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

Health and Disability Commissioner
COMMISSIONER’S OPINION
QUALITY OF CARE — DR HASIL — BREACH
Introduction
In my opinion, Dr Hasil did not provide services of an appropriate standard in a number
of respects. In particular:
• He did not perform laparoscopic sterilisation surgery with reasonable care and
skill.
• His record-keeping was inadequate.
• His informed consent process in relation to Patient C was substandard.
I asked Dr Ian Brown, formerly an obstetrician and gynaecologist, and Director of
Medical Services at Northland District Health Board, to provide independent expert
advice on this matter. Dr Brown’s advice is attached as Appendix 10.
Dr Brown has made a number of criticisms relating to the quality of care provided by Dr
Hasil. Overall, my advisor considered that in many respects, Dr Hasil failed to perform to
the standard expected of a medical officer. A number of other obstetricians and
gynaecologists have also raised concerns, including ACC advisor Dr Ngan Kee and the
obstetricians and gynaecologists who have reviewed aspects of his care — Dr A, Dr B
and a consultant obstetrician and gynaecologist at MidCentral DHB. 34
The specific deficits in Dr Hasil’s practice are set out in my consideration of the three
individual complaints from Patients A, B, and C. I will deal with each in turn.
Patient A
— Clinical care
In March 2006, Patient A consulted Dr Hasil for a tubal ligation. Dr Hasil briefly
recorded the consultation including “unwanted fertility … for sterilisation” and that no
abnormality was detected on gynaecological examination. Dr Hasil explained the
procedure and associated risks and they both signed a consent form for laparoscopic
sterilisation.
On 8 September 2006, Dr Hasil performed laparoscopic sterilisation surgery under
general anaesthesia. He recorded that the Filshie clips were placed on the right and left
Fallopian tubes. Five months after the operation, Patient A discovered that she was
pregnant, and this was confirmed at the Emergency Department on 12 February 2007.
Patient A saw Dr B, who noted that the photographs taken during Dr Hasil’s surgery
suggested the clips were placed laterally on each tube. Dr B was unable to establish
whether the Fallopian tubes were completely occluded.
Whanganui DHB subsequently became aware of eight failed sterilisations from a total of
32 sterilisation operations performed by Dr Hasil. Dr Brown commented that in light of
34 See Dr Ngan Kee’s advice to ACC regarding Patient A (page 53), Dr B’s concerns (page 41) and the
comments of the consultant obstetrician and gynaecologist at MidCentral DHB (page 28).
66 February 2008