Page Section: Centre Content Column

Surgery

Explaining an ongoing pain problem

Lack of information impacts on another condition resulting in cancelled surgery

Frustration at ongoing pain

Sloppy procedures after surgery

The involvement of an advocate finally results in an explanation

Lack of information prompts the need for a meeting

Surgeon changes practice after hernia repair failure

Information provided before bowel surgery

Lack of information delays surgery

A consumer solution

Plastic surgery by a general surgeon

Young person needing information

A problem following an operation

Care following an operation

Vision impairment following surgery

Information regarding follow-up care

Appropriate treatment for haemorrhoids

When fear immobilises

Results of thyroid surgery

Explanation for cancelled surgery

Claiming ACC following surgery

Confusion over administration of medication

A genuine mistake at a DHB

Helping to speed up a slow DHB

 

 

 

Explaining the ongoing pain problem
DHB ~ Surgeon ~ Right 4 ~ Ongoing pain ~ Right 5 ~Effective Communication
A consumer who had suffered a medical misadventure two years previously had ongoing pain which resulted in numerous visits to both her GP and the hospital. She said she had not had the opportunity to discuss her concerns with the provider and contacted an advocate to assist her to do so. 
The consumer chose to write to the provider informing him of her concerns and her desire to meet with him to discuss these. She advised she would have an advocate present for support.
At the meeting the consumer went through her concerns. In response the surgeon provided an explanation. He also acknowledged and apologized for her ongoing pain, offering options for medication which could ease it. He advised that he had undertaken further training to improve his skill. 
Following the meeting the consumer felt she had been heard, all her questions had been answered, and she was very satisfied with the good outcome from the meeting. 

Explaining an ongoing pain problem

DHB ~ Surgeon ~ Right 4 ~ Ongoing pain ~ Right 5 ~ Effective Communication

A consumer who had suffered a medical misadventure two years previous had ongoing pain which resulted in numerous visits to both her GP and the hospital. She said she had not had the opportunity to discuss her concerns with the provider and contacted an advocate to assist her to do so. 

The consumer chose to write to the provider informing him of her concerns and her desire to meet with him to discuss these. She advised she would have an advocate present for support.

At the meeting the consumer went through her concerns. In response the surgeon provided an explanation. He also acknowledged and apologized for her ongoing pain, offering options for medication which could ease it. He advised that he had undertaken further training to improve his skill. 

Following the meeting the consumer felt she had been heard, all her questions had been answered, and she was very satisfied with the good outcome from the meeting. 

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Lack of information impacts on another condition resulting in cancelled surgery

DHB ~ Surgery ~ Prolonged nil per mouth ~ Right 6 ~ Fully informed ~ Written information

A consumer contacted an advocate about her recent hospital experience.  As a result of not being given appropriate information prior to a scheduled operation she became unwell, resulting in the surgery being postponed. She was unhappy that a delay in having the surgery after she had been medicated, plus the length of time she was without food or fluids had impacted on another of her medical conditions resulting in the postponement.

Having thought about the options, the consumer chose to have assistance with putting her concerns in writing and requesting a written response from the provider.

Hospital staff involved with her care offered to meet with her. The consumer requested advocacy support at the meeting where she outlined her concerns about the lack of information she had received prior to her admission.

The staff advised that following receipt of her complaint they had investigated her concerns and wanted to offer her an apology. They told her the information was available in written form and that she should have been given a pamphlet. The consumer was advised that staff had been reminded of the need to make sure consumers were given both verbal and written information as part of the preparation for the surgery.

The consumer accepted the apology and was pleased her concerns had been taken seriously.

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Frustration at ongoing pain

DHB ~ Orthopaedic Surgeon ~ Right 6 ~ Fully informed ~ Fractures ~ Pain relief

A consumer, who had compound fractures of the lower tibia and fibula from a motorcycle accident, had them fixed with a steel rod and screws.

Over the next three months, whenever he saw the orthopaedic surgeon he complained about ongoing pain in his knee cap. He returned to work and commenced physiotherapy but had to stop as it was too painful. He had the rod removed by a different surgeon and was sent again for physiotherapy. However he was still in pain, which restricted his movement. In frustration at not getting adequate pain relief and the answers he needed about why his recovery was taking so long, he contacted an advocate for help.

After considering the options, he chose to write to the Orthopaedic Department to request a meeting. At the meeting he wanted a detailed explanation of why the insertion of the rod had been chosen over other options that may have been available, and whether a different option would have resulted in a different outcome. The consumer asked the advocate to support him at the meeting.

The meeting went very well and the consumer had all his questions fully answered. He was provided with an explanation about the ongoing pain and the expected time it would take for the bone bruising to heal. He was also reassured the length of the metal rod used had not contributed to his pain and was offered an alternative treatment to provide pain relief.

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Sloppy procedures after surgery

DHB ~ Orthopaedic surgery ~ Right 4 ~ Appropriate standards ~ Service changes

A consumer approached an advocate for help after a number of unsuccessful attempts to address her concerns directly with the DHB. She had had hip surgery and six weeks later was dismayed to be told that a screw had moved causing the head of the femur to drop, which could cause complications. She was told that this meant she must spend eight weeks in bed resting. Her request for an explanation about how this had happened resulted in unsatisfactory responses.

After considering her options, the consumer decided a letter should be sent to the hospital requesting a meeting with the surgeon, physiotherapist and occupational therapists.

At the resolution meeting the consumer was told the post-operative instructions of "non-weight-bearing" were hand-written by the surgical team as "touch-weight-bearing," resulting in the ward physiotherapy, occupational therapy, and community physiotherapy services not providing appropriate services. All the providers present apologised to the consumer for the detrimental impact of this error. They also acknowledged their failure to take into account the consumer's pre-existing condition when determining her rehabilitation plan. The surgeon agreed to continue to oversee her rehabilitation which was expected to take at least two years.

As a result of the complaint, she was told of procedural changes following orthopaedic operations. This included all handwritten instructions post-orthopaedic surgery to be typed immediately then crosschecked against a printed instruction sticker on each patient's file.

The consumer was happy with this outcome as she felt the staff involved had learnt from the complaint and improved the service as a result.

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The involvement of an advocate finally results in an explanation

DHB ~ hernia surgery ~ surgical mesh ~ ongoing pain ~ emergency repairs

A woman contacted an advocate  for help making a complaint about ongoing pain from a hernia operation two years previous. The problem was due to the surgical mesh used in the operation repeatedly coming loose. She had been back and forth to her GP as well as the hospital, with ongoing pain, resulting in emergency surgery and the need to stay in ICU for a lengthy period of time.

After two years she had had enough. At a meeting with the advocate to discuss her options she chose to write to the hospital to request a meeting with the surgeon to discuss her concerns.

At the resolution meeting the surgeon told her that following her mishap with the surgical mesh, he had re-looked at and had made changes to the way he was practising. He has stopped using the mesh and is now using both stapling and stitching when doing hernia repairs.

He apologised for the mistake he had made in her case and for the distress he had caused. He raised the probability of her having ongoing pain and offered medication options to ease this.

Following the meeting the woman felt that all of her questions had been answered. She was happy that he had re-looked at his practice following her situation and had improved the standard of care he was providing to others as a result. She was very pleased to have the support of an advocate as prior to the meeting she had been unsuccessful in her attempts over a number of months to receive an explanation for her concerns.

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Lack of information prompts the need for a meeting

DHB ~ Chronic infection ~ Multiple surgeries ~ Orthopaedics ~ Right 6 ~ Fully informed ~ Treatment plan

A man complained to an advocate that he wanted more information about a persistent leg infection he had had for almost eight months. During this time he had been admitted to hospital nineteen times for seventeen operations. His care had been jointly provided by both an Orthopaedic Surgeon and an Infectious Disease Consultant but neither has discussed a treatment plan or how much longer the infection could go on for.

After considering his options he asked the advocate to arrange a meeting for him with the Infectious Disease Consultant who was the doctor he felt he had the best rapport with. The advocate attended the meeting at the man's request to support him as well as family members present.

The meeting lasted two and a half hours with the man and family members asking a number of questions. The doctor provided as much information as he was able to so the man came out of the meeting feeling fully informed about the multiple bacterial infections he had, and the reason for the treatment regime he was on.

The doctor also agreed to complete private insurance forms and also to provide ACC with the additional information they had requested. The consumer was satisfied he had got what he needed from the meeting.



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Surgeon changes practice after hernia repair failure

A consumer had surgery to repair a hernia. The surgical mesh used during the operation kept coming away which resulted in the need for emergency surgery as well as a lengthy stay in the ICU. Over the next two years the consumer was back and forth to her GP and the hospital with ongoing pain.

She finally called the advocacy service to help her make a complaint. After considering the various options, the consumer opted to write to the surgeon to request a resolution meeting to discuss her concerns. At the resolution meeting the surgeon told the consumer that following the problems she had experienced with the mesh, he had made changes to the way he was practicing. He now used both stapling and stitching for hernia repairs.

He apologised for the mistake he had made and the distress this had caused. He also discussed the issue of ongoing pain and offered medication options to ease this. The consumer was happy with the meeting. All of her questions had finally been answered. She was also very pleased the surgeon had reviewed his practice to improve the standard of care to consumers in a similar position.

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Information provided before bowel surgery

Rights 6 + 7 ~ Information ~ Informed consent ~ DHB ~ Bowel surgery

A consumer had emergency surgery to manage a twisted bowel. When she awoke she had two bags rather than just the one she had expected. She had not been warned of this possibility before surgery, and had not received an explanation from the surgeon about why she needed a second bag. The consumer was distressed by this, and felt the surgeon had an uncaring and uninformative attitude. After considering her options, the consumer opted for a meeting with the head of surgery and asked the advocate to accompany her for support.

Prior to the meeting the consumer and advocate met to discuss the consumer's questions as well as how the advocate would provide support during the meeting. The meeting was attended by the head surgeon and hospital customer relations coordinator. The consumer was able to ask all of the questions that had been concerning her, and she received an in-depth explanation from the head surgeon about the surgical treatment she had received. The head surgeon apologised for the distress caused by the trauma of waking up to find she had two bags, without being advised this was a possibility before her surgery.

Following the meeting the consumer advised the advocate she had found the face-to-face discussion with the head surgeon in a safe and supportive environment a very helpful, healing process. She felt there had been a positive outcome from her complaint and most importantly she had received an easy to understand explanation. She also said she would not have been able to complete the process without the advocate's support as prior to calling the advocacy service she was ready to give up.

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Lack of information delays surgery

A man with cerebral palsy cancelled major surgery the day before it was due, as he felt he had insufficient information about the procedure and his post-operative care. He discussed his concerns with a provider who referred him to advocacy.

They discussed the advocacy process and the man clarified his concerns. They wrote directly to the specialist outlining the man's concerns, and asked whether:

  • the surgery would be performed by the specialist himself
  • a different surgical approach could be taken
  • the man would have the opportunity to meet with the anaesthetist before the operation to discuss anaesthetic options
  • the plan for post-operative care had been tailored to meet his needs taking disability into account.

While awaiting a response, the advocate contacted the hospital to check that the man remained on the surgical waiting list despite his cancelling the surgery. The advocate also contacted the local assessment agency to determine the man's entitlement to home support services. Both agencies responded positively which allayed some of the man's apprehension.

The specialist wrote back advising that the surgery should be performed without undue delay, and that he had made an urgent referral to the anaesthetist requesting the man be assessed and provided with the opportunity to discuss his concerns relating to anaesthesia.  The specialist offered a meeting between himself, the man and the advocate to discuss the actual surgery and post-operative care.

The consumer took up the offer of the meeting and the advocate attended as his support person to ensure that he was able to communicate his concerns and receive sufficient information to enable him to make an informed choice about proceeding. At the end of the meeting he was very satisfied with the information given and gave the specialist the "go ahead" to schedule a date for the surgery.

The man later contacted the advocate advising the surgery and post-operative period were uneventful with his needs being met every step of the way. 

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A consumer solution

Surgeon ~ Public hospital ~ Mastectomy ~ Incorrect diagnosis ~ Reparation ~ Standard of care ~ Right 4

A woman sought the assistance of an advocate after a breast lump was wrongly diagnosed as cancer, which had led to a total mastectomy. A meeting was arranged with the provider involved to discuss the woman's concerns. This face-to-face meeting was very successful. After the woman told her story, the provider apologised and asked what could be done to help the situation. The woman was due to have a breast reconstruction, but this required travelling to another area. She wanted her husband to be able to travel with her and to stay at a nearby motel, and for the provider to cover the cost. She also asked for a family member to be flown from another part of the country to look after their children as she had no family living close by. She wanted home help provided following the reconstruction to assist her recovery. These requests were all agreed to and provided by the provider. The woman has recovered from her reconstruction surgery and has returned to work.

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Plastic surgery by a general surgeon

Historical complaint ~ Media ~ Resolution meeting ~ Being heard ~ Paediatric plastic surgery ~ General surgeon

A consumer sought the assistance of her local advocate to deal with unresolved issues relating to plastic surgery performed on her as a child approximately 50 years ago. After discussing the options the consumer decided she wanted to meet with representatives of the organisation where the surgery had been performed. The advocate assisted her to write and send a letter requesting a meeting. In their response, the provider organisation declined to meet as the medical records from the time had been destroyed by fire.

Following this response, the consumer decided that her only way forward was to have her story told by the media. Her story, along with photographs, was published in her local paper. Following her story appearing in the newspaper she was contacted by a lawyer on behalf of the provider organisation inviting her to meet with them. The consumer contacted the advocate to support her at the meeting. She just wanted to tell her story and have someone listen to what the effects of having a general surgeon doing that type of surgery had had on her life.

After the meeting she went back to the media to say what a success the meeting had been. She had been able to tell her story and felt she had been listened to. The media did a follow-up article stating a meeting had been held and that the consumer was very happy with the outcome.

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Young person needing information

Student ~ Fully informed ~ Effective communication ~ Surgeon ~ Hospital

A 14-year-old high school student, boarding away from home, was diagnosed with a condition that she was told required urgent surgery. She contacted the local advocate as she felt she didn't have enough information about her situation. She also wanted to know when the surgery was scheduled to take place.

Following discussion with the advocate the consumer wrote to the surgeon outlining her concerns, including not fully understanding the condition or its seriousness. She received a response from the surgeon but unfortunately the response did not answer her questions or provide the information she needed.

After further discussion with the advocate the consumer decided to complain to the hospital, enclosing copies of the letter to the surgeon and the surgeon's reply.

The next day the manager of the service contacted the student and arranged for the surgery to be performed by another surgical team straight away.

Following the successful surgery and her recovery the consumer visited the advocate to say the support and options provided by the advocate had helped her to decide on actions she felt comfortable with and that they had ended with a great result.

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A problem following an operation

A consumer complained to an advocate that when in hospital for surgery an epidural was administered with both arms above his head. He believes they remained there throughout the operation leaving him with limited sensation - paralysis in one arm and partial mobility in the other arm. He was unable to hold anything with the paralysed hand and required assistance with eating and dressing. He was previously self employed and was no longer able to do his job.

His complaint highlighted the following issues:

  • He was not told what caused this problem and the clinical people involved in his care did not respond to his requests for information.
  • He was advised he did not fit the criteria for home support yet he required help with activities of daily living.
  • He needed  information to lodge an ACC claim for personal injury.

After considering the options, the consumer decided the best way to progress the matter was to use advocacy assistance to write to the Complaint Manager at the hospital. In his letter the consumer suggested he would like to meet if the written information he was requesting was not forthcoming. He also wanted a copy of his medical records to see what had happened.

He was very pleased to receive all the information he required including the claim form for ACC so a meeting wasn't necessary.

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Care following an operation

A consumer sought the assistance of an advocate as he had ongoing pain following an operation. He had raised the issue of the pain with the orthopaedic consultant when attending follow-up appointments and had been referred for physiotherapy, but continued to experience pain.

After discussions about advocacy process the consumer elected to, with advocacy support, write to the provider outlining his questions and seeking a meeting to discuss his concerns.

At the meeting the provider explained all the options that had been available at the time of the consumer's admission and why that particular treatment option had been chosen. He outlined the expected time for healing and was offered options for medication which could ease the pain while he continued with his rehabilitation.

Following the meeting the consumer felt that he had received answers to all his questions and that he considered the matter resolved. 

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Vision impairment following surgery

The man was contacted by a hospital nurse who told him to stop taking his blood thinning medication two days prior to his planned surgery. On admission, the same nurse told him she had been incorrect and he should not have stopped his medication.

After the operation, he noticed his vision had become impaired, and thought this may have been the result of a blood clot travelling from his leg. After discussing his concerns with an advocate, he wrote asking why he had been instructed to stop taking his medication and why, when the error was discovered, he was not contacted and told to recommence the tablets. He wanted an apology and to know what action would be taken to avoid something similar happening in the future.

The man decided he would like to meet with the provider, with the advocate's support. The nurse was there and offered an apology. A doctor was also present and advised that stopping the medication such a short time before surgery was unlikely to have caused a clot, that the clot behind the eye was not a result of the surgery.

At the conclusion of the meeting the consumer said he had received the information he required and was pleased to have received an apology.

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Information regarding follow-up care

A consumer was discharged from hospital feeling very unwell and in a great deal of pain. She contacted her GP and was referred back to hospital where it was discovered that as a result of the surgery she had urinary leakage requiring the insertion of a urinary catheter. The consumer felt that she was being given different information by each doctor she saw, and there was no clear plan for her care and treatment. Surgery had been presented as the best option. The family's private health insurance would not cover the proposed surgery and the consumer was becoming desperate as her health issues were affecting her ability to care for her young family.

The consumer requested an urgent meeting with the DHB, with advocacy support. The provider was made aware of the issues and desired outcome prior to the meeting and so was fully prepared when the meeting occurred. At the meeting the provider advised the consumer that her health concerns were a result of a treatment injury. An ACC form would be completed by the provider and surgery would be organised.

The provider was able to provide full information and explanations about what had occurred, and the proposed surgery, and the consumer left the meeting feeling happy that she had the information she required. 

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Appropriate treatment for haemorrhoids

A young man contacted advocacy stating that he was desperate for surgery as he was on the waiting list for ruptured haemorrhoids. At a previous consultation with his hospital specialist he was given the options of surgery or banding. He chose the second option but when the bands came off he was advised by the medical staff on duty that they were too busy to attend to him and he would have to come back to have the procedure re-done.

The pain became unbearable he was unable to walk, and was taken to the local emergency department by ambulance. On his arrival the bleeding had stopped so he was given medication and discharged. In total he went on five occasions and each time he was discharged without any further procedures being carried out.

After discussing the advocacy process the man asked that the advocate support him to meet with his GP to clarify what steps had been taken to get appropriate treatment for him. Having heard what the GP had done it was agreed that a letter should to the local hospital with a cover letter from the GP. The man advised he had received treatment. He was very pleased with the support advocacy had provided as prior to their involvement he had been attempting to get treatment for ten months.

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When fear immobilises

A man with a needle phobia contacted advocacy after he attended a pre-anaesthetic clinic where the specialist nurse and anaesthetist did not take his phobia seriously, even though the DHB had been advised of the phobia by his GP. They tried to joke and jolly him through the appointment, and insisted he watch a video on anaesthetics saying it would be beneficial for him. He was traumatised by the pre-anaesthetic procedure.

This experience left the consumer in extreme distress and unable to go ahead and have the scheduled operation two days later.

As he was so traumatised, he asked the advocate to contact the DHB and raise his complaint. The DHB wrote a letter of apology but the man did not think this fully addressed his problem, so he wrote another letter to his consultant and the manager of surgical services reiterating his concerns.

This resulted in a very positive and professional pre-anaesthetic appointment and his operation was scheduled for the following week. The man was very pleased with the outcome and thanked the Advocacy service for their assistance.

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Results of thyroid surgery

A woman had a lump on her throat removed by a specialist. He advised her that he would remove the thyroid only if it was cancerous, but after the surgery informed her that even though there was no cancer present he had removed her thyroid and that it would never grow again.

The woman was concerned that she was not told about the side effects of the removal of her thyroid, which includes a change in the voice.  Since the operation she had been unable to sing, which she had previously enjoyed. 

She had tried to address her concerns directly, but felt that the specialist did not listen to her.  With the assistance of an advocate, the client was able to formulate a letter to the outlining her issues and desired outcomes. As a result of this a meeting took place between the parties, facilitated by the advocate. The specialist provided answers to the queries she had in regard to the risks, and agreed to pay for a voice therapist in the private sector. She also received reimbursement for her follow-up visits to the clinic. 

She was very satisfied with these outcomes.

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Explanation for cancelled surgery

A woman in her late eighties contacted advocacy as she had received a phone call advising her surgery had been postponed, a couple of hours before she was due to go in to hospital. She had asked the hospital why her operation was cancelled and how long she might have to wait for another appointment but these questions were not answered. The woman felt that the surgery had been cancelled on the basis of her age and that she was not being given the same care and treatment as others. 

The woman asked the advocate to contact the provider for the information for her. The hospital said that an internal investigation would be carried out and they would contact the woman to let her know the outcome.

It was found that the short notice was due to the doctor being sick and the woman should have been advised of this. She was contacted and received an apology along with a new date for the surgery, and was very happy that the advocate had been able to assist her to get answers in a timely way.   

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Claiming ACC following surgery

The wife of an elderly man came to the Advocacy Service seeking assistance to resolve a complaint with the hospital. Her husband had undergone a simple surgical procedure to repair a hernia. While in recovery he vomited, there was a delay in aspirating him, and he was subsequently found to have some brain damage. 

The man experienced ongoing effects of the incident, so the advocate assisted the woman to prepare an ACC Claim but hospital medical staff declined to sign the form. Eventually a locum GP agreed to sign the form so the consumer would get a hearing from the ACC.  The claim was accepted as the wrong type of tube had been used to keep the airways clear in case of the patient vomiting.

The couple are bright and positive about the future and are appreciative of the help given by the advocate.  

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Confusion over administration of medication

A woman was in hospital being treated with IV antibiotics. Her daughter noted on one of her visits that the IV was disconnected, and when she returned the next day it was still not connected. Upon questioning the staff, the daughter was told there had been a change made to the administration of the antibiotics and as there was confusion about the charting of the medication it had not been given. When the woman transferred to another ward she did not receive her heart medication as there was confusion about the way this had been charted.

The woman and her daughter sent letters to both wards asking about the confusion over medications, seeking an apology. When no response was received, they asked an advocate to follow up.

The provider was unable to find any record of the complaints and requested a copy be re-sent. The provider advised they would undertake a full investigation and provide a written response that would be followed with a meeting with the consumer, her daughter and the advocate.

They wrote with the outcome of their investigation and offered a meeting. Upon receipt of the provider's letter the consumer advised she and her daughter were happy with the apology and the information provided and did not require a meeting.

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A genuine mistake at a DHB

Public hospital ~ Surgery ~ DHB ~ Rights 2, 6 ~ Prisoner

A referral was made for a prisoner to see a surgical specialist at the local hospital. He received a letter advising his referral had been prioritised as semi-urgent and that he would be seen within 2-6 months.  A few days later he received a second letter stating his referral had been declined. He believed the second letter was due to his being detained in a correctional facility and that he was being discriminated against because of his situation. He was very concerned about this and said it was causing him a lot of stress and anxiety. He sought advocacy support to help him clarify if he had an appointment or not. 

With assistance from the advocate, he wrote to the DHB asking for an explanation regarding the two letters and clarification of whether he would be seen by a specialist. He also made them aware that he felt the second letter was based on his situation.

The DHB responded with a written explanation and an apology and advised his condition was considered semi-urgent and he would soon be receiving an appointment with a specialist.

Extracts from the response follow:

"I have reviewed your complaint on behalf of the Surgical Service and sincerely apologise for the confusion and inconvenience caused to you.

Our investigation shows that a referral letter was received in January and you were added to the waiting list on 03 February.  I can confirm that you remained on the waiting list until an appointment was sent to…… as is the normal procedure.

The computer generated letter that was sent to you a few days later was generated in error by a staff member who is new to the organisation.  We have now provided additional training to ensure that this error is not repeated.

I hope you have found this response helpful.  Thank you for taking the time to convey your concerns."

The consumer was happy the issue was resolved and was pleased to have an appointment.

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Helping to speed up a slow DHB

Right 10 ~ Very slow complaint process

A consumer with a hearing impairment requested an advocate help him to obtain a response from a DHB. His dentures had gone missing from the operating theatre following his surgery four weeks previous. Although he had made several attempts to have his concerns addressed when in hospital and following his discharge, he had been unable to get a proper response.

The consumer had been unable to confirm whether the DHB had actually received his claim for reimbursement or the quote for replacement dentures. He was unable to proceed with replacing the dentures unless the DHB supported his claim.

After considering the options, the consumer asked the advocate to contact the DHB's quality unit to outline his concerns and request confirmation that his claim for reimbursement had been received and was being processed.

The following day the consumer received written confirmation of the claim, reimbursement, and an apology for the inconvenience from the provider. The consumer was very pleased the advocate had been able to get things moving so quickly.

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