Hong Kong’s High Court has granted an unconditional release to a 93-year-old physician previously convicted of manslaughter, resolving the city’s first highly publicized fatality linked to a cosmetic Botox injection. The decision, delivered on November 12, 2025, concluded a complex legal battle centered on medical negligence and the defendant’s mental fitness to stand trial.
The case originated in November 2018, when 52-year-old banker Zoe Cheung Shuk-ling died shortly after receiving a botulinum toxin treatment at the clinic of Dr. Franklin Li Wang-pong in Tsim Sha Tsui’s Grand Centre. Dr. Li, Cheung’s attending physician, was subsequently charged with manslaughter, citing gross negligence. While a jury initially determined that Li’s conduct amounted to manslaughter, the subsequent sentencing proceedings shifted focus to the doctor’s advanced age and cognitive decline.
Legal Crossroads Posed by Deteriorating Health
During the proceedings, defense lawyers pushed to excuse Li from entering a plea, arguing that his worsening dementia rendered him unfit to meaningfully participate in the trial. A seven-member jury, convened in October, was tasked with assessing his capacity before determining the ultimate course of action.
Prosecutors argued that Li breached his fundamental duty of care to Cheung. Specifically, allegations included failing to correctly assess the risks of administering a sedative, neglecting to monitor Cheung’s oxygen saturation levels, and not providing essential counter-sedative medication when she exhibited signs of respiratory distress. Furthermore, the prosecution contended that Li intentionally withheld crucial details about the treatment and prescribed medications from other healthcare professionals attempting to assist Cheung.
At sentencing, Mr. Justice Anthony Kwok stated that the court faced a narrow set of options regarding Li’s future: detention in a psychiatric facility, a guardianship order, or absolute, unconditional release.
Unconditional Release Granted Despite Manslaughter Finding
Ultimately, the High Court determined that a supervision order was unsuitable, leading to the unconditional release of the elderly doctor. This decision was heavily influenced by a report from the Social Welfare Department, which concluded that Li was not a suitable candidate for formal guardianship.
Mr. Justice Kwok’s ruling effectively ended the immediate legal jeopardy for Li, despite the jury’s prior finding that his actions caused Cheung’s death. The judge’s decision underscored the difficulty of balancing criminal justice outcomes with the realities of an elderly defendant suffering from severe mental impairment.
Implications for Medical Liability and Patient Safety
This landmark ruling highlights the significant legal complexities introduced when medical negligence cases involve defendants with deteriorating health. For the cosmetic procedure industry in Hong Kong, the case serves as a stark reminder of the critical importance of rigorous patient monitoring protocols, particularly when sedatives are involved.
The fundamental allegations of failing to monitor vital signs and withholding information underscore the essential commitment medical practitioners must maintain to patient safety and transparency. While the legal fate of Dr. Li is settled, the tragedy surrounding Cheung’s death continues to influence discussions regarding accountability and regulatory oversight within the non-surgical cosmetic treatment sector.
Key Actionable Takeaways for Patients Considering Injectables:
- Confirm the practitioner’s qualifications and experience.
- Inquire about access to emergency equipment and counter-sedative treatments.
- Ensure all pre-existing medical conditions are fully disclosed and documented.