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Sorry isn't good enough

by Whaleoil on July 8, 2010

Hands up those women who want to go see three doctors who between them contributed so significantly to a woman’s death that all three physicians have been recommended to review their practices.

Health and Disability Commissioner hides Idenities of Dodgy Doctors

Health and Disability Commissioner hides Identities of Dodgy Doctors

Well you can’t know if you want to see them because their names are suppressed to protect “their privacy”. There is a good chance that my female readers may be seeing one of these doctors. I mean there can’t be that many Obstetricians and Gynaecologists in New Zealand, it is a limited number. Now they are all smeared, if you will excuse the pun with the actions of these three.

The big news though is that one of the Doctors has been asked to apologise. Whoopy! We can all be assured these guys are amongst our finest, well they must be, their names are suppressed.

A specialist has been faulted over the case of a woman who died at 39 of cervical cancer.

The woman suffered recurrent episodes of bleeding after having sex, which she reported to her GP in April 2007, two months after the birth of her second child.

The case was reported yesterday on the Health and Disability Commissioner’s website, in a decision by former commissioner Ron Paterson. No parties were named.

The GP, Dr C, decided not to take a cervical smear test, instead ordering an x-ray and an ultrasound scan to rule out the possibility of a retained swab from the caesarean birth – an approach ruled appropriate by a medical adviser to Mr Paterson.

The patient saw Dr D the following month. She took a vaginal bacterial test, prescribed antibiotics and, owing to a vaginal discharge, deferred taking a smear, which was likewise ruled appropriate. The bacterial test was clear and the ultrasound found no sign of a swab and in late May 2007, Dr C referred the woman to a hospital gynaecologist, Dr B.

Dr B did not take a smear, nor do a colposcopy – a visual inspection with a magnifying instrument. He told the woman that her condition was related to breast-feeding and reassured her that she needed no further treatment.

Doctors B, C and D are hidden by the cosy club of all their peers. They essentially contribute to the death of a patient and no-one must know who they are because of “their privacy”.

Reading through the complaint it is quite appalling the level of care this poor woman received from Drs B, C and D. Yet at the end of it all only one doctor has to apologise they all have to review their practices. What that really means is that Drs B,C and D get a slap on the hand with a wet bus ticket, and get to carry on regardless. The public and their patients don’t get to know who they are, don’t get to choose whether they want to remain as patients in the care of these dodgy doctors because someone who knows better than all of us has decided that they should remain hidden.

Slap on the Hand with a wet bus ticket for three Dodgy Doctors

Slap on the Hand with a wet bus ticket for three Dodgy Doctors

What is the point of having a watchdog if the watchdog doesn’t bite? This decision is appalling on so many levels. The public deserves to know who these dodgy doctors are so we can judge for ourselves whether we want our wives and girlfriends to attend them.

Name Suppression in New Zealand isn’t protecting victims, it is protecting offenders. It is time these cosy arrangements are ended by law.

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  • grizz

    Hold on Whale. Do not lump this in with your crusade against name suppression for criminals. These doctors are guilty of medical misadventure by the Health and Disability commissioner. They have not been charged with a criminal offence in a court of law.

    I respect your campaign for outing people who have wilfully committed criminal acts. However you cannot ever accuse these doctors of being culpable of deliberately and wilfully setting out to harm this woman. Yes theeir practice was deficient and they have to stand up to the HDC and their recommendations, but it could never be seen as being criminal. If you want to out them, then you are taking your name suppression campaign to a whole new level.

  • grizz

    This is probably not the correct forum to discuss medical notes, however I note that the article states that the 2 GPs, Drs C and D decision not to perform cervical smears were actions deemed appropriate by an expert advisor. Reading the article I actually cannot see any evidence of inappropriate practice from these two doctors.

  • peterwn

    AFAIK there is nothing to stop the patient or rellies naming the professionals, hospitals, etc. Someone I know did just that when his wife died following a medical foulup, and it was easy to find the report in question. The poor guy had every right to be upset having unnecessarily lost his wife just after they were looking forward to a happy retirement.

    The main reason for suppression of all names etc is to protect the patient’s privacy since the patient may be otherwise be identifable.

  • toby

    It is my belief that all three of these doctors enjoy penetrative non-consenting orgiastic sexual intercourse with defenceless animals.

    But I can’t back that up.

  • cheshirecat

    Wrong, WO, on several counts. The Commissioner does not have a mandate under the HDC Act to impose penalties. If in his opinion there are grounds for further action to be taken against a practitioner, then his Office refers the case to the Health Practitioners’ Disciplinary Tribunal. The HDC regularly refers cases, depending on the investigation’s findings, and the Tribunal often imposes sanctions if a case is proven, that can range from a fine + costs to being de-registered professionally. The Tribunal does, if it feels that the demands of public safety outweigh the need for individual practitioners’ privacy, invariably name guilty ones. The HDC will on rare occasions name a practitioner, but often does not. He will, on the other hand, name DHBs and other organisations that are found in breach of the Code of Health & Disability Services Consumers’ Rights. Again, it’s about public safety.

    The days when the NZ Medical Council covered up for its chums are long gone, and our HDC is held by health providers in many countries to be one of the best, and definitely the fairest, system of resolving health complaints. Go to the HPDT website and read their decisions in full, and don’t rely on the slothful maggots in MSM in this country for accurate reporting about health cases.

    To get a full appreciation of what went wrong in this instance, you need to read all 46 pages of the report, not just the casenote.

  • http://www.macdoctor.co.nz macdoctor

    I’ve read through this HDC report, Whale. There is no way that the two GPs were guilty of anything more than doing their job. A cervical smear would certainly not be my first choice investigation had this poor woman presented to me, simply because she had had a recent birth. Cervical cancer in this scenario would be fairly rare. The second GP was simply unable to perform an adequate cervical smear. The only criticism that could be leveled is that neither GP scheduled a time to take a smear at a later date, when it was clear that the problem was probably not an internal uterine one.

    The two months it took the GPs to send her to a gynae would be unlikely to have changed the prognosis in any way. The real damage was done when the specialist did not do a smear or a colposcopy.

    HDC is not designed to be a punitive body because it is only concerned with breaches of the patient bill of rights, not correct medical procedure. If in the course of their investigation they think there may be a disciplinary case to answer, they refer this to the Medical Council. Their threshold for this is fairly low.

    For this reason, this is not really a subject for your name suppression project, Whale. HDC cannot make legal findings and therefore their threshold for releasing names should be very high, as it indeed is. Medical Council can make legal findings, but tend only to release names in there is evidence of gross misconduct. It would be manifestly stupid to destroy a doctor’s career on any grounds less than this.

  • nike

    This case saddens me a great deal, and not only because this unfortunate woman has died. Mr Paterson has not asked the right questions, and has not focussed his inquiry in the correct direction. It seems to me that Drs A, B & C have all contributed to the unsatisfactory outcome but macdoctor is in error when he states “The real dam­age was done when the spe­cial­ist did not do a smear or a colposcopy.”

    It is almost inconceivable that the disease was vascular-invasive (i.e. cancer cells had spread into blood and/or lymphatic vessels) but might have been curable a few months earlier (when the obgyn specialist neglected to perform investigations for cervical carcinoma).

    From the evidence presented the patient appears to have been in a cervical screening program, and is reported to have had a normal smear three years earlier. Again this is, if true, remarkable. Patients *do not have* normal smears and then develop late-stage carcinomas three years later (except perhaps in a few rare cases).

    Much, much more likely an inadequate smear was taken, or an abnormal smear was reported as being normal.

    In any case you can bet your bottom dollar that when the biopsy for the carcinoma was reported both the reporting pathologist and the cervical screening program would have followed up the earlier smears. I can almost guarantee that the slides have now *disappeared*.

    The greatest harm done to this patient, in my opinion, did not occur in her last couple of years of life, but much earlier. The important failure was not the foreign obgyn’s failure to take a smear, but a failure of the screening program IMHO.