Screams of pain from a delivery room are normal, but not when it comes to a C-section operation. What was meant to be a routine procedure turned into a clip from a horror movie after a doctor continued to perform a C-section operation on a not-fully anesthetized woman.

In August 2010, OB-GYN, Dr. Lee Kim Kwong, began the C-section operation in a Singapore hospital without first making sure that the mother’s epidural had taken full effect. The patient informed Kwong before the operation began that she still had some feeling in her legs, Asia One reported.

Ignoring her statement, the doctor made an incision into the mother’s abdomen, causing her to scream out in pain. An anesthetist then administered a gas mixture of oxygen and nitrous oxide on the woman to sedate her. The baby was delivered three minutes later, but the memory of the incident “stayed in the minds of several of the medical professional in that operating theatre,” Channel News Asia reported.

In his defense, Kwong insists that he had made a “test scratch,” not the C-section cut when the patient screamed. The Council ignored this defense stating that they were “hopelessly devoid of merits.” The Council ruled that Kwong’s incision “could not amount to an appropriate test, as it would defy all tenets of acceptable practice for a surgeon to conduct in this manner,” Channel News Asia reported.

It was found that although it is the anesthetist’s responsibility to check if the anesthesia had taken effect, “it was the surgeon’s ultimate responsibility and primary obligation to ensure that it was effective before commencing the procedure,” Singapore’s Today reported. The decision to continue the operation after the patient’s cries of pain was deemed “unacceptable.” The doctor faces a $10,000 fine and was initially suspended for nine months, but this was later reduced to five months.

A survey conducted by the Royal College of Anesthetists and the Association of Anesthetists of Great Britain and Ireland revealed that in 2011 30 percent of patients claimed they were awake for the duration of surgery. Of these, 62 percent said they suffered pain of distress at being awake during their operation, the Daily Mail reported.

“You have to make sure that they are under, but you don’t want to give them too much because that is dangerous in itself,” Professsor Tim Cook, co-author of the study and a consultant anesthetist in the UK explained to the Daily Mail. Cook assured that the majority of patients experienced a light tugging or can hear some noises. “Risks to patients undergoing general anesthesia are very small, and have decreased considerably in the last decades,” he said.