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Paediatric audiology care (12HDC00446)

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(12HDC00446, 26 June 2013)

Audiologist ~ District health board ~ Audiology ~ Hearing loss ~ Inadequate testing and diagnostic services ~ Documentation ~ Vicarious liability ~ Rights 4(1), 4(2) 

A WellChild nurse referred a three-year-old girl to the Audiology Department at a public hospital because her parents had raised concerns about her hearing, speech and frequent ear infections. She was seen by an audiologist. An audiogram indicated bilateral conductive hearing loss. The audiologist referred the girl to the Ear Nose and Throat (ENT) clinic for further management. Grommets were inserted.

Following further testing, the audiologist reported his results as bilateral hearing at the bottom end of the normal range with minimal asymmetry between the ears. There was no arrangement for a follow-up appointment.

A hearing check at school identified hearing loss in both ears. The girl was seen by a private audiologist who found significant right-sided sensorineural hearing loss, as well as mild low to mid frequency hearing loss in the left ear.

It was held that the audiologist failed to perform cross-checks and arrange for adequate follow-up of the girl. Accordingly, he did not provide services with reasonable care and skill and breached Right 4(1). His documentation of the girl's care was below expected standards and, accordingly, he also breached Right 4(2).

The District Health Board did not take reasonable steps to prevent the girl's rights being breached by failing to ensure that the audiologist was properly supervised, failing to provide peer support or checks on the audiologist's performance, and providing suboptimal facilities and equipment. Accordingly, the District Health Board was found to be vicariously liable for the audiologist's breach of Right 4(1).

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