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UNSPLASH
A GP cut out what he thought was a benign lump behind a woman’s ear. I was going to throw it away, but she wanted to keep it. Two years later she had it tested: it was metastatic cancer.
A woman in her 80s had a cyst removed behind her ear. It took about two years before the sample was tested and she was diagnosed with stage 4 metastatic skin cancer.
A report released by the Health and Disability Commissioner on Monday found that an unidentified GP was violating the patients’ rights code for failures in treating the woman, leading to her late diagnosis.
In 2017, the woman visited her GP (Dr. B) to have a lump removed behind her ear, which she had had for several years. The GP diagnosed the lesion as a sebaceous cyst, a benign, non-cancerous lump under the skin.
However, he did not follow the standard practice of the medical center and open the cyst to confirm the diagnosis visually, nor did he send it in for analysis to determine if it was benign.
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After removing the injury, the GP told the woman, referred to in the report as Mrs. A, that he intended to dispose of the sample, but she asked to keep it.
Over time, Ms A noticed that the area where the cyst had been removed was changing: it started to itch, was swollen, and felt tender.
She visited the medical center three times about this and was seen by three different doctors, including Dr. B, according to the report.
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The woman was eventually diagnosed with stage 4 malignant melanoma.
On her fourth visit, another GP checked on Ms A and found an additional lesion around the site.
She referred Ms A to the plastics department of the public hospital, but the referral was rejected with a note saying the story was unclear. She said the GP should refer Ms A again if she suspected malignancy.
That GP did it and the referral was accepted.
Almost two years after the lesion was removed, Ms. A submitted the original sample to the plastics clinic for analysis.
He was diagnosed with stage 4 metastatic melanoma in January 2019.
Former Commissioner Anthony Hill said the GP made a mistake by not confirming the contents of the sample before not sending it for analysis and by not documenting that decision in the clinical notes.
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Health and Disability Commissioner Anthony Hill said the GP made a mistake by not confirming what the injury was.
“This resulted in a late diagnosis of [Mrs A]. “
The Commissioner found that the primary care physician failed to serve the woman with reasonable care and skill.
He recommended that the doctor apologize to the woman, which the GP has done, according to the report.
Hill also recommended that the GP provide relevant evidence to show that minor surgery and analysis of surgical specimens were being handled appropriately, which he had done.
The GP, who at the time was a GP registrar, told HDC that he is “prepared to learn from this and change [his] Practice so this doesn’t happen again. “
Since then, the medical center has introduced a policy to ensure that all tissue samples are sent for analysis.
