In Ooi v Smith, Assunta Hospital, 1985 Dr Gwen Smith, Dr Chin Yoon Hiap, both consultant paediatricians and members of the Malaysian Paediatrician Association (MPA) saved themselves and The MDU millions of dollars in all future litigation involving neonatal jaundice by stretching the limits of physiological jaundice and denying the very existence of kernicterus! In an article published on 30 April 1984, just before litigation in an attempt to pervert the course of justice, they stated that serum bliirubin less than 20 mg/100ml is safe.

This opinion, at odds with international evidence-based medicine, is junk science. It is evident that Drs Chin, Smith and MPA were involved in a conspiracy to cheat and defraud a disabled person - and to deceive the learned judge Dato' Abdul Malek. The MDU and its solicitors in Sydney and Malaysia coached Dr Smith to provide under oath their distorted criteria for Physiological Jaundice (see A below).

It amounts to Child Abuse and Neglect as it would either kill babies or disable them profoundly and permanently.

More than a decade later after the decision, in May 1997, Dr Smith maintained that she would still treat jaundiced babies the way she treated Jarret Ooi in 1973, even though she knew that Jarret had become severely brain-damages as a consequence of her own negligence !!! MDU had argued in court that she was not negligent. And she was not going to change her ways.

The risk? Thousands of newborns are going to die or continue to exist as severely disabled citizens.




MDU'S LEGAL CRITERIA (1985 - 1998)

Defendant Centred Medicine (DCM)
Ooi JPL, Ooi TT v Bishop, Assunta Hospital Dr Gwen Smith, (Malaysian High Court, 1985)

(i) "There is not much difference between Jaundice at birth and Physiological Jaundice.

(ii) Bilirubin level of healthy Caucasian neonates is 10-12 mg/100 ml. In Chinese newborns it is much greater than 15 mg/100ml.

(iii) Bilirubin level of 13mg is mild to moderate Physiological Jaundice. Mild to moderate (up to 20mg) means doctors are not worried.

(iv) Jaundice is normal unless DOCTORS become concerned by it (!).

(v) Persistence of jaundice after first week is not always pathological."

The above opinions constitute JUNK SCIENCE and PERJURY. In contrast, MEDICAL SCIENCE is set out below. Observance of them would ensure that jaundiced babies are properly investigated and treated, so that none would die or be disabled.





Patient Centred Medicine (PCM)
Beischer NA; Mackay EV. Obstetrics & the Newborn. WB Saunders (1976), p 473

(i) "The jaundice does not develop within the first 24 hours of life.

(ii) The maximum plasma bilirubin level reached is 10 mg/100 ml in the term infant and 12 mg per 100 ml in the preterm infant.

(iii) The jaundice disappears within 7 days of birth.

If these criteria are not satisfied one must search for the cause of the infant's jaundice and not label it as physiological."


Care of the Newborn

Jaundice, Hypoglycaemia, Hypothermia

1. JAUNDICE (yellowness of eyes and skin)

All term infants whose serum bilirubin (yellow pigment) exceeds 170 mmol/L or 10 mg/dL at any stage in the first week of life should receive phototherapy (light treatment). As jaundice affects more than 90% of Asian as compared with only 50% of Caucasian babies, neonatalogists and and paediatricians need to exercise more care in multicultural Australia. Even so-called 'Physiological Jaundice' has been known to cause kernicterus (brain damage) in the author'experience (1).

2. HYPOGLYCAEMIA (low blood sugar)

Newborns on artificial feeding risk the danger of not being fed - by tired mothers or busy maternity staff. In one case, staff failed to feed a newborn baby for two days; as a result he suffered hypoglycaemia and cerebral palsy (2).

3. HYPOTHERMIA (low body temperature)

Many delivery rooms are air-conditioned for the comfort of medical staff and labouring mothers. Infants have been known to suffer cold stress and hypothermia. In combination with jaundice and hypoglycaemia, hypothermia increases the risk of kernicterus. Health providers should closely monitor the body temperature of infants cared in air-conditioned wards, besides ensuring that they are properly and warmly wrapped up.

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