JUDGMENTS

New South Wales. Administrative Decisions Tribunal

Holmes v Northern Sydney Central Coast Area Health Service [2010] NSWADT 163

Unlawful discrimination, victimisation, no evidence of either

New South Wales. Medical Tribunal

25/06/10: Rolleston, John

South Australia. District Court

Athanasiadis v Likos [2010] SADC 85

Torts - negligence - proof of negligence - weight and credibility of evidence.

Victoria. County Court

McKay v McPherson & Anor [2010] VCC 585 (11 June 2010)

This case concerns a medical negligence claim against Dr McPherson, a locum physician at Warley Hospital at Cowes, Phillips Island, and Dr McCormick, a general practitioner at the Bass Coast Family Medicine Centre in relation to treatment provided to Nathanial McKay (the plaintiff).

The plaintiff presented to Dr McPherson on 14 December 2003 seeking medical attention as he was having difficulty in breathing, had bloating in the abdomen, a sore throat, and felt very weak. He presented with tachycardia (a rapid heartbeat) and an ECG was performed which provided an 'unconfirmed report'.

The plaintiff also attended his general practitioner Dr McCormick on 15, 17 and 18 December 2003, who noted on 15 December that the plaintiff has bronchitis, a sore throat and headache, difficulty breathing and was very weak, and on examination had tachycardia and ordered for the plaintiff to have a chest x-ray. Dr McCormick received the results on 17 December, which showed an enlarged heart and changes consistent with cardiomyopathy. Dr McCormick consequently made an appointment for the plaintiff to see a cardiologist on 22 December. On 18 December, blood tests showed abnormal liver function, but a normal full blood count and thyroid function. Subsequently, Dr McCormick arranged for the plaintiff to be transferred to the Monash Medical Centre. The plaintiff had an echocardiogram on 19 December which showed a severely dilated left ventricle with severe reduction in systolic function, and by 12.30pm suffered an asystolic arrest of his heart, and was unconscious for ten minutes before spontaneous circulation was restored, and as a result suffered multi-organ failure and hypoxic brain damage.

The plaintiff argued that he had signs and symptoms that should have made it apparent to the defendants that he was seriously ill and required immediate assessment and had he been seen by a specialist physician or cardiologist and sent to a tertiary hospital on 14 or 15 December, it would be more probable than not that he would not have suffered the resulting injury.

The defendants denied that they were negligent in the care that they provided to the plaintiff. They argued that the relative lack of urgency in treating the plaintiff when he arrived at the Monash Medical Centre signified that he had not been so seriously ill to require urgent treatment.

Judge Hogan, in the County Court, found in favour of the plaintiff. The defendants were found to be in breach of section 58 of the Wrongs Act 1858 (Vic) ('WA') as they did not act with due care and that their negligence was a necessary condition of the occurrence of the harm suffered by the plaintiff (pursuant to section 51 of the WA).

Judge Hogan found that Dr McPherson should have taken a detailed history of the plaintiff particularly noting his difficulty in breathing and that had he properly observed the plaintiff's heart and respiratory rate and oxygen saturation, he would have seen that they were abnormal and indicators that the plaintiff was seriously unwell. Dr McPherson should have noted that the plaintiff required further investigation and assessment, and if this did not occur, he would probably become more seriously ill.

The Judge found that Dr McCormick should have obtained hospital notes prior to examining the plaintiff (but could not be satisfied that this had occurred between Dr McPherson and Dr McCormick on 15 December), and if he had done so, should have noticed the abnormal readings. Furthermore, it was reasonable to expect Dr McCormick to have taken the plaintiff's temperature, pulse, blood pressure and respiratory rates on 15 December, regardless of him having access to the hospital records, and if he had access this would have been more of a reason to check the plaintiff's vital signs. His history taking was also found to be deficient in that he failed to ascertain the circumstances where the plaintiff was having trouble breathing. Although the Judge found that Dr McCormick should not necessarily have diagnosed the plaintiff having cardiomyopathy, Dr McCormick should have recognised that he was very unwell, and although despite organising for the plaintiff to attend to a cardiologist five days later, such specialist assessment should have taken place immediately.

The Court will hear from the parties regarding costs and the quantum of damages agreed to by the parties at a later date.

LEGISLATION

Commonwealth

National Health (Highly specialised drugs program for private hospitals) Special Arrangements Instrument 2010 (No. PB 64 of 2010) - F2010L01860 - Health - These Arrangements ensure that an adequate supply of special pharmaceutical products will be available to persons who are receiving treatment with highly specialised drugs at private hospitals as non-admitted patients, day admitted patients or patients on discharge.

National Health (Highly specialised drugs program for public hospitals) Special Arrangements Instrument 2010 (No. PB 63 of 2010) - F2010L01657 - Health - These Arrangements ensure that an adequate supply of special pharmaceutical products will be available to persons who are receiving treatment with highly specialised drugs at private hospitals as non-admitted patients, day admitted patients or patients on discharge.

National Health (Trastuzumab) Special Arrangements Instrument 2010 - F2010L01656 - Health - This instrument provides that an adequate supply of special pharmaceutical products will be available for persons who require treatment with the drug Trastuzumab.

Health Insurance (Eligible Collection Centres) Approval Principles 2010 - F2010L01765 - Health - These Principles revoke and replace the Health Insurance (Eligible Collection Centres) Approval Principles 2008 to remove the restrictions on the number of approvals of eligible collection centres that may be granted to an approved pathology authority.

National Health (Eligible midwives) Determination 2010 - F2010L01509 - Health - This Determination specifies the requirements that a midwife must meet in order to be an 'eligible midwife'.

New South Wales

Health Legislation Amendment Act 2010 No. 52 - assented to on 28/06/2010

South Australia

Voluntary Euthanasia Bill 2010 - private member's Bill, sponsored by Bob Such MP. - House of Assembly second reading 24 June 2010.

REPORTS

Australia. Department of Health & Ageing

Media releases

Private Health Insurance Circular

Australia. Therapeutic Goods Administration

Consultation: Improving advertising arrangements for therapeutic goods (new)

RFT 14/0910: Membership nominations for the TGA Therapeutic Products Assessment Panel (added maps & Brisbane information session venue)

Scheduling of medicinal substances (new)

Scheduling policy framework (new)

Therapeutic Goods Administration - new structural arrangements (new)

Australia. Medical Board of Australia

Tuesday 29 June 2010 - Approved Programs of Study. - Australian Medical Council approved programs of study (pdf, 26kb) & Specialist quals for inclusion on specialist register (pdf, 49kb)

Australia. Physiotherapy Board of Australia

Tuesday 29 June - Guideline on Limited Registration - The Physiotherapy Board of Australia, under the authority of Glenn Ruscoe, Chair, has released a guideline on a Standard and Guidelines for Limited Registration of Physiotherapists. - Standard and guidelines on limited registration (pdf, 281kb)

Australia. National Health & Medical Research Council

Tracker - 25 June 2010

Australian Capital Territory. Department of Health

Media releases

New South Wales. Department of Health

Media releases

Policy directives & guidelines

Information bulletins

Northern Territory. Department of Health & Community Services

Media release

Queensland. Department of Health

Media releases

South Australia. Department of Health

Media releases

  • New ambulances for South Australia - Wednesday, 30 June 2010 - Health Minister John Hill has announced that 53 ambulances from the SA Ambulance Service (SAAS) fleet have been replaced this year, with another five in commission. "This financial year, we've allocated $6 million to the continuing roll out of SAAS' new fleet of ambulances." Minister Hill said. Read more...
  • Helping SA's young artists and performers - Monday, 28 June 2010 - Over $100,000 has been allocated in grants to support youth arts and music in South Australia. Project and Development Grant funds totalling $51,840 have been awarded to 14 individuals and organisations for projects in the second half of this year. Read more...
  • Loxton Hospital wins fourth 'Baby Friendly Hospital' accreditation - 28 June 2010 - Loxton Hospital has received its fourth consecutive 'baby friendly' accreditation. Read more...

Tasmania. Department of Health & Human Services

St Helens Water Quality - 29 Jun 2010

Victoria. Department of Health

Media releases

Patients get fit for a heart transplant - 25 June 2010 - A new exercise trial for left ventricular assist device patients is testing whether increased fitness training will put them in a better position before and after heart transplant.

Better Health Channel is number one again - 25 June 2010 - The Better Health Channel is Australia's number one health website for the second consecutive year.

Hospital circular - Publication Number 16 / 2010 - 29 June 2010 - Date Issued: 28 June 2010 - Subject: Highly Specialised Drugs Program

Western Australia. Department of Health

Media releases

New Zealand. Ministry of Health

1 Jul: Credentialing Framework for New Zealand Health Professionals This updated framework details the credentialing process for medical practitioners and health professionals in all New Zealand health and disability services, both public and private.

1 Jul: Cancer: New Registrations and Deaths 2007 This annual statistical publication collates and analyses data on primary malignant tumour cases diagnosed in New Zealand, as reported to the New Zealand Cancer Registry.

30 Jun: Invitation to comment on draft documents for Advance Care Planning - The Ministry of Health and Hospice New Zealand have developed two draft documents for Advance Care Planning in New Zealand.

30 Jun: Hospital-based Maternity Events 2006 - This publication provides information on the numbers of women who have gave birth in hospital; and the number of live born babies that were born either in hospital or born prior to their mother's admission to hospital (usually following birth outside hospital) in the 2006 calendar year.

Australian Medical Association

Coalition commitment on mental health 30 June 2010 - 12:55pm - The AMA welcomes the Coalition's substantial funding commitment on mental health services, including much needed funding for additional acute and sub-acute mental health beds.

Healthcare identifiers to kickstart e-health implementation 25 June 2010 - 1:15pm - AMA President, Dr Andrew Pesce, said today that the AMA is pleased that the Healthcare Identifiers legislation has been passed by the Parliament and now looks forward to an acceleration of the implementation of e-Health programs in Australia. Dr Pesce said healthcare identifiers are an important building block for electronic health records.

GP Network News Issue10, Number 21 - 25 June 2010 25 June 2010 - 4:00pm - Supporting family doctors – AMA listening tour; AMA member survey: new diabetes scheme; GPs get extra support to train new GPs; Time to put focus on links between alcohol and cancer; Members recognised in Queen's Birthday honours list

Doctors' engagement in the management of hospitals - 2010 25 June 2010 - 3:00pm - The management of hospitals works best when doctors are engaged in clinical and corporate governance. The AMA has developed a detailed policy as a basis for effective and genuine doctor engagement in hospital management.

British Medical Association

Medics vote to ban homeopathy from NHS - Doctors leader says remedies are 'nonsense on stilts'

Cut market not care, doctors urge - 'Listen to the views of frontline health professionals', experts tell government

Doctors demand end to 'irresponsible' screening adverts - Direct marketing of private health screening tests exploits vulnerable people, says BMA

Summary care records damned with faint praise - Review shows benefits are 'subtle, hard to articulate and difficult to isolate'

BMA helps member win £50,000 back pay - A former associate specialist in orthodontics secures payout from hospital

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