A doctor’s letter to a patient, apologising for missed opportunities following a treatment injury, never made it through to the patient who was permanently disabled as a result of spinal cord surgery in January 2022.
Ever since that operation, Hamilton father of two Pita Shelford has been seeking answers and accountability from Waikato Hospital, where the surgery took place.
The initial surgery to drain a cyst left Shelford with debilitating side effects, including reduced mobility and neurological function, and regular shaking fits.
Months later, Shelford sought a second opinion from another neurosurgeon, who said that the shunt wasn’t in the right position and was pushing into the fibres of his spinal cord, leading to nerve damage.
That surgeon later operated on Shelford to replace the spinal shunt that had caused Shelford’s nerve damage. According to Shelford, the doctor would say to him every day at the hospital after his surgery that he wished he’d got to him sooner. There is no suggestion this doctor did anything wrong.
Although Shelford received a letter in March from Te Whatu Ora apologising for the distress he and his whānau have experienced, Shelford has always wanted the hospital to recognise the missed opportunities that may have lessened the extent of his injury.
Shelford said that he and and the doctor had agreed at an appointment in May this year that an apology would be put in writing on behalf of the neurosurgical team for the missed opportunities in his post-operative treatment leading up to the second surgery.
According to Shelford, the doctor told him at that appointment that he wasn’t going to hear what he needed to from the hospital leadership: that there were three missed opportunities and that “we f...ed up”.
The doctor was approached for comment but did not respond.
However, after receiving a completely different letter from the doctor through his GP, Shelford emailed him for clarification.
Instead of a reply from the doctor, he received a response from the neurosurgery administrator inviting him to a clinic appointment: “Dr [name removed] is not permitted to enter into any email correspondence, hence the clinic invite.”
A spokesperson from Te Whatu Ora later told Stuff that the language used in this email was “unfortunate and is not correct”.
“Clinicians are able to continue correspondence with patients wherever this is clinically appropriate, but they may be advised to avoid duplication if a patient query has already been answered in full or a response is already under way.”
Shelford said that when he eventually met his doctor again at the clinic appointment, he was told that the letter had been stopped by management and that the doctor no longer had direct email access to him. The doctor also showed Shelford the letter that was intended for him.
The letter is significant for Shelford as “all the letters from the leadership never owned the responsibility or accountability.
“He is the only one who’s done me right and done the right thing,” said Shelford.
“He advised that he could lose his job if he sent the letter.
“Prior to this, I was able to email and correspond with [the doctor] directly, and now that channel is seized, as well as the letter that [he] said he would write to me,” Shelford said.
Following an Official Information Act request, Shelford received the letter on Friday, October 13, which Te Whatu Ora explained was shared with the patient in line with his rights under the Privacy Act.
“All the hospital had to do was send this letter in the first place,” said Shelford. “But they dragged it out and made me sicker.”
In the letter, the doctor said: “I offer my apologies to yourself for what you have gone through, especially with the development of weakness after surgery that was not investigated with scans until much later.
“I do think that the opportunity had been missed, especially when you first woke up with a weakness and a repeat scan was not done and you were discharged.
“Secondly, when you came back to the emergency department with a discoloured leg which was probably not picked up by the registrar and not investigated.
“If this had been done earlier there might have been a chance to reverse the weakness, however one cannot be 100% certain. Please accept my apologies on behalf of the neurosurgical team.”
Next to the doctor’s sign-off, the letter is marked “unapproved”.
A Te Whatu Ora spokesperson said that generally, clinic letters are dictated, processed by their dictation system and transcribed by a typist.
“The transcript is labelled as ‘unapproved’ as in the sample provided by Stuff until it has been reviewed by the responsibile clinician to confirm it has been transcribed accurately and is ready to be sent.”
While relieved to finally have the letter in his own hands, Shelford was “bloody furious” that the only way to get the letter was through his Official Information Act request.
“I do want to meet face to-face with the leadership of the hospital, I want them to actually hear me, and I want them to face me.”
He said the hospital leadership’s interference “censors genuine efforts of other clinicians willing to assist”.
To date, Shelford is still unable to communicate directly with the doctor, unless through a clinic appointment.
The spokesperson from Te Whatu Ora said written correspondence between doctors and patients is allowed.
“There may be circumstances where an individual doctor does not wish to correspond with a patient, but there is no national policy governing this.”
