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Private Health Care

Private surgery

Retained products retrieved by GP

A mixed up low resolution approach

Special medication destroyed without consumer's consent

Public hospital to the rescue

Contrite specialist gives refund

Private Hospital ~ Right 5 ~ effective communication ~ Right 6 ~ fully informed ~ Right 7 ~ choice & consent ~ Interpreter
The consumer advised an advocate that he had been on a waiting list for eye surgery for an excessive amount of time. However he had recently received advice that he had been referred by the public hospital to a private hospital for his surgery.
Two days before his surgery the private hospital advised they would not provide an interpreter and he should organise his own or bring a family member. The consumer advised he had no-one he could bring. Due to the time constraints the consumer asked the advocate to speak with the private facility staff. The advocate was also advised they could not provide an interpreter but that they could refer the consumer back to the public system. 
The consumer didn't want to go back on the waiting list. The advocate phoned the patient liaison officer at the public hospital, who acted very quickly and advised the advocate that the public hospital would provide the interpreter for the consumer at the private hospital. The consumer was extremely relieved to hear this information and delighted with the support given by the advocate. He is now promoting the advocacy service in his community. 

 

Private surgery

Surgery ~ private care ~ hidden cost ~ right to be fully informed ~ Right 6 (b)

A consumer contacted an advocate as she felt she had not been fully informed. She had chosen to have an operation privately and had agreed to the costs presented to her in advance.

However after the surgery she was required to wear a 'moon boot' which cost $280.00. This was an additional cost she had not been told about.

After considering her options the consumer decided to approach the provider directly. The provider advised that as most surgery done privately is paid for by ACC or Private Medical Insurance he hadn't thought to mention the cost. 

He then advised that it wasn't really necessary for her to have the boot and took it back agreeing to give the consumer a credit. The consumer was happy with this outcome.

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Retained products retrieved by GP

Private hospital ~ surgery ~ Right 4 ~ appropriate standards ~ retained products

A consumer had surgery at a private hospital. Prior to discharge her indwelling catheter was removed and she was sent home with antibiotics. A week or so following her discharge she noticed a smelly discharge which she consulted a GP about. The GP ordered a urine test and took a swab. She prescribed ointment for the discomfort.

A few days later the GP contacted the consumer to say the tests had come back clear. A few days later the consumer again consulted the GP as nothing had changed. The GP prescribed antibiotics which the consumer states did not help. 

A further week passed and the consumer says she woke feeling poorly. She "was giddy and had very low blood pressure".  Concerned, she called the "on call duty doctor" who advised the consumer to rest and if not better within 3 hours she should arrange to visit him. 

The following day she had another appointment with the GP at her medical centre. Upon examination the GP discovered some surgical packing which she removed. 

The following day she received a call from the distressed surgeon. She apologised but could not offer any explanation. The manager of the hospital also made contact with her, stating how horrified the staff were, that this had happened. 

The issues the consumer wanted addressed: 

  • Could the packing have been a threat to her life?
  • What procedures did the hospital have in place to prevent a situation such as this from occurring? 

The consumer also wanted the following questions addressed: 

  • When was the packing inserted?
  • What instructions had the surgeon given post-operatively?
  • How did this situation arise?
  • What are the procedures for counting swabs during surgical procedures? 
  • Who was responsible for what had occurred?
  • What was being done to prevent an event such as this from happening to others?

Upon contacting an advocate, the consumer stated a family member had suggested she should obtain her medical records before proceeding with a complaint. She asked if this was correct. The advocate advised that it was not imperative she obtain her records before making a complaint.  

After considering how she might submit her complaint the consumer opted to put it in writing. As she was capable of doing this she asked that the advocate check her letter before it was sent to the hospital. She was unsure whether she could also complain about the actions of the GP and was advised she had the right to complain about any health or disability service provider if she had concerns about her care and treatment.

On this basis she decided she would also send a letter to the GP asking for an explanation of her care. In her letter to the hospital the consumer requested a meeting and advised she would bring an advocate for support.

On the day of the meeting the advocate and consumer met an hour before the meeting with the providers to ensure the consumer was well prepared. 

At the meeting after hearing the consumer's concerns and questions the manager apologised to the consumer for the grave mistake they had made. The manager produced a review of the event, how it may have occurred and the steps that had been taken to prevent it from occurring again.  

The manager discussed various strategies that they could and would undertake in the future and requested the consumer's input. There was considerable discussion around the discharge process as well, including the legibility of discharge summaries. The discussion revolved around amending the current form, allowing nurses to write information on it, any medications scripted were also to be recorded, and that the information be given verbally - ideally in the presence of family or a friend. 

The manager also expressed gratitude to the consumer for bringing the complaint to their attention.  This had enabled the service to closely examine their current procedures, making them more robust and accountable. 

The consumer was pleased with the process. She came away feeling she had assisted in reviewing and developing a system that would hopefully ensure this event did not happen to anyone else.  

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A mixed up low resolution approach

DHB ~ Surgery ~ Right 4 ~ appropriate standards ~ provider meeting

A consumer contacted an advocate for support at a providers meeting after he had sent his complaint to the Commissioner's office. The consumer expressed concern that he had been told his prostate surgery would take approximately 5 hours when in fact it took 12 hours.

In recovery he complained of severe pain in his left leg. The next day he had swelling from his knee to ankle and discolouration of his left leg. He said his surgeon visited him while still in the private hospital and apologised stating he had "screwed up". Later that morning he was transferred to the public hospital with a Deep Vein Thrombosis (DVT) and renal failure. He had also developed compartment syndrome in his left leg. In the 6 weeks he was being treated for this syndrome he had to have ten other operations on his leg, blood transfusions and dialysis for two weeks.

He had a number of questions he wanted answers to. He wanted to receive the answers directly from the surgeon who had carried out the original operation.

1.   Why did the surgery take 12 hours? 

2.   If the surgeon was finding the robotic system difficult why didn't he make the decision to change to the shorter 5 hour surgery?

3.   Did the length of time taken to complete the surgery cause the DVT and Compartment Syndrome?

4.   What went wrong?

The providers had been supplied a copy of the complaint by the Commissioner's staff. The

Doctor explained the changes that had taken place in the  theatre since the consumer's operation, to reduce the risk of this happening to anyone else. The doctor offered an apology to the consumer and discussed the impact of the consumer's loss of mobility and the forced changes to his lifestyle. Compensation was discussed briefly and the appropriate referral was made to ACC. The consumer also raised issues about the nursing care and was advised these would also be followed up. 

The advocate requested those present sign the resolution agreement form but the providers declined on the basis that the complaint had been sent to the Commissioner and they were required to report back to him on the outcome. 

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Special medication destroyed without consumer's consent

Private Hospital ~ Right 4 ~ appropriate standards ~ Right 5 ~ effective communication ~  Right 6 ~ fully informed ~ medication ~ expiry date ~ disposal

A consumer contacted an advocate to discuss how Advocacy could assist. He wanted to make a complaint that on discharge from a private hospital he had not had all his medication returned. The consumer said that when he was admitted to the hospital he "handed" over his prescribed medications which included some restricted drugs that are only dispensed by the pharmacy on a weekly basis, are signed for by the consumer and do not have an expiry date. There was no signing by either parties to say the hospital had received his meds or from him to say he had "handed" them over. It was not until he arrived at a rest home for a period of rehabilitation he discovered the restricted medications were missing. 

He said he had contacted the hospital and was told they had been destroyed as they were past their expiry date. The consumer disputed this on the basis he did not believe they had an expiry date, they were dispensed by the pharmacy weekly and had to be signed for. He said he had written to the hospital requesting a full explanation and also contacted the Police and asked them to investigate. The consumer's issues were that there was no paper trail i.e. no-one signed for the medication when he handed them in, they were not given back to him as he was told they had been destroyed (but was not told how). He disputed the medication had expired and was concerned about drug misuse. The Police had contacted the consumer saying they had looked in to the matter and been told the medication had been destroyed.

The advocate discussed the processes available for resolution including a meeting of the parties. The consumer did not want to meet but decided to send a second letter requesting information about how and why the medication was destroyed, who destroyed it, and why there was no consultation with him prior to its disposal. The consumer advised the advocate he would write his own letter and did not require any further assistance at that stage.

As agreed, the advocate followed up with the consumer after two weeks at which time the consumer advised he had had a letter from the hospital and that he was happy with their response and did not want to take the matter any further. 

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Public hospital to the rescue

Private hospital ~ Right 5 ~ Effective communication ~ Right 6 ~ Fully informed ~ Right 7 ~ Choice & consent ~ Interpreter

A consumer advised an advocate that he had been on a waiting list for eye surgery for a long time. However he had recently received advice that he had been referred by the public hospital to a private hospital for his surgery.

Two days before his surgery the private hospital advised they would not provide an interpreter and he should organise his own or bring a family member. The consumer advised he had no-one he could bring. Due to the time constraints the consumer asked the advocate to speak with the private facility staff. The advocate was also advised they could not provide an interpreter but that they could refer the consumer back to the public system. 

The consumer didn't want to go back on the waiting list. The advocate phoned the patient liaison officer at the public hospital, who acted very quickly and advised the advocate that the public hospital would provide the interpreter for the consumer at the private hospital.

The consumer was extremely relieved to hear this information and delighted with the support given by the advocate. He is now promoting the advocacy service in his community. 

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Contrite specialist gives refund

Private Specialist ~ Right 1 ~ Respect ~ Refund

A complaint about a private specialist was referred to the advocacy service by the Commissioner. The advocate contacted the consumer and met with her to discuss her resolution options. She was initially reluctant to meet with the provider because of a previous bad experience. However, after considering the various options she felt that a meeting would be the best way to resolve her complaint.

In the lead up to the meeting the advocate and consumer were in regular contact to discuss strategies to enable her to feel confident to raise the issues of concern. In addition to the advocate, the consumer also planned to bring a family member for support.

At the meeting the consumer spoke about the consultation and how it had made her feel. The specialist listened and responded to her concerns from both his memory of the consultation and the notes he had made at the time. The consumer was happy her concerns were addressed and accepted the provider's verbal apology. He also agreed to write a letter to the consumer outlining what had been spoken about at the meeting. In the letter he apologised and also agreed to fully refund the fee charged for the consultation.



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