Health Practitioners Disciplinary Tribunal, 652/Med14/282D, (10 September 2014)
The Director of Proceedings brought an unsuccessful charge against Dr H in the Health Practitioner's Disciplinary Tribunal. The Director alleged that Dr H had negligently failed to follow up on raised glucose levels in his patient over a period of almost two years and multiple consultations. Dr H had tested his patient's non-fasting glucose levels at four consultations, each of which returned elevated glucose levels and a pathology recommendation for further follow-up testing for diabetes mellitus. Dr H did not carry out follow-up fasting tests and did not communicate the elevated test results to his patient. The patient was diagnosed with diabetes mellitus upon hospital admission nearly two years after the initial elevated tests results had been received by Dr H.
The case proceeded by way of an Agreed Summary of facts in which Dr H accepted that the charge of negligence was made out and was of such sufficient severity to warrant disciplinary sanction. Dr H acknowledged that he should have followed up the first and second test results and accepted that, by not following those up for a further 18 months, he failed to obtain the standard of care and skill reasonably to be expected of him. Dr H further accepted that the third test result was a further indication that prompt follow up was required and he acknowledged that because he was unavailable to follow up the results himself (due to illness and work commitments), he needed to ensure that these were nevertheless undertaken and the results communicated to the patient.
The Tribunal considered that there was no evidence that the patient's diabetes was long-standing in the community. The Tribunal concluded that, in relation to the first and second test results, there was no particular cause for communication of those results because they were not indicative of a diagnosis of diabetes. The Tribunal accepted that the third and fourth test results confirmed the diagnosis of diabetes mellitus but stated that, while the patient clearly had problems requiring further care, and the third blood test result did require follow up, there was no medical urgency for review at that point. The Tribunal considered there was no evidence of harm to the patient from the period of time that elapsed between the third and fourth tests. Accordingly, the Tribunal determined that there was no failure on the part of Dr H to adequately follow up and/or investigate the cause for the blood test results, Dr H's actions were not negligent and the charge was dismissed.
The Tribunal's decision can be found at: https://www.hpdt.org.nz/Charge-Details?file=Med14/282D
Last reviewed February 2019