Physiotherapist reprimanded for collapsing woman's lung

A woman's lung collapsed when a physiotherapist performed acupuncture on her. Photo/File

A physiotherapist who collapsed the lung of a patient while performing a type of acupuncture on her failed to provide adequate care to her patient, the deputy health and disability commissioner Rose Wall has found.

The woman had been receiving physiotherapy treatment for pain caused by her scoliosis (curved spine).

After a while the woman's progress plateaued so the physiotherapist moved on to more invasive techniques, in particular, trigger point needling using electro-stimulation.

The physiotherapist asked the woman if she was "open to acupuncture" but did not tell her scoliosis presented an increased risk and no advice was provided regarding what to expect and what symptoms she might experience. The risk of a pneumothorax (collapsed lung) was not discussed.

As soon as the first needle was activated, the patient told the physiotherapist she felt a large pulse in her chest and slight pain in her left lung area. The physiotherapist told her that was not unusual.

After leaving, the woman felt light headed and began shaking and a few hours later she was in extreme pain on the left side of her chest with difficulty breathing.

The woman called the clinic reporting right ribcage pain with breathing and "pins and needles" in the left arm. She also complained of being short of breath.

The physiotherapist said the woman advised her of her symptoms as being "not shortness of breath but pain on inhalation" and that she complained of "pain in the chest, referred symptoms of 'pins and needles' in the left arm and an inability to take a deep breath".

The physiotherapist considered that symptoms described to her were consistent with the side effects of needling a tight muscle and treating a stiff spinal joint unit with manipulation.

The woman said she told the physiotherapist she felt short of breath and she had to gasp for air as it hurt so much. The woman told the Health and Disability Commission that the physiotherapist told her the symptoms were "normal and it was the muscles tightening back up".

After the phone call, the physiotherapist did some research into acupuncture-induced pneumothorax and sent a text advising the woman to go to the hospital if her symptoms worsened.

The woman was already at the hospital when she received the text. Doctors found the woman had a collapsed lung at the site where the acupuncture needle had been placed.

Deputy health and disability commissioner Rose Wall said the physiotherapist was in breach of the Code of Health and Disability Services Consumers' Rights for the care provided to the woman.

Wall said the physiotherapist should have discussed the risk of pneumothorax with the woman, given her information regarding how her scoliosis presented an increased risk and told her what symptoms she might experience and what to do in those circumstances.

"Without that information the woman was not in a position to make an informed choice regarding the acupuncture treatment."

Wall also said the physiotherapist should have immediately recognised the symptoms of a collapsed lung and told her to go to the hospital.

Wall recommended the physiotherapist review her practice and report back to the commission on her learning and undertake further education and training on informed consent.

Wall also considered that there were learnings for the clinic from this situation and recommended that the clinic review its current policies and procedures.