A man forced to wait 12 weeks for a colonoscopy despite having rectal bleeding was then told he had just months left to live.
The man, who is in his 70s, had a family history of colon cancer and made four admissions to Dunedin Hospital between April 2018 and October 2019.
On the second occasion, he was scheduled for an outpatient colonoscopy but was forced to wait 12 weeks. The colonoscopy, and subsequent biopsy, revealed he had colon cancer.
The man and his family made a complaint to New Zealand's patient rights watchdog because of concerns about the delay in the man receiving a colonoscopy despite repeat admissions for rectal bleeding and a family history of bowel cancer.
The man was also told over the phone his cancer was terminal and he had a possible life expectancy of six to 12 months.
In a report released on Monday, the Health and Disability Commission (HDC) found the man's history and symptoms fulfilled the Southern District Health Board (SDHB) - now Te Whatu Ora Southern - criteria and Ministry of Health (MoH) referral guidelines for an urgent colonoscopy - within two weeks.
The HDC suggested the reason for the lower urgency was due to reliance on a normal result from a previous colonography.
The Commissioner's independent surgical advisor commented the request could've been prioritised under a six-week timeframe, according to the report.
Health and Disability Commissioner Morag McDowell found the 12-week wait exceeded Te Whatu Ora Southern's own recommended timeframe and the MoH's guidelines by at least six weeks.
This resulted in the Te Whatu Ora Southern breaching the Right 4(1) of the Code which gives consumers the right to services provided with reasonable care and skill.
However, McDowell did acknowledge that colonoscopy services around the country were facing pressures due to an increase in demand, staffing shortages and recruitment challenges.
"However, it is my view that when investigations are clinically indicated as urgent, or semi-urgent, healthcare consumers have the right to expect them to be scheduled sooner than occurred in this case," she said.
"A timely diagnosis can be particularly important for reducing morbidity and mortality for cancer patients, and often it is a key factor in survivability.
"Long waits for diagnostic procedures can also have a significant psychological impact on patients and their whānau who may be concerned that they have cancer."
McDowell also made an adverse comment about the concurrent use of anticoagulant medication and the lack of clarity in the discharge advice about anticoagulation.
But aside from that, she did not find any issues with the man's care.
McDowell recommended Te Whatu Ora Southern provide the man and his family a written apology for the deficiency in the care provided. She also urged them to consider using a standardised checklist and format for the provision of anticoagulation advice on discharge, to ensure all relevant aspects of advice are covered and presented in a manner that can be readily understood by the patient.
McDowell also wants Te Whatu Ora Southern to provide HDC with an update on current wait times for colonoscopy services, including any actions being taken to address delays where wait times are outside expected timeframes.
She noted the report should be viewed in the context of SDHB's previous actions to address issues relating to restricted access to colonoscopy services, including commissioned external reviews.
