GP fails to perform necessary diagnostic examination

General Practitioner fails to perform necessary diagnostic examination

Source: Health and Disability Commissioner

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Health and Disability Commissioner Anthony Hill today released a report finding a General Practitioner (GP) in breach of the Code of Health and Disability Services Consumers’ Rights for failing to perform a necessary diagnostic examination.

A woman went to her medical centre four times over a nine month period. She was seen by her GP of approximately 20 years, three times, and by a different doctor on the third of those four visits. Initially she presented with a perianal itch and irritation, but by the third appointment she had been experiencing intermittent bleeding from her rectum. By the fourth appointment she was experiencing ongoing bleeding from her rectum and a change to her bowel habits.

The GP carried out a physical examination at the second appointment, but did not perform an internal examination, as he thought the examination would have been too painful for her. The GP believed she had haemorrhoids.

The woman declined an examination from the doctor she saw at her third appointment. The GP did not carry out an examination at the fourth appointment because he thought his previous attempt had been too painful, and as he believed she had haemorrhoids, an examination would not change the treatment plan. He discussed with her a referral to the public hospital and ordered blood tests. The results of the liver function tests were abnormal, and he made a referral to the public hospital. The woman was diagnosed with rectal cancer two months later. She has subsequently passed away.

Mr Hill considered that the GP’s care of the patient at the first two appointments did not depart from a reasonable standard of care however the GP should have carried out a rectal examination during the fourth appointment. Mr Hill also noted that the GP’s clinical notes should have detailed why the internal examination was not performed.

Mr Hill recommended that the GP provide a written apology to the woman’s daughter and that has been done. Mr Hill also recommended that the GP provide evidence of what he learnt from the bowel cancer update he attended as part of his ongoing professional development, which has been completed.

The report for case 17HDC02317 is available on the HDC website.

ENDS

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