The head of neurosurgery at Singapore General Hospital, Lai Prashanth Rao, admitted in court that he did not report the death of a patient to the coroner as required by law. The acknowledgment came on the first day of a coroner’s inquiry into the 2024 death of 75-year-old Tan Suan Lin, who had a large brain tumour and was operated on by Rao.

Rao, also a senior consultant at the National Neuroscience Institute (NNI), stated that he initially informed Tan’s family that the case needed to be reported to the coroner. However, the family refused consent for an autopsy, expressing concerns about further incisions on the body. Citing compassion and a desire to offer the family closure, Rao chose instead to issue a death certificate, explaining, "Probably my heart overruled my brain."

He further testified that he was under the mistaken belief that only deaths occurring within 24 hours of surgery required mandatory reporting to the coroner, and that he had discretion in other cases. The death certificate listed the cause of death as "malignant neoplasm - brain, unspecified," intended to indicate death resulting from the brain tumour.

A forensic pathologist from the Health Sciences Authority raised the possibility that bleeding complications during surgery may have contributed to Tan’s death, a perspective that differs from Rao’s initial certification. The NNI reported the case to the coroner in February 2025, nearly a year after the patient’s death, and the police were notified the following month. Due to the delay, no autopsy was conducted.

Investigation officer Benedict Lim testified that Tan underwent brain surgery on January 3, 2024, but the medical team faced challenges controlling bleeding during the procedure, resulting in a loss of about three liters of blood. Rao halted the operation and conveyed Tan’s poor prognosis to her family; she passed away six days later.

An independent expert witness called by the state described the failure to report the death as a clear deviation from standard practice in the neurosurgical field, although he expressed understanding of the emotional factors involved. The expert remarked that reporting such deaths has been a fundamental aspect of medical training, while acknowledging that emotions can sometimes affect clinical judgment.

State Coroner Adam Nakhoda will deliver his findings at a later date.