Communication and follow-up of abnormal test results

Published: Mon 19 Aug 2019 02:13 PM
Health and Disability Commissioner Anthony Hill today released a report finding a General Practitioner (GP) in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for failures relating to the communication and follow up of abnormal blood tests.
A woman visited the GP, having experienced intermittent abdominal pain after eating. He diagnosed indigestion, prescribed omeprazole, and ordered blood tests. He told the woman and her son, who was acting as her translator, to return if the pain persisted.
However, as the pain improved over the following two weeks, the woman did not return and her son said he expected the GP would call him if the results were abnormal.
The results showed the liver function tests (LFT) were raised, which can indicate liver problems. The GP ordered further tests from the lab but did not let the woman or her son know about the abnormal test results.
When staying in another region with her daughter, the woman’s pain worsened and she saw a different GP who also ordered tests. When the second GP called the daughter about the abnormal LFT result, the woman was experiencing severe pain and the GP told her to take her mother to the Emergency Department where the woman was diagnosed with gall stone pancreatitis. She subsequently had her gall bladder removed.
Anthony Hill considered that the first GP failed to communicate abnormal test results to the patient and failed to act on the results appropriately.
"As the clinician who ordered the blood tests, the doctor had a responsibility to communicate the results and the implications. By failing to inform the woman on the results, the doctor failed to provide her with information that a reasonable person would expect to receive," Mr Hill said.
"In light of the test results, which were well outside the normal range, the doctor also had a responsibility to arrange further assessment of her condition."
Anthony Hill recommended that the GP apologise to the woman and arrange an independent audit of his record to ensure all abnormal test results had been communicated and followed up appropriately.
The full report for case 18HDC01602 is available on the HDC website.

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