A disability services provider breached the code of patient rights when an intellectually impaired man was injured while taking part in a work skills programme, the Health and Disability Commissioner says.
The man was cutting through a wooden plank with a power saw as part of the programme run by Timata Hou Limited when the blade went into his abdomen in September 2010.
The man, who has Attention Deficit Hyperactivity Disorder, was using the power saw earlier in the day, but was asked to do something else when the tool became entangled in his overalls.
He resumed using the saw after one of two supervising staff members was called away.
In findings released on Monday, Commissioner Anthony Hill said there was a culture of non-compliance with policies at Timata Hou Ltd including supervision requirements, training, hazard identification and incident reporting.
It has been referred to the Director of Proceedings for possible follow-up legal action.
In a statement on Monday, Timata Hou Ltd says it regrets the accident and has apologised to the man and his family.
The provider says it accepts the commissioner's findings and has reviewed health and safety policies and made a number of changes. These include giving all staff extra training and limiting the number of clients at the site.