News Video | Policy | GPs | Hospitals | Medical | Mental Health | Welfare | Search

 

GP fails in care of woman in early pregnancy

Health and Disability Commissioner Morag McDowell today released a report finding a general practitioner (GP) in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for failures in their care of a woman in early pregnancy.

The woman, in her twenties, received a positive pregnancy test result. She experienced pain and bleeding, which are signs of a possible ectopic pregnancy. At around five weeks pregnant she saw her GP. The woman stated that she reported her pain to the GP, but the GP did not recall the woman mentioning pain and there is no mention of pain in the woman’s medical notes.

The GP arranged tests for urinary tract infection, sexually transmitted infections and rising pregnancy hormone level, but did not organise an ultrasound as she did not think it would add any helpful information given the woman’s early stage of pregnancy. The GP did not examine the woman’s abdomen or take her blood pressure or pulse, and did not offer any safety netting advice about what the woman should do if things got worse. When the woman’s hormone results were received, the GP appeared to have misinterpreted them as being reassuring.

Two days later, the woman presented to the emergency department of her local hospital with severe abdominal pain. The woman was diagnosed with severe internal bleeding secondary to a ruptured ectopic pregnancy. She required emergency surgery to remove a fallopian tube.

The Commissioner found several deficiencies in the care provided by the GP to the woman. In particular, she considered that the GP’s failure to directly inquire about whether the woman was experiencing pain in the initial appointment, and her failure to record the woman’s pain history, were departures from accepted practice.

"A common symptom of ectopic pregnancy is abdominal pain, and its presence alongside vaginal bleeding should raise a red flag for doctors to consider ectopic pregnancy," said Ms McDowell.

"It’s clear that the GP should have questioned the woman specifically about abdominal pain and documented her answer. Her failure to inquire about the pain directly impacted the course of the woman’s subsequent management."

Ms McDowell recommended that the medical centre undertake a review of all patients who experience PV bleeding in early pregnancy over the three month preceding the date of the report, to assess whether staff have actively questioned women about abdominal pain, documented this and conducted appropriate examinations. She also recommended that the GP attend an education workshop.

The full report of case 20HDC00477 is available on the HDC website.

© Scoop Media

 
 
 
Culture Headlines | Health Headlines | Education Headlines

 


Howard Davis: Emerald Fennell's Promising Young Woman'


The Guardian needed not one, but three reviews to do justice to Fennell's unsettling approach, which indicates exactly how ambiguous and controversial its message really is. More>>


Howard Davis: Jill Trevelyan's Rita Angus

Although Angus has become one of Aotearoa’s best-loved painters, the story of her life remained little known and poorly understood before Jill Trevelyan's acclaimed and revelatory biography, which won the Non Fiction Award at the Montana New Zealand Book Awards in 2009, and has now been republished by Te Papa press. More>>

Howard Davis: The Back of the Painting

Painting conservators are the forensic pathologists of the art world. While they cannot bring their subjects back to life, they do provide fascinating insights into the precise circumstances of a painting's creation, its material authenticity, and constructive methodology. More>>


Howard Davis: Black Panthers on the Prowl

A passionate and gripping political drama from Shaka King, this is an informative and instructive tale of human frailty that centers around the charismatic Chicago Black Panther leader Fred Hampton, who was murdered at the age of twenty-one during a police raid. More>>

Howard Davis: Controlling the High Ground

Stephen Johnson's raw and angry film not only poses important questions with scrupulous authenticity, but also provides a timely reminder of the genocidal consequences of casual bigotry and xenophobia. More>>

Howard Davis: Dryzabone - Robert Conolly's The Dry

After the terrible devastation caused by last year’s bushfires, which prompted hundreds of Australians to shelter in the ocean to escape incineration and destroyed uncountable amounts of wildlife, The Dry has been released during a totally different kind of dry spell. More>>


Howard Davis: Hit the Road, Jack - Chloé Zhao's Nomadland

Nomadland is perhaps the ultimately 'road' movie as it follows a group of dispossessed and disenfranchised vagabonds who find a form of communal refuge in camp sites and trailer parks after the economic contraction of 2008. More>>

 
 
 
 
 
 

LATEST HEADLINES

  • CULTURE
  • HEALTH
  • EDUCATION
 
 
  • Wellington
  • Christchurch
  • Auckland