KUALA LUMPUR, Dec 17 – Proposed amendments to Act 342 that require the notification of suspected cases of infectious disease, including Covid-19, open medical practitioners up to medical liability litigation, two doctors’ groups said.
The 2021 amendment Bill of the Prevention and Control of Infectious Diseases Act 1988 changes Section 10(2) of Act 342 — which currently requires medical practitioners to notify government medical officers after treating or becoming aware of the existence of any infectious disease in any premise — to add the phrase “or has reason to believe or suspect”.
Medical Practitioners Coalition Association of Malaysia (MPCAM) president Dr Raj Kumar Maharajah said the proposed requirement for doctors to notify the Ministry of Health (MOH) of cases suspected for Covid-19 – without diagnosis from lab testing – opens physicians up to medical liability claims when certain businesses are shuttered due to their reporting that is later disproven.
“Let’s say a factory is closed for 14 days. The owner of the factory can actually sue the doctor for loss of income if examination shows the result is negative for Covid-19. So they will sue the doctor and say – your clinical judgment is wrong.
“So our indemnity is also going to go higher,” Dr Raj Kumar told CodeBlue.
He also explained that the proposed mandatory reporting of suspected coronavirus cases means that physicians will have to notify MOH of upper respiratory tract infections (URTI), as URTI is suspected for Covid-19 that shares symptoms with the flu.
He said as each general practitioner (GP) sees an average of 15 daily URTI cases, with 7,000 private GPs nationwide, this amounts to a whopping 105,000 cases every day that must be notified to MOH.
Dr Raj Kumar questioned what MOH would do with these notifications, pointing out that some of his patients previously complained about not being contacted by MOH even after testing positive for Covid-19. Currently, medical practitioners notify MOH whenever their patients test positive for the coronavirus, either through rapid antigen or RT-PCR tests.
“If we don’t inform suspected cases, we can be pulled up,” Dr Raj Kumar told CodeBlue, referring to criminal sanctions under the Act 342 amendment Bill.
MOH officials, in a Wednesday media briefing, told the press that medical practitioners can be compounded for the offence of not reporting suspected or confirmed cases of infectious disease.
Health director-general Dr Noor Hisham Abdullah did not confirm then if these compounds would be offered to doctors as individuals or institutions. The compounds of offences under Act 342 – in the latest version of the amendment Bill – are set at a maximum RM1,000 limit for individuals and RM500,000 for businesses and organisations.
Federation of Private Medical Practitioners Associations Malaysia (FPMPAM) president Dr Steven Chow said the Act 342 amendment Bill, which was tabled in Parliament on December 14, does nothing to address the failure of identifying and rectifying the source of mistaken or lack of notification for infectious disease.
“Requiring medical practitioners to notify merely on the basis of ‘suspecting’ a person or place to be harbouring an infectious disease is a death trap for doctors and opens the door to widespread litigation should a patient be proven negative by subsequent laboratory testing,” he told CodeBlue.
“The proposed amendment does not provide any indemnity or protection for such errors made out of good faith and in compliance with the new law.
“The new law will fuel stigmatisation of infectious diseases and drive infectious cases into hiding and will hamper contact tracing and early diagnosis and treatment.”
Dr Chow said he had asked MOH’s disease control division at its Wednesday briefing for medical practitioners on the Act 342 amendment Bill to specify at which stage the failure of Covid-19 notification lay – whether it was with the patient, community, employer, doctor, or the system itself.
“She did not reply except to say that the amendments were supposed to address more than just the issue of notification data,” said Dr Chow, referring to MOH’s disease control division director Dr Norhayati Rusli.
Throughout the three versions of the Act 342 amendment Bill as of yesterday, no changes were made to the new provision of notifying suspected cases of infectious disease; only to the quantum of punishments for offences.