Child Needed Liver Transplant After Drug Reaction — But Doctors’ Convictions Are Overturned
Two doctors convicted of professional negligence after a 12-year-old patient developed fulminant liver failure and required a liver transplant following a drug reaction have had their convictions reversed by the Supreme Court, which found the causal link between the alleged omissions and the outcome was not proven beyond reasonable doubt. Here are the key points.
Issue
Where a child suffers a severe drug reaction leading to liver failure and transplant, can the prescribing dermatologist and the treating pediatrician be convicted of occupational negligence causing bodily harm — and was it established beyond reasonable doubt that their specific omissions caused or materially contributed to the outcome?
Facts
- In July 2013, dermatologist A prescribed dapsone — a drug known to carry risks of toxic hepatitis and other serious side effects — to a 12-year-old girl presenting with a skin rash on her back. Dapsone requires regular blood tests and liver function monitoring before and during administration. A did not conduct these tests and did not explain the drug’s side effects or warn the family to stop medication and seek care immediately if adverse reactions appeared.
- The child developed a fever on July 31, was admitted to hospital on August 4 with a temperature above 38°C, and came under the care of pediatrician B.
- On August 9, B received a second consultation response from A recommending systemic steroid administration, with immunoglobulin as an alternative if steroids were not feasible. B began steroid treatment only after receiving this recommendation.
- The child fell into a coma from fulminant liver failure and received a liver transplant on August 9, resulting in a Grade 5 liver disability classification.
Lower Court Decisions
- The trial court convicted A and sentenced him to eight months imprisonment without labor, suspended for two years, finding A had failed to warn the family to stop the medication and seek immediate care if side effects appeared. B was acquitted.
- The appellate court upheld A’s conviction and reversed B’s acquittal, sentencing B to the same eight-month suspended term — finding B had been negligent in not initiating steroid treatment earlier during the hospitalization.
Supreme Court Decision
- The Supreme Court (Criminal Division 2, presiding Justice Kwon Yeong-jun) reversed both convictions on July 16, 2026, and remanded to Uijeongbu District Court.
On B, the court found it was not proven beyond reasonable doubt that B’s chosen treatment approach — navigating between the possibilities of drug hypersensitivity reaction and bacterial or viral infection — departed from reasonable medical practice. The diagnostic uncertainty B faced was genuine, and the evidence did not establish that an earlier steroid decision would clearly have been the medically required choice given the information available to B at the time.
On A, the court found that even if A had conducted pre-treatment tests and provided earlier warnings and guidance, it could not be concluded that the drug hypersensitivity reaction would have been diagnosed in time to prevent the outcome. The condition was difficult to diagnose even when multiple tests were conducted — meaning the causal link between A’s omissions and the child’s injury could not be established to the required standard of proof.
Key Takeaways
- Criminal negligence in medical cases requires proof beyond reasonable doubt — not merely that a better course of action might have been available, but that the specific omissions caused or materially contributed to the harm.
- Where the diagnosis was genuinely difficult even with the benefit of testing, and where the outcome might have been the same even with earlier intervention, the causal link between omission and injury is not established to the criminal standard.
- Treatment choices made in the face of genuine diagnostic uncertainty — where multiple conditions could explain the presentation — do not automatically constitute negligence simply because the outcome was serious.
- These findings do not preclude civil liability, which operates under a lower standard of proof than criminal conviction.
- The reversal does not mean the doctors acted correctly — it means the prosecution did not prove beyond reasonable doubt that their specific failures caused the child’s injuries.
Why This Matters
This ruling navigates the difficult boundary between outcome-based accountability and genuine criminal negligence in medical cases — a line that matters enormously for how medicine is practiced. Where adverse outcomes follow complex diagnostic challenges and treatment decisions made under uncertainty, criminal conviction requires rigorous proof that specific identifiable omissions caused the harm, not simply that things went badly wrong. For medical professionals, the decision reinforces that criminal liability must be grounded in clear causal evidence, not in retrospective reconstruction of what might have been done differently. For patients and families, it highlights the limits of criminal law as a remedy in complex medical cases — and the potential importance of civil negligence claims as an alternative avenue.
Article: https://www.lawtimes.co.kr/news/articleView.html?idxno=225998
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