Director of Proceedings v Bupa Care Services NZ Limited

Human Rights Review Tribunal, [2017] NZHRRT 55, (15 December 2017)

 
The Director of Proceedings filed proceedings by consent against Bupa Care Services NZ Limited (Bupa), in the Human Rights Review Tribunal.  Bupa accepted that its actions amounted to a breach of the Code of Health and Disability Services Consumers' Rights (the Code) and the matter proceeded by way of an agreed summary of facts.  The Tribunal was satisfied that Bupa failed to provide services to the aggrieved person with reasonable care and skill and issued a declaration that Bupa breached Right 4(1) of the Code.
 
Bupa is a registered company which owns and operates a Rest Home and Hospital which provided health and disability services to the aggrieved person while she was a private hospital-level resident.  The aggrieved person was a younger resident who suffered from debilitating progressive multiple sclerosis and was largely bed bound.  She also suffered from several co-morbidities, including diabetes.  Sadly, the aggrieved person died from septic shock due to necrotising fasciitis caused by an infected sacral pressure ulcer which had developed while she was a resident.  Over a period of a fortnight, several nurses had recorded the increasing deterioration of both the sacral wound and the aggrieved person’s general condition.  However, no action was taken to change the wound care plan, refer the aggrieved person to a wound care specialist nurse or for reassessment by her general practitioner when the wound appeared infected and not improving.  Further, on several occasions an additional dose of ‘as required’ zopiclone (a sleeping tablet) was administered to the aggrieved person after 3am causing her day time sleepiness and associated reduced appetite and nutrition. 
 
According to expert nursing advice, there were recurring failures by several registered nurses who cared for the aggrieved person (both individually and as a team) in the face of several significant clinical presentations and several opportunities for further reassessment.  The failures involved core nursing competencies and reflected a lack of insight into the recognition and management of significant presentations.  Bupa accepted it had a responsibility to operate the Rest Home and Hospital in a manner that provided its residents with services of an appropriate standard and accepted that it had ultimate responsibility for the failures in providing the expected standard of care required by a younger resident with chronic medical conditions and complex comorbidities.  Bupa acknowledged it had a responsibility to ensure all nursing staff were adequately familiar with its policies and procedures and complied with them.  Bupa also acknowledged that the inaction and failure of multiple staff to adhere to policies and procedures pointed towards an environment that did not sufficiently support and assist staff to do what was required of them. 
 
The Tribunal’s full decision can be found at:
http://www.nzlii.org/nz/cases/NZHRRT/2017/55.html
Last reviewed February 2019