HDC Case: Assessment of Patient with Abdominal Cramps 25 May 2020

Health and Disability Commissioner Anthony Hill today released a report finding a General Practitioner (GP) in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for failing to appropriately examine and assess a man who presented with abdominal cramps.

Source: Health and Disability Commissioner

19HDC01795

Health and Disability Commissioner Anthony Hill today released a report finding a General Practitioner (GP) in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for failing to appropriately examine and assess a man who presented with abdominal cramps.

The man, who was in his seventies, had several long-term health conditions. He attended an afterhours GP clinic with vomiting and abdominal cramps. The GP did not examine the man’s abdomen. The GP concluded the man had a mild gastric upset, and sent him home advising him to return if symptoms persisted. The man died two days later of complications from a bowel obstruction.

Anthony Hill considered that expected clinical practice was for the GP to conduct an abdominal examination. The GP also failed to record a provisional diagnosis for his findings.

"An abdominal examination was clinically indicated in this situation," said Mr Hill. "[The GP] missed an opportunity to provide further intervention to [the man] and [the man’s] continuity of care may have been compromised."

Mr Hill recommended that the GP apologise to the man’s wife, arrange an independent audit of his clinical notes to check that appropriate records have been made, and undertake further training. He also recommended that the medical centre report back to HDC on the implementation and effectiveness of the changes it has made as a result of this investigation.

The full report for case 19HDC01795 is available on the HDC website.

https://www.hdc.org.nz/decisions/search-decisions/2020/19hdc01795/