Page 4076 - Week 13 - Thursday, 6 December 2007
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Professor David. Detailed findings of the review of each of the 16 cases have been made available to ACT Health. It is noted that in seven of the 16 cases Dr X was neither the primary surgeon nor involved in the management of the case and that three of these seven cases did not involve the plastic and reconstructive surgery department.
The three cases that did not involve either Dr X or the plastic and reconstructive surgery department were out of scope for the committee’s investigation. These three cases will go through the normal system review undertaken by the clinical review committee of the relevant health facility. For the remaining 13 cases, the complaints in relation to the nine cases that involved Dr X and the four cases that involved the plastic and reconstructive surgery department were found to be unsubstantiated. In addition, the report noted that the management plans in the nine cases that involved Dr X and the four cases that involved the plastic and reconstructive surgery department were found to be reasonable. Subject to sections 123, 124 and 125 of the Health Act 1993 regarding protected and sensitive information, ACT Health is unable to release further details about the complaints or the findings against each case.
The reviews of the clinical records by the CPC and Professor David did not identify significant concerns in relation to patient safety or outcome. The report notes that the overriding impression of Dr X’s management of the nine cases was that this was a level of competency expected from a consultant surgeon. The report also notes that Dr X has had very adequate training in the treatment of facial fractures and maxillofacial surgery, that he has participated in continuing medical education in this field and that he conducts surgical audit on his patient outcomes. The report recommends that Dr X’s clinical privileges at the Canberra Hospital and Calvary Public Hospital should stay the same; that is Dr X’s clinical privileges should not be amended or withdrawn.
It is noted that the two major systems issues arising from the review of the complaints were the requirement for the establishment of a multidisciplinary service at TCH which will provide oral, maxillofacial, plastic and reconstructive services to the community, and the requirement for the enhancement of professional links and collaboration for this proposed service with one of the more established units in Australia.
The above-identified systems issues are being addressed by ACT Health within the context of the implementation of the recommendations arising from the review of the provision of oral and maxillofacial and plastic and reconstructive surgical services in the ACT that was undertaken in 2005. That review was undertaken by an expert panel, led by Professor Bruce Barraclough, the then chair of the Australian Council for Safety and Quality in Health Care, to make recommendations about the appropriate service capacity in these two surgical specialties, the levels of service to be provided and the distribution of services in the ACT.
This review, which evaluated structures, processes and information in order to make recommendations for service improvement, did not assess the performance of particular individuals or teams. This report was prepared by specialist clinicians with the support of another clinician who is considered an expert in the field.
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