HDC: Treatment of boy with skin lesion

Health and Disability Commissioner Anthony Hill today released a report finding an Emergency Department (ED) doctor in breach of the Code of Health and Disability Services Consumers’ Rights for the treatment provided to a boy with a skin lesion.

The boy was taken to an ED by his mother, who had concerns about a lesion on the boy’s back. The boy was seen by the doctor who offered two options for treatment - the first being painkillers and an urgent referral to the Dermatology Department, and the second to remove the lesion in the ED that evening. The boy and his mother opted to have the lesion removed. The doctor removed the lesion and sutured the site using ethyl chloride spray and topical lidocaine with adrenaline as anaesthesia. The mother complained that the pain relief was inadequate.

Mr Hill considered that the ethyl chloride spray and topical lidocaine used to remove the lesion would not have had any appreciable anaesthetic effect, and was inappropriate for the procedure.

Mr Hill recommended that the Medical Council of New Zealand consider whether a review of the doctor’s competence was warranted. Mr Hill also recommended that the employing DHB consider whether the doctor would benefit from ongoing collegial support and mentoring with respect to his documentation and clinical decision-making within the ED context.