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The Deputy Health and Disability Commissioner Dr Vanessa
Caldwell has found a radiologist in breach of the Code of
Health and Disability Services Consumers’ Rights (the
Code).
The breach involves the care provided to a
70-year-old man prior to the diagnosis of lung cancer.
Leading up to the diagnosis, errors were made in the
reporting of his chest X-rays.
Dr Caldwell says, “For
failing to identify the mass in chest X-rays in 2018 and
2019, the radiologist did not provide the consumer with an
appropriate standard of care, in breach of Right 4(1) of the
Code.”
This is the right for consumers to have
services provided with reasonable care and skill.
“The
radiologist had two opportunities to identify the mass,”
said Dr Caldwell. “I consider that a radiologist exercising
reasonable care and skill would have detected the mass in
both the 2018 and 2019 X-rays.”
Dr Caldwell noted
while it cannot be determined whether earlier detection of
the lung cancer would have changed the consumer’s
long-term prognosis, later detection meant the consumer was
denied the chance for earlier treatment. By the time the
consumer’s lung cancer was identified, it was
inoperable.
Dr Caldwell considered the errors to be
individual and the DHB (now Te Whatu Ora) had not breached
the Code. However, she reminded Te Whatu Ora of its
obligation to ensure consumers have services provided with
reasonable care and skill, and for employees to have the
conditions necessary to perform their work to an appropriate
standard.
The radiologist will be referred to the
Director of Proceedings to determine whether legal
proceedings should be taken.
Additionally, Dr Caldwell
made several recommendations including:
– For the
radiologist to provide a written apology to the
consumer.
– For the Medical Council of New Zealand to
consider the radiologist’s fitness to practise should he
return to practice, and consider if a review of his
competence is required.
– That Te Whatu Ora conduct an
audit of the radiologist’s plain chest X-ray images taken
between July 2018 and July 2020 to determine if they were
reported correctly.
Since the complaint, Te Whatu Ora
has made a number of changes, including installing new
X-ray, CT and MRI scanning equipment. A number of new staff
have also since been employed in this team. All radiologists
are required to participate in the Royal Australian and New
Zealand College of Radiology Continuing Professional
Development
programme.
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