A woman’s bowel cancer diagnosis was delayed by seven months due to a mishandled process at Waikato Hospital.
This led her to seek private healthcare, where a four-centimeter tumor was found. The delay in treatment resulted in the cancer spreading to her lungs. The woman’s husband filed a complaint with the Health and Disability Commissioner (HDC).
Deputy Commissioner Dr. Vanessa Caldwell released a report today recommending that Health New Zealand Waikato and one of its surgeons apologize to the patient. Caldwell stated that both parties breached the Code of Health and Disability Services Consumers’ Rights (the Code).
The surgeon failed to physically examine the woman despite her six-month history of unexplained rectal bleeding. Health NZ also breached the Code by giving the woman incorrect wait times for a colonoscopy.
The patient, Mrs. A, who had a family history of colorectal cancer, presented with rectal bleeding and changed bowel habits when she visited her GP in September 2017.
She was referred to Waikato Hospital’s gastroenterology department. In November, a consultant general and colorectal surgeon performed a sigmoidoscopy at Thames Hospital. Dr. B, the surgeon, reported examining the lower third of the intestine as usual.
An expert later determined that a competently performed sigmoidoscopy would likely have identified the cancer at that point. Two months later, Mrs. A returned to her GP due to increased bleeding. A physical exam was routine, and she was referred to the gastroenterology department at Waikato Hospital.
However, it was with ongoing unexplained bleeding from Waikato Hospital to Thames Hospital. Dr. C at Waikato Hospital noted worsening symptoms after the sigmoidoscopy and recommended another colonoscopy.
He failed to mention any urgency in their clinic letter six weeks late, dated 27 June 2018. Caldwell’s report highlighted that the referral to Thames Hospital should have been for a procedure within 14 days, but instead, it was set for within six weeks.
Additionally, it was noted that Dr. C did not perform a rectal exam or proctoscopy. Despite being a standard practice, no evidence suggests that another sigmoidoscopy is necessary.
Health New Zealand Waikato was also breached for advising Mrs. A that she would likely wait four months for the colonoscopy. Ministry of Health guidelines indicated her priority 3 referral should have warranted a six-week wait.
The Deputy Commissioner recommended that Health NZ Waikato and the second surgeon apologize to the woman. Additionally, the surgeon was advised to undertake an audit of clinical appointments to investigate rectal bleeding.
The task is to ensure that physical examinations are conducted and their documentation is accurate.
Click to read more about New Zealand
