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CASE STUDY
26
CASE STUDY:
GP disciplined for repeated failure
to follow up signs of serious illness
On 21 December 2011 the Health
Practitioners Disciplinary Tribunal issued a
decision (428/Med10/170D) in relation to
a general practitioner, fi nding the Director
of Proceedings’ charge of professional
misconduct made out.
The charge arose out of the doctor’s
care of a patient who subsequently
died of bowel cancer, and comprised six
“particulars” covering the period from 15
November 2007 to 20 November 2008.
Although only one of these particulars was
upheld, it concerned the doctor’s failure to
adequately follow up signs of pathology
in his patient. This was the central concern
in the case. The expert called by the
prosecution described a number of clear
warnings which should have alerted
the doctor to the need to identify the
underlying cause of his patient’s symptoms.
The doctor failed to (among other things)
adequately investigate a marked decrease
in his patient’s haemoglobin. This was a
“red fl ag” that there was some infective or
infl ammatory disease process occurring
in the body. The Tribunal found that
the doctor should have requested an
investigative procedure such as
gastroscopy or colonoscopy.
For the doctor to have decided instead that
what was required was an increase in his
patient’s intake of iron (he prescribed iron
tablets) without seeking to identify the
cause of the anaemia was a “signifi cant
error of judgment.”
The Tribunal found the doctor guilty of
professional misconduct, censured him
and imposed signifi cant conditions on
him should he seek to resume practise.
These conditions include: undergoing
a psychological assessment before he
resumes practice and then undergoing
such clinical psychologist treatment and
assistance and other rehabilitation steps
as are required by the Medical Council;
practising in a group practice that must
include a vocationally registered medical
practitioner; and practising under
supervision approved by the Medical
Council, with the doctor to meet all
attendant costs.
The Tribunal also ordered the doctor to pay
costs to the Director of Proceedings and to
the Tribunal totalling $106,190.