The GP - who had only recently arrived in New Zealand - has made several changes to her practice. Photo: 123rf
A GP who failed to refer a patient with a lump in his neck for urgent investigations has apologised to the man, after he was diagnosed with cancer and had surgery to remove all his teeth and one lung.
The man, who is in his 50s, saw the doctor twice in 2021 about the lump, which was making it hard to swallow.
At that time it had been present for about a year, but had increased in size and become more tender over the preceding three months.
Deputy Health and Disability Commissioner Dr Vanessa Caldwell found the GP - who treated the patient for a dental infection at the second appointment - should have urgently referred him to a specialist and provided follow-up or "safety-netting advice".
Some months later, the man sought further medical attention after moving overseas.
A biopsy of the neck lump revealed he had adenoid cystic carcinoma, a rare cancer of the salivary gland, which had spread to his lungs.
He had two operations on his neck and had his teeth and half of one of his lungs removed, and was unable to work for nine months.
Specialists told him his lung surgery and the loss of his teeth could have been avoided if his neck lump had been dealt with appropriately 12 months earlier, he told the commission.
In June 2022, he was advised that he had three to five years to live.
"Although the man's cancer is a rare, slow-growing type, which often hinders early diagnosis, his neck lump was persistent and significant in size, with no clear cause at either appointment. There were two missed opportunities to diagnose his cancer at an earlier stage," Caldwell said.
The GP - who had only recently arrived in New Zealand - had made several changes to her practice, was doing an audit and had provided a written apology to the patient.
