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Informed consent and adequacy of care (11HDC00871)
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(11HDC00871, 11 December
General practitioner ~ After hours clinic ~ Urinary tract
infection ~ Informed consent ~ Privacy ~ Documentation ~
Appropriateness of examination ~ Chaperone ~ Rights 1(1), 4(1),
4(2), 4(4), 4(5), 6(1), 7(1)
A patient presented to an after hours clinic with a history of
body aches and burning while urinating. The patient advised the
doctor that she suspected she had a urinary tract infection.
The doctor performed an unchaperoned examination of the patient,
including an examination of the patient's upper and lower body that
involved the doctor touching the patient's legs, groin, breasts and
back. During the lower body examination the patient was naked from
the waist down. During the upper body examination she was fully
naked. The patient was not given any privacy to undress or dress,
nor was she provided with a cover. The doctor did not wear gloves
during the examination. The patient's clinical notes were altered
numerous times following the completion of the examination.
It was held that the doctor breached Right 6(1) for failing to
provide the patient with sufficient information about the proposed
examination and therefore also breached Right 7(1) for not
obtaining the patient's informed consent.
It was also held that the doctor breached Right 4(1) because the
examination was not clinically indicated. For failing to wear
gloves during an intimate examination the doctor breached Right
4(2), and for failing to inform the patient of her right to have a
chaperone present the doctor breached Right 6(1).
The overall manner in which the doctor conducted the examination
lacked respect. Therefore, it was held that the doctor breached
Right 1(1). For altering the clinical records the doctor breached
professional standards and accordingly breached Right 4(2).
Furthermore, the doctor's actions may have impaired the ability of
other providers to provide continuity of care to the patient and,
as a result, the doctor failed to minimise the potential for harm
to the patient. Accordingly the doctor breached Rights 4(4) and
4(5). The doctor was referred to the Director of Proceedings. The
Director decided to institute a disciplinary proceeding, which is
The clinic was found not to have breached the Code.