MORE ON THE WONDERS OF GOVERNMENT MEDICAL SERVICES IN AUSTRALIA

Two reports below

Amazing public hospital negligence in Melbourne

The Alfred hospital allowed its former trauma chief to operate on patients' vital organs despite his medical licence restricting him to orthopedic surgery. The revelation could pose further legal problems for The Alfred, which already faces the prospect of medical negligence claims from some of Thomas Kossmann's former patients. A report by State Ombudsman George Brouwer found Professor Kossmann performed surgery on lungs, kidneys and bladders - procedures normally done by specialists.

The report, which exposed Professor Kossmann's systematic rorting [misdirection] of public funds and serious administrative failings at The Alfred and the Transport Accident Commission, also found he attempted "difficult and dangerous" surgery in areas in which he had "little experience or proven skill".

Mr Brouwer said The Alfred allowed Professor Kossmann to operate in areas outside his speciality of orthopedic surgery between 2002 and 2007. Orthopedic surgeons primarily deal with bones. The approval was despite an August 2002 ruling by the Medical Practitioners Board of Victoria which stated: "You are restricted to practising within the speciality of orthopedic surgery and are not permitted to practise outside this speciality." Mr Brouwer said the restriction was clearly visible on Professor Kossmann's annual practising certificate and the medical board's online register of practitioners.

Medical negligence lawyers told The Age yesterday that the failure to ensure Professor Kossmann stayed within his area of speciality could pose legal problems for The Alfred because it had a duty to ensure its surgeons were operating in their accredited fields. Law firm Slater & Gordon is already examining potential medical negligence cases against The Alfred and Professor Kossmann.

Alfred chief executive Jennifer Williams earlier this year announced a new policy requiring surgeons to demonstrate their skills before getting hospital approval to perform specialist surgery.

Mr Brouwer found that The Alfred did not act on an undertaking to review Professor Kossmann's credentials after he received an orthopedic fellowship from the Royal Australasian College of Surgeons in 2002. While he awaited acceptance from the college, The Alfred granted temporary approval for him to perform a broad range of procedures under the close supervision of college fellows. At the time, The Alfred acknowledged it would need to review Professor Kossmann's credentials once he was made a college fellow.

But Mr Brouwer found: "There is no evidence that Professor Kossmann's credentials and clinical privileges were ever reviewed. It appears Professor Kossmann, his surgical colleagues, his divisional directors and hospital medical administration did not revisit this important issue during the six years he was with The Alfred."

Professor Kossmann told Mr Brouwer he did not understand that his medical licence from 2002 onwards only permitted him to perform orthopedic surgery. It was only in the course of the Ombudsman's investigation that he became aware he had operated in areas he was not registered to do so. Professor Kossmann resigned from The Alfred in April.

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Another breast cancer victim sues government for negligence

A NSW case was reported here just a couple of days ago.

BREASTSCREEN Queensland radiologists failed to detect a malignant tumour in a woman's breast, according to a claim filed in the Supreme Court. She is the second breast cancer sufferer to file for damages in the Supreme Court in the past month over alleged medical negligence. A central Queensland resident has also sued four doctors and Queensland X-Ray after she was allegedly told all was well following a breast image and biopsy on October 19, 2005.

However, according to a claim filed in the Supreme Court registry in Mackay, her Queensland X-Ray image and biopsy report stated: "I am uncomfortable with the cytology (analysis of cells) finding so reassessment of the films is recommended with a review to a repeat biopsy." It is alleged a second doctor she visited did not advise the woman of this, while a third doctor on March 12 last year also failed to advise her. Despite that, two days later they suggested an early follow-up mammogram.

The woman, 53, has since allegedly been diagnosed with stage-four breast cancer with bone, breast and liver lesions. "Had the plaintiff been warned and advised ... she would have undergone further testing," her claim stated. It went on to say that had the further testing been carried out, an early diagnosis of cancer would have been made. Along with pain and suffering, she faced a "loss of expectation of life" and is suing for $276,400.

The woman's case came after another breast cancer sufferer, who now lives in Port Headland in Western Australia, claimed two radiologists at a BreastScreen Queensland service at the Nambour Hospital mistakenly interpreted an increased tissue density in her right breast as "benign". A claim filed in the Supreme Court registry in Brisbane alleged she in fact had a malignant tumour in her right breast, which radiologists should have detected at the time, in June 2005. A proper diagnosis was delayed by 15 months as a result of the negligence of the radiologists, her claim alleged. As a result she would need breast reconstruction surgery in the future and faced a 14 per cent increased chance of dying within the next 10 years. She has sued the state of Queensland for unspecified damages.

Spokeswomen for Queensland Health and Queensland X-Ray declined to comment, saying the matters were still before the court.

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