Surgeon told: Repay patient's wife $5000

A surgeon should pay a dead patient's wife $5000 after giving him inadequate information about surgery costs, the Health and Disability Commissioner has recommended.

The patient, named in the commissioner's report only as Mr B, was diagnosed with advanced colon cancer and consulted the private hospital surgeon, Dr A, in November 2007.

Dr A told Mr B his life expectancy was three to six months without treatment, and recommended an oncological treatment in which a surgically placed vascular access device was inserted to allow radiation to be directed to tumours in the liver.

Although Mr B and his wife had no health insurance, they opted for the surgery, which was available only privately and would cost between $35,000 and $45,000.

Dr A advised that in some cases a second treatment might be needed, at a cost of $18,000 to $20,000.

In June the following year, a CT scan showed more cancer on Mr B's liver, and, after a good response to the first oncological treatment, he decided to have it again.

Before the second treatment, the device inserted earlier was found to be not working, and the surgeon said a femoral artery catheter would have to be inserted to continue the treatment, increasing the cost by $5000 to $7000.

Mr B went ahead with the second treatment. In July, Mr B's wife wrote to the surgeon about her concerns about the cost of the second treatment.

"[My husband] and I both came away feeling quite disillusioned ... I understand that there will always be risks involved in any such treatment and we were prepared for these," she wrote.

"However, we both felt that the extra $7000 on top of the original amount was unfair."

Dr A wrote back, giving a breakdown of costs and saying he would meet $1000 of the costs, but that the hospital was unable to reduce them further.

"Periodically this is what happens and there is nothing we can do about it," he wrote.

Mr B died early the following year, aged 58.

In a complaint laid before he died with the commissioner, Ron Paterson, Mr B said he was concerned at the "huge extra expense" of the catheter insertion.

"I was unaware of the potential for [the device] to fail, and of the consequences, both medically and expense-wise," he said.

"My concern is that this process has taken all my funds, and then some: extra costs have come unexpectedly ... and I am thinking I have been financially taken advantage of."

Dr A told Mr Paterson the possibility of the device failing was unlikely to have been discussed with Mr B before the surgery.

The commissioner's report found Dr A had breached the health and disability code by not giving Mr B adequate information about the medical and financial implications if the device failed.

Mr Paterson said: "I consider that when repeat of the oncological treatment was raised and discussed with Mr B ... and Mrs B, Dr A should have discussed the possibility that the vascular access device might be blocked."

- NZPA