GP guilty of misconduct in breast cancer case

An Invercargill doctor who failed in his treatment of a pregnant patient suffering from breast cancer has been given a formal censure by the Health Practitioners Disciplinary Tribunal.

General practitioner Dr Ajit Johri admitted the facts of the case at a hearing in July.

The tribunal heard that Dr Johri saw a pregnant patient complaining of a lump in her breast on November 24, 2004.

Dr Johri prescribed a 10-day course of antibiotics and Panadol and made a further appointment for a week's time.

He intended to refer the patient to a breast surgeon if the lump did not respond to the treatment.

On December 1, the patient returned to Dr Johri, showing some reduction in pain and in the size of the lump.

Dr Johri did not refer the patient to a specialist, and there was no note of a follow-up appointment being made. He did not see the patient again.

In February 2005, following advice from her midwife, the patient visited the breast screening service at Dunedin Hospital and was diagnosed with a breast carcinoma.

Following a caesarean birth in March, and a mastectomy in April, the patient died in November 2005.

The tribunal found Dr Johri should have insisted on a follow-up appointment, and left "no stone unturned" to ensure the patient was again seen and examined once he realised the lump had not entirely disappeared in response to antibiotic treatment.

While it would never be known if the tragic outcome of his patient's death would have been avoided if he had responded more appropriately, his acts and omissions were a "serious departure" from the standards expected of a general practitioner, the tribunal's decision said.

The tribunal noted Dr Johri's medical record had, in the 24 years he had practised in New Zealand, in all other respects been exemplary. It also noted Dr Johri was one of a number of health professionals managing the patient.

Dr Johri said in his affidavit the effect on him had been profound. "Words cannot express how I feel and my sorrow about what happened."

In conclusion, the tribunal said Dr Johri was a doctor who took his professional position and responsibilities very seriously.

A formal censure was a genuine punishment.

He was also ordered to pay 30 per cent of the costs of the tribunal.

- NZPA