Doctors' errors revealed in ACC figures

By MARTIN JOHNSTON health reporter

Meningitis and skin cancer top an ACC list of conditions that general practitioners diagnose wrongly.

Misdiagnosis accounts for 58 of the 320 medical misadventure claims upheld by ACC against GPs since mid-1992. ACC believes the number could be higher if more patients made claims.

It is the single largest category in a draft report on claims against GPs, although it is outweighed by claims over various types of injections, which number 79 when counted together.

The report is part of ACC's bid to force down the number of medical failures and comes as the Government considers whether to levy health workers to pay for mistakes. Doctors strongly oppose the levy.

The annual ACC bill for medical mistakes is more than $13 million.

Half of the 320 claims against GPs were found to be medical error, which can involve negligence. The rest were medical mishaps: rare but severe complications.

The report notes that the number of errors does not appear to be rising but the same types continue to occur, such as meningitis misdiagnosis and injection problems.

The Medical Association is strongly opposed to a levy, which it says would have to be passed on to patients.

Chairwoman Dr Pippa MacKay said last night that with GPs conducting thousands of patient consultations a year, 320 claims in eight years was minuscule.

But ACC spokesman David Rankin said that with only six claims relating to meningococcal disease misdiagnosis, despite the epidemic of the infection, he suspected many people who suffered medical misadventure were not making claims to ACC. He urged them to do so.

He said the report was sparked by a series of well-publicised failures, such as the under-reporting of cervical smears in Gisborne. He hoped it would prompt GPs to look at the problem areas it identified.

Similar reports were being written on anaesthetics and obstetrics-gynaecology.

The corporation forecasts the number of new medical misadventure claims will rise from around 1100 last year to more than 1400 this year. Preventable medical failures in hospitals kill an estimated 1500 people a year.

The ACC report says the number of claims against GPs is the fourth highest of all categories of registered health workers. Obstetrics-gynaecology, general surgery and drug reactions all experienced a "much larger" volume of claims.

The six misdiagnosed cases of meningitis ended in death or severe deafness. Six other claims were for misdiagnosis of skin cancer and resulted in larger excisions or skin grafts or both.

Sixteen claims were about injections of the anti-inflammatory drug Voltaren.

Other examples included:

A patient who needed penis skin grafts after too much foreskin was removed during circumcision.

Ear syringing that resulted in perforation of the ear drum and consequent hearing loss.

The ACC board has considered the health-worker-levy idea, which is permitted in legislation, but did not make a decision. It referred the issue to ACC Minister Michael Cullen last Friday.