-jaga terhadap anda, mereka telah melanggar standard penjagaan yang dikehendaki, pelanggaran itu menyebabkan kecederaan anda, dan anda mengalami kerugian akibatnya. Tuntutan lazimnya disandarkan pada rekod perubatan anda dan pendapat pakar perubatan bebas, dan mesti difailkan dalam had masa yang ditetapkan, yang lebih singkat jika melibatkan hospital kerajaan.

Standard penjagaan: ujian yang digunakan mahkamah

Mahkamah Persekutuan telah memutuskan ujian yang terpakai dalam kes Zulhasnimar bt Hasan Basri & Anor v Dr Kuppu Velumani P & Ors [2017] 5 MLJ 438:

• Diagnosis dan rawatan dinilai menggunakan ujian Bolam, sebagaimana diperhalusi dalam kes Bolitho. Doktor tidak cuai jika dia bertindak mengikut amalan yang diterima sebagai wajar oleh satu badan pendapat perubatan yang bertanggungjawab, dengan syarat pendapat itu boleh bertahan apabila dianalisis secara logik.
• Kewajipan menasihati tentang risiko dinilai menggunakan ujian dalam kes Rogers v Whitaker, yang diterima pakai oleh Mahkamah Persekutuan dalam Foo Fio Na v Dr Soo Fook Mun & Anor [2007] 1 MLJ 593. Doktor wajib memaklumkan pesakit tentang risiko material, iaitu risiko yang mungkin dianggap penting oleh orang yang munasabah dalam kedudukan pesakit itu. Dalam aspek ini, mahkamah, bukan pendapat perubatan, yang memutuskan sama ada amaran yang diberi mencukupi.

Kedudukan ini disahkan oleh Mahkamah Persekutuan dalam Dr Hari Krishnan & Anor v Megat Noor Ishak bin Megat Ibrahim & Anor and another appeal [2018] 3 MLJ 281, yang turut mengiktiraf bahawa ganti rugi teruk (aggravated damages) boleh diawardkan dalam kes yang sesuai.

Siapa yang boleh disaman?

• Doktor itu sendiri, atas kecuaiannya.
• Hospital swasta, yang bertanggungan secara vikarius atas kecuaian pekerjanya. Sama ada hospital juga bertanggungan atas kecuaian pakar perunding bebas bergantung pada fakta kes; Mahkamah Persekutuan telah menimbangkan doktrin kewajipan yang tidak boleh diwakilkan (non-delegable duty) dalam Dr Kok Choong Seng & Anor v Soo Cheng Lin [2017] 10 CLJ 529.
• Kerajaan, jika rawatan diterima di hospital atau klinik kerajaan. Tuntutan sedemikian dibawa di bawah Akta Prosiding Kerajaan 1956, dan had masa yang lebih singkat terpakai.

Bagaimana tuntutan berjalan, langkah demi langkah

1. Mohon laporan perubatan dan rekod penuh. Ini termasuk nota kes, nota jururawat, keputusan ujian, imej pengimejan dan borang keizinan.
2. Dapatkan pendapat pakar bebas. Pakar dalam bidang yang sama akan meneliti rekod dan memberi pandangan tentang pelanggaran dan kausasi. Tanpa keterangan pakar yang menyokong, kebanyakan tuntutan tidak boleh berjaya.
3. Mohon penzahiran pra-tindakan jika rekod tidak diberikan. Di bawah Aturan 24 kaedah 7A Kaedah-Kaedah Mahkamah 2012, mahkamah boleh memerintahkan hospital menzahirkan dokumen sebelum guaman difailkan.
4. Hantar surat tuntutan yang menyatakan tuntutan dan mempelawa penyelesaian.
5. Failkan guaman di Mahkamah Sesyen jika tuntutan tidak melebihi RM1 juta, atau di Mahkamah Tinggi jika melebihi.
6. Pengurusan kes dan perbicaraan, di mana saksi pakar kedua-dua pihak memberi keterangan dan disoal balas.

Had masa

• Enam tahun dari tarikh perbuatan cuai atau kecederaan terhadap doktor atau hospital swasta, di bawah seksyen 6(1)(a) Akta Had Masa 1953. Tempoh lanjutan bagi kerosakan terpendam di bawah seksyen 6A tidak terpakai kepada tuntutan kecederaan diri.
• 36 bulan terhadap Kerajaan atau pihak berkuasa awam, di bawah seksyen 2(a) Akta Perlindungan Pihak Berkuasa Awam 1948.
• Tiga tahun dari tarikh kematian bagi tuntutan tanggungan, di bawah seksyen 7(5) Akta Undang-Undang Sivil 1956.

Oleh sebab mendapatkan rekod dan laporan pakar mengambil masa, adalah wajar mendapatkan nasihat lebih awal dan bukan menjelang tamat had masa.

Pampasan yang boleh dituntut

• Ganti rugi am bagi kesakitan, penderitaan dan kehilangan kemudahan hidup.
• Ganti rugi khas, termasuk kos perubatan terdahulu, pengangkutan dan penjagaan.
• Kehilangan pendapatan dan kehilangan pendapatan masa hadapan, ditaksir di bawah seksyen 28A Akta Undang-Undang Sivil 1956.
• Kos rawatan dan penjagaan masa hadapan, jika dibuktikan dengan keterangan.
• Bagi kes kematian, tuntutan tanggungan di bawah seksyen 7 Akta Undang-Undang Sivil 1956, termasuk ganti rugi kesedihan sebanyak RM30,000 bagi pasangan, anak atau ibu bapa.
• Ganti rugi teruk dalam kes yang sesuai.

Aduan atau tuntutan?

Aduan kepada Majlis Perubatan Malaysia atau Kementerian Kesihatan berkaitan dengan tatakelakuan dan disiplin profesional. Aduan itu tidak memberikan pampasan. Pampasan hanya diperoleh melalui tuntutan sivil, sama ada melalui penyelesaian atau penghakiman mahkamah.

Baca juga: Apa Itu Kecuaian Perubatan? Jika anda memerlukan nasihat berkenaan kemungkinan tuntutan kecuaian perubatan, anda boleh menghubungi pejabat kami atau membaca tentang amalan kecuaian perubatan kami. FAAIZ Law bertindak bagi pesakit dan keluarga di seluruh Malaysia melalui pejabat kami di Puchong, Durian Tunggal dan Sungai Petani.

Artikel ini ialah maklumat am tentang undang-undang Malaysia dan bukan nasihat undang-undang bagi mana-mana kes tertentu.