Findings

Charge Characteristics

Additional Orders

Commonly
Cited Cases

Precis

Charge:

A CAC charged that Dr Brown was guilty of disgraceful conduct in a professional respect or professional misconduct or conduct unbecoming a medical practitioner which reflects adversely on his fitness to practise medicine in that his management and communication concerning a patient was inadequate in one or more of the following respects:

1. Failed to ensure that the specimen taken following removal of a left breast lump of a patient on 14 December 1992 was properly examined by a pathologist.
2. In a letter dated 18 December 1992 misled the patient's GP and thus the patient by advising that the lump was a lipoma.
3. In a consultation held on or about 29 October 1993, lied to the patient, and her husband, by stating that the specimen had been examined and was benign.

Background:

The patient detected an abnormality in her left breast following routine self examination. She was examined by a doctor who referred her for a mammogram and to Dr Brown. On 14 December 1992 Dr Brown operated to remove the lump. In a letter dated 18 December 1992 Dr Brown reported to the patient's GP that the lump was a lipoma. The GP and the patient, on the basis of that letter, assumed the lump was benign. In August 1993 the patient presented with a more prominent lump in the same place on her left breast. This lump was found to be malignant. The patient underwent an extended simple mastectomy on 13 October 1993. She died on 26 January 1995.

Finding:

The Tribunal found Dr Brown guilty of professional misconduct.

Particular 1 was upheld. The Tribunal found that no specimen from the biopsy taken from the patient' s left breast was sent to a laboratory for testing and that Dr Brown failed to ensure that any specimen taken from the patient's left breast was properly examined by a pathologist. The Tribunal was satisfied that this failure constituted conduct unbecoming a medical practitioner which reflects adversely on Dr Brown's fitness to practise medicine.

As to Particular 2, Dr Brown admitted that his letter of 18 December 1992 was misleading although this was unintentional. The Tribunal said that the importance of ensuring that diagnostic information, especially in circumstances where the alternatives are so dire, could not be overstated. The Tribunal held that if this particular had been the only particular supporting the charge it would have found this failure constituted conduct unbecoming a medical practitioner that reflects adversely on Dr Brown's fitness to practise medicine.

The Tribunal regarded Particular 3 as containing a most serious allegation. It preferred the evidence of the patient's husband, to that of Dr Brown. It accepted the patient's husband's evidence that he specifically asked Dr Brown if the lump had been tested and Dr Brown stated that it had. The Tribunal found that Dr Brown knew there was no histological report but decided to tell the patient and her husband that it had been tested and was a lipoma.

Considering the charge in its totality the Tribunal found that the charge against Dr Brown is upheld and constitutes professional misconduct.

Penalty:

The Tribunal ordered that Dr Brown be: censured; fined $750 (maximum permitted $1000); pay 50% of the costs of the hearing and inquiry. The Tribunal also ordered publication pursuant to Section 138(2) of the Medical Practitioners Act 1995 in the New Zealand Medical Journal.