/ 2 August 2013

HPCSA ‘protecting’ hypocratic oafs

Jasper Hoon is fighting for justice after two doctors misdiagnosed his deep vein thrombosis in his leg.
Jasper Hoon is fighting for justice after two doctors misdiagnosed his deep vein thrombosis in his leg.

A Western Cape businessman is livid that he spent weeks undergoing treatment prescribed by two specialists for a condition he claims he does not suffer from. 

Now Jasper Hoon is seeking restitution, not only for the pain and suffering he says he was subjected to, but also for the financial setback he argues he experienced as a result of the “bungled diagnosis” and ensuing treatment that nearly cost him a foot. 

But, he says, almost two years of “filing complaints with the Health Professions Council of South Africa [HPCSA] and following procedures” as well as millions of rands in medical and legal cost haven’t brought him any closer to getting reparation. 

“The HPSCA is dodging and diving away from this. They’re making it so difficult for patients to file and follow through on complaints that many people give up,” he says. 

Hoon says his general practitioner referred him to an orthopaedic surgeon for treatment of a “crippling pain in his leg” in April 2011. The specialist, he says, looked at his leg and literally tapped his knee with a reflex hammer. He said the doctor told him that the swelling in his leg and foot was a result of an infection and that the pain was caused by referred pain from his back. 

Hoon was not happy with this diagnosis because he had lower back problems many years ago but did not have any of the same symptoms. 

He was hospitalised and treated with painkillers and physiotherapy and discharged two days later. 

 Hoon says his condition deteriorated and he was hospitalised again. At the hospital, he says, a neurosurgeon also told him that the pain in his leg was referred pain from his back. 

“The diagnosis was made without examining me or doing any tests. 

“Both doctors had the same diagnosis so I had to assume that this was correct as I am not a doctor,” says Hoon, who was discharged after three days in hospital. 

But the pain in his leg soon became “unbearable”, landing him in the emergency room of a Cape Town hospital. There he was eventually diagnosed with deep vein thrombosis, a condition that occurs when a blood clot forms in one or more veins that are deep in the body, usually in the legs.

Life will "never be the same again"
After spending another two weeks in hospital Hoon says doctors told him that his only chance of recovery would be to have his foot amputated and replaced with a prosthesis. Refusing to accept this, he requested to be treated at a different hospital two months later in July 2011, where he had reconstructive surgery. 

“I still walk with crutches and need two more operations. Because of this I am not able to go about my normal daily tasks as a development engineering consultant and running the other businesses I own,” he says.

“While I was in hospital all my businesses suffered. I have lost a lot of money and am trying to recover what I can. In the process I have had to sell one of my businesses and one of my properties in Cape Town.”

More painful than the loss of income was the daunting reality that life “would never be the same again”. 

“Hopefully I will recover 80% of my walking ability. The total medical cost is now just over R1.5-million. I am losing at least two years of my productive life because of doctors who do not listen to their patients and do not investigate the source of the problem. 

“If they did their work as they were supposed to, I would have walked into the hospital and left five days later without any problems,” he says.

Complaint to HPCSA
However, the lawsuit he wants to bring against the doctors has been put on hold pending the outcome of a complaint he laid with the health professions council, the organisation that regulates health practitioners. 

“My lawyers said my chances of winning a civil case will be better if there has already been a ruling against the doctors. So the process is on hold until the health professions council takes action,” says Hoon.

Hoon filed his complaint of medical negligence against the two specialists for failure to “perform thorough medical examinations” and the administration of the wrong treatment in September 2011. 

“It’s been two years since I lodged the complaint and I don’t even know if the case will be heard or not,” says Hoon, who accuses the council of “protecting incompetent doctors” by allowing the matter to drag on for as long as it has.

A timeline provided by the council shows that the two doctors in question had until November 11 2011 to answer the allegations brought against them because health practitioners are given 40 days to respond. 

“As both practitioners decided to make use of legal counsel, due legal processes are being followed. According to our regulations, each complaint is dealt with individually and, due to the legal process, it takes about 18 months on average to conclude, which in a legal environment is not unduly long,” says Bertha Peters-Scheepers, the health professions council’s spokesperson. 

In correspondence between Hoon and the council, the official investigating his case said that the doctors would be held in contempt of council should they not provide timely responses.

 However, the doctors have yet to answer to the complaint.

“Practitioners may refuse or be advised by their legal counsel not to provide an explanation, as an explanation may be used as evidence later,” says Peters-Scheepers.

She says doctors who ignore complaints against them might be referred to the council’s preliminary committee of inquiry, which can penalise them or add a charge of contempt of council to their charge sheet. This will be taken into consideration for the duration of the matter.

From HPCSA to public protector, and back
In April, Hoon was told that the preliminary committee of inquiry would gauge whether or not his complaint was valid during its meeting in June. However, the doctors have still not responded to his charge and the matter has been postponed to September when the committee will meet again.

Hoon’s case is still a long way from being resolved. If found to be valid, “a professional conduct enquiry will be held, during which evidence will be presented orally in a manner similar to that of a court of law,” says Peters-Scheepers.

In an attempt to speed up the process Hoon turned to the office of the public protector but was referred back to the health professions council. 

He says an investigator has told him that the office of the public protector is preparing to close the file. 

According to Hoon, the investigator said that only the preliminary committee of the council can make a judgment on his case, not the council’s legal department. 

“The legal department investigates the complaint and brings their findings before the preliminary committee. The legal department is like the police or prosecutor and the preliminary committee is like a presiding officer,” the investigator said in an email to Hoon on July 24.

Because members of the committee are independent and not part of the health professions council staff, they only meet four times a year. Their next meeting is in mid-September. It is expected that Hoon’s complaint will be dealt with at this time along with other matters as there is no special sitting of the committee. 

“May we also advise you that the delay by the Health Professions Council of South Africa has no effect whatsoever on your envisaged civil claim against the respondent. You are free to go ahead with the civil claim. The delay will not hinder your progress or claim in whatever manner,” the investigator said. 

No more hope
However, Hoon says he has lost all hope. 

“I’ve tried everything in my power but I keep hitting a brick wall. I’ve lost a lot of money and my quality of life has been compromised. I’m desperate. I’ll accept any help or advice I can get at this point.”

An attorney with the social justice organisation Section27, Umunyana Rugege, says people are often unhappy with the responsiveness of the council because they are not regularly informed of the progress of their cases. 

“It does take a long time for complaints to be finalised, but this can certainly be improved by communicating regularly with the complainants,” she says.

Only 248 complaints out of 2997 filed in the 2012-2013 financial year were finalise. One thousand eight hundred and twenty seven complaints were reviewed by the council’s preliminary committee, which finalised 734 matters (see “Unethical conduct is on the rise, says medical council”). 

“If it wasn’t for all the money that I have already lost through medical and legal costs, and loss of income because of the lengthy hospital stays, I would have given up by now,” says Hoon. “I just don’t know any more. I just don’t know.”


Unethical conduct is on the rise, says medical council

Preliminary figures (figures compiled for its annual report that will be published later this year) from the Health Professions Council of South Africa (HPCSA) show that complaints lodged with the regulatory body have increased from 2?687 in the 2011-2012 financial year to almost 3?000 in 2012-2013.

HPCSA spokesperson Bertha Peters-Scheepers said there could be a number of reasons for the slight increase. 

“People are more aware of their rights now. But South Africa’s health practitioners are still some of the best in the world.”

Peters-Scheepers said the number of complaints were “negligible in relation to the number of registered health practitioners in the country”. 

The HPCSA annual report for the 2012-2013 financial year is expected to be released this year. But initial results show that 117 cases were opened with the South African police because the practitioners concerned were not registered.  

Probably the most high-profile case the council has handled is that of former apartheid cardiologist Wouter Basson. Nicknamed Dr Death by the media, Basson headed the apartheid defence force’s secret Project Coast in the 1980s and 1990s. He’s alleged to have arranged the killing of about 200 political prisoners in Namibia. 

The HPCSA is investigating the ethics of his involvement in the large-scale production of several illicit drugs and “weaponised” teargas. He’s also accused of providing soldiers with tranquillisers to use in cross-border kidnappings and cyanide capsules to commit suicide in the event of capture.

If found guilty by the HPCSA, Basson could be barred from practising as a doctor in South Africa. The council may hear more testimony on August 20, pending a subpoena being served, but final arguments are due to be made in mid-September.

The professional conduct enquiry may have overshadowed other cases on the HPCSA’s books. 

In last year’s annual report the HPCSA noted that there had been an increase in cases of “unethical behaviour in graduates and recently qualified practitioners”.  

This was accompanied by more and more doctors being accused of sexual harassment. 

The number of “less serious complaints” dealt with by the office of the ombudsman decreased from 461 to 403. The number of cases resolved by disciplinary enquiries increased from 172 the year before to 189; 16 complaints about issues of consent were received; and the number of doctors found guilty of fraud and theft increased from 13 in the previous year to 49. 

The preliminary committees of inquiry, which adjudicates over complaints brought to the HPCSA, deliberated over 1?827 in 2012-2013, up from 1?695. The committee resolved 734 matters and referred 199 for inquiry.