[비즈한국] Yonsei Sarang Hospital Director Ko Yong-gon, who is on trial for violating the Medical Service Act (proxy surgery), provided answers in court that contradicted his previous statements regarding the presence of medical device supplier employees in the operating room.
Director Ko is accused of allowing nursing staff or medical device company employees to perform or assist with surgeries, such as joint replacement, that he was supposed to perform himself. It is reported that the prosecution applied charges of violating the Medical Service Act based on evidence that non-medical personnel were involved in the hospital's surgical procedures.
Since being indicted in August 2024, Director Ko’s side has consistently denied the charges in all hearings held to date. During a cross-examination by the prosecution at the Seoul Central District Court on the 11th, he claimed that he personally performed the core surgical procedures and that the role of the nursing staff was merely to assist in medical treatment under the direction of a doctor. He also emphasized the legitimacy of so-called “team-based surgery,” noting that patients were informed about the surgical methods beforehand and provided their consent.
However, during this process, Director Ko’s statements were inconsistent regarding whether employees of TJC Life (TJC), a medical device supplier, entered the operating room to assist in surgery. In the cross-examination, he explained in detail that a TJC employee helped with the surgery by holding retractors or using suction next to the PA (Physician Assistant) nurse, but in the subsequent redirect examination by the prosecution, he answered in a way that suggested a TJC employee had never entered the operating room.
Attacking Whistleblower Credibility while Emphasizing Legitimacy of ‘Team-Based Surgery’
Director Ko strongly denied the proxy surgery allegations and emphasized the legitimacy of his surgical system.
He argued that the “team-based surgery” system was inevitable given the nursing staff shortages experienced by small and medium-sized hospitals. He maintained that patients were briefed on the procedure in advance, provided consent, and that he personally performed the essential parts of the surgery.
He stated that his surgical team typically consists of about seven people: one lead surgeon, one anesthesiologist, one anesthesia nurse, one to two PA nurses, one scrub nurse, and one circulating nurse. Director Ko insisted that this team-based system, where multiple specialized personnel work organically, maximizes surgical efficiency.
Addressing allegations of how he could perform dozens of surgeries a day, he explained that it was physically possible because, based on 22 years of experience, the core surgical time took only about 15 minutes.
Meanwhile, Director Ko’s side challenged the credibility of the former nursing staff whose statements formed the core of the indictment. They highlighted that these individuals had short tenures at the hospital, some had listed false credentials on their resumes, or were unfamiliar with medical terminology. They also suggested the possibility that competitors, such as H Hospital or external figures, may have influenced the whistleblowers.
From “Non-Medical Duties” to “PA Assistance,” and Finally “Never Entered the Operating Room”
Regarding the role of TJC employees in the operating room, Director Ko initially described their duties in the first half of the trial as limited to non-medical tasks like inventory management, handling emergency situations, and preparing or selecting surgical instruments. He emphasized, “This is a practice that occurs in most hospitals in the country, including university hospitals. Because nurses cannot possibly know all of the hundreds of surgical products, the explanation and management by specialized company employees are essential.”
However, in the latter half of the trial, Director Ko provided answers that effectively acknowledged that TJC employees were actually sharing and assisting with the core tasks of PA nurses.
Previously, he clearly defined the three major auxiliary tasks required for patient safety and visibility during surgery as: △ operating the Army retractor to widen and fix the surgical site, △ using suction to remove blood, and △ stabilizing the leg, noting that these are core areas of medical assistance that should fundamentally be handled by PA nurses.
But when the focus shifted to situations where nurses were shorthanded, such as when a patient had a large physique or during the winter season when surgeries were concentrated, his explanation changed. Director Ko described, “In rare, special situations where the patient was very large or we were short-staffed, they provided help, but a PA nurse was always right next to them. To ensure the surgeon has a clear view, one person must hold the retractor, and another must use suction when there is blood.”
Later, during the prosecution’s follow-up questioning, he even denied the fact that TJC employees had entered the room at all. When the prosecutor asked again if TJC employees were eventually brought in to assist with surgery due to the difficulty in hiring nurses, Director Ko replied, “TJC employees have never entered the operating room.”
Previous Trials Saw Disputes over ‘Unqualified Sales Rep Surgeries’ and ‘Systemic Cover-up’ Allegations
In previous trials, the controversy centered on whether TJC employees stationed in the operating room went beyond simply handing over tools and performed actual “proxy surgery” (unlicensed medical practice).
In a trial held in April 2025, former TJC employee ‘A,’ appearing as a witness, testified: “I was stationed in the operating room and performed not only disinfecting the surgical site and fixing retractors but also, under the doctor’s instruction, direct drilling, hammering, and assembly of implant parts.” ‘A’ also stirred up controversy by revealing, “When I first started in the operating room, I didn’t even have a nursing assistant license.”
A former nurse at Yonsei Sarang Hospital who testified in a trial last September also revealed, “TJC sales reps stood by in surgical scrubs, and if a doctor let go for a moment, they would immediately continue by taking the sawing gun to cut bone or doing the hammering; they worked practically as one body with the doctors.” There was also testimony that during stem cell harvesting surgery, the PA nurse performed the extraction and suturing alone while the doctor was not in the room.
In a trial this July, evidence emerged regarding efforts to systematically hide signs of proxy surgery ahead of the Ministry of Health and Welfare’s medical institution certification evaluation. According to messages revealed by the prosecution, hospital management issued an instruction in June 2021 before the certification audit: “Recently, proxy surgeries have become a significant issue, so external evaluators may be watching; minimize the use of company employee assistants during surgery or respond according to the situation.” Director Ko admitted to giving such instructions. It was also suggested that discussions were held to deploy a TJC sales rep with a nursing assistant license as the “first assistant” and a regular nurse as the “second assistant.”
The statements in this trial could be a critical point in determining exactly which personnel entered the operating room and what roles each person performed in the ongoing case regarding proxy surgeries. Notably, TJC Life is a medical device development and sales company founded by Director Ko in 2016, which changed its name to Skive in July 2023. According to Skive’s financial statements from the end of last year, its transactions with Yonsei Sarang Hospital, including sales, amounted to approximately 13.127 billion won, accounting for 78.7% of its total revenue of 16.67 billion won during the same period. In essence, business with Yonsei Sarang Hospital constitutes a significant portion of Skive’s revenue.
Trading between medical device companies and hospitals is not inherently problematic. However, the economic relationship between Director Ko, the company, and Yonsei Sarang Hospital, and how these business dealings relate to the presence of company employees in the operating room, require further verification.
Bizhankook asked Director Ko and his legal counsel after the trial about the reasons for the contradictory statements regarding the TJC employees’ entry into the operating room, but they did not provide a response.