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Delayed Diagnosis Of Bladder Cancer

The Office of the Health and Disability Commissioner today released a report finding a medical centre and a general practitioner (GP) in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for failures in the care of a woman with urinary symptoms.

The woman made repeated visits to the medical centre with persistent urinary tract symptoms and blood in her urine. Over three years, she had several consultations with a number of providers at the medical centre, and was treated with antibiotics despite her urine test showing no infection.

The woman was not referred for a specialist review of her symptoms until more than three years after her initial consultation, at which time a cystoscopy revealed tumours in her bladder.

Former Commissioner Anthony Hill found the medical centre in breach of the Code for failing to provide an appropriate standard of care; for not informing the woman of her test results; and for the lack of effective cooperation between the practitioners who provided care to the woman.

He considered that a GP at the medical centre breached the Code by not reviewing her clinical history adequately and not following up her persistent symptoms appropriately, and thereby failing to provide services to the woman with reasonable care and skill.

"Clinicians must do the basics - read the notes, ask the questions, and talk with the patient," said Mr Hill. "With medical practices focusing less on individual doctor consultations and more frequently involving a multidisciplinary team, attention must be paid to the issues that can arise when no single clinician takes overall responsibility for the patient, and the need to ensure continuity of care. The… delay in [the woman’s] diagnosis with bladder cancer had significant consequences for her."

Mr Hill recommended that the medical centre discuss the findings of the HDC’s report with all staff currently employed who were involved in the woman’s care, and update its policy for the review of test results when staff require leave at short notice. He also recommended the centre should review its processes around provision of care to patients who present repeatedly with the same problem, report back to HDC regarding implementation of the changes it has made, and apologise to the woman.

Mr Hill recommended that the GP attend a Medical Protection Society workshop, review the HealthPathways guidance on urinary symptoms, and provide a written apology to the woman.

The full report for case 18HDC01892 is available on the HDC website.

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