Agony and ACC create private hell

By JULIE MIDDLETON

Without surgery, there might come a day when Su Nicholson will be able to walk only with sticks.

During an operation 10 years ago to fuse damaged discs in her spine, the curve in her back was virtually and inadvertently obliterated.

The medical mishap has left Su Nicholson with a straight back and a permanent forward stoop.

The former real estate agent cannot stand up straight without support, her internal organs are being pushed forward and her knees are beginning to suffer.

Walking is increasingly difficult and she is permanently on painkillers.

Termed "significantly disabled" and living on Accident Compensation Corporation handouts, she has been fighting it - first for recognition of the rare Flatback Syndrome arising out of the surgery, and for further treatment that will make her whole again.

That fight has now taken her to the Medical Council, which is investigating her claim that 13 ACC-contracted doctors played down her case to minimise the corporation's costs and are now closing ranks - or were simply incompetent.

"This is a serious complaint which is being taken seriously," says council communications coordinator Susan Pattullo.

The three-strong complaints assessment committee is about to start "getting the views of the doctors", who include seven orthopaedic surgeons, two internal medicine specialists, one psychiatrist, an occupational medicine specialist, a general practitioner and an anaesthesiologist.

Assistant Ombudsman Robin Wilson says the Chief Ombudsman, Sir Brian Elwood, is also probing Su Nicholson's "concerns about the way ACC selects, briefs and remunerates medical personnel, specifically, in her case, the people who advise on medical misadventure".

His office is also looking at whether management of her case has been reasonable.

"The complaints are well made and well-documented, and raise issues that are being investigated," says Mr Wilson, who expects that Sir Brian will "form an opinion" in the next few weeks.

This has been a long fight. Su Nicholson, a young-looking 50 with two adult children, is weary. She just wants a life again.

Formerly a social, sporty type - injuries while yachting and playing tennis led to the operating table - she now lives alone in the Auckland suburb of Kohimarama.

Restricted mobility makes relationships difficult and Su Nicholson describes her social life as non-existent.

"I feel so totally frustrated, as if I'm banging my head against a brick wall," she says. "They are masters at dragging the chain in the hope that claimants will just give up."

But she has been dogged. In the past 10 years she has won two medical mishap cases from ACC. One was over a neck injury during the spinal surgery, the other after a blood nurse launched a needle into two nerves last year, damaging them and exacerbating the pain that came with her condition.

But until Su Nicholson provided a report in July from an Australian specialist with proof of her condition and its treatability with surgery, ACC had disagreed with top spine doctors that she has the rare Flatback.

Its doctors tended to cite chronic pain syndrome - a woolly description that covers physiological and behavioural problems.

ACC is now stalling over whether to accept Su Nicholson's claim that her Flatback was caused by medical misadventure and must be treated.

Even if it does, ACC says it cannot pay for treatment overseas, whether or not the Australian specialist, Ashish Diwan, is the best person for the job.

"ACC is the trustee of public funds, says Paul Miller, an adviser in ACC's head office in Wellington. "It has a duty to its premium payers to only expend those public funds when a clear statutory authority permits."

How clearcut this is forms the basis of a third probe by the Ombudsman, says Mr Wilson.

Su Nicholson clings to her hope of surgery. Dr Diwan, of Sydney's St George Hospital, says that although an operation is "fraught with dangers ... long-term outcomes are quite promising".

Wedges would be cut into the spine to return the lumbar curve. Su Nicholson would be able to stand up straight again, and possibly return to work.

"ACC needs to be shamed into capitulating," she says.

"Ten nightmare years of not only having to fight with the pain problems, but also with them, is more than most people could cope with."