Source: Health and Disability Commissioner
In a report released today Deputy Health and Disability Commissioner Rose Wall has found a Medical Centre GP registrar breached the Code of Health and Disability Services Consumers’ Rights (the Code) for failing to reliably exclude pregnancy prior to insertion of a Jadelle contraceptive device.
The woman at the centre of the report, accessed contraception following the birth of her son three months prior. The woman’s usual GP arranged for the woman to have a Jadelle device fitted by a GP registrar.
The woman later discovered she was 20 weeks pregnant. The ultrasound indicated that she would have been pregnant at the time the contraceptive device was fitted. The discovery led to significant personal distress and concerns about the potential impact of her pregnancy.
The woman told HDC she did not feel she could cope with another baby so soon, but the pregnancy was too far advanced for termination to be considered and she was concerned about the health of her unborn baby.
Ms Wall considered several scenarios regarding pregnancy testing prior to fitting the device. On balance, she concluded that the GP registrar had omitted to discuss the method of contraception used by the woman prior to the consultation and to establish clearly whether the woman could be pregnant and, accordingly, offer her a pregnancy test.
Ms Wall found the GP registrar breached the Code for failing to provide services with reasonable care and skill, in particular failing to reliably exclude pregnancy before the Jadelle insertion, either through a pregnancy test or established criteria.
In addition, the medical centre’s documentation practices were found lacking, particularly in recording discussions about contraception and pregnancy risk.
Since the event, the GP registrar has made significant changes to her practice, including additional training and development of a detailed template to ensure thorough documentation and assessment. The medical centre has also taken steps to improve its practices and prevent similar issues in future.
Ms Wall said, “this case highlights the importance of thorough documentation and reliable exclusion of pregnancy in contraceptive consultations. We commend the GP registrar and the medical centre for their proactive steps to improve their practices.”
In addition to the changes made, Ms Wall made further recommendations in her report.
