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Man Whose Leg Was Amputated, Did Not Receive Continuity Of Care - HDC Decision Finds

The Deputy Health and Disability Commissioner, Dr Vanessa Caldwell has found Te Whatu Ora - Whanganui (formerly Whanganui DHB) breached the Code of Health and Disability Services Consumers’ Rights (the Code) following its treatment of a man who did not receive coordinated care in his leg being amputated below the knee.

The man went to Whanganui Hospital eight times over three months for treatment of an ingrown toenail and an unresolved infection. He had a complex medical history with a number of chronic conditions.

The man’s infection progressed over the three months and his right toe was amputated in an attempt to stop its spread. However, this was unsuccessful and six days later the leg amputation proceeded.

In her decision, Dr Caldwell said she was concerned that, despite the repeated presentations and unplanned admissions, a coordinated care plan directed by a senior staff member was not put in place, nor was there a multidisciplinary team approach. Instead, his presentations and admissions to ED were managed in isolation of each other.

Dr Caldwell found WDHB breached Right 4(5) of the Code, being the right to services of an appropriate standard, specifically that every consumer has the right to co-operation among providers to ensure quality and continuity of services.

"A hospital system would be expected to operate in such a way that a patient who has attended numerous times with the same issue would be afforded continuity of services, for example by having a dedicated team assigned to oversee, monitor and plan the patient’s care."

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"I would expect WDHB’s system to operate in this manner, and consider this should have been the case with Mr A."

Dr Caldwell also criticised aspects of the man’s care provided by three doctors and commented on the care provided by two further doctors.

WDHB has since established a high-risk foot clinic to focus on education and awareness, assessment, diagnosis and care plan development, initiation of treatment, follow up, and onward referral.


Editors notes

The full report of this case (20HDC00914) will be available on HDC’s website. Names have been removed from the report to protect privacy of the individuals involved in this case.

The Commissioner will usually name providers and public hospitals found in breach of the Code, unless it would not be in the public interest, or would unfairly compromise the privacy interests of an individual provider or a consumer.

More information for the media and HDC’s naming policy can be found on our website here.

HDC promotes and protects the rights of people using health and disability services as set out in the Code of Health and Disability Services Consumers' Rights (the Code).

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