Director of Proceedings v Tui Medical Limited

Director of Proceedings v Tui Medical Limited [2021] NZHRRT 44 (20 September 2021)

The Director filed proceedings by consent against Tui Medical Centre (“Tui Medical”) in the Human Rights Review Tribunal, regarding the care it provided to Mrs A. At the time, Tui Medical operated six general practice services and two drop-in centres for urgent care services, and employed 30 FTE clinicians.

Mrs A was in her late 70s when she first presented to a Tui Medical clinic with urinary symptoms. Over the following three years, she made repeated visits with urinary tract symptoms (including micro haematuria,[1] frequency,[2] and dysuria[3]), which were treated with antibiotics despite test results consistently failing to confirm a urinary tract infection. Multiple providers failed to consider a possible illness outside of urinary tract infection (such as kidney disease), and failed to refer Mrs A for urinary tract imaging or a specialist referral for urological assessment and cystoscopy, as recommended by guidelines. The multiple and repeated failures to follow up test results or investigate symptoms appropriately, resulted in a delayed diagnosis of Mrs A’s bladder cancer. Mrs A had several bladder lesions removed surgically and subsequently underwent surgery to remove her bladder, uterus, and lymph nodes followed by a course of chemotherapy. The surgery was radical and extensive, and left her with a permanent urostomy bag and an increased risk of future issues.

 Tui Medical accepted that it:

  • failed to provide Mrs A with an appropriate standard of care, through the failure of multiple doctors to review her clinical history adequately and apply critical thinking, and through missing opportunities to identify the need to refer Mrs A for imaging or specialist assessment;
  • failed to ensure effective cooperation between Mrs A’s practitioners, including that there was no clear policy for the review of test results when staff went on leave at short notice; and
  • failed to inform Mrs A of her test results following one of her consultations.

 

Tui Medical accepted that its failures in care amount to breaches 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 Tui Medical failed in the care that it provided to Mrs A, and issued a declaration that Tui Medical breached Rights 4(1), 4(5), and 6(1)(f) of the Code.

 The Tribunal’s full decision can be found at:

https://www.justice.govt.nz/assets/Documents/Decisions/2021-nzhrrt-44-director-of-proceedings-v-tui-medical-ltd.pdf

 [1] Blood in the urine visible only under a microscope.

[2] The need to urinate frequently.

[3] Painful or difficult urination.