Lack of continuity of girl’s care criticised
A 6-year-old girl spent months in hospital on strict bed rest with acute rheumatic fever after doctors at a medical centre in Palmerston North sent her away three times.
Health and Disability Commissioner Anthony Hill has found the failures in care breached her health consumer rights.
From December 2018, the young girl visited The Palms three times as a casual patient, seeing different doctors, with symptoms of intermittently running a fever, of unexplained painful joints, and she was losing weight.
She was sent for X-rays, which showed no cause for the pains. No further investigations were ordered despite her worsening condition, and it was not until she saw her regular GP in January that she was sent to hospital.
The GP had not received notes from The Palms about her previous visits.
By the time the girl was admitted to hospital she had a cough, and a heart murmur. Hill said the girl’s case was not a typical presentation of rheumatic fever, which was quite rare, and it would have been unusual for a primary health provider to identify.
It took the hospital aweek to confirm the diagnosis.
But he said The Palms showed a pattern of poor care in failing to recognise and investigate her deteriorating condition.
‘‘This case highlights the shortcomings of treating patients episodically, and the importance of critical thinking when a patient presents multiple times in a short timeframe, particularly when multiple providers are involved.’’
The commissioner’s expert adviser Ian St George said the case highlighted the importance of sharing a patient’s history of previous visits.
The girl was seen by different doctors, and none of them saw how the pattern of symptoms and signs was getting worse, St George said.
Hill said the failures deprived the girl of the opportunity for earlier investigations and interventions that potentially could have prevented the severity of her condition.
Hill recommended The Palms apologise to the girl’s family, and use an anonymous version of the case study for training purposes.
The Palms general manager Wayne Hayter said staff were apologetic and disappointed about the lapses.
‘‘We accept the importance of thorough clinical notes and need to ensure these notes are always delivered to the general practice where the person is enrolled in the most timely and efficient way possible.’’