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Radiology

Assistance needed for reassurance of breast cancer fears

Distressing communication by a radiographer

Difficulty inserting luer prior to CT scan

Appropriate standards in the radiology department 

Proactive provider

 

 

 

 

 

 

 

Assistance needed for reassurance of breast cancer fears

DHB ~ Mammogram ~ Breast lump ~ Biopsy ~ MRI ~ Family history ~ Right 5 ~ Effective communication

A consumer contacted the local advocate as she was very concerned about recent results she had received after a mammogram and breast biopsy.  Although the specialist had told her there was nothing to worry about, he had used words she didn't understand. She was too embarrassed to ask any questions and was very worried as she could still feel a painful lump. Following the appointment, she discovered her grandmother had died of breast cancer so this increased her level of concern. She asked the advocate to support her at the next appointment so she could get the answers she needed.
 
At the appointment the specialist told the consumer that although a lump could be felt, the biopsy had revealed it was not cancerous.  The consumer told the specialist about her family history and that she was still worried as the lump was painful. The specialist offered her an MRI scan to rule out any possibility of cancer and to put her at ease. She was pleased she got to ask the questions that she wanted and was very relieved to be having an MRI scan. The consumer told the advocate that she was very grateful for the support as she had felt very overwhelmed by the situation.

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Distressing communication by a radiographer

Rights 5 & 6 ~ Effective communication ~ Information ~ Breast cancer ~ Mammogram

A woman who had previously had breast cancer had been given the all clear after fourteen months of medical intervention including a mastectomy and chemotherapy. Once the treatment was completed she was advised to have annual mammograms. After her first annual mammogram and a 15-minute wait she was told it was all clear. She left feeling elated and was very upset to receive a call to her home 30 minutes later saying 'Oops we made a mistake - you need to come back'. The impact of this 'destroyed her world'.

In her conversation with the radiographer the woman was not told why they thought they had made a mistake, nor was she told what the abnormality was or where it had been found. The consumer was sure her cancer was back and felt extremely distressed about this. However, when she returned to the clinic she was told the cause for concern was in the other breast, that is was very small and thought to be a cyst.

The woman spoke with a social worker from the Cancer Society who recommended she contact the Nationwide Health and Disability Advocacy Service which she did. During the meeting with the advocate the woman identified her issues and her desired outcomes, and decided she would send a letter of complaint to the provider and request a meeting. She said she wanted to discuss the casual way she was informed of the mistake, the language used, as well as the lack of empathy and information. The staff at the radiology practice agreed to meet and discuss her concerns. Following the meeting the woman received a letter of apology along with an outline of the changes made by the practice as a result of her complaint.

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Difficulty inserting luer prior to CT scan

Public hospital ~ Radiology department ~ CT scan ~ Effective communication ~ Anaesthetist

A consumer advised the nurse before her CT scan that from past experience she anticipated difficulty with inserting a luer in her arm. She was assured the anaesthetist was very skilled. However, it took a painful forty minutes to insert the luer and the doctor was still holding it in place until the final second before the consumer entered the machine.

The consumer said that seconds into the scan she was in a lot of pain and her arm swelled alarmingly. The attending nurses seemed to panic, not knowing what to do, and this further alarmed the consumer. Two doctors were called in and checked what had been done, but seemed uninterested. They did not explain what was causing the pain and said everything seemed to be ok.

The consumer sought advocacy support to make her complaint to the hospital. After discussion with the advocate she chose to have assistance with writing a letter of complaint. She was keen for the radiology department to look into their procedures for dealing with patients who anticipate problems.

The consumer was very satisfied with the response from the hospital. She said:

"I feel that they treated the matter with the right amount of seriousness, they addressed all the issues that I mentioned and promised to have the right tools to cope with a similar event happening again … I feel I can put it all behind me."

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Appropriate standards in the radiology department 

A consumer had a chest x-ray at her local hospital. The report was sent to her GP who recommended urgent biopsies of her lungs. As the waiting list was two weeks, she requested a referral to a specialist. The specialist advised her of the prognosis, and she and her family began organising for terminal care.

Ten days later, the specialist reviewed her x-ray and discovered her lungs were clear. It transpired that the results were those of a person with a similar name who also received care from the same GP. The consumer wanted to know why the provider had not checked the x-ray report against the x-ray, NHI number and other identifiers, and wanted the provider to understand how this mistake had affected her and her family. She wanted to be reimbursed for the cost of the specialist consultation.

With the assistance of an advocate, a meeting was set up with the specialist, radiologist and the clinical director of medicine. The consumer and her family were able to talk about the impact this mistake had had on the family. The doctor apologised and explained that a digit had been entered incorrectly into the computer. The hospital was in the process of having a new computer system installed and the doctor believed the new system would prevent this type of error occurring again. The DHB agreed to pay the cost of the specialist consultation if ACC did not accept a claim.

The consumer was pleased to have had the opportunity to meet and hear this explanation.

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Proactive Provider 

A consumer received a call from a specialist whom he had seen over a year previous. The doctor asked to meet with him and his wife to discuss the results of an x-ray taken while under his care. The doctor suggested they may like to make contact with the local advocate who could support them at the meeting. The consumer acted on the doctor's suggestion and contacted the advocate. At that stage the consumer was unsure of the purpose of the meeting.

At the meeting the doctor explained that the pre-operative x-ray report, from a year ago, had recorded an abnormality and recommended a CT scan which had not been followed up. The doctor had learned of the error as a result of the consumer requiring another x-ray and radiology personnel reviewing the original report. He accepted responsibility, as the consultant surgeon, for the failure to follow up on the original recommendation. He explained he had called the meeting to offer an apology and determine what support he could offer the consumer. The doctor offered to fill out an ACC form with a supporting report and was prepared to assist the consumer to take his complaint to the Health and Disability Commissioner if he chose to. The parties agreed to meet again in a week after the couple had had time to reflect on the situation. In the meantime the doctor would forward his report to them.

Prior to the second meeting the couple met with the advocate to clarify the issues and discuss their expectations.

At the second meeting the doctor agreed to complete the ACC form. If the consumer required further treatment he agreed to make every attempt to expedite such treatment including assisting with any travel costs if treatment was provided outside of the area. He also gave an assurance that the system for checking results would be reviewed.

The couple chose not to take their complaint to the Commissioner as they were happy with the outcome of the meeting. The advocate had assisted them to have their personal needs meet as well as instigating a systemic change to prevent others from suffering a similar fate.

 

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