An anaesthetist talked at length about his own health during a consultation, leaving his patient feeling her experiences were being minimised.
The patient had been in pain for years following a crush fracture to a disc in her spine in 1988. While she had a spinal fusion operation in 2002, she had continued to have chronic lower back and left leg pain, Health and Disability Commissioner Anthony Hill said.
In January 2012 she felt a popping sensation in her lower back, followed by severe pain in her lower back, which spread to her left leg.
Accompanied by a support person, the woman went to see the anaesthetist in April 2012, for consideration of an epidural spinal steroid injection.
During the discussion, the anaesthetist talked at length about his own health, including that his ACC claim had been denied, Hill's report said.
The woman felt those comments were a criticism of her own use of ACC, but the anaesthetist said she had taken his comments "totally the wrong way".
"Mrs A recalled that Dr B spent at least 15 minutes discussing details of his own health condition and explaining his pain experience and management," the report said.
"Dr B said that mentioning his own health was an attempt to be empathetic, and not to minimise Mrs A's condition."
After a consultation of almost two hours, the anaesthetist explained the risks and benefits of an epidural steroid injection. The woman decided to go ahead with the procedure, which she had been considering for four years.
The woman said that by the following day her pain had increased 300 per cent. She had severe pain in her head, lower back, and leg. She was extremely sensitive to light, irritable, with nausea, ringing in the ears and shock due to irritation of the membrane covering the spinal cord.
"Mrs A experienced pain for more than three months following the procedure and continues to suffer with headaches."
The commissioner found the anaesthetist breached the Code of Health and Disability Services Consumers' Rights.
The anaesthetist did not conduct a thorough examination of the patient before the epidural procedure. By the date of the appointment he had only received a brief referral note from the sports physician who referred the patient, along with an MRI scan. He had not received the more detailed letter that he would normally get.
He did not use an assistant, and his sterile precautions were insufficient. He breached professional boundaries when he introduced his own health conditions into the consultation, making the woman feel her experience was being minimised and devalued, the report said.
The doctor said he had changed his practice to meet Australian and New Zealand college of Anaesthetists guidelines.
- © Fairfax NZ News
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