Follow-up Tests And Appointments Essential In Timely Diagnosis

Deputy Health and Disability Commissioner Vanessa Caldwell 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 the care of a woman whose bowel cancer diagnosis was delayed.

The woman, in her thirties, who had a complex medical history, presented to her medical centre with significant weight-loss, abdominal pain, iron deficiencies and bowel issues between 2015 and 2018.

Due to her young age her GP did not consider her to be at high risk of bowel cancer. Instead he considered her symptoms to be consistent with new onset inflammatory bowel disease.

The Deputy Commissioner was critical that the GP missed opportunities in 2016 and 2017 to recognise unexplained iron deficiencies, examine the woman’s abdomen, order repeat blood tests, follow up on stool and blood tests that weren’t completed and make a referral for an endoscopy.

In January 2018 the woman presented to the medical centre with tailbone pain and another GP found a rectal mass. She underwent chemotherapy, surgery and palliative chemotherapy/radiotherapy. Sadly, she passed away in 2019.

"In my opinion, a number of oversights in the GP’s care contributed to a delay in the woman’s diagnosis of bowel cancer, thus delaying her treatment," said Dr Caldwell.

Dr Caldwell recognised that although each of the failures may appear mild when viewed individually, cumulatively they presented a pattern of poor care.

"I do acknowledge that the complexity and chronicity of the woman’s medical conditions was a difficult background upon which to provide care and diagnosis, and I have taken this into account," said Dr Caldwell.

The Deputy Commissioner recommended that the GP review the Royal Australian College of Physicians’ presentation on cognitive factors in diagnosis, report back to HDC on his reflections, and provide a written apology to the woman’s family.

The full report for case 19HDC01773 is available on the HDC website.

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