Roman Hasil and the Whanganui DHB - Health and Disability ...

Health and Disability Commissioner
Panadol and ibuprofen (non-steroidal anti-inflammatory medication used for pain and
inflammation).
— Subsequent events
On 12 February 2007, Patient A attended the Whanganui Accident and Medical Clinic.
Nurse B noted that Patient A had her “tubes tied” last year and had found out that day
that she had become pregnant. She noted that Patient A had three children and was
feeling quite stressed about the situation, being financially unable to support more
children. Nurse B advised Patient A to call Wanganui Hospital and ask for Community
Health to arrange some counselling.
Patient A was then seen by a locum GP at the Wanganui Accident and Medical Clinic.
The GP noted that Patient A had had worsening right lower quadrant pain for two weeks
and was suffering from morning sickness, and that a beta-HCG was positive on that day.
The GP’s clinical examination revealed tenderness with rebound and guarding at the right
lower quadrant of the abdomen, and tenderness on the right tubo-ovarian region on
bimanual palpation. She ordered an ultrasound scan of the pelvis.
The GP referred Patient A to a doctor at the Emergency Department at Wanganui
Hospital. On 12 February, the Emergency Department doctor saw Patient A and noted
that she had a two-week history of increased right lower abdominal pain and a high level
of beta-HCG at 140,389. The vaginal ultrasound scan showed a normal early pregnancy
consistent with Patient A’s menstrual history.
The Emergency Department doctor referred Patient A to Dr B for a gynaecology
outpatient appointment. He stated that Patient A was 31-year-old woman, referred by a
general practitioner with a history of amenorrhoea (abnormal absence or suppression of
menstruation) and right lower abdominal pain.
Patient A recalls that around July–August 2006, she had seen Patient B, a former school
friend who had recently found out that she was pregnant after a sterilisation procedure.
When Patient A later became pregnant, she discovered that Dr Hasil had performed both
sterilisation procedures.
On 14 February 2007, the DHB received a verbal complaint from Patient A. She
complained that she had had a tubal ligation on 8 September 2006 and that she was
seven weeks’ pregnant. She asked why the procedure had failed and indicated that she
knew of another woman who had also had a failed sterilisation performed by the same
doctor. Patient A suggested that the DHB trace and review the women who had had
tubal ligation procedures undertaken by Dr Hasil to ensure that the procedures had been
successful. Manager C, who was responsible for the investigation, arranged for social
work support for Patient A.
On 23 February 2007, Patient A presented to Dr B at the Gynaecology Clinic. He noted
that she had had a laparoscopic sterilisation on 8 September 2006 that had failed. He also
noted that the photos taken during the procedure appeared to suggest the clips had been
placed quite laterally on each tube. He could not establish whether they were completely
occluded. Dr B noted the ultrasound scan performed on 12 February 2007 and that
52 February 2008