Southern DHB failed to obtain consent for sensitive procedure


The Health and Disability Commissioner found that the Southern District Board of Health breached the Health and Disability Consumer Rights Code when medical students were involved in the insertion of a IUD without the patient's consent. [Generic, file photo]

Louie Douvis/AP

The Health and Disability Commissioner found that the Southern District Board of Health breached the Health and Disability Consumer Rights Code when medical students were involved in the insertion of a IUD without the patient’s consent. [Generic, file photo]

A young mentally disabled woman was subjected to the insertion of an IUD in front of students without her consent while she was under general anesthesia, the Health and Disability Commission has found.

A clerk and an anethist were ordered to formally apologize to the young woman, then in her twenties, and Commissioner Morag McDowell recommended that the Southern District Health Board, now Te Whatu Ora Southern, proceed with an audit of obstetrics and gynecology cases in which the students were involved.

The case and the identity of the chief medical officer involved have also been passed to the Medical Council of New Zealand.

McDowell said the failure to obtain informed consent from students for them to be involved in sensitive medical procedures had become a “systemic problem” in New Zealand.

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The case in question underscored the need for clear ethical leadership and a culture of vigilance, and McDowell had written to medical schools, DHBs and Te Whatu Ora – Health New Zealand to reinforce this message, it said. she declared.

The commission investigated the case after a complaint from a woman in her 20s, named Ms A, with mild intellectual disability.

The woman expected a Mirena to be inserted by a consulting obstetrician, but the procedure was performed by a medical student and registrar, and observed by other medical students, without her consent, the woman found. commission.

The consultant delegated responsibility to the registrar who did not review the consent form, McDowell said.

She also criticized an anesthetist for not addressing another anesthetist’s concern about the woman’s ability to consent to her anesthesia.

Health and Disability Commissioner Morag McDowell said

ROSA WOODS / Stuff

Health and Disability Commissioner Morag McDowell said “it is clear that such examinations can only be carried out with unequivocal informed consent, given the vulnerability of the person being examined. It is at the heart of patient-centred care”. [File photo]

The women underwent the procedure in July 2018 and the Mirena was inserted by a fifth-year student.

She went to her GP five days later with worsening abdominal pain and it was when the doctor checked her operation notes that she and her mother discovered students had been involved.

Ms A told the Health and Disability Commission that she felt she had not been treated with respect.

She wants the hospital to ensure people with special needs are treated properly and with dignity, the statement read.

McDowell noted in his report that the Southern DHB has reviewed its policies, processes and forms regarding student participation since the incident, but added that a national approach was needed to ensure it does not happen again.

“I will continue to monitor this issue closely and follow up with Te Whatu Ora – Health New Zealand.”

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