GP failed cancer mum then lied about medical records

An Auckland doctor failed to properly examine a female patient - and then tampered with her clinical notes as the mother-of-three lay dying in hospital.

The doctor later admitted lying to authorities investigating the case yet continues to work in the profession despite being found guilty of four counts of misconduct.

And the doctor's identity remains a secret because of name suppression - meaning other patients are not aware of the saga or the mistakes the doctor made.

The Herald on Sunday will fight to have name suppression lifted.

Auckland mother-of-three Virginia Duncan, 43, died in February 2003 of colorectal cancer, after complaining of severe abdominal pains and constipation for more than a year.

She was admitted to hospital in January 2003 and had two large tumours removed, but died at home the following month.

Last week, the Health Practitioners Disciplinary Tribunal found the general practitioner guilty on four charges of professional misconduct.

The tribunal found that the doctor in question:

* failed to investigate Ms Duncan's symptoms properly during three appointments.

* ignored the advice of another doctor and did not book specialist treatment to rule out bowel cancer.

* was found guilty of writing additional entries in Ms Duncan's medical records without dating them.

* lied about the changed records to the Health and Disability Commissioner after an investigation was launched.

The guilty verdict pleased Virginia's family, but her twin sister said: "That won't bring my sister back".

Fiona Duncan flew from Sydney for the three-day tribunal. She said her sister could be alive today if she had seen a different doctor. "It's absolutely horrifying.

She was so anxious and tense and stressed. She had advanced cancer without knowing."

Fiona Duncan was critical of the tribunal's decision to grant interim name suppression.

"The public has the right to know. [The doctor] didn't rule out cancer, was stuck on Virginia's original diagnosis of irritable bowel syndrome."

Virginia was first seen by the doctor in August 1999, and complained of longstanding constipation and pain in September 2001. She was initially diagnosed with irritable bowel syndrome and prescribed laxatives.

Her symptoms persisted but she was not referred for specialist treatment to rule out bowel cancer.

Fiona Duncan was particularly angry about an appointment in July 2002, when the doctor told Virginia and her teenage daughter Frances Priggen to ignore the advice of another GP because she "over-reacts".

The previous month, a colleague of the doctor gave Virginia a full examination and went into her family history - her grandfather had died of bowel cancer at 43.

Raising the possibility of hereditary cancer, the doctor told Virginia she should have a check-up, advice later ignored by the original practitioner. Priggen, now 20, told the tribunal her mother's doctor reassured them the symptoms were not cancerous.

"The doctor had reassured us that it was not cancer - I know I felt reassured by that."

Denying that the conversation ever happened, the doctor said in evidence last week that Virginia had been advised to undergo a proper investigation but had refused.

However, the tribunal found that charge proven.

Virginia was diagnosed with terminal cancer in January 2003, and asked for her records to be transferred to another doctor.

An extra page of notes had been added but left undated, relating to appointments in May, October and December 2002. They stated the doctor had referred Virginia for specialist opinion but that she had refused.

At the tribunal, the doctor denied changing the records in a panic, or in a cover-up attempt, saying: "The entries were accurate comments of what had happened and been said during the three consultations."

The doctor said the extra notes were accurate observations to help the new doctor who was inheriting a "difficult patient at a very difficult time".

"I was very upset about this lady, having such a poor prognosis.

"I tried to call her several times at the hospital and at home, but could never get through," the doctor said.

However, the doctor admitted lying to the Health and Disability Commissioner about writing the extra notes and failing to date them.

"I felt terrible, that's why I wrote the letter to the commissioner, it was eating away at me for ages."

The tribunal found that the doctor failed on several occasions to examine Virginia properly, had ignored the recommendations of a colleague, and failed to refer her for tests to rule out bowel cancer.

Jonathan Green, Virginia's fiancee, said that in 2002 she was often in extreme pain, suffered from mood swings and was tearful.

"The pain was so intense, she would not walk, did not want to talk and would lie on the bed clutching herself and moaning," he said in evidence.

Fiona Duncan last saw her sister alive during at Christmas 2002. The normally sprightly woman was "exhausted, thin and yellowish".

The doctor was found not guilty of misconduct charges relating to four earlier appointments.

The health disciplinary tribunal said a fine for professional misconduct would be appropriate, but a decision would be made next month.

Until then, the doctor would have interim name suppression, which could become permanent.