Surgeon censured after patient dies

File Photo / NZ Herald

A Wellington surgeon who has been the subject of numerous complaints about failing to properly inform patients has been ordered to pay more than $100,000 in fines and costs after the death of a patient.

Richard Stubbs, a specialist at Wakefield Hospital treating liver cancer and obesity, was found guilty by the Health Practitioners' Disciplinary Tribunal of professional misconduct over the care he provided to a patient who died in February 2006 after an operation for gastric bypass surgery.

Prof Stubbs and the hospital had unsuccessfully applied for name suppression.

The patient, known as Mr N, was under anaesthetic for the surgery when tests showed abnormal liver function. Instead of waking the patient to inform him of increased risk of death or complications as a result of the surgery, Prof Stubbs continued with the surgery.

The risk of death had risen to 20 per cent at 90 days, as opposed to 1 per cent as Mr N had been informed.

Prof Stubbs also failed to obtain the patient's informed consent before the operation, and failed to adequately document post-operative care, the tribunal found.

Prof Stubbs accepted the tribunal's decision that he should not have proceeded with the surgery, and said he would not consider such a decision again.

He was not suspended but was censured, ordered to undertake a mentoring programme for 18 months and have a practice audit.

He was also fined $20,000, and ordered to pay half the costs of the tribunal and the director of proceedings for the Health and Disability Commissioner, which totalled $178,371. His half totalled $89,185.50.

He had argued that a large part of his personal earnings were spent on supporting a science research programme, meaning he only had a small salary payment for himself.

However, the tribunal was "not impressed" with Prof Stubbs evidence about his financial circumstances and found he had given an "incomplete picture of his true financial worth".

It was not the first time Prof Stubbs had appeared before a disciplinary tribunal on the issue of informed consent.

In 1999, the tribunal's predecessor found him guilty of conduct unbecoming a medical practitioner.

Five other complaints had also been made to the Health and Disability Commissioner, largely on the issue, between 2002 and 2004.

Another two complaints to the commissioner had resulted in final opinions on the cases, both of them at the end of 2007.

The High Court dismissed an application for judicial review of one case, and Prof Stubbs intended to file a complaint with the Office of the Ombudsman about the other.

In the second complaint, released by the commissioner today, a 64-year-old man known as Mr A was not responding to chemotherapy for colorectal cancer with liver metastases, and was referred to Prof Stubbs for consideration of Selective Internal Radiation Therapy (SIRT) to treat the cancer.

The patient was warned of a 1 per cent risk of death from the surgery.

After Prof Stubbs did an initial operation before the SIRT, Mr A developed a leak in the abdomen, had surgery for that at a public hospital, and died two months after being discharged.

The commissioner had recommended Prof Stubbs apologise to Mr A's family and review his informed consent practice.

- NZPA