Controversy Over Mcperan Injection for Vomiting Patients...KMA President: "No Patient Worth Doctors Risking Prison"

Doctor Found Guilty for Prescribing Medication to Vomiting Patient
Medical Association President: "Do Not Prescribe Drugs to Vomiting Patients"
KMDS, Neurology Society, and Other Medical Groups Protest Increasingly
Health Center Posts Notice Restricting Certain Prescriptions

Recently, as the court ruled guilty of professional negligence causing injury against a doctor who prescribed medication to a patient, opposition from the medical community has been growing day by day. Lim Hyun-taek, president of the Korean Medical Association (KMA), has been continuously issuing harsh criticisms, saying, "There is no patient worth risking going to prison for," while a public health center even posted a notice specifying drugs with restricted prescriptions.

Im Hyuntaek, President of the Korean Medical Association.
Photo by Kang Jinhyung, Asia Economy

On the 11th, President Lim posted on his social media service (SNS), "From now on, do not use any drugs for all patients who come to hospitals or clinics with vomiting," adding, "There is no important patient worth risking going to prison for." This is interpreted as a reference to the court case in January 2021, where Doctor B at a clinic in Geoje-si, Gyeongnam, was prosecuted for administering 2 ml of Mcperan injection to an 80-year-old patient A, resulting in injuries such as general weakness, speech disorder, and worsening of Parkinson's disease. The court found Doctor B guilty for administering the drug without properly confirming the medical history of the Parkinson's patient and sentenced him to 10 months in prison with a 2-year probation.

Mcperan injection is commonly used to treat symptoms such as nausea and vomiting. Although it has side effects that can worsen Parkinson's disease symptoms, its half-life is relatively short at about 5 hours, during which the drug concentration reduces by half, and the probability of Parkinson's symptom aggravation is significantly low, so it is frequently administered to patients. However, due to these side effects, it is recommended to exercise caution when administering to elderly Parkinson's patients. Doctor B claimed that he fulfilled the duty of medical inquiry before administration and that it was not negligence, but the court did not accept this argument.

President Lim stated, "From now on, absolutely do not use all antiemetics such as Mcperan and Ondansetron, which very rarely cause side effects, for all patients who come to hospitals." On the 8th, he also publicly revealed the face and real name of the judge who made the ruling on SNS, harshly criticizing, "Is this woman sane?" In response, the Changwon District Court expressed regret through a statement, calling it a serious insult to the judge's character.

KMDS and Neurology Societies Protest

Macperan injection (10 mL).
[Photo by Seoul Asan Medical Center]

Lawmaker Lee Ju-young of the Reform New Party, who is a medical doctor, also strongly criticized the court's decision at the Supreme Council meeting the day before, saying, "Mcperan is the only drug approved for use in vomiting symptoms in our country," and "If you only want to use 100% safe drugs, there are no drugs available in the world."

On the same day, the Korean Movement Disorder Society (KMDS) issued a statement saying, "Adverse outcomes that occur unexpectedly during medical practice stem from the unique nature of medical treatment," and "If guilty verdicts are handed down for this, which doctor would dare to take risks to treat patients' diseases and save lives?" They added, "This will not only encourage doctors nationwide to avoid treating high-risk patients but also lead to further avoidance of essential medical care, which is already facing gaps," warning, "Ultimately, this will result in harm to patients."

Yoon Woong-yong, president of the Korean Neurological Association, also called it an "absurd ruling," stating, "Of course, Mcperan can worsen Parkinson's symptoms. But Parkinson's patients can worsen their condition if they catch a cold, have weakened immunity, undergo surgery due to external factors, or have poor nutrition." He criticized, "However, it is incomprehensible to judge that Parkinson's worsened solely because of Mcperan."

Public Health Center Posts Notice Restricting Drug Prescriptions: "Difficult to Prescribe Drugs with Side Effects"

A public health center posting a notice on drug prescription restrictions.
[Photo by Online Community]

Medical communities that require doctor certification for membership are also continuing their criticism of the ruling. Contributor C took a photo of a notice posted in front of a public health center and emphasized, "Let's follow these rules from now on." According to the 'Public Health Center Drug Prescription Restriction Notice' posted by C, the health center stated, "The patient did not inform Doctor B that he had Parkinson's disease, but the court revoked the doctor's license citing the recommendation for cautious administration to elderly patients and negligence in confirming medical history," adding, "Accordingly, the scope of drug prescriptions is restricted, and due to the ruling that licenses can be revoked if side effects occur, considering the difficulty of dealing with side effects in public health centers and the characteristics of specialized fields, it is difficult to prescribe the following drugs without significant reasons."

The drugs that the public health center specified for restricted prescription are as follows. For cold medicines: ▲Kofusyrup ▲analgesic anti-inflammatory drugs (risk of gastrointestinal bleeding) ▲antihistamines, and for antifungal drugs: ▲Fluconazole ▲Nadazole. For skin diseases, steroid ointments are prescribed restrictively, and urology drugs include medications for benign prostatic hyperplasia. The health center also noted that prescriptions for all other drugs that may cause side effects beyond the center's capacity to manage may be restricted in the future, while continuing diagnosis and prescriptions for existing hypertension, diabetes, and hyperlipidemia as usual.

A netizen D, who identified as a public health doctor, said, "A few days ago, an elderly person brought an unknown infusion saying 'my grandchild gave it to me.' Even though I refused, they insisted on getting the infusion and caused a scene," adding, "Kofusyrup has a sweet taste, so elderly people often ask for 'just a little.' Most public health doctors prescribe according to dosage, and no drug is perfect, but it must be frustrating to receive probation for undisclosed medical history."