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A former cancer patient with pain in his leg was told he’d be seen for an MRI within 31 days - but ended up waiting more than 20 weeks, by which point his cancer had not only returned, but also spread.
The delay for the “urgent” scan was so long that the chance to fight the disease was lost, leaving him with a terminal diagnosis.
The case is yet another example of delays in what was formerly the Southern District Health Board (DHB), after an explosive report in April identified multiple cases of patients who suffered harm as a result of delays in treatment.
According to the decision of the deputy Health and Disability Commissioner (HDC) Vanessa Caldwell released today, the unnamed man had a history of cancerous melanoma.
In late 2021, when the man was experiencing pain in his leg, his doctor ordered an urgent MRI scan to check for any relapse of cancer.
The accepted practice at the time meant a patient was to receive an MRI scan within 31 days of the request, but the man’s scan didn’t occur until 20 weeks, or 140 days after it was ordered.
The impact of the delay was immediately apparent, and according to the man, deadly. The MRI revealed his cancer had returned and spread to his spine, causing spinal cord compression.
“This delay meant further spread of the cancer through my spine and organs, resulting in the current situation whereby the cancer is now not survivable,” the man told the HDC.
After the man complained to the commissioner, Te Whatu Ora Southern, previously the Southern DHB, accepted that it failed to complete the scan within an appropriate time frame.
It agreed with the HDC’s proposed finding that Te Whatu Ora breached the code of consumer rights by failing to provide care with reasonable care and skill.
“We appreciate that not receiving health care in an accepted timeframe is very concerning and stressful for any patient,” Te Whatu Ora Southern chief medical officer David Gow told NZME.
“We have sincerely apologised to the patient and their family for the distress and impact caused.”
Gow said Te Whatu Ora Southern accepted the findings and has since made changes to its practice. That includes the installation of a second MRI scanner at Dunedin Hospital, improving wait times to 4-6 weeks as at March this year.
It has also updated its radiology referrals policy and is working with the Cancer Control Agency to look at a digital solution to improve the tracking of cancer patients.
“We would like to reassure our community that these changes will reduce the chances of our systems and processes failing in the future,” Gow said.
Caldwell recommended Te Whatu Ora Southern provide a written apology to the man, and provide the HDC with a progress report on the development of the digital solution and MRI wait times.
Yet another case of delays at Te Whatu Ora Southern
In April, a scathing report was released by the HDC, exploring how the Southern DHB had delivered non-surgical cancer treatments between 2016 and 2022.
Commissioner Morag McDowell’s investigation began after a complaint from Melissa Vining, the wife of bowel cancer patient Blair Vining, who was told it would be 12 weeks before he would be seen by an oncologist.
The advice came after his initial prognosis, which was that he had just six to eight weeks to live. Vining died in October 2019.
The inquiry found that in 2020 and 2021, between 65 and 73 per cent of patients were receiving their first treatment within 62 days of being referred to a specialist. The Ministry of Health target is to see 90 per cent of people within 62 days.
Dunedin Hospital. Photo / George Heard
She said the problems were because of poor overall clinical governance systems, including inadequacies in quality measures and indicators, and poor relationships between clinicians and executive leadership.
She ruled Te Whatu Ora Southern breached the Code of Health and Disability Services Consumers’ Rights.
A report by the Otago Daily Times in 2021 revealed 27 patients had suffered because of cancer treatment delays in the Southern DHB area.
That patient, who had presented to Dunedin Hospital four times with rectal bleeding, waited nearly 13 weeks for a colonoscopy, which identified colon cancer in late 2019.
He was later told over the phone by a nurse that his cancer was terminal and he had between six and 12 months to live.
Again, the HDC found the then-Southern DHB in breach of the code of consumer rights.
Ethan Griffiths covers crime and justice stories nationwide for Open Justice. He joined NZME in 2020, previously working as a regional reporter in Whanganui and South Taranaki.
