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Diagnosis of cardiac problem (07HDC20618)

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(07HDC20618, 10 December 2008)

Doctor ~ Accident and medical clinic ~ Gastric pain ~ Myocardial infarction ~ Right 4(1)

A man attended an accident and medical clinic complaining of bad indigestion. He was triaged and an electrocardiogram (ECG) commenced. Following the standard process the nurse printed off two ECGs from the machine ready for the doctor to review.

The man was then seen by the doctor, who queried whether there might be some cardiac involvement that warranted further investigation, but not urgent treatment. The doctor reviewed only one of the ECGs printed, not realising that the two traces were not identical. The patient subsequently went to the hospital by car. Shortly after his arrival he was diagnosed as having had a myocardial infarction and underwent surgery.

Because the doctor had been working at the medical centre for only a short time, it was held that he was not solely responsible for failing to read all the ECGs. However, the doctor failed to respond with sufficient urgency and put the patient at risk by allowing him to go to the hospital by private car, and breached Right 4(1) by failing to provide services with reasonable care and skill.