26 Jun 2017

GP failed to give patient cancer diagnosis

2:51 pm on 26 June 2017

A 78-year-old man did not find out for more than three years that he had cancer because his doctor did not tell him.

Doctor, nurse of other health worker filling out medical form

Photo: 123RF

In a report today, Health and Disability Commissioner Anthony Hill said an unnamed GP had breached patient rights in several respects.

Health and Disability Commissioner Anthony Hill

Health and Disability Commissioner Anthony Hill. Photo: Supplied

Mr A went to Dr C in early 2012 with a sore knee. He was also experiencing a slowing of speech and a fizzing feeling in his feet.

Dr C ordered blood tests, and chronic lymphocytic leukaemia was confirmed six days later.

In 2013, Mr A moved to another region and his clinical notes were transferred from his original medical centre to the new one.

Mr Hill said between 2013 and 2015 Mr A consulted with GPs many times. Blood tests were requested regularly and it appears that Mr A's chronic lymphocytic leukaemia (CLL) was being monitored.

Mr A only knew about it on 8 September 2015 when he went to a pre-admission appointment for impending knee surgery.

Mr A told Hr Hill, "I was interviewed by a nurse on my particulars and health and in the process while looking through my records she stated that I had leukaemia. This came as a total shock to us both. We had never heard of this but she mentioned blood tests done [before I moved]... My understanding [was that] blood tests were done for blood pressure and cholesterol."

Expert adviser David Maplesden told Mr Hill that after receiving results indicating a diagnosis of CLL, he would expect any clinician to communicate to the patient, in a timely way, the results of that test and the implications of the conditon.

Mr Hill said, "I am concerned that although Dr C requested the blood tests and received the results, he did not ensure that Mr A was aware of the diagnosis."

He said doctors owed patients a duty of care in handling patient test results, including advising them of and following up on abnormal results.

He rejected a view of Dr C that he could have "deputised" someone else to do this. He also did not believe it was reasonable for Dr C to expect a public hospital would search a community laboratory database for such findings.

Mr Hill also asked the unnamed first medical centre to review its policy regarding high-priority test results and to audit compliance with its policy regarding the communication of test results to consumers.