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Scott Hammond / Stuff
Emily Stein was diagnosed with breast cancer in mid-2015 and died in 2019. She is pictured with her daughters Ada and Mabel and her husband Chris McMurtrie.
A GP has been ordered to apologize to the widower of a young mother who died of breast cancer following delays in a referral for specialty care.
Emily Stein died of breast cancer in 2019 at age 32, despite first presenting to her GP with a “red flag symptom” in 2015.
Stein, who was 20 years old when she first went to her GP, was concerned about her left breast and was sent for an ultrasound, but she was not referred to a breast surgeon.
Three weeks after his initial presentation, he underwent the scan and was told by a nurse that the results were “fine.” They told him to come back if he had any concerns.
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In a report released Monday, the Office of the Health and Disability Commissioner (HDC) said that Stein should have been referred to a breast specialist regardless of the scan result, because she had a warning symptom: one-sided nipple discharge stained with blood, but that didn’t happen.
Supplied
Stein undergoes treatment before his mastectomy.
Nine months after receiving the scan result, a biopsy of Stein’s left breast confirmed that she had breast cancer. She underwent treatment but died in 2019.
Her husband, Chris McMurtrie, said the family was happy with the HDC’s findings and “feels like Em would be too.”
Stein had been part of a group of New Zealand women who applied to Parliament for funding for Kadcyla in 2018, which could have prolonged her life. Pharmac subsequently announced plans to fund Kadcyla for the treatment of breast cancer beginning in December last year.
“There is a bit of anger and resentment because many of us feel like it should have been funded a long time ago,” McMurtrie said at the time.
In a piece that Stein wrote for Stuff In January last year, she said she refused to be labeled a cancer victim, despite the “inner and personal reality” of her illness.
“I hope my journey of drugs, guilt, scars, blemishes, baldness, joy, love and living life can serve a higher purpose so that others continue to fight their fight whatever it may be,” he wrote.
Scott Hammond / Stuff
Chris McMurtrie with his daughters Ada and Mabel. His wife Emily died of breast cancer in 2019 after campaigning strongly for Pharmac to fund Kadcyla breast cancer treatment.
The HDC found that Stein’s family physician violated the Health and Disability Services Consumers’ Rights Code by missing the opportunity to diagnose his cancer.
Stein had finished breastfeeding her first child six months before seeing her GP with the complaint.
About eight months after the scan and two days after giving birth to her second child, she returned for a checkup.
Her chest was “rock hard and tender” and she was prescribed antibiotics for possible mastitis (inflammation of the breast).
The symptoms did not resolve and the GP sent an urgent request for another ultrasound, which confirmed a diagnosis of breast cancer.
The HDC found that the primary care physician did not provide services with reasonable care and skill.
Former Commissioner Anthony Hill said the failure to refer Stein to a breast surgeon after his first ultrasound was a missed opportunity to diagnose and treat his cancer at an earlier stage.
“The inescapable fact is that [the GP] should have referred [Stein] to a breast surgeon after her scan, regardless of the scan results, due to the blood-stained unilateral nipple discharge, but she did not, ”she said.
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The primary care physician failed to provide services with reasonable care and skill, according to a report from the Commissioner of Health and Disabilities.
“Failure to do so led to [Stein] being informed that her results were okay and that no scheduled follow-up was required, and placed responsibility on [Stein] follow up if I had any further concerns, which was inappropriate advice under the circumstances. “
Hill recommended that the GP’s medical center audit 10 random patients who had developed a sinus symptom in the past year to ensure that the care provided was consistent with current guidance.
The audit would also provide evidence of the steps the practice had taken to ensure a stronger follow-up and safety netting process for high-risk patients.
Hill also recommended that the GP apologize to Stein’s husband.
