Case studies

These case studies highlight the range of outcomes we can achieve through complaint resolution. They are all real complaints we've received, with names and some details omitted to protect privacy.

Man telling his story
The complaint

A man complained that his father had suffered pain and swelling at the site of a radiology procedure. He said his father was rushed through the consent form and the procedure was not stopped when he indicated unusual pain. He’d since paid hundreds of dollars in medical appointments and medication to treat his reaction to the injection. He was also concerned that the consent form did not list his specific side effect, known as extravasation, where medication leaks into tissue around an intravenous injection site.

What we did

We presented the man’s complaint to the radiologist, who explained that this side effect was not uncommon and had been treated appropriately in this case.

The radiologist agreed to add extravasation to the list of side effects in the information sheet for patients but declined the request for reimbursement. The resolution officer then handled the compensation request through the radiologist’s insurer.

The outcome

The insurer did not consider the side effect to be a compensable injury but offered to cover out-of-pocket expenses for follow-up treatment as a sign of goodwill. The insurance agency also provided a draft of the new consent form showing extravasation was now listed.

The complaint

A woman complained about the care her child received from a GP over several years and the poor complaint handling when she raised concerns.

As his health deteriorated over time, the child became increasingly depressed and anxious. The woman was told the main cause of his illnesses was not a medical condition but psycho-social issues and her parenting style.

The mother disagreed and pointed out that she and other family members had once had the same symptoms, then recovered after a particular procedure to improve their breathing. However, the GP did not believe this was relevant and tests for this condition were not carried out. When the child finally had surgery to fix the breathing issue his health and psychological wellbeing improved.

What we did

We arranged for the parents to meet the GP in a confidential conciliation meeting with an agreed agenda to resolve the complaint.

We worked with both parties to prepare them for the meeting and to talk about being able to listen to the other person’s perspective.

The outcome

The parents were pleased to have a chance to share their experience, and the GP said the mediated process was much better than expected. Prior to the meeting the GP saw the complaint as a ‘witch-hunt’, but meeting the couple face to face and hearing their interest in having similar cases better handled for the next family changed the GP’s mind. It also helped the GP to reflect on communication issues that may have contributed to the complaint, leading to a revision of complaint handling processes with staff.

The parents received a detailed explanation of why the GP had followed the particular course of action and an apology for how their feedback had been handled.

The complaint

A woman complained about a myotherapist who had prescribed expensive orthotics for her two preschool-aged children. The myotherapist had advised the woman she would be able to claim the orthotics on her private health insurance, but as the myotherapist was not a registered podiatrist, the health fund declined the claim. The woman then took her children to a registered podiatrist, who advised her that the children did not require orthotics.

What we did

We contacted the provider to obtain a response to the woman’s concerns. We spoke with the provider about the importance of operating within their scope of practice and referred to information obtained from the Australian Podiatry Association and the Myotherapy Association Australia regarding the guidelines around paediatric orthotics.

The outcome

The myotherapist offered to refund the woman for the cost of one of the pairs of orthotics. The woman was satisfied with this outcome.

The complaint

A prisoner complained that he had been waiting more than three years to begin a hepatitis C treatment program. Since initially being tested and recommended for treatment he had moved prison several times and still not started the program, despite making several attempts to follow it up.

What we did

We contacted the prison’s health service provider to request an explanation.

The provider explained that prisoners previously had to commence the program at particular prisons but that a state-wide hepatitis C program now in place would cover the complainant.

The outcome

The prisoner received this explanation, and the health service provider assured him he would begin the program within the next couple of months, prioritised according to need in that time.

The complaint

A man complained that years of medical records at his local health service were no longer available since it merged with another health service. The man was concerned that doctors had no access to older records when making clinical decisions. He felt having to rely on memory or to redo tests was not acceptable so requested a copy of his records from the closed provider. He wanted to take his records to his appointments because he had complex medical conditions and his memory was unreliable.

What we did

We discussed the situation with both parties, then helped them to prepare to meet and work through a solution. At the meeting the health service provider explained what had happened and detailed the actions they were taking to rectify the issue.

The outcome

The complainant received a copy of his records and was satisfied that he'd been heard. The matter was resolved.

The complaint

A man complained that his son, who is on the autism spectrum, was receiving poor-quality care in a public hospital. The boy was admitted after becoming non-verbal, losing motor skills and not eating. A feeding tube was inserted the next day.

The boy’s condition deteriorated and he became aggressive and agitated. His father requested that he be sedated and given pain medication. He was given pain medication but not sedated so he again requested sedation, which was refused. The next day the child’s attending doctors and consultant agreed he needed sedation, but this was not administered until midday the next day. In the meantime, the father reported that the child had soiled himself overnight, was in pain and was increasingly agitated. He later developed an infection at the site of the feeding tube.

What we did

We advised the father about lodging a complaint with the hospital, including who to contact, what information to include and how we could help if he was unable to resolve the matter with them directly. We explained that as direct resolution was often the quickest and easiest way to resolve complaints, our legislation expected this to be attempted in the first instance.

The outcome

The complainant was satisfied with the advice on resolving his complaint and took his complaint to the hospital knowing what to expect and how the HCC could help if that did not resolve the matter.

The complaint

A man complained about persistent pain in his knee following a total knee replacement.

He told the surgeon of the pain one month after the operation but was assured there was no cause for concern and to continue physiotherapy to strengthen the knee. Nine months later the man still had pain in his knee but was again told there was nothing to worry about and returned to his knee-strengthening exercises for several months.

The man eventually sought a second opinion and a full leg x-ray, which showed an abnormal distortion in his new knee requiring another total knee replacement to straighten the leg.

What we did

We presented the complaint to the original surgeon, who denied any wrongdoing. However, an independent opinion that we obtained concluded there had been a technical error in the original procedure, causing the distortion and pain, which now required corrective surgery.

The outcome

The report was made available to both parties and negotiation led to a significant amount of compensation to cover out-of-pocket medical expenses and loss of earnings. The man was satisfied that his complaint had been resolved.

The complaint

A couple complained that during the birth of their child at a public hospital, their doctor attended multiple times with a medical student without their consent. The couple knew the student personally and found their presence stressful but felt too awkward asking them to leave. A complaint made to the hospital had received no response.

What we did

We contacted the hospital to request an explanation.

Hospital staff said it was usual practice to seek consent and were unsure why it hadn’t happened in this case. They were aware of this particular complaint and said a personal letter of apology from the doctor was on file but had never been sent to the couple. The letter apologised for not seeking consent and said the incident served as a reminder to keep the patient at the centre of clinical care at all times.

The outcome

The doctor’s apology was sent to the couple, along with an additional letter of apology from the hospital.

The complaint

A woman had her gall bladder removed by the surgeon of her choice at a private hospital. After the procedure she received a letter from an assistant surgeon saying they would be helping with the operation. This letter was followed by an account for the assistant surgeon’s service.

The woman said she had not been informed anyone except her chosen surgeon would be involved in the operation, or be invoicing her separately for it. She complained to the assistant surgeon but did not receive a response.

What we did

We worked with the woman to identify the issues to be resolved.

A summary of these issues was sent to the assistant surgeon for response, which came two days later. The assistant surgeon explained that they had been assisting the woman’s chosen surgeon on a regular basis for several years. The assistant surgeon’s usual practice was to send patients a letter introducing themselves and explaining their invoicing procedure. The assistant surgeon said these letters were sent because experience showed patients rarely read the standard paperwork explaining the involvement and possible costs of anaesthetists and assistant surgeons. The assistant surgeon normally followed these letters up by meeting the patients as they came into theatre. However, on this occasion the meeting had not occurred and the letter had arrived late in the mail, after the operation.

The outcome

The assistant surgeon provided this explanation and an apology to the woman and waived the outstanding account. The woman was satisfied this had resolved her complaint.