Doctor’s failure costs $20k

Michael Neilson

A doctor who missed red flags in diagnosing her patient’s oesophegeal cancer has been ordered to pay more than $20,000.

The Practitioners Disciplinary Tribunal found “Dr H” had failed to refer her patient to a specialist or for an endoscopy on four separate occasions despite his presenting cancer symptoms.

The tribunal said this amounted to professional misconduct and censured the doctor, a general practitioner who has permanent name suppression, ordering her to pay 30 per cent of the tribunal costs amounting to $21,636.

Dr H has appealed against the tribunal’s decision to the High Court.

Mr A, a male patient in his 50s, was having trouble swallowing, had a sore throat and pain in his chest and stomach. He had lost weight, but not deliberately.

He made an appointment at a medical centre and was allocated to see Dr H. Mr A had four separate appointments with Dr H over a fivemonth period.

He reported his symptoms to her and she undertook treatment and investigations on each occasion.

However, it was not until about nine months later, when Mr A requested to see a different doctor, Dr D, who he had seen previously, that he was referred for a gastroscopy.

Mr A had been “disillusioned with the treatment he was getting . . . and felt there was something more serious going on”.

A month later he was diagnosed with oesophegeal cancer.

Mr A had surgery to remove the cancer and has since undergone chemotherapy and radiation treatment.

Dr H said she accepted she had failed to properly refer Mr A to a specialist or for an endoscopy, but denied professional misconduct.

She said she became “blinkered” by her initial diagnosis that he had gastritis.

The practitioner did not consider oesophageal cancer to be a possibility at the time as she was aware that it was a relatively rare diagnosis.

She was extremely upset for the patient, and had since done extra training, education and supervision.

However, the tribunal found Dr H had been “negligent from the outset” in not referring Mr A.

A general practitioner who presented as an expert witness said the patient being aged over 50, dyspepsia (pain in upper abdomen), difficulty swallowing and losing weight for months without trying were all red flags.