A GP has been found to be in breach of the patients’ rights code for failing to adequately inform a patient of their deteriorating kidney function or for failing to implement a plan to manage their condition. (file photo)
A doctor has been reprimanded after failing to adequately inform a man for five years that his kidney function was deteriorating.
The man is now in kidney failure stage 4 and may need a transplant.
On Monday, Health and Disability Deputy Commissioner Morag McDowell found the GP breached the patients’ rights code for “deficiencies” in patient care and recommended the Medical Council consider whether a review of your competition.
The patient, in his 30s, saw his GP for an annual checkup in July 2015, according to McDowell’s report, released Monday.
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The patient requested Brufen (a nonsteroidal anti-inflammatoryor NSAIDs) for chronic back pain.
The tests showed impaired renal (kidney) function, which Dr. B thought was related to the patient’s use of NSAIDs, but there was no evidence that the patient had received the abnormal result.
Kidneys cleanse the blood of toxins and transform waste into urine. NSAIDs can cause decreased blood flow to the kidneys, which can cause kidney damage.
The report said the July 2015 test indicated the patient had chronic kidney disease, but the GP “was unable to understand the actual or potential severity” at the time, or at subsequent consultations.
Claire Christie has had two failed kidney transplants and has required numerous blood and plasma transfusions.
Results of a June 2016 test showed the patient’s kidney function was “chronically impaired, but stable.”
However, there was no documented discussion of these results with the patient. There was also no discussion of the risk of continued use of NSAIDs, which the GP was still prescribing.
A February 2017 test showed further deterioration, but it wasn’t until July that the doctor documented that they “discussed kidney function.”
The patient told the Health and Disability Commission that he recalled a conversation with his GP about his kidney dysfunction, in which the GP said he “had the kidneys of a 60-year-old” and that the situation would be monitored. However, he was not alerted to the importance of the test results.
The GP ordered kidney function tests eight times between July 2015 and October 2019. Five were completed.
In November 2019, the patient was sent to an emergency department, where he was eventually diagnosed with stage 4 kidney disease.
People with stage 4 kidney disease have advanced kidney damage and will likely need dialysis or a kidney transplant in the future.
McDowell said a “series of oversights” contributed to a delay in diagnosis.
These included not informing the patient of their deteriorating kidney function, not further investigating their deteriorating kidney function (including determining the stage of deterioration), and not implementing a management plan.
The report also found that the GP had no formal follow-up to manage test results.
The patient’s wife said that while the complaint wouldn’t change the outcome, “if we had known about it five years ago, it wouldn’t have been as shocking.”
“We could have made lifestyle changes to slow the progression of the disease…and most of all, we could have cherished life and our young family…while [my husband] he was well enough to do it.
McDowell considered the GP’s errors to be “individual faults” and not indicative of systems problems at the medical center.
Dr. B was “deeply sorry that harm had been done” to his patient, according to the report.
“If it were in my power to remedy this by [him]surely I would.”
McDowell recommended that the GP provide a written apology to the patient and their family and conduct an audit to ensure their clinical documentation is of an “appropriate standard”.
The medical center was also advised to apologize.