False Reporting Of Test Result By Registrar

Health and Disability Commissioner Anthony Hill today released a report finding a doctor in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for lying to a senior colleague about a patient’s test results.

The man presented to hospital with a history of worsening lower back pain. He was reviewed by an orthopaedic registrar, who performed a bladder void scan to check for cauda equina syndrome, a serious condition that can result in permanent disability. The results of the scan were borderline, so the registrar phoned the on-call orthopaedic consultant, who told him to perform a second bladder void scan and report back to him with the results.

Unfortunately, the registrar misunderstood the instructions and discharged the man without performing the second scan. When the consultant followed up on the test results later that evening, the registrar realised that he had misunderstood the instructions, but rather than admit this, he told the consultant that he had performed the test, and made up normal results. The registrar repeated this lie to the consultant at a meeting the next morning. Two weeks later, the man was diagnosed with cauda equina syndrome and required urgent surgery.

In his decision, Mr Hill was severely critical of the registrar for lying repeatedly about the test results and found he had breached the Code.

"I am cognisant of the power dynamic between senior and junior doctors, and cannot diminish the real and tangible effect this can have… Nevertheless, in my view, [the doctor] allowed his own needs and the pressure he felt to take precedence over [the man’s] well-being. [The doctor] actively chose to lie to his superior, and the effect of that lie was disastrous for his patient. His behaviour was unacceptable," Mr Hill said.

Mr Hill recommended that the registrar apologise to the man and provide HDC with his reflections and learning from relevant training. He also recommended that the Medical Council of New Zealand consider carrying out a competence or conduct review of the registrar.

Mr Hill also recommended that the DHB involved consider improvements to its support and guidelines for junior and senior staff in relation to interpersonal relationships and communication, and to use this complaint for staff training.

The full report for case 18HDC00309 is available on the HDC website.

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