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Inappropriate examination of patient (13HDC00158)
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(13HDC00158, 18 February
Doctor in general practice ~ Chaperone ~ Informed consent ~
Documentation ~ Respect ~ Rights 1(1), 4(1), 4(2), 6(1),
A woman, aged 34 years, had recently returned from an overseas
trip and was unwell. Her symptoms were general nausea, diarrhoea
and extreme tiredness. Initially the woman had had abdominal pain,
but that had abated by the time she returned to New Zealand.
The woman consulted a doctor at a general practice. After asking
the woman some questions, the doctor examined her abdomen, groin,
and labia, and inserted a finger or fingers into her vagina. Apart
from the abdominal examination, the doctor did not explain the
reason for the examination or the nature of the proposed
The doctor did not offer a chaperone, provide the woman with a
private space to disrobe and re-dress, or provide a cover for her.
The doctor made no records at the time of the consultation about
the nature of the examination he conducted, the reasons for it, or
It was held that the doctor's examination of the woman (apart
from the abdominal examination) was not clinically indicated in
light of the woman's reported symptoms. Accordingly, the doctor did
not provide services to the woman with reasonable care and skill
and breached Right 4(1).
The doctor had a duty to inform the woman about the nature of
the examination he proposed to undertake and the reasons for it. He
also had a duty to inform her that she could have a chaperone or
support person present. By failing to provide the woman with the
required information, the doctor breached Right 6(1). As the woman
did not receive sufficient information about the nature of and the
reasons for the examination, or the option of having a chaperone
present for the intimate parts of that examination, she was not in
a position to make an informed choice and give informed consent to
the examination. Accordingly, the doctor also breached Right
It was also held that, by failing to make records at the time of
the consultation, the doctor did not comply with professional
standards, breaching Right 4(2), and did not treat the woman with
respect, breaching Right 1(1).
The doctor was referred to the Director of
Proceedings. The Director laid a charge before the
Health Practitioners Disciplinary Tribunal. Professional misconduct
was not made out.
Adverse comment was made about the general practice for failing
to update the woman regarding her complaint and for not making a
written record of her account.