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Ophthalmology care and inadequate management of patient appointments (06HDC15893)

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(06HDC15893, 28 May 2008)

Ophthalmologist ~ Public hospital ~ District health board ~ Ophthalmology ~ Documentation ~ Appointment booking system ~ Glaucoma ~ Rights 4(1), 4(2), 4(5)

A 57-year-old man was referred to a public hospital's ophthalmology clinic by his general practitioner, with a painful eye and reduced vision. He saw the ophthalmologist at the clinic on seven occasions over the next 16 months with episodes of sore eyes and reduced vision.

The man then presented to the ophthalmologist with severely reduced vision. The ophthalmologist diagnosed glaucoma and arranged an appointment at the clinic the next week to investigate further. That appointment was cancelled and the man did not receive any further care from the clinic until his vision deteriorated and his wife contacted the hospital six weeks later. By that stage, the man was almost blind. He underwent urgent glaucoma drainage surgery on each eye and subsequent investigations revealed widespread low-grade B cell lymphoma. The man is now legally blind.

It was held that the ophthalmologist breached Right 4(1) and Right 4(2), by failing to regularly measure the man's intraocular pressures and failing to fully document his assessments in the man's clinical record.

It was also held that the public hospital failed in its duty to appropriately manage patient bookings and provide the man with necessary follow-up appointments, and therefore breached Right 4(5).