The decision said the woman was referred to the orthopaedic surgeon by her GP after an ankle injury in 2023.<\/p>\n
The woman told the HDC that the surgeon explained her options for ankle stability on two occasions: at the first appointment and on the day of surgery.<\/p>\n
To the woman\u2019s understanding, the options were inserting screws into her ankle bone and either using an artificial fibre to connect to the screws or her own tissue, the latter of which is called an autograft.<\/p>\n
The autograft would use a ligament from the woman\u2019s thigh, and the woman agreed to both the autograft and artificial options.<\/p>\n
However, the surgeon told the HDC that on those two occasions he explained the surgical options using the terms autograft and \u201callograft\u201d \u2013 meaning the use of somebody else\u2019s tissue.<\/p>\n
The woman signed an Accident Compensation Corporation (ACC) form before surgery that used the words \u201callograft\/autograft\u201d to describe the procedure.<\/p>\n
Four months later, she had the surgery where a donor ligament was used.<\/p>\n
The surgeon claimed to have again explained the use of donor tissue the day after the surgery, the decision said, but the woman denied that claim.<\/p>\n
Then, more than a week after surgery she found the \u201cturn grief into grace\u201d card in reference to the allograft and was \u201cconfused\u201d as she didn\u2019t think she had received any donor parts.<\/p>\n
It was only at her two-week follow-up appointment, when she showed the card to her surgeon, that she realised what had happened.<\/p>\n
The woman told the HDC that the doctor never asked her cultural or religious beliefs, nor was she given the opportunity to refuse the donated tissue.<\/p>\n
She said discovering the donated tissue had impacted her mental health.<\/p>\n
The surgeon apologised to the health watchdog for the patient\u2019s dissatisfaction and said he had no idea of her beliefs and did not anticipate it causing her distress.<\/p>\n
He said records showed that he had told the woman about the potential use of an allograft, but he admitted she clearly didn\u2019t understand what it meant.<\/p>\n
He claimed to have tried his best to make sure the woman understood the process and was under \u201cno impression\u201d that she was unaware of the procedure.<\/p>\n
He promised to be more specific in future when using donor body parts and to improve on his communication overall.<\/p>\n
An \u2018informed choice\u2019<\/p>\n
In the decision, Deputy Health and Disability Commissioner Vanessa Caldwell noted that a patient\u2019s \u201cinformed consent\u201d could only be given if the person made an \u201cinformed choice\u201d \u2013 which she said, in this case, did not occur.<\/p>\n
Caldwell said the fact the woman found the card and asked the surgeon about it proved that she didn\u2019t know about the donated tissue before surgery.<\/p>\n
While the woman signed the ACC form, the deputy commissioner disagreed with the surgeon\u2019s statement that the patient was \u201cobviously informed\u201d.<\/p>\n
There was a difference, Caldwell said, between signing off on the word allograft in the form and the woman receiving a \u201cclear and concise\u201d explanation of what it meant, and its implications.<\/p>\n
Caldwell was critical of the surgeon\u2019s explanation that he was \u201cunaware\u201d of his patient\u2019s religious beliefs and didn\u2019t know it would affect her.<\/p>\n
She reminded the surgeon it was his \u201cresponsibility\u201d to make sure enough information was given to patients on procedures so their cultural\/religious beliefs can \u201cbe surfaced\u201d in response.<\/p>\n
That would ensure the beliefs are managed sensitively and in co-operation with the patient, she said.<\/p>\n
The patient should expect to get an explanation of the procedure in \u201cplain language\u201d, she said, as well as details about, when possible, where and who the tissue came from.<\/p>\n
This would also give a patient time to \u201cprepare appropriately\u201d for the procedure.<\/p>\n
She also said a plain language description of an allograft should have been added to the ACC form and\/or, in absence of appropriate communication, an educational leaflet on the procedure should be provided.<\/p>\n
She found the surgeon in breach of a right of HDC\u2019s code, which is the right to make an informed choice and give informed consent.<\/p>\n
She acknowledged that the surgeon did not agree with this decision but recommended that he provide a written apology to the woman.<\/p>\n
She also recommended that within three months of the decision, the surgeon undergo education on communication and \u201cthe importance of cultural\/religious perspectives in clinical care\u201d and report it back to the HDC.<\/p>\n
He was also to make an easy-to-understand information sheet on allografts to give to the appropriate clients, and to send a copy to the Medical Council of New Zealand and to the HDC, to publish on its website.<\/p>\n
Ella Scott-Fleming has been a journalist for three years and previously worked at the Otago Daily Times, Gore Ensign and Metro Magazine. She has an interest in court and general reporting. She\u2019s currently based in Auckland covering justice related stories.<\/p>\n","protected":false},"excerpt":{"rendered":"The decision said the woman was referred to the orthopaedic surgeon by her GP after an ankle injury…\n","protected":false},"author":2,"featured_media":512037,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[42639,11421,115256,11424,11423,42,43,1523,1597,12718,63439,6290,96473,40,38,41,39],"class_list":["post-512036","post","type-post","status-publish","format-standard","has-post-thumbnail","category-headlines","tag-ankle","tag-breached","tag-donor","tag-finds","tag-hdc","tag-headlines","tag-news","tag-over","tag-patient","tag-rights","tag-surgeon","tag-surgery","tag-tissue","tag-top-news","tag-top-stories","tag-topnews","tag-topstories"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/512036","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/comments?post=512036"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/512036\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media\/512037"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media?parent=512036"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/categories?post=512036"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/tags?post=512036"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}