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On January 30, 2019, The People’s Court of Hoa Binh Province found Dr. Hoang Cong Luong guilty of involuntary manslaughter and sentenced him to 42-month-imprisonment.

The verdict caused an outcry across different sectors in Vietnam’s society, especially among other doctors who did not agree with the court’s reasoning.

They believed that Dr. Luong did not breach his duty of care as a medical doctor.

Dr. Luong was a former nephrologist at Hoa Binh General Hospital who was charged with involuntary manslaughter for failing to check the RO (reverse osmosis) water before initiating a hemodialysis treatment in May 2017, causing 18 patients to suffer anaphylactic-like symptoms – eight of whom later died as a result.

A total of seven people were put on trial this year for “involuntary manslaughter” under Article 98 and “negligence of responsibility, causing serious consequences” under Article 285 of the 1999 Penal Code.

The case was initially tried in May 2018 where Dr. Luong was charged with Article 285. The court dismissed the case and returned the file to the prosecution for re-investigation in June 2018.

The prosecution came back and formally filed charges against Dr. Luong for involuntary manslaughter in December 2018. The second trial commenced in January 2019.

According to the trial court’s verdict of yesterday, Dr. Luong was guilty because he failed to wait for the documentation confirming the water’s safety before initiating the dialysis. Instead, Dr. Luong relied on the verbal confirmation of the staff in charge.

The court’s reasoning also put Dr. Luong in the position of a gatekeeper, which many doctors disagreed and argued that would have required nephrologists to be more than medical service providers.

According to these Vietnamese doctors, the failure to wait for the appropriate documentation was only an administrative mistake, not enough to constitute his criminal culpability.

They also argued that other doctors would have used the same method as Dr. Luong because having the documentation – in reality – does not make any difference compares to the verbal confirmation of the staff before starting the dialysis. Delaying the dialysis to wait for the documentation could also cost the patients their lives.

According to the community of doctors standing with Dr. Luong, when faced with such circumstances, whether he had waited for the documentation or went ahead with a verbal confirmation, nothing could have changed the fact that the water was contaminated and Luong could never detect such contamination.

The evidence at trial also established that the water in question was contaminated due to improper cleaning performed by the maintenance staff.

One of the witnesses, Nguyen Huu Dung, the Head of the Dialysis Department of Bach Mai Hospital in Hanoi, testified that the responsibility to maintain the water safety was one of the maintenance department, not the treating physician.

Regardless of the testimony from the experts and the doctors’ community standards, the court still decided Dr. Luong had committed involuntary manslaughter.

Throughout the process, not only the public and the doctors’ community stood by Dr. Luong, but all of the victims’ families have also pleaded with the court to exonerate him. Their action constituted one of the conditions under Vietnam’s laws which could exempt Dr. Luong from criminal liability under Article 29, Penal Code of 2015 .

While the new penal code only took effect on January 1, 2018, which was after the alleged medical malpractice had happened, Vietnamese laws allowed the retroactive application of any section that could have benefited the accused.

For his defense, Dr. Luong should have been able to use any section involving the extenuating circumstances, and other exemptions from criminal liability under the recently amended 2015 Penal Code, to defend his action. That did not happen.

The public outrage, in this case, started since its commencement where the director of the hospital, Truong Quy Duong, was first exempt from prosecution and was able to leave the country to go abroad to Canada back in 2018.

Due to public pressure and Dr. Luong’s lawyers’ argument, he was later charged with negligence and had to return to stand in the second trial.

Other doctors had pointed out that the absence of a national standard for dialysis procedures should make the Ministry of Health liable in this case as well.

The case also revealed more unanswered questions regarding the maintenance of the RO water system being used in dialysis at Hoa Binh General Hospital.

As the director of that hospital, should the responsibility of overseeing the maintenance and operation of all departments belongs to Truong Quy Duong, and that he should have been ultimately held liable for the death of the patients?

The case of Dr. Hoang Cong Luong has become one of the most controversial criminal cases in recent years, underlining issues that challenge Vietnam’s legal system today and in years to come.

People questioned the neutrality and fairness of the court and the role of the prosecution in this case. Was the prosecution’s decision to file charges against Dr. Luong for involuntary manslaughter done according to laws?

Not only there is a lacking of the standard of care for doctors in medical malpractice cases in the country, but also, there are other criminal procedures’ issues that urgently need reform, such as evidence admissibility and the standard for expert witnesses’ testimony.