Ms ST's  

 

                          DISCREPANCIES                          

 

 

 

 

ST.x = Paginated record.  BoE.x  = Book of Evidence. Tab.  TS.x:y = Transcript.page:line

                                                                                                                  Significance &

Issue                                         Discrepancy noted                                             Reference

Duration of tumour growth

Stated – 2 months                     ST.198

Not believable

Minor

Size of original tumour

Stated – 8 cm diam.                  TS78:10-1

Documented –  9 cm diam.

                         10 cm diam.

Minor

   ST.198

   ST.275

Tumour size post chemo.

Stated – 2-3 cm diam.              TS78:24-5

Documented – 4-5 cm diam.

                         40-60 mm

Minor

   ST.200

   ST.083

Mastectomy advice 1996-7

Stated – Linacre (etc.) neutral  TS79:11-2

Documented – Linacre strongly for

                          Kimber strongly for

                          Ward strongly for

Significant

 ST.238, 267-8

  ST.140-2,

  ST.250

  ST.200, 230-1

  ST.266

Operation Type

Stated – Quadrantectomy        TS79:3-4

                                                                TS80:16

               Halfway between       TS183:26-7

               lumpectomy

               and  mastectomy               

                                                                 

Documented - Lumpectomy

Minor

  ST.200

 

 

 

 

  ST.074

  ST.315

Spot on breast April 2000

Stated – Linacre checked in May ? -

               advised await ~ 2 months

                                           TS82:20-23

                                                         TS194:16-17                

Documented – seen June 7th – spot

               noted. No advice. Review –

               end of year

Significant

 

 

  ST.315

   ST.148

Linacre spot review interval

   – June 2000

Stated – see in a few months     TS:28-30

Documented – Nil soon (end of year)

                         “See U later”

Moderate

 ST.148

 BoE.60

Cooper, seen late 2000

Stated – September                  TS84:10

Documented – No notes Sep

                         & Oct 2000

Moderate

  ST.314

 

Cooper saw spot late 2000

Stated – he did suggest            TS84:18-19

 going back to Linacre

Documented – Not seen by

Cooper until 17/11/2000 (after Linacre)

Significant

 

   ST.034

   ST.314

Spot in late October 2000

Stated – spot, not lump              TS84:16

Documented- thick, hard, Indurated

Significant

ST.149,254,082

Biopsy late 2000

Stated – September                  TS84:27

Documented –  October

(30/10/2000)

Moderate

Mastectomy 2000

Stated – early November         TS85:4-5

Documented – 28/11/2000

Moderate

Post operative advice 2000

Stated – he cleared it with a    TS86:15-16

 margin – good result               TS86:14

Documented – very close to

lateral margins – probably

complete

Moderate

 

   ST.302

Linacre recommendation

  December 2000

Stated – No recommended : -

                 Chemo                  TS87:9

                 X-ray therapy       TS87:11

Documented – Adjuvant therapy contrived. See Kimber/Ward                     

Significant

 

 

   ST.247

Linacre & Oncocare 2000

Stated – impartial                        TS89:19

Documented – hypothermia a question mark

Moderate

 

   ST.246

Ward recommendation 2000

Stated – Chemo first                TS87:16-22

               Radiation – might cure, but

               may only last a certain time

Documented – Wide field RT & adjunct chemo. Recurrence is virtually inevitable

Significant

 

 

 

  ST.249

  ST.185

Chemotherapy pre-Oncocare

Stated – not done because used

               pre(??)                        ST.319

Documented – Patient declined

Significant

 

BoE.60

Cooper – recurrences 2001

Stated –  didn’t have facilities  TS96:25-6

                to biopsy

             – recommended            TS96:26

                biopsy

Documented – Do not look like 2ndaries

                 R/V if increase to see

                 Kimber

Significant

 

 

 

 ST.036

Why no Biopsy by Cooper or Kimber

Stated – they did not have the facilities

Not believable

Significant

Kimber – recurrences 2001

Stated – don’t know till biopsy    TS97:3-4

            - See Linacre                   TS97:15

Documented – not entirely characteristic θ Linacre

Minor

 

 

ST.225

Lymph nodes in axilla

Stated – Not removed              TS81:20-23

Documented – removed (subtotal, as for lumpectomy)

Significant

 

ST.315

State of breast post- mastectomy

Stated – Normal at Oncocare  TS91:6-7

   (normal) Definitely,    TS191:2-3

    Yes

-  Felt normal                TS191:6

Documented – Indurated

Histology – Oedema & fibrotic

Significant

 ST.248, 258

 ST.001

Eurixor - obtaining

Stated – Dr Spall prescribed    TS72:23-4

               and instructed

            - “I was given the          TS95:13-6

               piece of paper by

               Dr Spall and faxed

               that”

             - Spall gave form         TS196:9-10

Documented – it was prescribed by Cooper 27/11/2000 – she ordered it from Germany herself by Facsimile 9/1/2001, the same day she saw Cooper.

Arrived requesting it.

Spall & Traill deny prescribing, recommending or providing ordering information.

Significant

 

 

 

 

 

 

 

ST.034

BoE.54

 

 

 

 

 

BoE.60

Initial examination assessment at Oncocare

Stated – Dr Spall                     TS194:23-5

                                                                 TS195:29-30

                                                                         BoE.45

                      Spall took notes          TS196:1-2

Documented – Traill first      

Significant

 

 

BoE.60

Intravenous injection

Stated – probably some           TS195:14-5

               glucose-based substance

Documented – GSSG/SMCSO

Minor

Chemotherapy advice at Oncocare

Stated – may have developed   TS197:1-3

              sensitivity – advised against

Documented – Not asked to

               Administer in referral

               (typical Chemo). Not keen

Moderate

 

 

BoE.62,60

ST.191

Eurixor - administration

Stated – asked to bring it to     TS72:28-30

              clinic                                                                                                                                      

Documented – No prescription, nor

              Advice to obtain or bring

Significant

State of Equipment

Stated – broken down. Being serviced

               Frequently                   TS72:18-9

            – had to wait for up to 2 hours

Nurse F – not so                           BoE.109

Significant

  TS190:29

Reliability of equipment availability at start time

Stated – there were times         TS92:17-8

               when one of them wasn’t

               working

            - there were delays        TS92:22-3

  that were fairly lengthy

- in some cases              TS92:25-6

   several hours

- Start times 11:00 h      TS190:29-30

  (hour) On a couple of   TS190:27-8

  occasions

Nurse F – not so  

Documented – Start times not in

accord with stated (see graph)

Significant

 TS205:26-31

 

 

 

 

 

 

 

 

BoE.109

 

BoE.49

Lesion at Oncocare –first seen

Stated – ~15/1/2001

                                                  TS.157,319

Documented – During treatment (23/1/2001)

Moderate

 

BoE.60

BoE.45

 

Lesion on arrival Oncocare 1

Stated – “ . . lesion ~7 cm below .. excision line…”                         BoE.45

Documented – “small nodule on scar ~ posterior end”

Significant

 BoE.60

Lesion on arrival Oncocare 2

Stated – present but “dismissed”

            - no advice recalled      TS91:26-29

Documented “? Secondary” (Advised wait and see)

Significant

 

  BoE.60

Treatment type

Stated – Experimental             TS193:21-2

Documented  - Nil supporting

Moderate

Advice about Lithium

Stated – Nil                              TS194:4-5

Nurse F - confirms advice                       

Significant

TS237:2-3

TS207:24-26

Recurrence Feb-Mar 2001

Stated –  . .  a few centimetre

                below  the scar line    TS91:20-23

Documented – on scar

Moderate

BoE.60

More lesions Feb-Mar 2001

Stated – “at very end of             TS75:1-3

               treatment” ?

               during treatment          ST.077

                       13/2                                                                                                    

Documented  12/2/2001                    

Moderate

  ST.60

Lesion(s) change θ March

Stated – Increase in size/more  TS74:12-3

               Slowly increasing       ST.157

Documented – no change

Unaffected by treatment           ST.077

Significant

  ST.077

 

  BoE.60

Linacre recommendation

   2001

Stated -  Chemo.                      TS98:9-10

            - Radiation - had no

               memory of mention      TS98:1112       Documented – May involve further surg. Radiotherapy & Chemo as discussed before. Went to see Ward

Significant

  ST.157

Kimber recommendation

   2001

Stated – Various possible         TS98:28

                      Chemos.

Documented - Nil

Significant

ST.225

Aerial boxes hot

Stated – L hot; R cold              TS93:13-4

               R not working            TS93::9-10

                                                                  BoE.54

Nurse F – not so

Significant

TS208:22

Heat on skin

Stated – little or no                   TS94:27

               sensation on right

Documented – cutaneous nerve

               damage

Nurse F – not so

Significant

 

TS210:3-31

Aerial boxes and light

Stated – light boxes                    TS92:2

              “white light” when on   TS94:5-6

Nurse F/MAT - not so      

Significant

TS209:16-19

(no lights, white or otherwise)

Faint

Stated – I wouldn’t say I            TS94:8     

               actually fainted

Documented – Syncope, with fall

Significant

 

BoE.60

Operator of local hyperthermia equipment

Stated – Dr Spall

Documented – Nurse F (usually)

Significant

BoE.49

Eurixor & Spall

Stated – I was given the            TS95:13-6

               piece of paper by

               Dr Spall and faxed that

Documented – Nil at Oncocare

Significant

(fax was sent 9/1/2001, the same day as seeing Cooper)          BoE.54

ST.035

Eurixor/Helixor/Plenosol in Tasmania

Stated – Eurixor given till       TS100:30

               used up

- Came back with        TS101:7&22

  injections of Plenosol

- Nil Helixor ever        TS188:7       

Documented – Cooper adjusted

               Eurixor dose, (0.1-0.5 mL)

            - Eurixor listed 21/9/2001

            - Helixor listed

Significant

    ST.036-7,

        039, 042,

      245, 244

 

 

 

 

 

     ST.036

     ST.042, 078

Lithium Carbonate when in Germany

Stated – Nil given                     TS101:26

Documented – given                TS102:2-4

Significant

  ST.070, 244

Viscum album (mistletoe) in Germany (Plenosol)

Stated – Nil given                     TS100:26

               Nil Helixor ever          TS188:7

Documented – given (Plenosol ?iv)

Moderate

   ST.039, 070, 244

Cost for German treatment

Stated – Out of pocket            TS189:17-20

             $10-20,000

Documented – Estimated total

                        Aust.$50,000

Significant

Teachers Health Fund cover

Stated – . .received back from Teachers Health Fund             TS189:20-23

Documented – Only covers “rack

rate” (basic hospital cover for non-elective/accidental problems when travelling). Nil in discovery (Summons).

No major payment in Fund documents (obtained by Summons)

Significant

Time in Germany

Stated –  3½ weeks                 TS193:11-2

               

Documented – 3 weeks, 6 days

Only 1 WBHT with Chemo. Well documented. (1 with Vit C)

Moderate

(15/4-11/5)

 ST.068

Chemo.+WBHT when in Germany

Stated –3 cycles                      TS

Documented – 1 cycle (?2)

Moderate

ST.070-

ST.222

Lithium Carbonate when in Tasmania

Stated – Li was for HT            TS10128-10

               in Melbourne.

               Nil else                      TS188:8-10

                                                                         TS188:11-20

Documented – (prescribed & given)

 by Dr Cooper

Significant

 

 ST.040, 042

Medicare claims

Stated – Only injection            TS75:24-26

                                                               TS75:31-

                                                                TS76:1

Attendances were claimable: Items 104-5 (Specialist Consultations)

Moderate

Payment for Complaint

Stated – no payment for complaint for this Board (!)                         TS191:10-11

Documented – question was general –

   her complaint was to the Health

   Services Commissioner

Significant

 

BoE.35

 

 

ST’s perceptions

Treating Doctors: Linacre, Kimber, Ward                                 TS98:18

No firm directions post Bx March 2001                                    TS99:24-5

Cooper knew Douwes                                                              TS99:9-10

Cooper had been to Germany & looked at clinic                        TS100:1-2

Linacre Bx wound healed well before Germany                         TS102:15-7

 

 

 

 

Testamentary status, Cognitive status

 

A.     Intrinsic

 

a)      Fay, forgetful, dreamer

b)      Chemo Brain – cognitive impairment

 

B. Secondary

c)      Good of society: So that these events should not happen to others

d)      Seeking refund/compensation

e)      Vengeance/vindictive

f)        Was paid to complain and coached

 

Motivation to pursue complaint – notes

 

Why would a meek and mild single mother with potentially terminal cancer become so hostile ?

 

a.                   To see that no-one else suffers as she has

b.                  Displacement of her anger

i.                     Deflecting her role in directing her own medical management that has proved defective

ii.                   Linacre’s failure to biopsy June 2000

c.                   To pursue Civil damages (too late? weak case now ?)

d.                  Wants money back. No pursuit of this approach since initial complaint

e.                   Was paid to complain – establishing an estate for her next of kin

 

The monetary aspects

a.       A single parent

b.      Teacher’s salary

c.       Paid Oncocare ~$10K

d.      Could afford a trip to Germany for treatment – probable total cost about Aust$50K. Refund from Teachers Health NSW

Real out of pocket costs

e.       Sought release of funds form her Superannuation Fund in

      June – after the German trip

f.    Had Photodynamic therapy in box Hill – cost~ $15,000

 

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© Copyright MA Traill, 2006