JUST one week before the coroner's inquiry into his wife's death, Mr Surender Singh made peace with the gods.



The 37-year-old prisons officer visited the Golden Temple in Punjab, India, and bade his final farewell to his beloved wife.

He left his gold wedding ring behind.

And with it, he let go of the guilt and blame that had been plaguing him for the past two years.

His wife died in February 2005 after donating one of her kidneys to him.

Madam Narindar Kaur, then 33, died at the National University Hospital from abdominal bleeding about five hours after her kidney was removed.

Said Mr Singh: 'Before this trip, I kept asking God why this had to happen to me. I lived with the guilt that she died so I could live.

'Now, I accept that it is fate. Blaming myself will not bring her back.'

The two-week trip, he said, was his wife's wish.

'We never went on our honeymoon. Going on a pilgrimage together had always been her dream. In a way, I've fulfilled her dream because I brought a piece of her with me.

'I also left my wedding ring at the temple as an offering because the ring doesn't matter anymore. What matters is that I'll always have her in my heart.'

He returned from India on Sunday.

The trip, he said, gave him peace of mind and some closure that he had so desperately been seeking for the past two years.

Closure - which he had been hoping to get from the coroner's hearing into the cause of his wife's death.

The case was finally heard yesterday after several postponements.

Earlier, the case kept being adjourned because no independent expert witness could be found.

In September last year, the case was again postponed because a new coroner wanted more information before proceeding.

But the coroner's court ruling yesterday of Madam Narindar's death as a misadventure was little comfort for Mr Singh.

State Coroner Tan Boon Heng ruled out any criminal negligence on the part of the doctors at NUH.

It was heard in court yesterday that Madam Kaur had been admitted to NUH on 16 Feb 2005 to donate her left kidney to her husband.

The three-hour operation, which ended around noon, went smoothly.

Madam Kaur left the operating theatre at noon and was monitored in the recovery room.

She showed no signs of abnormality and was transferred to a general ward at 2.10pm.

A doctor checked her blood pressure at 2.30pm. At the time, her pulse and blood pressure were normal.

But around 4pm, when her sister-in-law Jasmail Kaur, 40, visited her, she found that Madam Kaur was having difficulty breathing.

That was when medical staff were alerted.

At the time, Madam Kaur was already cold, clammy and did not respond when called.

A team of doctors and nurses tried to resuscitate her for about an hour but their efforts proved futile.

She was pronounced dead at 5.10pm.

The autopsy report stated that Madam Kaur had died from sudden internal bleeding in her abdominal region because the clips that had been used to stop the blood flow from the severed end of her left renal artery had slipped.

In a kidney transplant, the main veins and arteries surrounding the organ are clipped to stop the flow of blood to the kidney so that the organ can be successfully harvested.

But the coroner said there was no evidence to suggest that it was medical negligence that led to the clips being dislodged.

There was also no evidence to explain how exactly the clips became loose.

It was only in April last year - more than a year after Madam Kaur's death - that the clips manufacturer, US company Teleflex Medical, issued a warning about their use on living kidney donors.

The post-mortem revealed that Madam Kaur showed signs of small coronary artery disease, which had been 'clinically silent' before her death.

But the autopsy could not conclude that this condition had contributed to her death.

Mr Singh said yesterday: 'I was hoping to get some answers, but the court hearing has not shed much light on who caused my wife's death. Someone has to stand up and take responsibility.'

Which is why he is determined to pursue a civil suit against the hospital, to claim some form of compensation.

It was heard in court yesterday that Associate Professor Chia Sing Joo, head and senior consultant of general surgery at Tan Tock Seng Hospital, was called as an independent medical expert to give his opinion on whether there was any medical negligence.

His report noted that there appeared to be no negligence in general, but he raised the question of whether Madam Kaur could have been saved if 'the bleeding was detected much more early and more visibly'.

Dr Li Man Kay, head of the Ministry of Health renal transplant team who performed the surgery on Madam Kaur, testified yesterday that he had given clear instructions that she was to be monitored every hour when she was released to the general ward.

But when questioned by Mr Singh's lawyer, Mr Amolat Singh, he said no checks were made between 2.30pm and 4pm.

Said Dr Li: 'But even with continuous monitoring, we may still not have been able to revive Madam Narindar.'

The coroner concluded that Madam Kaur's abdominal bleeding happened 'suddenly and unexpectedly'.

He added that 'there was sufficiently close monitoring of the deceased and there was no unreasonably long lapse of hours in which the deceased was left unattended such that the sudden bleeding could have been detected even earlier'.


FRUSTRATED

The findings have left Mr Singh baffled and frustrated, but he appeared calm in court yesterday.

He said: 'I still need to know how the clips became dislodged. I already know my wife died of excessive bleeding. But who and what caused this bleeding? I still don't know.

'Why could they not have detected the bleeding earlier?'

Since his wife's death, the father of two girls, aged 12 and 5, and a boy, aged 11, has been struggling to support the family on his sole income of $2,200. She used to earn about $2,400 as an executive in a shipping firm.

He needs about $500 worth of medicine a month to prevent his body from rejecting the transplanted kidney.

NUH has been absorbing his medical bills.

He has also been seeing a psychiatrist in private practice once every six weeks.

While in India, he had two separate photographs of himself and his wife specially merged into one and framed.

The picture now hangs on the living room wall of his five-room Hougang flat.

Although he said the trip to India has helped him let go of his wife, he still hopes for more answers about her death.

'We have waited two years for answers and this court case has given me little. All I want is someone to take responsibility so I can have closure.'

NUH said in a statement yesterday that it would continue to support Mr Singh and his family and would provide them assistance wherever possible.

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