Hospital failure stunted boy's development

An audiologist uses an otoscope to check the ear canal of a patient. Photo by ODT.
An audiologist uses an otoscope to check the ear canal of a patient. Photo by ODT.
A Southern District Health Board audiologist failed to diagnose a boy's profound hearing loss despite seeing the boy five times over 11 years.

A review of the audiologist's work resulted in 123 children being retested and a further six identified with hearing issues.

In a decision released yesterday, deputy Health and Disability Commissioner Theo Baker found the audiologist breached the patient rights' code.

She found he failed to provide adequate testing and diagnostic services, and kept inadequate documentation.

The delay in diagnosis had a major impact on the boy's speech, language, literacy development, cognitive, and social development, the audiologist who eventually provided the diagnosis of moderate to profound hearing loss said.

Southern District Health Board vicariously breached the code by failing to provide adequate support and supervision of the audiologist, named Mr B in the report.

The matter sparked the review at its audiology department that led to 1532 letters to parents offering retesting early last year.

The boy was 2 when he was first assessed by Mr B, in 2000. He was assessed four more times by Mr B, between 2003 and 2010, because of persistent concerns he had a hearing problem.

Each time, Mr B diagnosed the boy with hearing within the normal range, but at the lower end of the scale.

The boy's moderate to profound hearing loss was diagnosed in April 2011, by another audiologist, who was reviewing the service following complaints.

The review identified two main issues: inadequate facility and equipment, and a lack of suitably qualified personnel.

Mr B worked as a sole-charge audiologist from the late 1980s to 2010, employed by the DHB's Otago predecessor entities.

Mr B needed external supervision to be granted full membership of the New Zealand Audiological Society (NZAS), but this did not occur for various reasons, including cost.

The board said the issues had arisen mostly because Mr B was not a member of the NZAS.

His position was disestablished in late 2010 in a restructuring.

The health board wrote to the parents of 1532 children who had been identified as being under 5 when they were tested by Mr B, between 2007 and 2010.

Of these, 123 parents requested retesting. One child was found to have significant hearing loss, and five needed further testing for specific diagnosis.

The board did not review every patient assessed by Mr B because many would now be adults.

Of particular concern, Mr B did not perform cross-checks, used incorrect parameters for one test type, and failed to arrange follow-up checks, Ms Baker said.

''In my view, SDHB did not take adequate steps to ensure that Mr B received supervision and peer support.

"Given that Mr B was working as a sole-charge audiologist, and he did not meet the requirements for membership of the NZAS, SDHB should have done more to satisfy itself that Mr B was competent to perform the role for which he was employed.

''Mr B was working as a sole charge audiologist, in a department with sub-optimal facilities and equipment.''

Ms Baker recommended that in the event of Mr B resuming work in audiology, he should undertake suitable training and supervision.

Ms Baker requested further information on improvements to the DHB's audiology service.

The matter would be referred to the director of proceedings to consider whether further legal proceedings should take place, the report said.

Contacted for comment, the health board issued a statement to the Otago Daily Times listing ''significant improvements'' to processes, systems, and equipment since 2010.

''Following the implementation of these service improvements, in our last audit we were commended for the quality of the audiology service,'' patient services medical director Richard Bunton said.

eileen.goodwin@odt.co.nz

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